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Lumbar Tactile Acuity in Patients With Low Back Pain and Healthy Controls: Systematic Review and Meta-Analysis
Discussion: A gap of knowledge regarding tactile acuity in populations with acute and chronic non-neuropathic LBP needs to be addressed in future research as this may significantly help the understanding of the causality of tactile acuity alterations. (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - December 7, 2017 Category: Anesthesiology Tags: Review Article Source Type: research

Obesity Moderates the Effects of Motivational Interviewing Treatment Outcomes in Fibromyalgia
Objective: Obesity is a common comorbid condition among patients with fibromyalgia (FM). Our objective was to assess if obesity moderates the treatment benefits of exercise-based motivational interviewing (MI) for FM. Materials and Methods: This is a secondary data analysis of a completed clinical trial of 198 FM patients who were randomized to receive either MI or attention control (AC). Using body mass index (BMI) to divide participants into obese (BMI≥30 kg/m2) and nonobese (BMI (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - December 7, 2017 Category: Anesthesiology Tags: Original Articles Source Type: research

Elevated Production of Nociceptive CC Chemokines and sE-Selectin in Patients With Low Back Pain and the Effects of Spinal Manipulation: A Nonrandomized Clinical Trial
Background: The involvement of inflammatory components in the pathophysiology of low back pain (LBP) is poorly understood. It has been suggested that spinal manipulative therapy (SMT) may exert anti-inflammatory effects. Purpose: The purpose of this study was to determine the involvement of inflammation-associated chemokines (CC series) in the pathogenesis of nonspecific LBP and to evaluate the effect of SMT on that process. Methods: Patients presenting with nonradicular, nonspecific LBP (minimum pain score 3 on 10-point visual analog scale) were recruited according to stringent inclusion criteria. They were evalua...
Source: The Clinical Journal of Pain - December 7, 2017 Category: Anesthesiology Tags: Original Articles Source Type: research

Mindfulness-based Cognitive Therapy and Persistent Pain in Women Treated for Primary Breast Cancer: Exploring Possible Statistical Mediators Results From a Randomized Controlled Trial
Discussion: The results of the present study may have clinical implications. An increased focus on the proposed mediators may optimize the clinical use of MBCT for persistent pain in women treated for breast cancer. (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - December 7, 2017 Category: Anesthesiology Tags: Original Articles Source Type: research

Efficacy of Postoperative Analgesia of Local Ketamine Wound Instillation Following Total Thyroidectomy: A Randomized, Double-blind, Controlled Clinical Trial
Conclusions: Local wound ketamine instillation provided superior postoperative analgesia with lower incidence of side effects in comparison with IM ketamine and placebo following total thyroidectomy. (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - December 7, 2017 Category: Anesthesiology Tags: Original Articles Source Type: research

Preoperative Pain Neuroscience Education Combined With Knee Joint Mobilization for Knee Osteoarthritis: A Randomized Controlled Trial
This study aimed to first compare the effects of a preoperative treatment combining pain neuroscience education (PNE) with knee joint mobilization versus biomedical education with knee joint mobilization on central sensitization (CS) in patients with knee osteoarthritis, both before and after surgery. Second, we wanted to compare the effects of both interventions on knee pain, disability, and psychosocial variables. Materials and Methods: Forty-four patients with knee osteoarthritis were allocated to receive 4 sessions of either PNE combined with knee joint mobilization or biomedical education with knee joint mobilizati...
Source: The Clinical Journal of Pain - December 7, 2017 Category: Anesthesiology Tags: Original Articles Source Type: research

Orexin Receptor Antagonism in Painful Diabetic Neuropathy: A Phase 2 Trial With Filorexant
Discussion: These data do not provide evidence for the efficacy of nightly filorexant for the treatment of PDN. (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - December 7, 2017 Category: Anesthesiology Tags: Original Articles Source Type: research

Sensitivity of the DN4 in Screening for Neuropathic Pain Syndromes
This study examined the sensitivity of the Douleur Neuropathique en 4 Questions (DN4) in screening for various neuropathic pain syndromes. Materials and Methods: This prospective observational study was conducted in 7 Canadian academic pain centers between April 2008 and December 2011. All newly admitted patients (n=2199) were approached and 789 eligible participants form the sample for this analysis. Baseline data included demographics, disability, health-related quality of life, and pain characteristics. Diagnosis of probable or definite neuropathic pain was on the basis of history, neurological examination, and ancil...
Source: The Clinical Journal of Pain - December 7, 2017 Category: Anesthesiology Tags: Original Articles Source Type: research

Attentional Avoidance is Associated With Increased Pain Sensitivity in Patients With Chronic Posttraumatic Pain and Comorbid Posttraumatic Stress
This study investigated AB for linguistic pain-related stimuli and trauma-related stimuli, and clinical and thermal sensitivity in patients with chronic posttraumatic pain with and without PTSD. Materials and Methods: In total, 34 patients with chronic posttraumatic cervical pain performed the visual attentional probe task assessing patterns of selective attentional responding to trauma cues and to pain cues. The task used short (500 ms) and long (1250 ms) stimulus exposure durations to ensure sensitivity to both the orienting and maintenance of attention. Heat pain threshold was assessed at the nonpainful hand. Clinica...
Source: The Clinical Journal of Pain - December 7, 2017 Category: Anesthesiology Tags: Original Articles Source Type: research

Patients With Knee Osteoarthritis Who Score Highly on the PainDETECT Questionnaire Present With Multimodality Hyperalgesia, Increased Pain, and Impaired Physical Function
This study aimed to determine whether those with a higher “positive neuropathic” score on the PainDETECT questionnaire also had greater pain, hypersensitivity, and reduced function compared with individuals with knee OA with lower PainDETECT scores. Materials and Methods: In total, 130 participants with knee OA completed the PainDETECT, Western Ontario and McMaster Universities Arthritis Index (WOMAC), and Pain Quality Assessment Scale questionnaires. Quantitative sensory testing was carried out at 3 sites (both knees and elbow) using standard methods. Cold and heat pain thresholds were tested using a Peltie...
Source: The Clinical Journal of Pain - December 7, 2017 Category: Anesthesiology Tags: Original Articles Source Type: research

Contribution of Endocannabinoid Gene Expression and Genotype on Low Back Pain Susceptibility and Chronicity
Background: A major research emphasis has been focused on defining the molecular changes that occur from acute to chronic pain to identify potential therapeutic targets for chronic pain. As the endocannabinoid system is dynamically involved in pain signaling, a plausible mechanism that may contribute to chronic pain vulnerability involves alterations in the amount of circulating endocannabinoids. Therefore, this study sought to examine cannabinoid type 1 (CNR1), type 2 (CNR2) receptors, fatty acid amide hydrolase (FAAH), and the vanilloid receptor (transient receptor potential cation channel subfamily V member 1 [TRPV1])...
Source: The Clinical Journal of Pain - December 7, 2017 Category: Anesthesiology Tags: Original Articles Source Type: research

Expectancy Reduces Symptoms but not Functional Impairment Following Exercise-induced Musculoskeletal Injury
Discussion: Positive expectations before a sham treatment enhanced reduction in pain intensity but did not improve functional impairments following exercise-induced acute musculoskeletal injury. (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - December 7, 2017 Category: Anesthesiology Tags: Original Articles Source Type: research

Common Pediatric Pain Disorders and Their Clinical Associations
Conclusions: In light of their extensive associations, the common pain conditions, persistent pain, restless legs syndrome, iron deficiency, anxiety and depression, are likely to involve common etiological mechanisms that warrant further investigation. (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - November 8, 2017 Category: Anesthesiology Tags: Review Articles Source Type: research

Effects of Single Nucleotide Polymorphisms on Surgical and Postsurgical Opioid Requirements: A Systematic Review and Meta-Analysis
Discussion: Investigation of single changes in 1 gene can only yield limited information regarding genetic effects on opioid requirements. Rapid development of whole genome sequencing enables information on all genetic modifications that may affect analgesic response to be collected. The information collected must include data on the individual’s metabolic enzymes, as well as information on drug receptors and enzymes responsible for drug degradation, so that a personal profile can be built up which will predict individual response to drugs, and guide clinicians on the type and dosage of drug to use. (Source: The Clin...
Source: The Clinical Journal of Pain - November 8, 2017 Category: Anesthesiology Tags: Review Articles Source Type: research

Reduced Sufentanil Doses are Effective for Postoperative Analgesia After Ductal Closure in Extremely Premature Infants: A 10 Years Retrospective Cohort Study
The objective of the study was to assess the efficacy of reduced sufentanil doses for postoperative analgesia following surgical ductal closure in extremely premature infants. Methods: This was a retrospective, single-center, cohort study comparing 2 sufentanil dosing regimens used between 2001 and 2010 and included all infants born at (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - November 8, 2017 Category: Anesthesiology Tags: Original Articles Source Type: research

Mixed Pain Can Be Discerned in the Primary Care and Orthopedics Settings in Spain: A Large Cross-Sectional Study
Conclusions: Patients with mixed pain showed more clinical complexity than patients with other types of pain. The consideration of mixed pain as an independent pathophysiological category may be justifiable on empirical clinical grounds. (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - November 8, 2017 Category: Anesthesiology Tags: Original Articles Source Type: research

The Fear-Avoidance Components Scale (FACS): Responsiveness to Functional Restoration Treatment in a Chronic Musculoskeletal Pain Disorder (CMPD) Population
In this study, 426 chronic musculoskeletal pain disorder patients were admitted to a Functional Restoration Program (FRP). They were categorized into 5 FACS severity levels, from subclinical to extreme, at admission, and again at discharge. Associations with objective lifting performance and other patient-reported psychosocial measures were determined at admission and discharge, and objective work outcomes for this predominantly disabled cohort, were assessed 1 year later. Results: Those patients in the severe and extreme FACS severity groups at admission were more likely to “drop out” of treatment than those ...
Source: The Clinical Journal of Pain - November 8, 2017 Category: Anesthesiology Tags: Original Articles Source Type: research

Age Interactions on Pain Sensitization in Patients With Severe Knee Osteoarthritis and Controls
This study investigated the influence of age on pressure hyperalgesia, TSP, and CPM in patients with KOA and controls. Materials and Methods: One hundred thirty-three severe KOA patients and 50 age-matched and sex-matched asymptomatic controls were assessed by cuff algometry and handheld pressure algometry. Pain sensitivity was assessed around the head of the gastrocnemius muscle to identify mild pain detection threshold (MPDT) and pressure tolerance threshold (PTT). TSP was assessed by visual analogue scale scores of the pain evoked by 10 repetitive cuff stimulations. CPM was assessed as the difference in PTT before and ...
Source: The Clinical Journal of Pain - November 8, 2017 Category: Anesthesiology Tags: Original Articles Source Type: research

PPARĪ³ Agonists Attenuate Trigeminal Neuropathic Pain
Discussion: This is the first study localizing PPARγ immunoreactivity throughout the brainstem trigeminal sensory spinal nucleus (spV) and its increase three weeks after TIC nerve injury. This is also the first study to demonstrate that activation of PPARγ attenuates trigeminal hypersensitivity in the mouse TIC nerve injury model. The findings presented here suggest the possibility of utilizing the FDA approved diabetic treatment drug, PIO, as a new therapeutic that targets PPARγ for treatment of patients suffering from orofacial neuropathic pain. (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - November 8, 2017 Category: Anesthesiology Tags: Original Articles Source Type: research

Altered Functional Connectivity in Sickle Cell Disease Exists at Rest and During Acute Pain Challenge
This study identified and characterized the neural correlates of possible central sensitization in SCD. We found functional connectivity abnormalities in individuals with SCD in the brain’s somatosensory network, salience network, and default mode network during both an unstructured resting state and paradigm involving acute pain challenge. Discussion: There was evidence for both increased and decreased connectivity which is consistent with findings in other chronic pain disorders. Preliminary evidence was found that subcortical brain regions might contribute to neurodevelopmental abnormalities in chronic pain. The ...
Source: The Clinical Journal of Pain - November 8, 2017 Category: Anesthesiology Tags: Original Articles Source Type: research

Peripheral Nerve Block as a Supplement to Light or Deep General Anesthesia in Elderly Patients Receiving Total Hip Arthroplasty: A Prospective Randomized Study
Conclusions: Lumbosacral plexus block reduced the need for opioids and offered satisfactory postoperative analgesia. It led to better postoperative outcomes in combination with intraoperative light sedation (high bispectral index). (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - November 8, 2017 Category: Anesthesiology Tags: Original Articles Source Type: research

The Impact of Serum Drug Concentration on the Efficacy of Imipramine, Pregabalin, and their Combination in Painful Polyneuropathy
Objective: The aim of this study was to explore the serum concentration-effect relation for first-line drugs in neuropathic pain and to determine if efficacy could be increased. Methods: Data from a randomized, placebo-controlled, cross-over trial on imipramine, pregabalin, and their combination in painful polyneuropathy were used. Treatment periods were of 4 weeks’ duration, outcome was the weekly median of daily pain rated by a 0 to 10 numeric scale, and drug concentrations were determined by high-performance liquid chromatography. Results: In 47 patients, pain was reduced −1.0 (95% confidence interval [CI]...
Source: The Clinical Journal of Pain - November 8, 2017 Category: Anesthesiology Tags: Original Articles Source Type: research

A Narrative Review of the Evidence on the Efficacy of Dexamethasone on Postoperative Analgesic Consumption
Conclusions: Dexamethasone administered at a dose of 8 mg before surgical incision may be beneficial in laparoscopic cholecystectomies, thyroid, laparoscopic gynecologic and breast surgery, and tonsillectomies in children. Dexamethasone’s potential impact on reducing postoperative analgesic requirements should be investigated in more detail in a systematic manner, to support its use in other kinds of operations. (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - October 7, 2017 Category: Anesthesiology Tags: Review Article Source Type: research

The Associated Factors and Clinical Features of Neuropathic Pain After Brachial Plexus Injuries: A Cross-sectional Study
Introduction: Neuropathic pain in patients with brachial plexus injuries brings complicated obstacles to the treatment and recovery for both surgeons and patients. Objectives: The clinical features of neuropathic pain, including pain intensity, type and time phase, need to be investigated. Moreover, possible associated factors need to be explored. Methods: A cross-sectional study containing 77 participants was conducted. Their baseline information and injury-related conditions were collected. The Present Pain Index evaluated by the Visual Analog Scale, self-reports using the specific pain questionnaires were used for scr...
Source: The Clinical Journal of Pain - October 7, 2017 Category: Anesthesiology Tags: Original Articles Source Type: research

A Mindfulness Program Adapted for Adolescents With Chronic Pain: Feasibility, Acceptability, and Initial Outcomes
Discussion: The MBI-A is a feasible, well-received intervention for adolescents with chronic pain conditions. Findings support the need for further investigation of the efficacy of MBI-A through randomized-controlled trials. (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - October 7, 2017 Category: Anesthesiology Tags: Original Articles Source Type: research

Emergency Department Pain Management in Children With Appendicitis in a Biethnic Population
Objectives: Our goal was to examine factors associated with the administration of emergency department analgesia (any analgesia, opioid analgesia) in patients with acute appendicitis in a tertiary children’s hospital in Israel, and to examine ethnic differences. Methods: A retrospective cohort study of children evaluated in the emergency department, who had International Classification Of Disease—Ninth Revision (ICD-9) diagnosis of acute appendicitis. Regression analysis was used to test the effect of multiple variables on the provision of analgesia. Medications were administered according to a nurse-driven pa...
Source: The Clinical Journal of Pain - October 7, 2017 Category: Anesthesiology Tags: Original Articles Source Type: research

Muscle Pain Induces a Shift of the Spatial Distribution of Upper Trapezius Muscle Activity During a Repetitive Task: A Mechanism for Perpetuation of Pain With Repetitive Activity?
Objective: An association exists between repetitive movements and the development or perpetuation of neck-shoulder muscle pain. The mechanisms underlying this association remain unclear. This observational study investigated the effect of upper trapezius muscle pain on the distribution of upper trapezius activity during repetitive lifting. It was hypothesized that nociception would change the distribution of activity resulting in activation of muscle regions which would not normally be active during the task. Materials and Methods: Healthy men repeatedly lifted a box with a cycle time of 3 seconds for 50 cycles, at baseli...
Source: The Clinical Journal of Pain - October 7, 2017 Category: Anesthesiology Tags: Original Articles Source Type: research

Pain Beliefs and Quality of Life in Young People With Disabilities and Bothersome Pain
Discussion: The findings provide new information regarding the role that pain beliefs have in predicting function and have important clinical implications regarding how youth with physical disabilities and pain might be most effectively treated. (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - October 7, 2017 Category: Anesthesiology Tags: Original Articles Source Type: research

Vulnerability to Psychopathology and Dimensions of Personality in Patients With Fibromyalgia
Conclusions: Patients with FM have a high probability of anxious-depressive-type psychopathologic alterations. Their vulnerability to these conditions may be determined by personality traits. The SD character dimension may have implications for therapy, as low SD is associated with the presence of psychopathology and with a low capacity to cope with the disease. (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - October 7, 2017 Category: Anesthesiology Tags: Original Articles Source Type: research

Gray Matter Abnormalities Associated With Chronic Back Pain: A Meta-Analysis of Voxel-based Morphometric Studies
Conclusions: The present study demonstrates a pattern of GM alterations in CBP. These data further advance our understanding of the pathophysiology of CBP. (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - October 7, 2017 Category: Anesthesiology Tags: Original Articles Source Type: research

Possible Opioid Shopping and its Correlates
Conclusions: The use of ≥3 prescribing practices and ≥3 dispensing pharmacies over 18 months sharply discriminated courses of opioid treatment from courses of diuretics. This pattern of fills was additionally associated with the numbers of nonspecialist and self-paid fills, the total morphine milligram equivalents dispensed, and heavier use of drugs for anxiety, sleep, attention, and psychosis. (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - October 7, 2017 Category: Anesthesiology Tags: Original Articles Source Type: research

Happy Despite Pain: A Randomized Controlled Trial of an 8-Week Internet-delivered Positive Psychology Intervention for Enhancing Well-being in Patients With Chronic Pain
Discussion: The results suggest that an internet-based positive psychology and cognitive-behavioral self-help interventions for the management of chronic pain are clinically useful. Because the self-help exercises as used in the current program do not require therapist involvement, dissemination potential is large. Further studies should examine whether it can best be used as stand-alone or add-on treatment combined with established pain treatment programs. (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - October 7, 2017 Category: Anesthesiology Tags: Original Articles Source Type: research

Goals of Chronic Pain Management: Do Patients and Primary Care Physicians Agree and Does it Matter?
Discussion: Patients and physicians prioritize substantially different goals for chronic pain management, but there is no evidence that agreement predicts patient experience or physician-reported visit difficulty. Primary care physicians may have adapted to new recommendations that emphasize functional goals and avoidance of long-term opioid therapy, whereas patients continue to focus on reducing pain intensity. (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - October 7, 2017 Category: Anesthesiology Tags: Original Articles Source Type: research

Measuring Glutamate Levels in the Brains of Fibromyalgia Patients and a Potential Role for Glutamate in the Pathophysiology of Fibromyalgia Symptoms: A Systematic Review
Discussion: Although the cause of FM remains inconclusive, there is converging data in favor of a dysregulation of pain processing in the central nervous system of FM patients, particularly associated with an increase in cerebral glutamate levels. Furthermore, there is evidence to support an association between increased glutamate levels and an increase in FM symptoms. (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - September 6, 2017 Category: Anesthesiology Tags: Review Article Source Type: research

Acupuncture for the Treatment of Chronic Pain in the Military Population: Factors Associated With Treatment Outcomes
Discussion: The use of electrical stimulation and higher baseline pain score were associated with a positive treatment outcome, while the presence of a psychological comorbidity diminished the likelihood of treatment success. Practitioners should consider using electrical stimulation more frequently, and addressing psychopathology before or concurrent to treatment, when initiating acupuncture. (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - September 6, 2017 Category: Anesthesiology Tags: Original Articles Source Type: research

Chronic Lateral Epicondylalgia Does Not Exhibit Mechanical Pain Modulation in Response to Noxious Conditioning Heat Stimulus
This study aimed to determine whether LE exhibits a less efficacious CPM compared with that in pain-free controls. Results: Results: Twenty participants with LE, aged 50.7 years (SD=7.05) and who had their condition for 10.2 months (range: 2 to 80 mo), were matched by age and sex to 22 pain-free participants. All participants indicated their PPT over the lateral epicondyle(s) before and during a conditioning noxious heat stimulus that was applied over the calf. A CPM score was calculated as the difference between the PPT before and during the heat pain-conditioning stimulus expressed as a percentage of PPT before the heat...
Source: The Clinical Journal of Pain - September 6, 2017 Category: Anesthesiology Tags: Original Articles Source Type: research

Capsaicin 8% Patch Repeat Treatment in Nondiabetic Peripheral Neuropathic Pain: A 52-Week, Open-Label, Single-Arm, Safety Study
Conclusions: Generally, capsaicin 8% patch repeat treatment over 52 weeks was well tolerated, with variable alteration in sensory function and minimal chance of complete sensory loss. (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - September 6, 2017 Category: Anesthesiology Tags: Original Articles Source Type: research

Comparisons in Muscle Function and Training Rehabilitation Outcomes Between Avoidance-Endurance Model Subgroups
This study sought to examine whether or not the avoidance-endurance model subgroups, FAR, distress-endurers (DER), eustress-endurers (EER), and adaptive responders (AR), differed in physical measures and outcomes after training therapy. Materials and Methods: A total of 137 chronic low back pain patients were assessed before, at the end of, and 6 months after a 6-month rehabilitation training. Patients performed maximum back extension strength and trunk range-of-motion measures, flexion-relaxation tests, and completed the following questionnaires: Avoidance-Endurance Questionnaire, Roland-Morris Disability Questionnaire, ...
Source: The Clinical Journal of Pain - September 6, 2017 Category: Anesthesiology Tags: Original Articles Source Type: research

Smoking May Increase Postoperative Opioid Consumption in Patients Who Underwent Distal Gastrectomy With Gastroduodenostomy for Early Stomach Cancer: A Retrospective Analysis
This study evaluated whether smokers require higher doses of opioid to reduce pain when they undergo surgery. Methods: A retrospective review of 236 patients who had intravenous patient-controlled analgesia after distal gastrectomy with gastroduodenostomy between October 2013 and September 2014 was performed to analyze the difference in postoperative opioid requirements between smokers and nonsmokers. Total opioid consumption was observed from the day of operation to postoperative day 2. Patients were grouped into smokers (N=117) and nonsmokers (N=119) for comparison. Simple and multiple regression analyses were performed...
Source: The Clinical Journal of Pain - September 6, 2017 Category: Anesthesiology Tags: Original Articles Source Type: research

A Network Analysis of Depressive Symptoms in Individuals Seeking Treatment for Chronic Pain
Discussion: Consistent with past research with patients undergoing treatment for major depression, the current findings are supportive of a model in which depressive symptoms are causally connected within a network rather than being manifestations of a common underlying disorder. The research and clinical implications of the findings, such as developing treatments targeting the most central symptoms, are discussed. (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - September 6, 2017 Category: Anesthesiology Tags: Original Articles Source Type: research

Treatment Adherence in Child and Adolescent Chronic Migraine Patients: Results From the Cognitive-Behavioral Therapy and Amitriptyline Trial
Discussion: Our findings demonstrate that youth with chronic migraine who agree to be a part of a clinical trial do quite well at attending therapy sessions, and report that they are adherent to completing home/practice between sessions and taking medication. These results lend further support to consideration of CBT+A as a first-line treatment for youth with chronic migraine and suggest that measurement of adherence when this treatment is provided in practice will be important. (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - September 6, 2017 Category: Anesthesiology Tags: Original Articles Source Type: research

Multidimensional Prognostic Modelling in People With Chronic Axial Low Back Pain
This study entered multidimensional data (demographics, pain characteristics, pain responses to movement, behaviors associated with pain, pain sensitivity, psychological, social, health, lifestyle) at baseline, and interventions undertaken, into prognostic models for pain intensity, disability, global rating of change and bothersomeness at 1-year. Results: The prognostic model for higher pain intensity (explaining 23.2% of the variance) included higher baseline pain intensity and punishing spousal interactions, and lower years in education, while participating in exercise was prognostic of lower pain intensity. The model ...
Source: The Clinical Journal of Pain - September 6, 2017 Category: Anesthesiology Tags: Original Articles Source Type: research

Provoked Vestibulodynia: A Comparative Examination of Mental Health, Sleep, Sexual Functioning, and Relationship Adjustment
Discussion: These results indicate that women with PVD and PHN experience similar mental health difficulties, but women with PHN experience more severe impact on their day-to-day functioning and mood. These results support the classification of PVD as a chronic pain condition, as both the pain groups differed from pain-free control participants on a range of measures. Finally, the presence of mental health difficulties and poorer sexual functioning highlights the importance of conducting biopsychosocial pain assessments. (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - September 6, 2017 Category: Anesthesiology Tags: Original Articles Source Type: research

Duloxetine as an Analgesic Reduces Opioid Consumption After Spine Surgery: A Randomized, Double-Blind, Controlled Study
This study was prospective, double-blind, randomized, and placebo controlled. Patients received either 60 mg duloxetine or an identical placebo 1 hour before surgery and again the following morning. The study participants were allocated into 2 groups: Group C (control) participants received the placebo and Group D (duloxetine) participants received 60 mg duloxetine. The total consumption of fentanyl 48 hours after surgery was measured. Secondary end points were pain scores and the presence or absence of adverse effects, such as headache, nausea, vomiting, itching, dizziness, and drowsiness. Results: Demographic characteri...
Source: The Clinical Journal of Pain - September 6, 2017 Category: Anesthesiology Tags: Original Articles Source Type: research

Postoperative Analgesia by a Transversus Abdominis Plane Block Using Different Concentrations of Ropivacaine for Abdominal Surgery: A Meta-Analysis
This study aimed to identify the optimal ropivacaine concentration of TAPB using a meta-analysis. Materials and Methods: This study consisted of a meta-analysis of randomized controlled trials (RCTs). We searched online databases, including PubMed, Embase, the Cochrane Database of Systematic Reviews, and Web of Science. RCTs investigating the 24-hour postoperative opioid consumption and the rest and dynamic pain scores 2, 12, and 24 hours after surgery were included in this analysis. We also assessed opioid-related side-effects and patient satisfaction 24 hours after surgery. Results: Nineteen RCTs (1217 patients) were i...
Source: The Clinical Journal of Pain - August 9, 2017 Category: Anesthesiology Tags: Review Articles Source Type: research

A Review of Adult and Pediatric Neuropathic Pain Assessment Tools
Conclusions: This article summarizes the various screening and assessment tools available to clinicians for evaluating NP. Despite the availability of the 15 tools discussed, a deficiency remains, particularly in the pediatric realm. To date, there is no well-validated NP assessment tool for children younger than 5 years, no pediatric NP screening tool that has been validated outside the domain of chemotherapy-induced peripheral neuropathy, and no consistent recommendation regarding the optimal tool to use with pediatric patients who have chronic pain. These areas, as well as others, would benefit from further research and...
Source: The Clinical Journal of Pain - August 9, 2017 Category: Anesthesiology Tags: Review Articles Source Type: research

The Association Between Headaches and Temporomandibular Disorders is Confounded by Bruxism and Somatic Symptoms
The objective of this observational study was to establish the possible presence of confounders on the association between temporomandibular disorders (TMD) and headaches in a patient population from a TMD and Orofacial Pain Clinic. Materials and Methods: Several subtypes of headaches have been diagnosed: self-reported headache, (probable) migraine, (probable) tension-type headache, and secondary headache attributed to TMD. The presence of TMD was subdivided into 2 subtypes: painful TMD and function-related TMD. The associations between the subtypes of TMD and headaches were evaluated by single regression models. To study...
Source: The Clinical Journal of Pain - August 9, 2017 Category: Anesthesiology Tags: Original Articles Source Type: research

Sensory Symptom Profiles of Patients With Neuropathic Pain After Spinal Cord Injury
Conclusions: Classification of SCI-NP patients into the 5 groups identified in the present study based on their distinct sensory symptom profiles may allow identification of those most likely to respond to a specific analgesic approach. (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - August 9, 2017 Category: Anesthesiology Tags: Original Articles Source Type: research

Ethnicity, Cortisol, and Experimental Pain Responses Among Persons With Symptomatic Knee Osteoarthritis
Discussion: Consistent with previous findings in young healthy adults, cold-pressor pain responses are related to pre-CPT cortisol concentrations in NHW persons with knee OA but not in their AA counterparts. Additional studies are required to better understand this finding. (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - August 9, 2017 Category: Anesthesiology Tags: Original Articles Source Type: research

Mediators of Treatment Effect in the Back In Action Trial: Using Latent Growth Modeling to Take Change Over Time Into Account
Discussion: Fear-avoidance beliefs were found to mediate the effect of treatment on disability outcome. Measurement of all potential mediator variables in future studies would help to more strongly identify which factors explain observed treatment effects. Latent growth modelling was found to be a useful technique to apply to studies of treatment mediation, suggesting that future studies could use this approach. (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - August 9, 2017 Category: Anesthesiology Tags: Original Articles Source Type: research