Effectiveness and Safety of CGRP-mAbs in Menstrual-Related Migraine: A Real-World Experience
AbstractIntroductionMigraine shows a significantly higher prevalence in women, especially during reproductive age when menstrual-related hormonal fluctuations represent the most common migraine trigger. Indeed, over 50% of patients report a higher occurrence of migraine attacks during the perimenstrual window. Menstrual migraine attacks are consistently referred to as more disabling, less responsive to symptomatic treatments, longer in duration, and more prone to relapse than non-menstrual migraine attacks. Evidence strongly suggests that estrogen fluctuations are involved in migraine attacks worsening during the perimenst...
Source: Pain and Therapy - June 9, 2021 Category: Anesthesiology Source Type: research

A Comparison of 1000  Hz to 30 Hz Spinal Cord Stimulation Strategies in Patients with Unilateral Neuropathic Leg Pain Due to Failed Back Surgery Syndrome: A Multicenter, Randomized, Double-Blinded, Crossover Clinical Study (HALO)
AbstractIntroductionMulticenter, randomized, double-blinded crossover study. The Netherlands (ClinicalTrials.gov NCT02112474). We hypothesized that the pain suppressive effects of 1000  Hz and 30 Hz spinal cord stimulation (SCS) strategies are equally effective in patients with chronic, neuropathic, unilateral leg pain after back surgery.MethodsThirty-two patients (18 –70 years, minimum leg pain 50 mm on 100 mm visual analog scale (VAS), minimal back pain) were randomized (1:1) to start 1000 Hz or 30 Hz neurostimulation for 9 days. After a 5-day washout, they crossed over, for ...
Source: Pain and Therapy - June 6, 2021 Category: Anesthesiology Source Type: research

The Italian Questionnaire for Cancer Breakthrough Pain Diagnosis, a Multicenter Validation Study
ConclusionsThe IQ-BTP extensive formal validation showed satisfactory psychometric and validity properties. Its content, face, construct, and criterion validities and its reliability, interpretability, and responsiveness were shown. Its use enabled potential-BTcP to be identified and differentiated into three likelihood classes with direct therapeutic and epidemiological implications. The latter may be confirmed in future studies. (Source: Pain and Therapy)
Source: Pain and Therapy - June 6, 2021 Category: Anesthesiology Source Type: research

Cluster Headache is Still Lurking in the Shadows
AbstractCluster headache, apart from its legendary reputation as the most violent headache that can exist, suffers from an average 60-month delay in diagnosis. The simplicity of the clinical manifestations, although dramatic, makes this delay inexplicable. The education of emergency department physicians and various specialists not specifically dedicated to headaches allows cluster headache to remain in a lurking position with flourishing periods of disease that are often unpredictable in both onset and disappearance. Older drugs have always shown high efficacy but also an equally high rate of adverse events, often discour...
Source: Pain and Therapy - June 6, 2021 Category: Anesthesiology Source Type: research

Preemptive Intravenous Nalbuphine for the Treatment of Post-Operative Visceral Pain: A Multicenter, Double-Blind, Placebo-Controlled, Randomized Clinical Trial
ConclusionsPreemptive nalbuphine administered at a dose of 0.2  mg·kg−1 was safe and effective at reducing the postoperative visceral pain and supplemental analgesic use in patients undergoing laparoscopic cholecystectomy.Trial RegistrationChinese Clinical Trial Registry; ChiCTR1800014379. (Source: Pain and Therapy)
Source: Pain and Therapy - June 4, 2021 Category: Anesthesiology Source Type: research

Impact and Consequences of Opioid-Induced Constipation: A Survey of Patients
ConclusionOur results provide additional evidence that management of OIC is inadequate in many cases. Moreover, they indicate that there is a definite need for better education about OIC among HCPs. (Source: Pain and Therapy)
Source: Pain and Therapy - June 3, 2021 Category: Anesthesiology Source Type: research

Failure of SCS MR-Conditional Modes Due to High Impedance: A Review of Literature and Case Series
ConclusionThis case series highlights the need for further investigation of impedance in SCS systems and potential limitations for future MRI usage. The review of literature of impedance in SCS shows both device- and physiologic-related etiologies for changes in impedance that warrant consideration by the implanting physician. (Source: Pain and Therapy)
Source: Pain and Therapy - May 14, 2021 Category: Anesthesiology Source Type: research

Phenotype of Cluster Headache: Clinical Variability, Persisting Pain Between Attacks, and Comorbidities —An Observational Cohort Study in 825 Patients
ConclusionsThe variability of the phenotype of cluster headaches can preclude some patients from receiving an appropriate diagnosis and effective therapy if the diagnostic criteria applied are too strict. The occurrence of persisting pain between attacks should also be diagnostically evaluated due to its high prevalence and severity as well as psychological strain. When treating patients with cluster headaches, accompanying psychological illnesses should carefully be taken into account. (Source: Pain and Therapy)
Source: Pain and Therapy - May 4, 2021 Category: Anesthesiology Source Type: research

The Role of Nutrient Supplementation in the Management of Chronic Pain in Fibromyalgia: A Narrative Review
ConclusionsThe etiology of FM is complex, and has shown to be multi-factorial with genetics and environmental exposures lending influence into its development. Preliminary results are promising, however, much of the existing evidence regarding diet supplementation is of poor quality. Further, more robust studies are needed to fully elucidate the potential of this alternative therapeutic option. (Source: Pain and Therapy)
Source: Pain and Therapy - April 28, 2021 Category: Anesthesiology Source Type: research

Real-World Evidence for Control of Chronic Migraine Patients Receiving CGRP Monoclonal Antibody Therapy Added to OnabotulinumtoxinA: A Retrospective Chart Review
ConclusionsIn this real-world study, combination treatment with onabotulinumtoxinA and CGRP mAbs was well tolerated, with no new safety signals identified, and was associated with additional clinically meaningful benefits. More real-world and controlled trials should be considered to further assess safety and potential benefits of combination treatment. (Source: Pain and Therapy)
Source: Pain and Therapy - April 21, 2021 Category: Anesthesiology Source Type: research

Management of Osteoarthritis: Expert Opinion on NSAIDs
AbstractOsteoarthritis (OA) is a leading cause of disability among older adults worldwide. Treatment aims are to alleviate inflammatory pain and improve physical function through non-pharmacological and pharmacological interventions. Non-steroidal anti-inflammatory drugs (NSAIDs) are recommended as first-line therapy. However, selection is challenged by patient age, comorbidities and polypharmacy, and by the drug ’s benefit/risk balance, all of which together influence the risk of cardiovascular (CV), gastrointestinal (GI) and renal adverse events (AEs). While the efficacy profile of the various NSAIDs is delineated,...
Source: Pain and Therapy - April 19, 2021 Category: Anesthesiology Source Type: research

Acute Pain Predictors of Remote Postoperative Pain Resolution After Hand Surgery
This study compared acute pain descriptors among patients undergoing carpal tunnel release (CTR) or trigger finger release (TFR). We hypothesized worst pain intensity on postoperative day (POD) 10 would be best to predict the time to pain resolution.MethodsIn this secondary analysis of a negative, randomized, double-blind placebo-controlled trial, adult veterans undergoing CTR or TFR were enrolled January 2012 –January 2014, with data analysis February 2020–October 2020. Participants were randomized to receive minocycline 200 mg or placebo 2 h prior to the operation, then minocycline 100 mg or placebo...
Source: Pain and Therapy - April 18, 2021 Category: Anesthesiology Source Type: research

Analgesic Effects of Navigated Repetitive Transcranial Magnetic Stimulation in Patients With Acute Central Poststroke Pain
AbstractIntroductionCentral poststroke pain (CPSP) develops commonly after stroke, which impairs the quality of life, mood, and social functioning. Current pharmacological approaches for the treatment of CPSP are not satisfactory. Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive technique which has been recommended for the treatment of chronic CPSP. However, few studies have evaluated the analgesic effects of rTMS in patients with acute neuropathic pain after stroke.MethodsWe evaluated the analgesic effects of rTMS applied over the upper extremity area of the motor cortex (M1) in patients with acute CPS...
Source: Pain and Therapy - April 17, 2021 Category: Anesthesiology Source Type: research

Switching From Pregabalin to Mirogabalin in Patients with Peripheral Neuropathic Pain: A Multi-Center, Prospective, Single-Arm, Open-Label Study (MIROP Study)
AbstractIntroductionMirogabalin, which is a selective ligand of the α2δ subunit of voltage-gated Ca2+ channels, was recently approved in Japan for peripheral neuropathic pain. The α2δ ligands, including mirogabalin and pregabalin, are associated with significant risk of adverse events (AEs) such as somnolence or dizziness, leading to poor compliance and subsequent inefficacy. Safety and efficacy data for switching patients from pregabalin to mirogabalin are scarce.MethodsThis prospective, single-arm, open-label study involving ten participating centers in Japan recruited patients aged  ≥&t...
Source: Pain and Therapy - April 15, 2021 Category: Anesthesiology Source Type: research

Psychosocial, Functional, and Emotional Correlates of Long-Term Opioid Use in Patients with Chronic Back Pain: A Cross-Sectional Case –Control Study
AbstractIntroductionThe opiate epidemic has severe medical and social consequences. Opioids are commonly prescribed in patients with chronic pain, and are a main contributor to the opiate epidemic. The adverse effects of long-term opioid usage have been studied primarily in dependence/addiction disorders, but not in chronic pain. Here, we examine the added iatrogenic effects, psychology, and brain morphology of long-term opioid use in matched patients with chronic pain with and without opioid use (case –controlled design).MethodsWe compared psychosocial, functional, and psychological measures between patients with ch...
Source: Pain and Therapy - April 12, 2021 Category: Anesthesiology Source Type: research

Correction to: Machine Learning Algorithm Guiding Local Treatment Decisions to Reduce Pain for Lung Cancer Patients with Bone Metastases, a Prospective Cohort Study
In the original publication, authorship equal contribution note was missing. (Source: Pain and Therapy)
Source: Pain and Therapy - April 11, 2021 Category: Anesthesiology Source Type: research

Ultrasound-Guided Continuous Thoracic Paravertebral Infusion of Methylene Blue in the Treatment of Postherpetic Neuralgia: A Prospective, Randomized, Controlled Study
ConclusionsUltrasound-guided continuous thoracic paravertebral infusion with MB is a safe and effective therapy for PHN. Continuous infusion with MB can significantly reduce pain intensity, improve pain-related depression, increase quality of life, and decrease the amount of rescue medicine with no serious adverse complications. (Source: Pain and Therapy)
Source: Pain and Therapy - April 11, 2021 Category: Anesthesiology Source Type: research

Does Inhaled Methoxyflurane Implement Fast and Efficient Pain Management in Trauma Patients? A Systematic Review and Meta-Analysis
This study aimed to determine the efficacy and safety of inhaled methoxyflurane for trauma pain on the basis of published randomized controlled trials (RCTs).MethodsRCTs assessing the efficacy of methoxyflurane in adults or adolescents with acute trauma pain published in PubMed, Web of Science, Embase, Cochrane Library, and Google Scholar were searched. The control groups were those that received placebo or standard analgesic treatment (SAT). The primary outcome was the change from baseline in pain scores during the first 30  min of treatment. Secondary outcomes included time to first pain relief, the proportion of pa...
Source: Pain and Therapy - April 10, 2021 Category: Anesthesiology Source Type: research

Correction to: Food for Special Medical Purposes and Nutraceuticals for Pain: A Narrative Review
One of the author names Giustino Varrassi was erroneously omitted in the original publication. (Source: Pain and Therapy)
Source: Pain and Therapy - April 9, 2021 Category: Anesthesiology Source Type: research

Postoperative Analgesic Efficacy of Erector Spinae Plane Block in Patients Undergoing Lumbar Spinal Surgery: A Systematic Review and Meta-Analysis
AbstractLumbar spine surgery is one of the most widespread types of surgery for treating back and leg pain. However, the postoperative period always presents with severe pain due to the removal of skin, subcutaneous tissues, bones, and ligaments. Patients usually require high doses of opioids to relieve pain during the initial three days after operation, as well as experience drug-related complications and prolonged length of stay in hospital. We found that Erector spinae plane block significantly reduced postoperative opioid consumption and pain scores. The present systematic review revealed that ESPB was effective and sa...
Source: Pain and Therapy - April 7, 2021 Category: Anesthesiology Source Type: research

Early Management of OnabotulinumtoxinA Treatment in Chronic Migraine: Insights from a Real-Life European Multicenter Study
AbstractIntroductionOnabotulinumtoxinA (BT-A) quarterly was the first treatment approved specifically for chronic migraine (CM). It is unclear whether three cycles are better than two to assess early BT-A response.MethodsWe performed a retrospective analysis on real-life prospectively collected data in 16 European headache centers. All the centers provided data on patients treated with BT-A for CM over the first three cycles of treatment. For each treatment cycle we defined patients as “good responders” if reporting a ≥ 50% reduction in monthly headache days compared with the three months befor...
Source: Pain and Therapy - March 28, 2021 Category: Anesthesiology Source Type: research

CDC ’s Efforts to Quantify Prescription Opioid Overdose Deaths Fall Short
AbstractIn a 2018 report titled,Quantifying the Epidemic of Prescription Opioid Overdose Deaths, four senior analysts of the Centers for Disease Control and Prevention (CDC), including the head of the Epidemiology and Surveillance Branch, acknowledged for the first time that the number of prescription opioid overdose deaths reported by the CDC in 2016 was erroneous. The error, they said, was caused by miscoding deaths involving illicitly manufactured fentanyl (IMF) as deaths involving prescribed fentanyl. To understand what caused this error, the authors examined the CDC ’s methodology for compiling drug-related mort...
Source: Pain and Therapy - March 24, 2021 Category: Anesthesiology Source Type: research

Analgesic Effect of Noninvasive Brain Stimulation for Neuropathic Pain Patients: A Systematic Review
ConclusionsOur systematically reviewed the evidence for positive and negative responses to rTMS and tDCS for NP patient care and underscores the analgesic efficacy of NIBS in patients with NP. The treatment of NP should allow the design of optimal treatments for individual patients. (Source: Pain and Therapy)
Source: Pain and Therapy - March 22, 2021 Category: Anesthesiology Source Type: research

Machine Learning Algorithm Guiding Local Treatment Decisions to Reduce Pain for Lung Cancer Patients with Bone Metastases, a Prospective Cohort Study
AbstractIntroductionAs life expectancy increases for lung cancer patients with bone metastases, the need for personalized local treatment to reduce pain is expanding.MethodsPatients were treated by a multidisciplinary team (MDT), and local treatment including surgery, percutaneous osteoplasty, or radiation. Visual analog scale (VAS) and quality of life (QoL) scores were analyzed. VAS at 12  weeks after treatment was the main outcome. We developed and tested machine learning models to predict which patients should receive local treatment. Model discrimination was evaluated by the area under curve (AUC), and the best mo...
Source: Pain and Therapy - March 19, 2021 Category: Anesthesiology Source Type: research

Personalizing Cancer Pain Therapy: Insights from the Rational Use of Analgesics (RUA) Group
ConclusionThese findings may assist clinicians in applying clinical evidence to routine care settings and call for a reappraisal of current pain treatment recommendations with the final aim of optimizing the clinical use of strong opioids in patients with cancer. (Source: Pain and Therapy)
Source: Pain and Therapy - March 17, 2021 Category: Anesthesiology Source Type: research

Pain in Women: A Perspective Review on a Relevant Clinical Issue that Deserves Prioritization
DiscussionResearch is needed into the pathophysiological basis for gender differences in the generation of acute pain and maintenance of chronic pain, including the factors that put women at higher risk for developing chronic pain. In addition, different specialties need to collaborate to develop gender-related diagnostic and therapeutic guidelines, and healthcare professionals need to upskill themselves in the appropriate management of pain using existing diagnostic tools and therapeutic options. (Source: Pain and Therapy)
Source: Pain and Therapy - March 15, 2021 Category: Anesthesiology Source Type: research

COVID-19 and the Opioid Epidemic: Two Public Health Emergencies That Intersect With Chronic Pain
AbstractThe COVID-19 pandemic has affected the entire world and catapulted the United States into one of the deepest recessions in history. While this pandemic rages, the opioid crisis worsens. During this period, the pandemic has resulted in the decimation of most conventional medical services, including those of chronic pain management, with the exception of virtual care and telehealth. Many chronic pain patients have been impacted in numerous ways, with increases in cardiovascular disease, mental health problems, cognitive dysfunction, and early death. The epidemic has also resulted in severe economic and physiological ...
Source: Pain and Therapy - March 14, 2021 Category: Anesthesiology Source Type: research

Common Clinical Practice for Low Back Pain Treatment: A Modified Delphi Study
ConclusionThe results of this study provide a summary of favored clinical practice for the management of chronic LBP. While the consensus statements were generally agreeable to survey respondents, some areas of ambiguity, including how to increase the feasibility of multidisciplinary strategies, when and how to use diagnostic imaging in LBP, and LBP classification, necessitate clarification in future studies and guidelines. (Source: Pain and Therapy)
Source: Pain and Therapy - March 13, 2021 Category: Anesthesiology Source Type: research

Comparison of Efficacy of Ketoprofen and Ibuprofen in Treating Pain in Patients with Rheumatoid Arthritis: A Systematic Review and Meta-Analysis
ConclusionsThe result of this meta-analysis shows that ketoprofen is more effective than ibuprofen in managing RA pain at therapeutic doses, thus supporting its use in clinical practice. (Source: Pain and Therapy)
Source: Pain and Therapy - March 5, 2021 Category: Anesthesiology Source Type: research

Auricular Therapy for Treating Phantom Limb Pain Accompanied by Jumping Residual Limb: A Short Review and Case Study
AbstractPhantom limb pain (PLP) is a common complaint among patients after amputation, while jumping residual limb is a rare post-amputation complication, they rarely happen at the same time and both remain difficult to manage. At present, there is a paucity of literature on this topic, and no treatment has been proven effective for treating both of them. In the present brief report, we described a patient who developed severe PLP accompanied by jumping residual limb after below-the-knee amputation and she was treated by auricular therapy (AT) with satisfactory effect. (Source: Pain and Therapy)
Source: Pain and Therapy - March 4, 2021 Category: Anesthesiology Source Type: research

Pain, Smell, and Taste in Adults: A Narrative Review of Multisensory Perception and Interaction
AbstractEvery day our sensory systems perceive and integrate a variety of stimuli containing information vital for our survival. Pain acts as a protective warning system, eliciting a response to remove harmful stimuli; it may also be a symptom of an illness or present as a disease itself. There is a growing need for additional pain-relieving therapies involving the multisensory integration of smell and taste in pain modulation, an approach that may provide new strategies for the treatment and management of pain. While pain, smell, and taste share common features and are strongly linked to emotion and cognition, their inter...
Source: Pain and Therapy - February 26, 2021 Category: Anesthesiology Source Type: research

Effect of Occipital Nerve Stimulation (ONS) on the Orbicularis Oculi Reflex Triggered by a Standardized Air Flow in Patients with Chronic Migraine —A Prospective, Randomized, Interventional Study
ConclusionsThe results show that under active ONS compared to inactive ONS in patients with chronic migraine, the orbicularis oculi reflex, dynamically triggered by a standardized air flow, is significantly reduced. This suggests that ONS is able to directly counteract the trigeminally mediated central sensitization in chronic migraine and protectively reduce the effects of aversive peripheral stimulation. (Source: Pain and Therapy)
Source: Pain and Therapy - February 25, 2021 Category: Anesthesiology Source Type: research

Nalbuphine Versus Ketorolac as an Adjuvant to Local Wound Infiltration Anesthesia in Open Colorectal Surgery: A Prospective Randomized Controlled Study
AbstractIntroductionAdding adjuvants to local wound infiltration (LWI) provides long analgesic duration with fewer adverse effects. We aimed to compare the clinical effects of nalbuphine and ketorolac as an adjuvant to LWI in patients undergoing open colorectal cancer surgery.MethodA total of 126 ASA I –III patients aged ≥ 18 years who were scheduled for open colorectal cancer surgery were included. Patients were randomly assigned to receive LWI using 10 mL 0.75% ropivacaine, with 20 mL normal saline (group R), 10 mg nalbuphine in 1 mL (group RN), or 25 mg ketorolac in 0.8&nb...
Source: Pain and Therapy - February 24, 2021 Category: Anesthesiology Source Type: research

A Retrospective, Multicenter, Quantitative Analysis of Patients ’ Baseline Pain Quality (PROMIS-29) Entering into Pain and Spine Practices in the United States (ALIGN)
ConclusionThis data set is the first published normative data set describing the PROMIS-29 assessment in the chronic pain population. The patient population is more homogeneous than expected, and females were found to have higher levels of dysfunction. (Source: Pain and Therapy)
Source: Pain and Therapy - February 23, 2021 Category: Anesthesiology Source Type: research

Continuous Wound Infiltration with Local Anesthetic Is an Effective and Safe Postoperative Analgesic Strategy: A Meta-Analysis
ConclusionCWI with local anesthetic is an effective postoperative analgesic strategy with good safety profiles in laparotomy and sternotomy surgery, and thus CWI with local anesthetic may be a promising analgesic option enhancing recovery after surgery programs for these surgeries. (Source: Pain and Therapy)
Source: Pain and Therapy - February 22, 2021 Category: Anesthesiology Source Type: research

Pain Study in X-Linked Adrenoleukodystrophy in Males and Females
ConclusionThe study of pain and of the sensory profile appears to indicate a difference in the mechanisms underlying the AMN/cAMN/cALD and AD clinical forms and in the treatment of the respective generated pain types. (Source: Pain and Therapy)
Source: Pain and Therapy - February 20, 2021 Category: Anesthesiology Source Type: research

Structural and Functional Brain Changes in Migraine
AbstractMigraine is a prevalent primary headache disorder and is usually considered as benign. However, structural and functional changes in the brain of individuals with migraine have been reported. High frequency of white matter abnormalities, silent infarct-like lesions, and volumetric changes in both gray and white matter in individuals with migraine compared to controls have been demonstrated. Functional magnetic resonance imaging (MRI) studies found altered connectivity in both the interictal and ictal phase of migraine. MR spectroscopy and positron emission tomography studies suggest abnormal energy metabolism and m...
Source: Pain and Therapy - February 16, 2021 Category: Anesthesiology Source Type: research

Food for Special Medical Purposes and Nutraceuticals for Pain: A Narrative Review
ConclusionIn our opinion, this review could be of great interest to clinicians, as it offers a complementary perspective in the management of pain. Trials with well-defined patient and symptoms selection and a robust pharmacological design are pivotal points to let these promising compounds become better accepted by the medical community. (Source: Pain and Therapy)
Source: Pain and Therapy - February 16, 2021 Category: Anesthesiology Source Type: research

Tramadol/Dexketoprofen Analgesic Efficacy Compared with Tramadol/Paracetamol in Moderate to Severe Postoperative Acute Pain: Subgroup Analysis of a Randomized, Double-Blind, Parallel Group Trial —DAVID Study
ConclusionOverall, the results of this subgroup analysis of the DAVID study confirmed the superiority of the analgesic efficacy of TRAM/DKP vs TRAM/paracetamol, irrespective of the baseline PI. (Source: Pain and Therapy)
Source: Pain and Therapy - February 11, 2021 Category: Anesthesiology Source Type: research

Management of Musculoskeletal Pain: An Update with Emphasis on Chronic Musculoskeletal Pain
AbstractMusculoskeletal pain is a challenging condition for both patients and physicians. Many adults have experienced one or more episodes of musculoskeletal pain at some time of their lives, regardless of age, gender, or economic status. It affects approximately 47% of the general population. Of those, about 39 –45% have long-lasting problems that require medical consultation. Inadequately managed musculoskeletal pain can adversely affect quality of life and impose significant socioeconomic problems. This manuscript presents a comprehensive review of the management of chronic musculoskeletal pain. It bri efly explo...
Source: Pain and Therapy - February 11, 2021 Category: Anesthesiology Source Type: research

Efficacy and Safety of Methylnaltrexone for the Treatment of Opioid-Induced Constipation: A Meta-analysis of Randomized Controlled Trials
ConclusionMethylnaltrexone is an effective and safe drug for the treatment of OIC, but the safety of abdominal pain should be considered. (Source: Pain and Therapy)
Source: Pain and Therapy - February 11, 2021 Category: Anesthesiology Source Type: research

Response to Comment on “Gabapentinoid Benefit and Risk Stratification: Mechanisms Over Myth”
(Source: Pain and Therapy)
Source: Pain and Therapy - February 9, 2021 Category: Anesthesiology Source Type: research

Letter to the Editor: Comment on “Gabapentinoid Benefit and Risk Stratification: Mechanisms Over Myth”
(Source: Pain and Therapy)
Source: Pain and Therapy - February 9, 2021 Category: Anesthesiology Source Type: research

Low Incidence of Opioid-Induced Respiratory Depression Observed with Oliceridine Regardless of Age or Body Mass Index: Exploratory Analysis from a Phase 3 Open-Label Trial in Postsurgical Pain
AbstractIntroductionAdvanced age and obesity are reported to increase the risk of opioid-induced respiratory depression (OIRD). Oliceridine, an intravenous opioid, is a G-protein-biased agonist at the µ-opioid receptor that may provide improved safety. The recent phase 3 ATHENA open-label, multicenter study evaluated postoperative use of oliceridine in patients with moderate-to-severe acute pain. This exploratory analysis of the ATHENA data examined the incidence of OIRD in older (≥ 65 year s) and/or obese (BMI ≥ 30 kg/m2) patients and analyzed risk factors of OIRD.MethodsPatients...
Source: Pain and Therapy - January 21, 2021 Category: Anesthesiology Source Type: research

The Effect of Ultrasound-Guided Erector Spinae Plane Block Combined with Dexmedetomidine on Postoperative Analgesia in Patients Undergoing Modified Radical Mastectomy: A Randomized Controlled Trial
AbstractIntroductionOne of the most common malignancies in women worldwide is breast cancer. Erector spinae plane block (ESPB) can reduce pain after modified radical mastectomy for breast cancer. The duration of nerve block analgesia is limited if local anesthetic agents are used alone. The purpose of this study was to evaluate the effect of dexmedetomidine on postoperative analgesia during a single injection of local anesthetics.MethodsIn this double-blind, randomized study, 60 female American Society of Anesthesiologists (ASA) I –II patients undergoing modified radical mastectomy were randomized into two groups: ul...
Source: Pain and Therapy - January 21, 2021 Category: Anesthesiology Source Type: research

Burden of Renal Events Associated with Nonsteroidal Anti-inflammatory Drugs in Patients with Osteoarthritis and Chronic Low Back Pain: A Retrospective Database Study
AbstractIntroductionNonsteroidal anti-inflammatory drugs (NSAIDs) have long-term benefits but are limited by side effects. We assessed the health and economic burden of renal events associated with NSAID use in patients with osteoarthritis (OA) and/or chronic low back pain (CLBP).MethodsThis retrospective, large-scale, medical claims database study of Japanese patients receiving NSAIDs for OA and/or CLBP between 2009 and 2018 assessed the incidence of renal events and effect of treatment duration, mode of administration, and usage consistency of NSAIDs.ResultsOf 180,371 patients, NSAIDs were prescribed as first-line analge...
Source: Pain and Therapy - January 13, 2021 Category: Anesthesiology Source Type: research

Cervical Proprioception Impairment in Neck Pain-Pathophysiology, Clinical Evaluation, and Management: A Narrative Review
AbstractNeck pain is very common, but most of the causes are unknown, making diagnosis and treatment extremely challenging. Current studies have found that one of the main problems in patients with neck pain is the impairment of cervical proprioception, which subsequently leads to cervical sensorimotor control disturbances. Cervical spine has a very delicate proprioceptive system that plays a crucial role in controlling posture and balance. Cervical proprioceptive impairment in neck pain occurs through a variety of mechanisms. Experimental neck muscle pain induced by injection of hypertonic saline results in inhibition of ...
Source: Pain and Therapy - January 12, 2021 Category: Anesthesiology Source Type: research

Interventional Radiofrequency Treatment for the Sympathetic Nervous System: A Review Article
ConclusionsRF treatments can be effective in carefully selected patients who are refractory to conservative management. However, further randomized controlled studies are needed prior to implementing it into common practice. (Source: Pain and Therapy)
Source: Pain and Therapy - January 12, 2021 Category: Anesthesiology Source Type: research

Effect of Single-Injection Thoracic Paravertebral Block via the Intrathoracic Approach for Analgesia After Single-Port Video-Assisted Thoracoscopic Lung Wedge Resection: A Randomized Controlled Trial
AbstractIntroductionPain is still severe after single-port video-assisted thoracoscopic (SPVAT) lung wedge resection. We observed the effect of single-injection thoracic paravertebral block (TPB) via the intrathoracic approach for analgesia after SPVAT lung wedge resection.MethodsSixty patients undergoing SPVAT lung wedge resection were randomly divided into a control group and an observation group. All patients underwent TPB via the intrathoracic approach at the T4 level with a scalp needle before closing the chest. The patients in the observation group received 20  ml 0.375% ropivacaine at the T4 level, and the pati...
Source: Pain and Therapy - January 9, 2021 Category: Anesthesiology Source Type: research

Comparison of Crude Population-Level Indicators of Opioid Use and Related Harm in New Zealand and Ontario (Canada)
AbstractNorth America and select other Commonwealth jurisdictions have been experiencing unprecedented opioid epidemics characterized by excessive and persistently high levels of opioid misuse, morbidity and mortality, and related disease burden. Recent discussions have considered whether New Zealand might undergo or needs to expect a similar ‘opioid crisis’. Towards further informing these considerations, we examine and compare essential, publicly available indicators of opioid utilization and harms (mortality) from New Zealand and the Canadian province of Ontario, due to the fact that both operate public heal...
Source: Pain and Therapy - December 31, 2020 Category: Anesthesiology Source Type: research