Articles: pain-measurement.
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J Neuroimmune Pharmacol · Dec 2020
Review Meta AnalysisAnalgesic Effects of Cannabinoids for Chronic Non-cancer Pain: a Systematic Review and Meta-Analysis with Meta-Regression.
There is growing interest in using cannabinoids for chronic pain. We performed a systematic review and meta-analysis of randomized controlled trials to evaluate the analgesic efficacy and adverse effects of cannabinoids for chronic non-cancer pain. PubMed, EMBASE, Web of Science, Cochrane CENTRAL and clinicaltrials.gov were searched up to December 2018. ⋯ The GRADE level of evidence was low to moderate. Pain intensity of chronic non-cancer patients was reduced by cannabinoids consumption, but effect sizes were small. Efficacy for neuropathic and non-neuropathic pain was similar.
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Reg Anesth Pain Med · Dec 2020
ReviewIs the minimal clinically important difference (MCID) in acute pain a good measure of analgesic efficacy in regional anesthesia?
In the field of acute pain medicine research, we believe there is an unmet need to incorporate patient related outcome measures that move beyond reporting pain scores and opioid consumption. The term "minimal clinically important difference" (MCID) defines the clinical benefit of an intervention as perceived by the patient, as opposed to a mathematically determined statistically significant difference that may not necessarily be clinically significant. The present article reviews the concept of MCID in acute postoperative pain research, addresses potential pitfalls in MCID determination and questions the clinical validity of extrapolating MCID determined from chronic pain and non-surgical pain studies to the acute postoperative pain setting. We further suggest the concepts of minimal clinically important improvement, substantial clinical benefit and patient acceptable symptom state should also represent aspirational outcomes for future research in acute postoperative pain management.
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Neuropathic facial pain occurs due to pathologic dysfunctions of a nerve responsible for mediating sensory fibers to the head. Surgical interventions, in cases of failed medical therapy, include microvascular decompression, radiofrequency (RF) ablation, percutaneous balloon decompression, and stereotactic radiosurgery. In this review, we focused on RF ablation as a treatment for chronic facial pain. ⋯ This systematic review found evidence that RF ablation is efficient in treating patients with facial pain, as well as in improving quality of life and reducing oral medication use. Maximal pain control is achieved using combined CRF and PRF therapy. Complications are uncommon and include facial numbness, masseter weakness, cheek hematomas, diminished corneal reflex, and dry eyes.
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Review Meta Analysis Comparative Study
Comparing central pain processing in individuals with non-traumatic neck pain and healthy individuals: a systematic review and meta-analysis.
This systematic review and meta-analysis examined the evidence for altered central pain processing in people with nontraumatic neck pain and the relationship among central pain processing, demographics, and pain-related characteristics. Case-control studies reporting measures of altered central pain processing using quantitative sensory testing were reviewed. Standardized mean differences (SMDs) and 95% confidence intervals between people with nontraumatic neck pain and controls were calculated. ⋯ This review suggests that altered central pain processing is present in people with nontraumatic neck pain and may be associated with disability levels and age. PERSPECTIVE: This review found moderate-quality evidence of mechanical hyperalgesia at remote nonpainful sites in patients with nontraumatic neck pain compared with controls, indicating altered central pain processing. However, more studies are needed to confirm findings from dynamic quantitative sensory testing.
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Meta Analysis
Epidural corticosteroid injections for sciatica: An Abridged Cochrane Systematic Review and Meta-Analysis.
Systematic with meta-analysis OBJECTIVES.: The aim of this study was to investigate the efficacy and safety of epidural corticosteroid injections compared with placebo injection in reducing leg pain and disability in patients with sciatica. ⋯ 1.