Latest & greatest articles for pain

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Top results for pain

21. Pre-emptive and preventive opioids for postoperative pain in adults undergoing all types of surgery.

Pre-emptive and preventive opioids for postoperative pain in adults undergoing all types of surgery. BACKGROUND: Postoperative pain is a common consequence of surgery and can have deleterious effects. It has been suggested that the administration of opioid analgesia before a painful stimulus may improve pain control. This can be done in two ways. We defined 'preventive opioids' as opioids administered before incision and continued postoperatively, and 'pre-emptive opioids' as opioids given (...) before incision but not continued postoperatively. Both pre-emptive and preventive analgesia involve the initiation of an analgesic agent prior to surgical incision with the aim of reducing intraoperative nociception and therefore postoperative pain. OBJECTIVES: To assess the efficacy of preventive and pre-emptive opioids for reducing postoperative pain in adults undergoing all types of surgery. SEARCH METHODS: We searched the following electronic databases: CENTRAL, MEDLINE, Embase, AMED, and CINAHL

Cochrane2018

22. Cannabinoids for Chronic Pain

Cannabinoids for Chronic Pain Cannabinoids for Chronic Pain November 2018 Mailing Address: Therapeutics Initiative The University of British Columbia Department of Anesthesiology, Pharmacology & Therapeutics 2176 Health Sciences Mall Vancouver, BC Canada V6T 1Z3 Tel.: 604 822 0700 Fax: 604 822 0701 E-mail: info@ti.ubc.ca www.ti.ubc.ca 115 C anada’s parliament legalized the recreational use of herbal cannabis (marijuana) in October 2018. The well-publicized limitations of clinical re- search (...) and well-recognized side effects such as canna- bis intoxication have not deterred people from seeking out and using herbal cannabis for chronic pain in in- creasing numbers. This is occurring with or without a physician’s authorization. 1 In fact, half of Canadians reporting a medical use of herbal cannabis used it for pain relief. 2 Adult patients in Canada still require a physician’s ‘au- thorization’ to legally access cannabis from a licensed producer of cannabis for medical purposes. Facilitating

Therapeutics Letter2018

23. Transcranial MRI-guided focused ultrasound thalamotomy for neuropathic pain

Transcranial MRI-guided focused ultrasound thalamotomy for neuropathic pain T T r ranscr anscranial MRI-guided focused ultr anial MRI-guided focused ultrasound asound thalamotom thalamotomy for neuropathic pain y for neuropathic pain Interventional procedures guidance Published: 28 November 2018 nice.org.uk/guidance/ipg632 Y Y our responsibility our responsibility This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising (...) -guided focused ultrasound thalamotomy for neuropathic pain shows there are serious safety concerns. There is very limited evidence of efficacy. Therefore, this procedure should not be used. © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 1 of 42 2 The condition, current treatments and procedure The condition, current treatments and procedure The condition 2.1 Neuropathic pain results from dysfunction of sensory

National Institute for Health and Clinical Excellence - Interventional Procedures2018

24. Effect of Intravenous Oxycodone in Combination With Different Doses of Dexmedetomdine on Sleep Quality and Visceral Pain in Patients After Abdominal Surgery: A Randomized Study

Effect of Intravenous Oxycodone in Combination With Different Doses of Dexmedetomdine on Sleep Quality and Visceral Pain in Patients After Abdominal Surgery: A Randomized Study 30134283 2018 11 06 1536-5409 34 12 2018 Dec The Clinical journal of pain Clin J Pain Effect of Intravenous Oxycodone in Combination With Different Doses of Dexmedetomdine on Sleep Quality and Visceral Pain in Patients After Abdominal Surgery: A Randomized Study. 1126-1132 10.1097/AJP.0000000000000645 Oxycodone (...) or dexmedetomidine (DEX) alone are widely used in clinical practice. The aim of this study was to observe the effect of 2 oxycodone and DEX combinations on postoperative sleep quality. This was a prospective and randomized clinical study. A total of 99 patients underwent laparoscopic-assisted operations on stomach and intestines with general anesthesia were enrolled and randomly divided into 3 groups according to postoperative analgesic protocol (n=33 each). The analgesic protocols were as follows after

EvidenceUpdates2018

25. The Effect of Foot Massage on Pain Intensity and Anxiety in Patients Having Undergone a Tibial Shaft Fracture Surgery: A Randomized Clinical Trial

The Effect of Foot Massage on Pain Intensity and Anxiety in Patients Having Undergone a Tibial Shaft Fracture Surgery: A Randomized Clinical Trial 30444801 2018 11 16 1531-2291 32 12 2018 Dec Journal of orthopaedic trauma J Orthop Trauma The Effect of Foot Massage on Pain Intensity and Anxiety in Patients Having Undergone a Tibial Shaft Fracture Surgery: A Randomized Clinical Trial. e482-e486 10.1097/BOT.0000000000001320 To determine the effect of massage therapy on pain intensity and anxiety (...) almond oil, the most common lubricant used in massage therapy. Data were collected using pain numeric rating scale and Spielberger State-Trait Anxiety Inventory before and after intervention. After intervention, the mean scores for pain intensity, and anxiety in the intervention and control groups were 4.72 (0.97) and 5.72 (0.91), and 42.84 (6.50) and 58.36 (10.37), respectively. A significant difference was noted between the intervention and control groups concerning pain intensity and anxiety

EvidenceUpdates2018

26. Music intervention for pain and anxiety management of the primiparous women during labour: A systematic review and meta-analysis

Music intervention for pain and anxiety management of the primiparous women during labour: A systematic review and meta-analysis 30289556 2018 11 12 1365-2648 2018 Oct 05 Journal of advanced nursing J Adv Nurs Music intervention for pain and anxiety management of the primiparous women during labour: A systematic review and meta-analysis. 10.1111/jan.13871 To determine the effect of music on the management of pain and anxiety in primiparous women during labour. Music is cost-effective (...) intervention in clinical practice to reduce pain, stress, and anxiety. However, a systematic review with meta-analysis for investigating its effects during labour is still lacking. A systematic review with meta-analysis. MEDLINE, EMBASE, and CINAHL databases. Randomized controlled trials or quasi-experimental trials concerning the effects of music among primiparous women who were expected to give normal spontaneous delivery were searched and screened up to 31 July 2017. The recruited trials for this review

EvidenceUpdates2018

27. Identifying and Engaging Neuronal Oscillations by Transcranial Alternating Current Stimulation in Patients With Chronic Low Back Pain: A Randomized, Crossover, Double-Blind, Sham-Controlled Pilot Study

Identifying and Engaging Neuronal Oscillations by Transcranial Alternating Current Stimulation in Patients With Chronic Low Back Pain: A Randomized, Crossover, Double-Blind, Sham-Controlled Pilot Study 30268803 2018 11 25 1528-8447 2018 Sep 27 The journal of pain : official journal of the American Pain Society J Pain Identifying and Engaging Neuronal Oscillations by Transcranial Alternating Current Stimulation in Patients With Chronic Low Back Pain: A Randomized, Crossover, Double-Blind, Sham (...) -Controlled Pilot Study. S1526-5900(18)30642-4 10.1016/j.jpain.2018.09.004 Chronic pain is associated with maladaptive reorganization of the central nervous system. Recent studies have suggested that disorganization of large-scale electrical brain activity patterns, such as neuronal network oscillations in the thalamocortical system, plays a key role in the pathophysiology of chronic pain. Yet, little is known about whether and how such network pathologies can be targeted with noninvasive brain

EvidenceUpdates2018

28. Nerve-ous About Opioids? Treatment of neuropathic pain with opioids

Nerve-ous About Opioids? Treatment of neuropathic pain with opioids Tools for Practice is proudly sponsored by the Alberta College of Family Physicians (ACFP). ACFP is a provincial, professional voluntary organization, representing more than 4,800 family physicians, family medicine residents, and medical students in Alberta. Established over sixty years ago, the ACFP strives for excellence in family practice through advocacy, continuing medical education and primary care research. www.acfp.ca (...) June 18, 2018 Nerve-ous About Opioids? Treatment of neuropathic pain with opioids Clinical Question: What are the risks and benefits of opioids for neuropathic pain? Bottom Line: Compared to placebo, high-dose opioids moderately (at least 30%) reduce pain for an additional 1 in every 5-8 people over 4-12 weeks. Opioid-related adverse events lead to discontinuation for 1 in every 11-12 people over placebo. Other medications (like tricyclic antidepressants, gabapentin/pregabalin, and duloxetine

Tools for Practice2018

29. Pain getting on your nerves? Tricyclic antidepressants for neuropathic pain

Pain getting on your nerves? Tricyclic antidepressants for neuropathic pain Tools for Practice is proudly sponsored by the Alberta College of Family Physicians (ACFP). ACFP is a provincial, professional voluntary organization, representing more than 4,800 family physicians, family medicine residents, and medical students in Alberta. Established over sixty years ago, the ACFP strives for excellence in family practice through advocacy, continuing medical education and primary care research (...) . www.acfp.ca May 7, 2018 Pain getting on your nerves? Tricyclic antidepressants for neuropathic pain Clinical Question: What are the benefits and harms of using tricyclic antidepressants (TCAs) for neuropathic pain? Bottom Line: Compared to placebo, TCAs may provide a 30% reduction in pain for an additional 1 in 4-6 people with neuropathic pain, with 1 in 5 experiencing an adverse event and 1 in 11 stopping medication because of side effects. Overall, evidence is limited by inconsistent outcome reporting

Tools for Practice2018

30. Topical Capsaicin for Neuropathic and Osteoarthritis Pain: Maybe not so hot?

Topical Capsaicin for Neuropathic and Osteoarthritis Pain: Maybe not so hot? Tools for Practice is proudly sponsored by the Alberta College of Family Physicians (ACFP). ACFP is a provincial, professional voluntary organization, representing more than 4,800 family physicians, family medicine residents, and medical students in Alberta. Established over sixty years ago, the ACFP strives for excellence in family practice through advocacy, continuing medical education and primary care research (...) . www.acfp.ca December 10, 2018 Topical Capsaicin for Neuropathic and Osteoarthritis Pain: Maybe not so hot? Clinical Question: What are the benefits and harms of topical capsaicin for neuropathic or osteoarthritis pain? Bottom Line: Evidence for topical capsaicin in neuropathic pain and hand osteoarthritis is highly inconsistent, with some studies showing clinical benefit (variably defined) for one in 4-7 patients while other studies show no benefit. There is no benefit in knee osteoarthritis. Local

Tools for Practice2018

31. Preventing Painful Pokes: Decreasing Immunization Pain in Kids

Preventing Painful Pokes: Decreasing Immunization Pain in Kids Tools for Practice is proudly sponsored by the Alberta College of Family Physicians (ACFP). ACFP is a provincial, professional voluntary organization, representing more than 4,800 family physicians, family medicine residents, and medical students in Alberta. Established over sixty years ago, the ACFP strives for excellence in family practice through advocacy, continuing medical education and primary care research. www.acfp.ca (...) February 12, 2018 Preventing Painful Pokes: Decreasing Immunization Pain in Kids Clinical Question: What are the best methods for decreasing immunization pain in young children? Bottom Line: The most consistent evidence is for breastfeeding (prevents more severe pain for 1 in 2 patients versus control), topical anesthetics (prevent clinically significant pain for 1 in 4 children versus placebo) and video distraction (reduces pain by ~2.4 points more than placebo on a 5-point pain scale). The evidence

Tools for Practice2018

32. Comparison of Preoperative Administration of Pregabalin and Duloxetine on Cognitive Functions and Pain Management After Spinal Surgery: A Randomized, Double-blind, Placebo-controlled Study

Comparison of Preoperative Administration of Pregabalin and Duloxetine on Cognitive Functions and Pain Management After Spinal Surgery: A Randomized, Double-blind, Placebo-controlled Study 30020088 2018 11 06 1536-5409 34 12 2018 Dec The Clinical journal of pain Clin J Pain Comparison of Preoperative Administration of Pregabalin and Duloxetine on Cognitive Functions and Pain Management After Spinal Surgery: A Randomized, Double-blind, Placebo-controlled Study. 1114-1120 10.1097/AJP (...) .0000000000000640 Surgical trauma is known to induce hyperalgesia, and if pain management is insufficient, it contributes to persistent pain in the postoperative period.In this study, our primary aims were to compare the effect of pregabalin and duloxetine on postoperative pain scores and cognitive functions. Our secondary aim was to determine drug-related side effects. This was a prospective, randomized, double-blind, placebo-controlled study. The study was carried out in the setting of the operating room

EvidenceUpdates2018

33. Does improvement towards a normal cervical sagittal configuration aid in the management of cervical myofascial pain syndrome: a 1- year randomized controlled trial

Does improvement towards a normal cervical sagittal configuration aid in the management of cervical myofascial pain syndrome: a 1- year randomized controlled trial 30419868 2018 12 07 1471-2474 19 1 2018 Nov 12 BMC musculoskeletal disorders BMC Musculoskelet Disord Does improvement towards a normal cervical sagittal configuration aid in the management of cervical myofascial pain syndrome: a 1- year randomized controlled trial. 396 10.1186/s12891-018-2317-y There is a growing interest concerning (...) the understanding of and rehabilitation of the sagittal configuration of the cervical spine as a clinical outcome. However, the literature on the topic specific to conservative treatment outcomes of patients with chronic myofascial cervical pain syndrome (CMCPS) has not adequately addressed the relationship between cervical sagittal alignment and improved pain, disability and range of motion. A randomized controlled study with a 1-year follow-up. Here, 120 (76 males) patients with chronic CMCPS and defined

EvidenceUpdates2018 Full Text: Link to full Text with Trip Pro

34. Targeted Muscle Reinnervation Treats Neuroma and Phantom Pain in Major Limb Amputees: A Randomized Clinical Trial

Targeted Muscle Reinnervation Treats Neuroma and Phantom Pain in Major Limb Amputees: A Randomized Clinical Trial 30371518 2018 10 29 1528-1140 2018 Oct 26 Annals of surgery Ann. Surg. Targeted Muscle Reinnervation Treats Neuroma and Phantom Pain in Major Limb Amputees: A Randomized Clinical Trial. 10.1097/SLA.0000000000003088 To compare targeted muscle reinnervation (TMR) to "standard treatment" of neuroma excision and burying into muscle for postamputation pain. To date, no intervention (...) is consistently effective for neuroma-related residual limb or phantom limb pain (PLP). TMR is a nerve transfer procedure developed for prosthesis control, incidentally found to improve postamputation pain. A prospective, randomized clinical trial was conducted. 28 amputees with chronic pain were assigned to standard treatment or TMR. Primary outcome was change between pre- and postoperative numerical rating scale (NRS, 0-10) pain scores for residual limb pain and PLP at 1 year. Secondary outcomes included

EvidenceUpdates2018

35. Effect of Intravenous Dexmedetomidine During General Anesthesia on Acute Postoperative Pain in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Effect of Intravenous Dexmedetomidine During General Anesthesia on Acute Postoperative Pain in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials 29771731 2018 11 06 1536-5409 34 12 2018 Dec The Clinical journal of pain Clin J Pain Effect of Intravenous Dexmedetomidine During General Anesthesia on Acute Postoperative Pain in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. 1180-1191 10.1097/AJP.0000000000000630 Dexmedetomidine has been (...) shown to have an analgesic effect. However, no consensus was reached in previous studies. Electronic databases such as PubMed, Embase, and Cochrane Central were searched for relevant randomized controlled trials. The relative risk and weighted mean difference (WMD) were used to analyze the outcomes. Random-effects model was used for meta-analysis. Compared with the normal saline group, patients using DEX showed a significantly decreased pain intensity within 6 hours [WMD=-0.93; 95% confidence

EvidenceUpdates2018

36. Liposomal bupivacaine efficacy for postoperative pain following posterior vaginal surgery: a randomized, double-blind, placebo-controlled trial

Liposomal bupivacaine efficacy for postoperative pain following posterior vaginal surgery: a randomized, double-blind, placebo-controlled trial 30273586 2018 11 16 1097-6868 219 5 2018 Nov American journal of obstetrics and gynecology Am. J. Obstet. Gynecol. Liposomal bupivacaine efficacy for postoperative pain following posterior vaginal surgery: a randomized, double-blind, placebo-controlled trial. 500.e1-500.e8 S0002-9378(18)30821-4 10.1016/j.ajog.2018.09.029 Effective postoperative pain (...) management is a crucial component of recovery following surgery. Narcotics are a cornerstone of postoperative analgesia, but can require a redosing requirement, encompass a lengthy list of side effects and adverse reaction risks, as well as carry a dependency potential. The national focus on decreasing opioid use has directly impacted postoperative pain management. Previous studies have reported the beneficial use of a single intraoperative injection of extended-release liposomal bupivacaine in postoperative pain

EvidenceUpdates2018

37. Analgesic efficacy and safety of morphine in the Procedural Pain in Premature Infants (Poppi) study: randomised placebo-controlled trial.

Analgesic efficacy and safety of morphine in the Procedural Pain in Premature Infants (Poppi) study: randomised placebo-controlled trial. BACKGROUND: Infant pain has immediate and long-term effects but is undertreated because of a paucity of evidence-based analgesics. Although morphine is often used to sedate ventilated infants, its analgesic efficacy is unclear. We aimed to establish whether oral morphine could provide effective and safe analgesia in non-ventilated premature infants for acute (...) procedural pain. METHODS: In this single-centre masked trial, 31 infants at the John Radcliffe Hospital, Oxford, UK, were randomly allocated using a web-based facility with a minimisation algorithm to either 100 μg/kg oral morphine sulphate or placebo 1 h before a clinically required heel lance and retinopathy of prematurity screening examination, on the same occasion. Eligible infants were born prematurely at less than 32 weeks' gestation or with a birthweight lower than 1501 g and had a gestational age

Lancet2018

38. Hypnosis intervention for the management of pain perception during cataract surgery

Hypnosis intervention for the management of pain perception during cataract surgery 30288086 2018 11 14 1178-7090 11 2018 Journal of pain research J Pain Res Hypnosis intervention for the management of pain perception during cataract surgery. 1921-1926 10.2147/JPR.S174490 To investigate the effectiveness of hypnosis in pain management during cataract surgery. Male or female patients with bilateral age-related cataract who wished to have both eyes subjected to phacoemulsification surgery were (...) preliminarily admitted. Immediately after the first-eye surgery, each patient was evaluated for pain using the visual analog scale (VAS), and patients with a VAS score >1 were enrolled. By using block randomization, the enrolled patients were allocated to either the treatment group, which received a hypnosis intervention before the scheduled second-eye surgery, or the control group, which did not undergo hypnosis. The levels of anxiety, pain, and cooperation were evaluated independently by the patients

EvidenceUpdates2018 Full Text: Link to full Text with Trip Pro

39. Does the Use of Electrotherapies Increase the Effectiveness of Neck Stabilization Exercises for Improving Pain, Disability, Mood, and Quality of Life in Chronic Neck Pain?: A Randomized, Controlled, Single-Blind Study

Does the Use of Electrotherapies Increase the Effectiveness of Neck Stabilization Exercises for Improving Pain, Disability, Mood, and Quality of Life in Chronic Neck Pain?: A Randomized, Controlled, Single-Blind Study 29652778 2018 11 14 1528-1159 43 20 2018 Oct 15 Spine Spine Does the Use of Electrotherapies Increase the Effectiveness of Neck Stabilization Exercises for Improving Pain, Disability, Mood, and Quality of Life in Chronic Neck Pain?: A Randomized, Controlled, Single-Blind Study (...) . E1174-E1183 10.1097/BRS.0000000000002663 This study was a prospective, randomized, controlled study. The aim of this study was to determine whether transcutaneous electrical nerve stimulation (TENS) or interferential current (IFC) increase the effectiveness of neck stabilization exercises (NSEs) on pain, disability, mood and quality of life for chronic neck pain (CNP). Neck pain is one of the three most frequently reported complaints of the musculoskeletal system. Electrotherapies, such as IFC

EvidenceUpdates2018

40. Do liposomal bupivacaine infiltration and interscalene nerve block provide similar pain relief after total shoulder arthroplasty: a systematic review and meta-analysis

Do liposomal bupivacaine infiltration and interscalene nerve block provide similar pain relief after total shoulder arthroplasty: a systematic review and meta-analysis 30271195 2018 11 14 1178-7090 11 2018 Journal of pain research J Pain Res Do liposomal bupivacaine infiltration and interscalene nerve block provide similar pain relief after total shoulder arthroplasty: a systematic review and meta-analysis. 1889-1900 10.2147/JPR.S177716 Controversy still exists regarding the efficiency (...) and safety of liposomal bupivacaine (LB) vs interscalene nerve block (INB) for pain management after total shoulder arthroplasty (TSA). The aim of the present meta-analysis was to perform a relatively credible and overall assessment to compare the efficiency and safety of LB-based infiltration vs INB for pain management after TSA. The PubMed, Cochrane Library, Web of Science, and EMBASE were systematically searched. Only studies published up to March 2018 comparing LB vs INB for pain control after TSA

EvidenceUpdates2018 Full Text: Link to full Text with Trip Pro