Articles: neuralgia.
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Randomized Controlled Trial
Effect of ketamine combined with magnesium sulfate in neuropathic pain patients (KETAPAIN): study protocol for a randomized controlled trial.
Neuropathic pain is difficult to treat, and the efficacy of recommended drugs remains limited. N-methyl-D-aspartate receptors are implicated, and antagonists are a pharmacological option. Ketamine is widely used in French pain clinics, but without consensus or recommendations. Furthermore, the association of ketamine with magnesium has been poorly studied. The aim of the present study is to evaluate the benefit of ketamine with or without magnesium in refractory neuropathic pain. ⋯ Considering the poor efficacy of the drugs available for neuropathic pain, ketamine with or without magnesium sulfate may be a valuable therapeutic option that needs to be standardized.
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To provide family physicians with a practical clinical summary of the Canadian Pain Society (CPS) revised consensus statement on the pharmacologic management of neuropathic pain. ⋯ Many pharmacologic analgesics exist for the treatment of neuropathic pain. Through evidence-based recommendations, the CPS revised consensus statement helps guide family physicians in the management of patients with neuropathic pain.
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Observational Study
The Associated Factors and Clinical Features of Neuropathic Pain after Brachial Plexus Injuries: A Cross-sectional Study.
Neuropathic pain in patients with brachial plexus injuries brings complicated obstacles to the treatment and recovery for both surgeons and patients. ⋯ Though the pain type and time phase manifested differently across patients, paresthesia/dysesthesia occurred most commonly. Patients were more likely to develop neuropathic pain if they had total brachial plexus injuries, avulsion and bad life habits. Moreover, the function of the upper limbs was affected by pain.
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Compared with nociceptive pain, neuropathic pain is a challenging diagnosis to make and successfully treat in children with cancer. ⋯ VLDM shows promise as an effective, safe, and inexpensive way to treat refractory neuropathic pain in children with cancer.
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Journal of neurosurgery · Nov 2017
Randomized Controlled TrialEfficacy of deep rTMS for neuropathic pain in the lower limb: a randomized, double-blind crossover trial of an H-coil and figure-8 coil.
OBJECTIVE Electrical motor cortex stimulation can relieve neuropathic pain (NP), but its use requires patients to undergo an invasive procedure. Repetitive transcranial magnetic stimulation (rTMS) of the primary motor cortex (M1) using a figure-8 coil can relieve NP noninvasively, but its ability to relieve lower limb pain is still limited. Deep rTMS using an H-coil can effectively stimulate deep brain regions and has been widely used for the treatment of various neurological diseases; however, there have been no clinical studies comparing the effectiveness of figure-8 coils and H-coils. ⋯ None of the patients exhibited any serious adverse events. CONCLUSIONS The current findings suggest that the use of deep rTMS with an H-coil in the lower limb region of the M1 in patients with NP was tolerable and could provide significant short-term pain relief. Clinical trial registration no.: UMIN000010536 ( http://www.umin.ac.jp/ctr/ ).