Latest & greatest articles for pain

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This page lists the very latest high quality evidence on pain and also the most popular articles. Popularity measured by the number of times the articles have been clicked on by fellow users in the last twelve months.

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Top results for pain

3381. Brief courses of palliative radiotherapy for metastatic bone pain: a pilot cost-minimization comparison with narcotic analgesics

Brief courses of palliative radiotherapy for metastatic bone pain: a pilot cost-minimization comparison with narcotic analgesics Brief courses of palliative radiotherapy for metastatic bone pain: a pilot cost-minimization comparison with narcotic analgesics Brief courses of palliative radiotherapy for metastatic bone pain: a pilot cost-minimization comparison with narcotic analgesics Macklis R M, Cornelli H, Lasher J Record Status This is a critical abstract of an economic evaluation that meets (...) the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology The use of palliative radiotherapy for metastatic bone pain. The study did not include a clearly defined comparator. The outcomes were measured before and after the treatment. The costs were compared with the published costs for narcotic pain regimens. Type

1998 NHS Economic Evaluation Database.

3382. Health economic assessment of behavioural rehabilitation in chronic low back pain: a randomised clinical trial

Health economic assessment of behavioural rehabilitation in chronic low back pain: a randomised clinical trial Health economic assessment of behavioural rehabilitation in chronic low back pain: a randomised clinical trial Health economic assessment of behavioural rehabilitation in chronic low back pain: a randomised clinical trial Goossens M E, Rutten-van Molken M P, Kole-Snijders A M, Vlaeyen J W, Van Breukelen G, Leidl R Record Status This is a critical abstract of an economic evaluation (...) that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology Behavioural rehabilitation programmes of chronic low back pain: OPCON (operant programme with cognitive programme/relaxation), OPDIM (operant programme with a group discussion treatment) and USUAL (operant rehabilitation as usual). Type of intervention

1998 NHS Economic Evaluation Database.

3383. Acupuncture for back pain: a meta-analysis of randomized controlled trials

Acupuncture for back pain: a meta-analysis of randomized controlled trials Acupuncture for back pain: a meta-analysis of randomized controlled trials Acupuncture for back pain: a meta-analysis of randomized controlled trials Ernst E, White A R Authors' objectives To perform a meta-analysis of trials of acupuncture for the treatment of back pain. Searching The following databases were searched: MEDLINE from 1969 to 1996, the Cochrane Controlled Trials Register (Issue 1, 1997), and CISCOM (...) (November 1996), a database specialising in complementary medicine, including much of the "grey literature", such as unpublished studies and conference reports. Searches were performed using the keywords acupuncture, electroacupuncture, and backache and textword searches for the above terms together with low back pain and lumbago. The authors' files of published articles were screened and several experts in different countries were invited to contribute published studies on the topic. The bibliographies

1998 DARE.

3384. Electrical spinal-cord stimulation for painful diabetic peripheral neuropathy. (Abstract)

Electrical spinal-cord stimulation for painful diabetic peripheral neuropathy. Conventional treatment for painful peripheral diabetic neuropathy is largely symptomatic and often ineffective, with unacceptable side-effects. We tested electrical spinal-cord stimulation for the management of chronic neuropathic pain.Ten diabetic patients who did not respond to conventional treatment (mean age 51 [SD 9.3] years, six with type II diabetes, mean duration of diabetes 12 [6.3] years, mean duration (...) of neuropathy 5 [2.1] years) were studied. The electrode was implanted in the thoracic/lumbar epidural space. Immediate neuropathic pain relief was assessed by visual analogue scale (VAS) after connecting the electrode, in a random order, to a percutaneous electrical stimulator or to a placebo stimulator. Exercise tolerance was assessed on a treadmill.Eight subjects had statistically significant pain relief with the electrical stimulator (p < 0.02) and were therefore converted to a permanent system

1997 Lancet Controlled trial quality: uncertain

3385. Randomised double-blind active-placebo-controlled crossover trial of intravenous fentanyl in neuropathic pain. (Abstract)

Randomised double-blind active-placebo-controlled crossover trial of intravenous fentanyl in neuropathic pain. The effectiveness of opioid analgesics in non-cancer neuropathic pain is unpredictable and can be disappointing. It is not clear whether opioids, when effective, relieve pain by decreasing pain intensity or pain unpleasantness or by their sedative effect. The aim of this prospective randomised double-blind placebo-controlled crossover trial was to assess relief of pain intensity (...) and pain unpleasantness with intravenous infusions of fentanyl.We compared the analgesic effect of intravenous dose titration of fentanyl with diazepam (active placebo) or saline (inert placebo) in 53 patients with different types of neuropathic pain. Patients were randomly assigned two consecutive infusions: fentanyl plus diazepam (27 patients) or fentanyl plus saline (26 patients). Study medication was infused at a constant rate for a maximum of 5 h. Pain, sedation, and side-effects were assessed

1997 Lancet Controlled trial quality: predicted high

3386. Efficacy and safety of lidocaine-prilocaine cream for pain during circumcision. (Abstract)

Efficacy and safety of lidocaine-prilocaine cream for pain during circumcision. Neonatal circumcision is a painful surgical procedure often performed without analgesia. We assessed the efficacy and safety of 5 percent lidocaine-prilocaine cream (Emla) in neonates undergoing circumcision.We carried out a double-blind, randomized, controlled trial in 68 full-term male neonates: 38 were assigned to receive lidocaine-prilocaine cream, and 30 to receive placebo. One gram of lidocaine-prilocaine (...) cream is efficacious and safe for the prevention of pain from circumcision in neonates.

1997 NEJM Controlled trial quality: predicted high

3387. Effect of neonatal circumcision on pain response during subsequent routine vaccination. Full Text available with Trip Pro

Effect of neonatal circumcision on pain response during subsequent routine vaccination. Preliminary studies suggested that pain experienced by infants in the neonatal period may have long-lasting effects on future infant behaviour. The objectives of this study were to find out whether neonatal circumcision altered pain response at 4-month or 6-month vaccination compared with the response in uncircumcised infants, and whether pretreatment of circumcision pain with lidocaine-prilocaine cream (...) (Emla) affects the subsequent vaccination response.We used a prospective cohort design to study 87 infants. The infants formed three groups--uncircumcised infants, and infants who had been randomly assigned Emla or placebo in a previous clinical trial to assess the efficacy of Emla cream as pretreatment for pain in neonatal circumcision. Infants were videotaped during vaccination done at the primary care physician's clinic. Videotapes were scored without knowledge of circumcision or treatment status

1997 Lancet Controlled trial quality: uncertain

3388. Costs of an emergency department-based accelerated diagnostic protocol vs hospitalization in patients with chest pain: a randomized controlled trial. (Abstract)

Costs of an emergency department-based accelerated diagnostic protocol vs hospitalization in patients with chest pain: a randomized controlled trial. More than 3 million patients are hospitalized yearly in the United States for chest pain. The cost is over $3 billion just for those found to be free of acute disease. New rapid diagnostic tests for acute myocardial infarction (AMI) have resulted in the proliferation of accelerated diagnostic protocols (ADPs) and chest pain observation units.To (...) African American and Hispanic population.A sample of 165 patients was randomly selected from a larger consecutive sample of 429 patients with chest pain concurrently enrolled in an ADP diagnostic cohort trial. Eligible patients presented to the ED with clinical findings suggestive of AMI or acute cardiac ischemia (ACI) but at low risk using a validated predictive algorithm.Primary outcomes measured for each subject were LOS and total cost of treatment.The hospital admission rate for ADP vs control

1997 JAMA Controlled trial quality: uncertain

3389. Randomised trial of epidural bupivacaine and morphine in prevention of stump and phantom pain in lower-limb amputation. (Abstract)

Randomised trial of epidural bupivacaine and morphine in prevention of stump and phantom pain in lower-limb amputation. Epidural analgesia before limb amputation is commonly used to reduce postamputation pain. But there have been no controlled studies with large numbers of patients to prove such a pre-emptive effect. We investigated whether postamputation stump and phantom pain in the first year is reduced by preoperative epidural blockade with bupivacaine and morphine.In a randomised, double (...) -blind trial, 60 patients scheduled for lower-limb amputation were randomly assigned epidural bupivacaine (0.25% 4-7 mL/h) and morphine (0.16-0.28 mg/h) for 18 h before and during the operation (29 patients; blockade group) or epidural saline (4-7 mL/h) and oral or intramuscular morphine (31 patients; control group). All patients had general anaesthesia for the amputation and were asked about stump and phantom pain after 1 week and then after 3, 6, and 12 months by two independent examiners. Study

1997 Lancet Controlled trial quality: predicted high

3390. Randomised trial of oral morphine for painful episodes of sickle-cell disease in children. (Abstract)

Randomised trial of oral morphine for painful episodes of sickle-cell disease in children. Oral controlled-release morphine can provide effective analgesia through a non-invasive route and may facilitate outpatient management of severe episodes of sickle-cell pain. We compared the clinical efficacy and safety of oral morphine with continuous intravenous morphine in children with severe episodes of sickle-cell pain, by a double-blind, randomised, parallel-group design.56 children aged 5-17 years (...) received loading doses of intravenous morphine of up to 0.15 mg/kg, followed by randomly assigned oral morphine 1.9 mg/kg every 12 h plus intravenous placebo (saline), or intravenous morphine 0.04 mg kg-1 h-1, plus placebo tablet. Breakthrough pain was treated with oral, immediate-release morphine 0.4 mg/kg every 2-3 h as required. Pain was assessed daily at 0900 h, 1300 h, 1700 h, and 2100 h with a picture face scale, a pictorial scale (Oucher), a behavioural-observational scale (CHEOPS

1997 Lancet Controlled trial quality: predicted high

3391. In-patient vs out-patient pain management programmes that adopt a cognitive behavioural approach

In-patient vs out-patient pain management programmes that adopt a cognitive behavioural approach In-patient vs out-patient pain management programmes that adopt a cognitive behavioural approach In-patient vs out-patient pain management programmes that adopt a cognitive behavioural approach Evans R Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database (...) . Citation Evans R. In-patient vs out-patient pain management programmes that adopt a cognitive behavioural approach. Southampton: Wessex Institute for Health Research and Development (WIHRD) 1997 Authors' objectives The author aims to determine whether in-patient pain management centres that adopt a behavioural approach confer any benefit over out-patient therapy that adopt similar practices. Authors' conclusions The author concludes that the evidence of effectiveness and cost-utility ratio described

1997 Health Technology Assessment (HTA) Database.

3392. Systematic review of outpatient services for chronic pain control

Systematic review of outpatient services for chronic pain control Systematic review of outpatient services for chronic pain control Systematic review of outpatient services for chronic pain control McQuay HJ, Moore RA, Eccleston C, Morley S, de C Williams AC Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation McQuay HJ, Moore RA, Eccleston C (...) , Morley S, de C Williams AC. Systematic review of outpatient services for chronic pain control. Health Technology Assessment 1997; 1(6): 1-137 Authors' objectives This report reviews the evidence about the effectiveness of treatments for chronic pain. While treatment of chronic pain is usually seen as an integrated service, this report concentrates on the individual interventions that constitute the service. Authors' conclusions The findings show that there is excellent evidence of effectiveness

1997 Health Technology Assessment (HTA) Database.

3393. A systematic review of controlled clinical trials on the prevention of back pain in industry

A systematic review of controlled clinical trials on the prevention of back pain in industry A systematic review of controlled clinical trials on the prevention of back pain in industry A systematic review of controlled clinical trials on the prevention of back pain in industry van Poppel M N, Koes B W, Smid T, Bouter L M Authors' objectives To evaluate the effectiveness of education, exercise, and lumbar supports in the prevention of back pain in industry. Searching Trials were identified (...) by searching MEDLINE (from 1966 to 1996), ERIC (from 1966 to 1996), EMBASE (from 1988 to 1996) and PsycLIT (from 1984 to 1996) using the following keywords: 'back pain', 'backache', 'musculo-skeletal diseases', 'orthoses', 'exercise', 'education', 'prevention', and 'controlled trial'. Studies reported in any language were considered. The bibliographies of the identified papers were also examined for additional studies. Abstracts and unpublished data were excluded. Study selection Study designs

1997 DARE.

3394. Potential cost effectiveness of initial myocardial perfusion imaging for assessment of emergency department patients with chest pain

Potential cost effectiveness of initial myocardial perfusion imaging for assessment of emergency department patients with chest pain Potential cost effectiveness of initial myocardial perfusion imaging for assessment of emergency department patients with chest pain Potential cost effectiveness of initial myocardial perfusion imaging for assessment of emergency department patients with chest pain Radensky P W, Hilton T C, Fulmer H, McLaughlin B A, Stowers S A Record Status This is a critical (...) abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology Initial single-photon emission computed tomography (SPECT) myocardial perfusion imaging using technetium-99m sestamibi in the evaluation of emergency department patients with chest pain. Type of intervention Diagnosis

1997 NHS Economic Evaluation Database.

3395. Systematic reviews of bed rest and advice to stay active for acute low back pain

Systematic reviews of bed rest and advice to stay active for acute low back pain Systematic reviews of bed rest and advice to stay active for acute low back pain Systematic reviews of bed rest and advice to stay active for acute low back pain Waddell G, Feder G, Lewis M Authors' objectives To review all randomised controlled trials (RCTs) of the effectiveness of bed rest and advice to stay active for acute back pain. Two reviews were presented, one for each intervention. Searching MEDLINE (...) and EMBASE were searched from 1966 to April 1996 using the search terms 'back-pain' or 'low back pain' and 'randomised-controlled-trial' or 'controlled-clinical-trial'.'Bed-rest' was used to search for studies where bed rest was one treatment arm. Citations were tracked with no time limit from these trials and previous reviews using the Science Citation Index, the Social Sciences Citation Index, and a personal bibliography. Additional published and unpublished studies were identified through

1997 DARE.

3396. Does pancreatic enzyme supplementation reduce pain in patients with chronic pancreatitis: a meta-analysis

Does pancreatic enzyme supplementation reduce pain in patients with chronic pancreatitis: a meta-analysis Does pancreatic enzyme supplementation reduce pain in patients with chronic pancreatitis: a meta-analysis Does pancreatic enzyme supplementation reduce pain in patients with chronic pancreatitis: a meta-analysis Brown A, Hughes M, Tenner S, Banks P A Authors' objectives To determine whether pancreatic enzyme supplements significantly decrease abdominal pain in patients with chronic (...) pancreatitis. Searching MEDLINE was searched for English language studies using the keywords 'pancreatic enzyme supplements', 'pain', and a combination of these terms. Study selection Study designs of evaluations included in the review Prospective, randomised double-blind placebo-controlled trials (RCTs), which evaluated the usage of pancreatic enzymes for the relief of pain in patients with chronic pancreatitis, were included. The duration of the studies ranged from 2 weeks to 8 months. Specific

1997 DARE.

3397. Conservative treatment of acute and chronic nonspecific low back pain: a systematic review of randomized controlled trials of the most common interventions

Conservative treatment of acute and chronic nonspecific low back pain: a systematic review of randomized controlled trials of the most common interventions Conservative treatment of acute and chronic nonspecific low back pain: a systematic review of randomized controlled trials of the most common interventions Conservative treatment of acute and chronic nonspecific low back pain: a systematic review of randomized controlled trials of the most common interventions van Tulder M W, Koes B W (...) , Bouter L M Authors' objectives To assess the effectiveness of the most common conservative types of treatment for patients with acute and chronic nonspecific lower-back pain (LBP). Searching MEDLINE was searched from 1966 to September 1995, EMBASE from 1980 to September 1995, and PsycLIT from 1984 to September 1995; the search terms were provided. The bibliographies of identified studies were examined. Only English language publications were selected. Study selection Study designs of evaluations

1997 DARE.

3398. Randomized controlled trials in industrial low back pain. Part 3: subacute/chronic pain interventions

Randomized controlled trials in industrial low back pain. Part 3: subacute/chronic pain interventions Randomized controlled trials in industrial low back pain. Part 3: subacute/chronic pain interventions Randomized controlled trials in industrial low back pain. Part 3: subacute/chronic pain interventions Scheer S J, Watanabe T K, Radack K L Authors' objectives To assess the effectiveness of interventions for subacute and chronic industrial lower-back pain for facilitating return to work (...) . Searching MEDLINE, PsycINFO, REHABDATA, CINAHL and Dissertation Abstracts were searched from 1975 to 1993 for studies published in English, using the descriptors 'back pain' and 'low back pain'. Study selection Study designs of evaluations included in the review Randomised controlled trials (RCTs) were included. Specific interventions included in the review Exercise; cognitive and behavioural strategies; back school; lumbar facet injections of bupivicaine and methylprednisolone; a rigid corset

1997 DARE.

3399. A critical review of controlled clinical trials for peripheral neuropathic pain and complex regional pain syndromes

A critical review of controlled clinical trials for peripheral neuropathic pain and complex regional pain syndromes A critical review of controlled clinical trials for peripheral neuropathic pain and complex regional pain syndromes A critical review of controlled clinical trials for peripheral neuropathic pain and complex regional pain syndromes Kingery W S Authors' objectives The purpose was to summarise controlled trial data for Peripheral Neuropathic Pain (PNP) and Complex Regional Pain (...) controlled trials with similar methodology and adequate data, but with contradictory results. 4) Identify potential flaws in design and differences in methods between PNP and CRPS trials. 5) Determine what treatments were used in both PNP and CRPS trials and if there were treatment outcome differences specific to these diagnoses. Searching The initial sources searched were the references of 7 recent review articles on neuropathic pain and CRPS (dates ranging from 1993 to 1996). This was followed

1997 DARE.

3400. Systematic review of outpatient services for chronic pain control

Systematic review of outpatient services for chronic pain control Systematic review of outpatient services for chronic pain control Systematic review of outpatient services for chronic pain control McQuay H J, Moore R A, Eccleston C, Morley S, De C Williams A C Authors' objectives To review the evidence for the effectiveness of treatments for chronic back pain, concentrating on the individual interactions that constitute the service. Searching MEDLINE (from 1966 to 1997), EMBASE, Cochrane (...) blockade; epidural corticosteroids; injections of corticosteroids; spinal cord stimulators. Pharmacological interventions: minor analgesics; anticonvulsant and antidepressant drugs; systemic local anaesthetic-type drugs; topical non-steroidal anti-inflammatory drugs (NSAIDs); topical capsaicin. Psychological approaches: cognitive-behavioural therapies. Participants included in the review Patients with acute and chronic back pain were included. Outcomes assessed in the review The outcome measure

1997 DARE.