Articles: pain-measurement.
-
Microvascular decompression (MVD) is a potentially curative surgery for drug-resistant trigeminal neuralgia (TN). Predictors of pain freedom after MVD are not fully understood. ⋯ Approximately three-quarters of patients with drug-resistant TN achieve pain freedom after MVD. Shorter disease duration, arterial compression, and type 1 Burchiel classification may predict more favorable outcome. These results may improve patient selection and provider expectations.
-
The aims of this study were to review the psychometric properties of the widely used Pain Catastrophizing Scale (PCS) using meta-analytic methods and to investigate the relationship between PCS scores and participant characteristics. A systematic search from 1995 found 229 experimental, quasi-experimental, and correlational studies that report PCS scores. Multivariate regression explored variables related to pain catastrophizing and participant demographics. ⋯ Study type influenced PCS scores with nonrandomized controlled trials reporting higher PCS scores than other study types, but results were confounded with pain diagnosis, as controlled trials were more likely than quasi-experimental studies to recruit clinical samples. The meta-analytic results provide insights into demographic influences on pain catastrophizing scores and highlight areas for further research. The advantages of systematic review and meta-analytic methods to achieve greater understanding and precision of psychometric properties-in this case, of the PCS-are applicable to other widely used outcome tools.
-
Review Meta Analysis
Quantitative Sensory Testing (QST) and predicting outcomes for musculoskeletal pain, disability and negative affect: a systematic review and meta-analysis.
Hypersensitivity due to central pain mechanisms can influence recovery and lead to worse clinical outcomes, but the ability of quantitative sensory testing (QST), an index of sensitisation, to predict outcomes in chronic musculoskeletal disorders remains unclear. We systematically reviewed the evidence for ability of QST to predict pain, disability, and negative affect using searches of CENTRAL, MEDLINE, EMBASE, AMED, CINAHL, and PubMed databases up to April 2018. Title screening, data extraction, and methodological quality assessments were performed independently by 2 reviewers. ⋯ Meta-analysis revealed that baseline QST predicted musculoskeletal pain (mean r = 0.31, 95% confidence interval [CI]: 0.23-0.38, n = 1057 participants) and disability (mean r = 0.30, 95% CI: 0.19-0.40, n = 290 participants). Baseline modalities quantifying central mechanisms such as temporal summation and conditioned pain modulation were associated with follow-up pain (temporal summation: mean r = 0.37, 95% CI: 0.17-0.54; conditioned pain modulation: mean r = 0.36, 95% CI: 0.20-0.50), whereas baseline mechanical threshold modalities were predictive of follow-up disability (mean r = 0.25, 95% CI: 0.03-0.45). Quantitative sensory testing indices of pain hypersensitivity might help develop targeted interventions aiming to improve outcomes across a range of musculoskeletal conditions.
-
Meta Analysis Comparative Study
Local anaesthetic infiltration via wound catheter versus epidural analgesia in open hepatectomy: a systematic review and meta-analysis of randomised controlled trials.
Although epidural analgesia (EA) provides effective pain control after open hepatectomy, postoperative hypotension is a common problem that limits ambulation. There is growing interest in alternative methods of pain control after open abdominal surgery, including a potential role for local anaesthetic infusion via wound catheter (WC). The aim of this study was to evaluate the available evidence for WC in open hepatectomy by conducting a meta-analysis of randomised trials. ⋯ Despite higher pain scores on the second postoperative day, functional recovery after open hepatectomy is faster in patients with wound catheters compared with epidural analgesia. Wound catheters should be considered the preferred mode of analgesia after open hepatectomy.
-
Minerva anestesiologica · May 2019
Review Meta AnalysisIntraoperative monitoring of nociception for opioid administration: a meta-analysis of randomized controlled trials.
Under-dosage or over-dosage of intraoperative analgesia can cause harm to patients. Many studies have demonstrated the clinical advantages of nociception monitoring tools, but with some conflicting results. To clarify the issue, this meta-analysis compared the effects of Analgesia Nociception Index (ANI), Surgical Pleth Index (SPI), and pupillometry monitoring methods with those of analgesia management practices of intraoperative opioid administration. ⋯ Nociception monitoring devices seem to have an advantage over standard clinical practice on intraoperative management of analgesia during general anesthesia. Future research should focus on identifying appropriate indicators to objectively assess the degree of pain in children and perform large-scale multicenter trials to prove clinical advantages of nociception measurements during propofol anesthesia.