Latest & greatest articles for pain

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Top results for pain

1. Evidence Brief - Benefits and Harms of Long-term Opioid Dose Reduction or Discontinuation in Patients with Chronic Pain

Evidence Brief - Benefits and Harms of Long-term Opioid Dose Reduction or Discontinuation in Patients with Chronic Pain Enter search terms Button to search HSRD ® Inside VA Budget and Performance Inside the News Room National Observances Special Events » » » » » Evidence Brief: Benefits and Harms of Long-term Opioid Dose Reduction or Discontinuation in Patients with Chronic Pain Health Services Research & Development Evidence Brief: Benefits and Harms of Long-term Opioid Dose Reduction (...) or Discontinuation in Patients with Chronic Pain to the ESP Report RSS feed Prepared by: Evidence Synthesis Program (ESP) Coordinating Center Portland VA Health Care System Portland, OR Mark Helfand, MD, MPH, MS, Director Recommended Citation: Mackey K, Anderson J, Bourne D, Chen E, Peterson K. Evidence Brief: Benefits and Harms of Long-term Opioid Dose Reduction or Discontinuation in Patients with Chronic Pain. Washington, DC: Evidence Synthesis Program, Health Services Research and Development Service, Office

2019 Veterans Affairs Evidence-based Synthesis Program Reports

2. Evidence Brief - Managing Acute Pain in Patients with Opioid Use Disorder on Medication-assisted Treatment

Evidence Brief - Managing Acute Pain in Patients with Opioid Use Disorder on Medication-assisted Treatment Enter search terms Button to search HSRD ® Inside VA Budget and Performance Inside the News Room National Observances Special Events » » » » » Evidence Brief: Managing Acute Pain in Patients with Opioid Use Disorder on Medication-assisted Treatment Health Services Research & Development Evidence Brief: Managing Acute Pain in Patients with Opioid Use Disorder on Medication-assisted (...) Treatment to the ESP Report RSS feed Prepared by: Evidence Synthesis Program (ESP) Coordinating Center Portland VA Health Care System Portland, OR Mark Helfand, MD, MPH, MS, Director Recommended Citation: Veazie S, Mackey K, Bourne D, Peterson K. Evidence Brief: Managing Acute Pain in Patients with Opioid Use Disorder on Medication-Assisted Treatment. Washington, DC: Evidence Synthesis Program, Health Services Research and Development Service, Office of Research and Development, Department of Veterans

2019 Veterans Affairs Evidence-based Synthesis Program Reports

3. Ultrasound-Guided Pectoral Nerve Block I and Serratus-Intercostal Plane Block Alleviate Postoperative Pain in Patients Undergoing Modified Radical Mastectomy

Ultrasound-Guided Pectoral Nerve Block I and Serratus-Intercostal Plane Block Alleviate Postoperative Pain in Patients Undergoing Modified Radical Mastectomy Simultaneous application of pectoral nerve block and serratus-intercostal plane block (SPB) is one of the most desirable multimodal analgesic strategies, with wide implementation of the enhanced recovery after surgery pathway for modified radical mastectomy (MRM).The aim of the present study was to investigate the efficacy and safety (...) , the duration at the postanesthesia care unit, and the incidence of adverse events were lower in group PS, compared with that of the group C. Moreover, PECS I together with SPB contributed to better sleep quality and higher patient satisfaction of pain relief.This study was limited by its sample size.These results suggest that the combination of PECS I and SPB provide superior perioperative pain relief in breast cancer surgery.Pectoral nerve block, serratus-intercostal plane block, postoperative analgesia

2019 EvidenceUpdates

4. Pain Neuroscience Education for Adults With Chronic Musculoskeletal Pain: A Mixed-Methods Systematic Review and Meta-Analysis

Pain Neuroscience Education for Adults With Chronic Musculoskeletal Pain: A Mixed-Methods Systematic Review and Meta-Analysis Chronic musculoskeletal pain (CMP) is an urgent global public health concern. Pain neuroscience education (PNE) is an intervention used in the management of CMP aiming to reconceptualize an individual's understanding of their pain as less threatening. This mixed-methods review undertook a segregated synthesis of quantitative and qualitative studies to investigate (...) the clinical effectiveness, and patients' experience of, PNE for people with CMP. Electronic databases were searched for studies published between January 1, 2002, and June 14, 2018. Twelve randomized, controlled trials (n = 755 participants) that reported pain, disability, and psychosocial outcomes and 4 qualitative studies (n = 50 participants) that explored patients experience of PNE were included. The meta-analyzed pooled treatment effects for PNE versus control had low clinical relevance in the short

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2019 EvidenceUpdates

5. Pharmacological interventions for chronic pain in children: an overview of systematic reviews

Pharmacological interventions for chronic pain in children: an overview of systematic reviews

2019 EvidenceUpdates

6. Effect of Tanezumab on Joint Pain, Physical Function, and Patient Global Assessment of Osteoarthritis Among Patients With Osteoarthritis of the Hip or Knee: A Randomized Clinical Trial. (PubMed)

Effect of Tanezumab on Joint Pain, Physical Function, and Patient Global Assessment of Osteoarthritis Among Patients With Osteoarthritis of the Hip or Knee: A Randomized Clinical Trial. Patients with osteoarthritis (OA) may remain symptomatic with traditional OA treatments.To assess 2 subcutaneous tanezumab dosing regimens for OA.A randomized, double-blind, multicenter trial from January 2016 to May 14, 2018 (last patient visit). Patients enrolled were 18 years or older with hip or knee OA (...) , inadequate response to OA analgesics, and no radiographic evidence of prespecified joint safety conditions.Patients received by subcutaneous administration either tanezumab, 2.5 mg, at day 1 and week 8 (n = 231); tanezumab, 2.5 mg at day 1 and 5 mg at week 8 (ie, tanezumab, 2.5/5 mg; n = 233); or placebo at day 1 and week 8 (n = 232).Co-primary end points were change from baseline to week 16 in Western Ontario and McMasters Universities Osteoarthritis Index (WOMAC) Pain (0-10, no to extreme pain), WOMAC

2019 JAMA

7. Fentanyl (Actiq and other brands) and other opioids: risk of increased pain

Fentanyl (Actiq and other brands) and other opioids: risk of increased pain Prescrire IN ENGLISH - Spotlight ''Fentanyl (Actiq° and other brands) and other opioids: risk of increased pain'', 1 July 2019 {1} {1} {1} | | > > > Fentanyl (Actiq° and other brands) and other opioids: risk of increased pain Spotlight Every month, the subjects in Prescrire’s Spotlight. 100 most recent :  |   |   |   |   |   |   |   |   |  Spotlight (...) Fentanyl (Actiq° and other brands) and other opioids: risk of increased pain Paradoxically, fentanyl, like other opioids, can exacerbate the pain it is intended to relieve. In 2018, the European Medicines Agency (EMA) reported 16 cases of hyperalgesia (severe pain) in patients taking transmucosal fentanyl. Hyperalgesia is a known adverse effect of opioids. The key symptom is an increase in the intensity of pain felt, an increase associated with the effects of the opioid. It is difficult to distinguish

2019 Prescrire

8. Stimulation of the Gasserian Ganglion for Trigeminal Neuropathic Pain Refractory to Medical Management

Stimulation of the Gasserian Ganglion for Trigeminal Neuropathic Pain Refractory to Medical Management "Stimulation of the Gasserian Ganglion for Trigeminal Neuropathic Pain " by Jessica Smedley < > > > > > Title Author Date of Graduation Summer 8-10-2019 Degree Type Capstone Project Degree Name Master of Science in Physician Assistant Studies Rights . Abstract Background: Trigeminal neuropathic pain (TNP) is an often debilitating facial pain syndrome for which there is no known cure (...) using Clinical Key, MEDLINE-Ovid and Web of Science and the following search terms: trigeminal neuropathic pain, neuromodulation and stimulation. Articles were assessed for quality using GRADE criteria. Results: Two case series studies fit all eligibility criteria. Each utilized a temporary electrode placed for a trial period to assess efficacy and determine candidacy for permanent implantation. One study found that in those with a positive trial, 96.3% at 6 months and 46.7% of patients at 24 months

2019 Pacific University EBM Capstone Project

9. The Effect of Acupuncture on Pain in Inpatient Medicine

The Effect of Acupuncture on Pain in Inpatient Medicine "The Effect of Acupuncture on Pain in Inpatient Medicine" by Jessica Kolahi < > > > > > Title Author Date of Graduation Summer 8-9-2019 Degree Type Thesis Degree Name Master of Science in Physician Assistant Studies Rights . Abstract Background : Pain management has become a controversial topic. Opioids, which once held the promise of improving quality of life for millions of Americans, have resulted in an epidemic of addiction (...) . As a result, national organizations are investigating alternative methods to treat pain, including acupuncture. The purpose of this review is to investigate the effect of acupuncture on the general symptom of pain, within the context of the controlled environment of inpatient medicine. Methods : An exhaustive search of MEDLINE-Ovid, CINAHL, and Web of Science was conducted using the search terms acupuncture , inpatient , and pain . Included studies measured pain scores before and after acupuncture

2019 Pacific University EBM Capstone Project

10. Acetaminophen (Paracetamol) is the short-term drug of choice for orthodontic pain

Acetaminophen (Paracetamol) is the short-term drug of choice for orthodontic pain UTCAT3387, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title Acetaminophen (Paracetamol) is the short-term drug of choice for orthodontic pain. Clinical Question In patients experiencing pain from orthodontic tooth movement, what is the drug of choice to relieve pain without the inhibition of orthodontic tooth movement? Clinical Bottom Line (...) Acetaminophen is comparable to systemic NSAIDs in terms of relieving orthodontic pain without the side effects of NSAIDs that could inhibit orthodontic tooth movement. Best Evidence (you may view more info by clicking on the PubMed ID link) PubMed ID Author / Year Patient Group Study type (level of evidence) #1) Fang et al/2016 128 patients undergoing orthodontic treatment Meta-Analysis Key results Throughout five different studies included, celecoxib, acetaminophen, and aspirin were used to determine

2019 UTHSCSA Dental School CAT Library

11. Acetyl-L-carnitine in painful peripheral neuropathy: a systematic review

Acetyl-L-carnitine in painful peripheral neuropathy: a systematic review Acetyl-L-carnitine (ALC) has shown a neuroprotective effect in patients with peripheral neuropathies of different etiologies. Preclinical studies demonstrated a central anti-nociceptive action, both in neuropathic and nociceptive pain models. The present review aims to provide the knowledge on the efficacy of ALC in patients with painful peripheral neuropathy, based on the evidence. Consistent with the PRISMA statement (...) in painful peripheral neuropathy, a meta-analysis of four randomized controlled trials was performed. Mean difference in pain reduction as measured on a 10-cm VAS, and 95% CIs were used for pooling continuous data from each trial. Four randomized controlled trials tested ALC in patients with neuropathy secondary to diabetes and to antiretroviral therapy for HIV. Compared to placebo, ALC produced a significant pain reduction equal to 20.2% (95% CI: 8.3%-32.1%, P<0.0001) with respect to baseline. Clinical

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2019 EvidenceUpdates

12. Intravenous lidocaine in the management of chronic peripheral neuropathic pain: a randomized-controlled trial

Intravenous lidocaine in the management of chronic peripheral neuropathic pain: a randomized-controlled trial Neuropathic pain, resulting from injury to the peripheral or central nervous system, is due to upregulation of aberrant sodium channels with neuronal hyperexcitability. Lidocaine blocks these channels and several studies show that intravenous (IV) lidocaine infusion provides significant relief in patients with chronic peripheral neuropathic pain in the short term (for up to six hours (...) ). Our objective was to determine if IV lidocaine provides significant pain relief and overall improvement in quality of life in the longer term (for up to four weeks).This single site randomized double-blind, crossover trial compared IV lidocaine infusion (5 mg·kg-1) with active placebo infusion containing diphenhydramine (50 mg) in patients with chronic neuropathic pain of peripheral nerve origin of at least six months duration. The primary outcome was average pain intensity reduction from IV

2019 EvidenceUpdates

13. Paravertebral Dexmedetomidine in Video-Assisted Thoracic Surgeries for Acute and Chronic Pain Prevention

Paravertebral Dexmedetomidine in Video-Assisted Thoracic Surgeries for Acute and Chronic Pain Prevention Video-assisted thoracoscopic surgery (VATS) is considered as one of the minimally invasive surgeries. Early postoperative pain alleviation is very important to avoid complications, at the same time, proper early pain control is an established fact to decrease the incidence of chronic pain.To evaluate the efficacy of thoracic paravertebral block (PVB) by a bupivacaine/ dexmedetomidine mixture (...) on acute and chronic post-thoracoscopic surgery pain in patients undergoing VATS.A randomized prospective double-blinded trial.Assiut University Hospitals, Orman Cardiology Hospital.Sixty adult patients underwent elective VATS surgery under general anesthesia randomly allocated into 2 groups; Group I received thoracic PVB with isobaric bupivacaine 0.5% (0.3 mL/kg) and Group II received PVB with isobaric bupivacaine 0.5% (0.3 mL/kg) and dexmedetomidine (1 mcg/kg). Postoperative pain (at rest, with cough

2019 EvidenceUpdates

14. Automated Self-management (ASM) vs. ASM-Enhanced Collaborative Care for Chronic Pain and Mood Symptoms: the CAMMPS Randomized Clinical Trial

Automated Self-management (ASM) vs. ASM-Enhanced Collaborative Care for Chronic Pain and Mood Symptoms: the CAMMPS Randomized Clinical Trial Chronic musculoskeletal pain is often accompanied by depression or anxiety wherein co-occurring pain and mood symptoms can be more difficult to treat than either alone. However, few clinical trials have examined interventions that simultaneously target both pain and mood conditions.To determine the comparative effectiveness of automated self-management (...) (ASM) vs. ASM-enhanced collaborative care.Randomized clinical trial conducted in six primary care clinics in a VA medical center.Two hundred ninety-four patients with chronic musculoskeletal pain of at least moderate intensity and clinically significant depressive and/or anxiety symptoms.ASM consisted of automated monitoring and 9 web-based self-management modules. Comprehensive symptom management (CSM) combined ASM with collaborative care management by a nurse-physician team. Both interventions

2019 EvidenceUpdates

15. Effect of ultrasound-guided peripheral nerve blocks of the abdominal wall on pain relief after laparoscopic cholecystectomy

Effect of ultrasound-guided peripheral nerve blocks of the abdominal wall on pain relief after laparoscopic cholecystectomy Purpose: The aim of this study was to compare the effect of an ultrasound-guided transversus abdominis plane block (TAPB) and rectus sheath block (RSB) combination, an ultrasound-guided posterior TAP block combined with the local anesthetic infiltration (LAI) and LAI alone on pain relief after laparoscopic cholecystectomy (LC). Patients and methods: One hundred eighty (...) patients who were American Society of Anesthesiologists class Ι or Π were included in this randomized, double-blind, non-inferiority study. All patients underwent three-port LC and were divided into 3 groups. The LAI group had ropivacaine mixed with dexmedetomidine injected around the trocar entrance site preoperatively. The TL group underwent ultrasound-guided posterior TAPB combined with LAI, and the TR group underwent ultrasound-guided TAPB combined with RSB. Postoperative pain was evaluated

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2019 EvidenceUpdates

16. Combined ultrasound-guided Pecs II block and general anesthesia are effective for reducing pain from modified radical mastectomy

Combined ultrasound-guided Pecs II block and general anesthesia are effective for reducing pain from modified radical mastectomy Purpose: Combined regional and general anesthesia are often used for the management of breast cancer surgery. Thoracic spinal block, thoracic epidural block, thoracic paravertebral block, and multiple intercostal nerve blocks are the regional anesthesia techniques which have been used in breast surgery, but some anesthesiologists are not comfortable because (...) of the complication and side effects. In 2012, Blanco et al introduced pectoralis nerve (Pecs) II block or modified Pecs block as a novel approach to breast surgery. This study aims to determine the effectiveness of combined ultrasound-guided Pecs II block and general anesthesia for reducing intra- and postoperative pain from modified radical mastectomy. Patients and methods: Fifty patients undergoing modified radical mastectomy with general anesthesia were divided into two groups randomly (n=25), to either Pecs

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2019 EvidenceUpdates

17. Desmopressin/indomethacin combination efficacy and safety in renal colic pain management: A randomized placebo controlled trial

Desmopressin/indomethacin combination efficacy and safety in renal colic pain management: A randomized placebo controlled trial Renal colic is a prevalent cause of abdominal pain in the emergency department. Although non-steroidal anti-inflammatory drugs and opioids are used for the treatment of renal colic, some adverse effects have been reported. Therefore, desmopressin -a synthetic analogue of vasopressin- has been proposed as another treatment choice. In the present study, indomethacin (...) in combination with nasal desmopressin was compared with indomethacin alone in the management of renal colic.Included in the study were 124 patients with initial diagnosis of renal colic and randomized to receive indomethacin suppository (100 mg) with either desmopressin intranasal spray (4 puffs, total dose of 40 micrograms) and or placebo intranasal spray.All the included patients were finally diagnosed with renal colic. There was no difference between the two groups in pain at the baseline (p = 0.4

2019 EvidenceUpdates

18. Peripheral nerve ablation for limb pain

Peripheral nerve ablation for limb pain Final Peripheral nerve ablation for limb pain: findings and decision Page 1 of 9 Health Technology Clinical Committee Findings and Decision Topic: Peripheral nerve ablation for limb pain Meeting date: January 18, 2019 Final adoption: May 17, 2019 Meeting materials and transcript are available on the HTA website. Number and coverage topic: 20190118B – Peripheral nerve ablation for limb pain HTCC coverage determination: Peripheral nerve ablation, using any (...) technique, to treat limb pain including for knee, hip, foot, or shoulder due to osteoarthritis or other conditions, is not a covered benefit for adults and children. HTCC reimbursement determination: Limitations of coverage: N/A Non-covered indicators: N/A Agency contact information: Agency Phone Number Labor and Industries 1-800-547-8367 Public Employees Health Plan 1-800-200-1004 Washington State Medicaid 1-800-562-3022 WA - Health Technology Assessment May 17, 2019 Final Peripheral nerve ablation

2019 Washington Health Care Authority

19. Is Low-Dose Ketamine an Effective Alternative to Opioids for Acute Pain?

Is Low-Dose Ketamine an Effective Alternative to Opioids for Acute Pain? Is Low-Dose Ketamine an Effective Alternative to Opioids for Acute Pain? - Annals of Emergency Medicine Email/Username: Password: Remember me Search Terms Search within Search Share this page Access provided by Volume 73, Issue 5, Pages e47–e49 Is Low-Dose Ketamine an Effective Alternative to Opioids for Acute Pain? x Jonathan M. Kirschner , MD (EBEM Commentator) , x Benton R. Hunter , MD (EBEM Commentator) Department (...) of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN DOI: | Publication History Published online: December 11, 2018 Expand all Collapse all Article Outline Take-Home Message In adult emergency department (ED) patients with acute pain, low-dose intravenous ketamine (0.3 to 0.5 mg/kg) may provide pain relief within 10 minutes that is similar to that of single-dose intravenous morphine (0.1 mg/kg). Methods Data Sources A medical librarian searched MEDLINE, EMBASE, Scopus, Cochrane

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2019 Annals of Emergency Medicine Systematic Review Snapshots

20. Comparison of intravenous NSAIDs and trigger point injection for low back pain in ED: A prospective randomized study

Comparison of intravenous NSAIDs and trigger point injection for low back pain in ED: A prospective randomized study Low back pain (LBP) is a common complaint originating from muscles Myofascial pain syndrome (MPS) is mainly associated with trigger points (TrP) in the muscle tissue. We compared the intravenously administered non-steroidal anti-inflammatory drug (NSAID) and trigger point injection (TPI) in the treatment of LBP patients admitted to the emergency department due to pain caused (...) by TrPs.After randomization, NSAID was administered intravenously in group 1 and TPIs were performed as specified by Travell and Simons in group 2. The TrPs were identified with the anamnesis and physical examination Demographic characteristics and vital signs of the patients were recorded. Pain scores were measured with the Visual Analogue Scale (VAS) at admission; and in minutes 5, 10, 15, 30, and 60.There were 32 patients in group 1 and 22 patients in group 2. The demographics, vital signs, and pain

2019 EvidenceUpdates