Articles: acute-pain.
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Cochrane Db Syst Rev · Jun 2015
Review Meta AnalysisTranscutaneous electrical nerve stimulation for acute pain.
This is a second update of a Cochrane Review originally published in Issue 2, 2009. Transcutaneous Electrical Nerve Stimulation (TENS) is a non-pharmacological agent, based on delivering low voltage electrical currents to the skin. TENS is used by people to treat a variety of pain conditions. ⋯ This Cochrane Review update includes seven new trials, in addition to the 12 trials reviewed in the first update in 2011. The analysis provides tentative evidence that TENS reduces pain intensity over and above that seen with placebo (no current) TENS when administered as a stand-alone treatment for acute pain in adults. The high risk of bias associated with inadequate sample sizes in treatment arms and unsuccessful blinding of treatment interventions makes definitive conclusions impossible. There was incomplete reporting of treatment in many reports making replication of trials impossible.
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Cochrane Db Syst Rev · Jun 2015
Review Meta AnalysisTopical NSAIDs for acute musculoskeletal pain in adults.
Use of topical NSAIDs to treat acute musculoskeletal conditions has become widely accepted because they can provide pain relief without associated systemic adverse events. This review is an update of 'Topical NSAIDs for acute pain in adults' originally published in Issue 6, 2010. ⋯ Topical NSAIDs provided good levels of pain relief in acute conditions such as sprains, strains and overuse injuries, probably similar to that provided by oral NSAIDs. Gel formulations of diclofenac (as Emugel®), ibuprofen, and ketoprofen, and some diclofenac patches, provided the best effects. Adverse events were usually minimal.Since the last version of this review, the new included studies have provided additional information. In particular, information on topical diclofenac is greatly expanded. The present review supports the previous review in concluding that topical NSAIDs are effective in providing pain relief, and goes further to demonstrate that certain formulations, mainly gel formulations of diclofenac, ibuprofen, and ketoprofen, provide the best results. Large amounts of unpublished data have been identified, and this could influence results in updates of this review.
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Cochrane Db Syst Rev · May 2015
Review Meta AnalysisCognitive-behavioural treatment for subacute and chronic neck pain.
EXPRESSION OF CONCERN - Professor Marco Monticone has acted as the first author of this Cochrane review. Readers should be informed that multiple randomized controlled trials authored by Professor Monticone have been scrutinized because of potential research integrity issues, including irregularities in the data (doi:10.1097/j.pain.0000000000002659). One of the trials suspected of research integrity issues is included in this Cochrane review (doi:10.1007/s00586-012-2287-y). The Cochrane editorial team has concerns about the trustworthiness of the trial data and is applying Cochrane's policy on managing potentially problematic studies (https://www.cochranelibrary.com/cdsr/editorial-policies#problematic-studies). No major differences to the conclusions of this review were found after performing a sensitivity analysis on the main outcomes, whether the potentially problematic trial was included or excluded. Cochrane will take further action as needed on this review once additional investigations into the potentially problematic trial are concluded. In the meantime, a new version of this review topic is underway with a new author team. The new review will supersede this review. ⋯ With regard to chronic neck pain, CBT was found to be statistically significantly more effective for short-term pain reduction only when compared to no treatment, but these effects could not be considered clinically meaningful. When comparing both CBT to other types of interventions and CBT in addition to another intervention to the other intervention alone, no differences were found. For patients with subacute NP, CBT was significantly better than other types of interventions at reducing pain at short-term follow-up, while no difference was found for disability and kinesiophobia. Further research is recommended to investigate the long-term benefits and risks of CBT including for the different subgroups of subjects with NP.
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Clinical therapeutics · May 2015
Meta AnalysisPerioperative Pregabalin for Acute Pain After Gynecological Surgery: A Meta-analysis.
Pregabalin has been used as an adjuvant in some trials to control postoperative pain after gynecologic surgery. However, the potential clinical advantage remains debatable. ⋯ Pregabalin has an analgesic and opioid-sparing effect and does not increase the frequency of adverse effects in acute postoperative pain management after gynecologic surgery.
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Meta Analysis
Lidocaine patch for acute pain management: a meta-analysis of prospective controlled trials.
Local anesthetic is one of the cornerstones of multimodal analgesia. We investigated the efficacy of the lidocaine patch for acute pain management. ⋯ The limitations were a small number of included studies, potential biases from some unblinded studies, clinical heterogeneity between studies, and incomplete reported data for adjunct analgesics.