Articles: pain-management.
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Multiple randomized controlled trials (RCTs) and systematic reviews have been conducted to summarize the evidence for administration of local anesthetic (lidocaine) alone or with steroids, with discordant opinions, more in favor of equal effect with local anesthetic alone or with steroids. ⋯ Overall, the present meta-analysis shows moderate (Level II) evidence for epidural injections with lidocaine with or without steroids in managing spinal pain secondary to disc herniation, spinal stenosis, discogenic pain, and post-surgery syndrome based on relevant, high-quality RCTs. Results were similar for lidocaine, with or without steroids.
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Review Meta Analysis
Effects of erector spinae plane block on postoperative pain and side-effects in adult patients underwent surgery: A systematic review and meta-analysis of randomized controlled trials.
Recently, the effects of erector spinae plane block on postoperative pain have become increasingly controversial. This meta-analysis compared the effects of ESP block versus placebo on postoperative analgesia and side effects to determine whether the new technique is a reliable alternative for pain management. ⋯ ESP block as a novel technique exhibited superior postoperative analgesic effects, reducing the postoperative complications in spinal, thoracic, and abdominal surgeries during the early postoperative period. However, as a new nerve block technique, numerous large-sized RCTs are needed for further research.
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Review Meta Analysis
Transcutaneous Electrical Nerve Stimulation As A Pain-Relieving Approach in Labor Pain: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Transcutaneous electrical nerve stimulation (TENS) is a non-invasive electrophysical pain-relieving modality that also can be used in labor pain. Compared to other methods, TENS is not commonly practiced in intrapartum care due to a lack of knowledge about its clinical efficacy. Hence, a comprehensive overview of all types of randomized controlled trials (RCTs) on TENS can provide a better insight into this method and its efficacy in labor pain. ⋯ The forest plot showed a small, but statistically significant efficacy of TENS on the reduction of pain intensity. However, it is not clear if the results were affected by the poor quality of the studies. This systematic review is the first that shows the application of TENS has significant efficacy in lowering labor pain. Findings from this review encourage the application of qualified methods for future and prospective studies with TENS applied in labor pain.
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Previous systemic reviews have examined the efficacy of individual therapeutic agents, but which type of treatment is superior to another has not been pooled or analyzed. The objective of the current study was to compare the clinical effectiveness of epidural steroid injection (ESI) versus conservative treatment for patients with lumbosacral radicular pain. ⋯ According to the results of this meta-analysis, the use of ESI is more effective for alleviating lumbosacral radicular pain than conservative treatments in terms of short-term and intermediate-term. Patients also reported more successful outcomes after receiving ESI when compared to conservative treatment. However, this effect was not maintained at long-term follow-up. This meta-analysis will help guide clinicians in making decisions for the treatment of patients with lumbosacral radicular pain, including the use of ESI, particularly in the management of pain at short-term.
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Journal of physiotherapy · Jul 2020
Meta AnalysisPhotobiomodulation therapy does not decrease pain and disability in people with non-specific low back pain: a systematic review.
In people with non-specific low back pain (LBP), what are the effects of photobiomodulation therapy (PBMT) on pain, disability and other outcomes when compared with no intervention, sham PBMT and other treatments, and when used as an adjunct to other treatments? ⋯ CRD42018088242.