Articles: chronic.
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Journal of anesthesia · Aug 2014
Randomized Controlled TrialLateral Trendelenburg with the injected side down after the block improves the efficacy of the axillary approach to brachial plexus block.
We hypothesized that, after axillary block, positioning the patient in a lateral position with the injected side down and simultaneously in a 20° Trendelenburg position will increase the success rate and quality of the block. ⋯ We conclude that, for patients undergoing an axillary block, positioning the patient laterally with the injected side down and in a 20° Trendelenburg position increases the success rate and quality of the block.
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Randomized Controlled Trial Multicenter Study Observational Study
Clinical Application of the COPD Assessment Test: Longitudinal Data from the CHAIN Cohort.
The COPD Assessment Test (CAT) has been proposed for assessing health status in COPD, but little is known about its longitudinal changes. The objective of this study was to evaluate 1-year CAT variability in patients with stable COPD and to relate its variations to changes in other disease markers. ⋯ One-year longitudinal data show variability in CAT scores among patients with stable COPD similar to mMRC scale score, which is the best predictor of 1-year CAT changes. Further longitudinal studies should confirm long-term CAT variability and its clinical applicability.
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Randomized Controlled Trial
Ecological momentary assessment for chronic pain in fibromyalgia using a smartphone: a randomized crossover study.
Daily diaries are a useful way of measuring fluctuations in pain-related symptoms. However, traditional diaries do not assure the gathering of data in real time, not solving the problem of retrospective assessment. Ecological momentary assessment (EMA) by means of electronic diaries helps to improve repeated assessment. However, it is important to test its feasibility in specific populations in order to reach a wider number of people who could benefit from these procedures. ⋯ The findings of this study support the use of smartphones for EMA even in specific populations with a specific pain condition, fibromyalgia and with low familiarity with technology. These methods could help clinicians and researchers to gather more accurate ratings of relevant pain-related variables even in populations with low familiarity with technology.
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J Pain Palliat Care Pharmacother · Jun 2014
Randomized Controlled TrialChronic postthoracotomy pain and perioperative ketamine infusion.
The objectives of this study were to investigate whether continuous intravenous ketamine during the first 72 hours after thoracotomy could reduce the incidence and intensity of chronic postthoracotomy pain (CPTP) and to define the incidence and risk factors of CPTP. Seventy-eight patients receiving thoracotomy for lung tumor (benign or malignant) were randomly divided into two groups: ketamine group (n = 31) and control groups (n = 47). Patients in the ketamine group received intravenous ketamine 1 mg/kg before incision, followed by 2 μg/kg/minute infusion for 72 hours plus sufentanil patient-controlled intravenous analgesia after thoracotomy. ⋯ Retractor used time (OR = 5.811, P = .002), inadequate acute pain control (NRS ≥ 5) (OR = 5.425, P = .048), and chemotherapy (OR = 3.784, P = .056) were independent risk factors for chronic postthoracotomy pain. The authors conclude that continuous intravenous ketamine (2 μg/kg/min) during the first 72 hours after thoracotomy was not beneficial to prevent chronic postthoracotomy pain. The independent risk factors for chronic postthoracotomy pain were retractor used time, inadequate acute pain control, and chemotherapy.
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Randomized Controlled Trial
Perioperative Epidural or Intravenous Ketamine Does Not Improve the Effectiveness of Thoracic Epidural Analgesia for Acute and Chronic Pain After Thoracotomy.
Persistent postsurgical pain (PPP) after thoracotomy effect 50% to 80%. Nerve damage and central sensitization involving NDMDAr activation may play an important role. This study evaluates the efficacy of adding intravenous (IV) or epidural ketamine to thoracic epidural analgesia (TEA) after thoracotomy. ⋯ Adding epidural or IV racemic ketamine to TEA after thoracotomy did not lead to any reduction in PPP or allodynia. Epidural administration produced similar plasma ketamine levels to the IV route.