Articles: pain.
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Randomized Controlled Trial
Effect of Transcutaneous Electrical Nerve Stimulation on Patients with Total Knee Replacement: A Randomized Controlled Trial.
The aim of this study was to determine the effect of transcutaneous electrical nerve stimulation (TENS) on pain, functionality, quality of life, and analgesic consumption in patients undergoing TKR. ⋯ Nurses can provide effective postoperative pain control in patients undergoing TKR, increase functionality, accelerate the healing process, and improve their quality of life by using TENS, a non-pharmacological treatment method, in the perioperative period.
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Comparative Study Observational Study
A Double-Blind Comparative Study of burstDR Versus Tonic Epidural Motor Cortex Stimulation for the Treatment of Intractable Neuropathic Pain.
Preliminary studies on epidural motor cortex stimulation (eMCS) for the treatment of drug-resistant neuropathic pain have supported the extension to novel stimulation waveforms, in particular burstDR. However, only a low level of evidence is available. The aim of this retrospective observational study was to compare the analgesic efficacy of burstDR versus tonic eMCS. ⋯ In the present paper, we provide for the first time a double-blinded study comparing burstDR versus tonic eMCS for the treatment of intractable, drug-resistant neuropathic pain. Our results show that burstDR eMCS is a promising option in a population of patients especially difficult to treat, and support the ongoing move toward new stimulation waveforms able to more efficiently activate the brain networks involved in pain modulation.
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Randomized Controlled Trial
The Role of Negative Affect and Experiential Avoidance in Postsurgical Pain and Fatigue Among Norwegian Women With Breast Cancer.
Women undergoing breast cancer surgery frequently experience postsurgical pain and fatigue, which reduces their quality of life. Although psychological factors have been shown to play a role in predicting postsurgical outcomes, the subacute recovery phase often remains underexplored. In this secondary analysis of data from a randomised controlled trial, we sought to investigate the predictive role of negative affect and experiential avoidance on postsurgical symptoms during both acute and subacute recovery. ⋯ Women with higher levels of negative affect and experiential avoidance before undergoing breast cancer surgery appear to be at greater risk for experiencing heightened acute postsurgical pain and fatigue. The identification of these psychological predictors can help clinicians recognise individuals at risk for severe postoperative symptoms and develop targeted preventive and curative interventions to mitigate these symptoms and prevent them from becoming chronic.
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J Pain Symptom Manage · Feb 2025
Distributed Opioids in Morphine Equivalent: A Global Measure of Availability for Palliative Care.
Estimates of serious health-related suffering (SHS) demonstrate immense unmet need for palliative care, predominately in low- and middle-income countries (LMICs). Because opioids are essential medicines in palliative care (PC), measuring their availability can be used to evaluate the capacity of health systems to meet need. ⋯ DOME and DOME%SHSNEED can be used to monitor health system progress to redress disparities and promote access to medically indicated opioid therapy in palliative care.
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Standard anterograde placement of a surgical paddle lead (SPL) for spinal cord stimulation (SCS) can be challenging in patients with scarring from prior spine surgery, instrumentation obstructing the targeted level, or severe stenosis below the targeted level. One potential alternative is retrograde (caudal) insertion by performing laminotomies cephalad to the targeted levels. The literature is limited to only a small number of individual cases describing this technique. In this report, the authors present their experience over the last ten years of the retrograde insertion of SPLs for SCS. ⋯ The retrograde insertion of SPLs is a low-risk and feasible procedure that can be performed with minimal risk of lead migration, fracture, or deep surgical site infection. The retrograde strategy can be used in SPL trials or permanent placements.