Journal of Pain Research最新文献

{"title":"Acute Pain Trajectory Phenotypes are Associated with Kinesiophobia and Functional Recovery in Surgical/Trauma ICU Patients: A 5-Year Retrospective Cohort Study Using a PERMA-Informed Framework.","authors":"Yun Li, Hao Wang, Peng Lu, Wei Jia, Yu Gao, Wei Liu, Kun Wang, Jie Ma, Xiaoqiu Liu","doi":"10.2147/JPR.S620341","DOIUrl":"https://doi.org/10.2147/JPR.S620341","url":null,"abstract":"<p><strong>Background: </strong>Early mobilization (EM) mitigates Post-Intensive Care Syndrome (PICS). However, kinesiophobia (fear of movement) driven by severe acute pain is often overlooked. This study aimed to identify acute pain trajectory phenotypes, evaluate their association with kinesiophobia, and explore outcomes under a PERMA-informed exploratory framework.</p><p><strong>Methods: </strong>A single-center retrospective cohort study was conducted including surgical/trauma ICU patients (January 2021-December 2025). Group-based trajectory modeling (GBTM) identified latent classes of pain over the first 5 ICU days. Kinesiophobia and PERMA-related proxy variables (Relationships, Accomplishment) were extracted. Multivariable logistic regression, restricted cubic splines (RCS), and Cox proportional hazards models assessed outcomes.</p><p><strong>Results: </strong>Among 586 eligible patients, four pain trajectories were identified: \"Rapid Relief\" (38.4%), \"Persistent Moderate\" (29.5%), \"Delayed Onset/Flare-up\" (21.3%), and \"Persistent Severe\" (10.8%). After adjusting for confounding factors, Delayed Onset (Adjusted OR 3.85, 95% CI 2.15-6.84) and Persistent Severe (Adjusted OR 6.12, 95% CI 3.25-11.56) trajectories were independently associated with kinesiophobia. RCS demonstrated a significant plateauing association between cumulative opioid doses and kinesiophobia. Patients with kinesiophobia exhibited significant delays in first out-of-bed mobilization, prolonged ICU lengths of stay, and a reduced likelihood of direct discharge to home. In adjusted outcome models, kinesiophobia was associated with delayed first target mobilization (HR 0.42, 95% CI 0.33-0.54, P<0.001) and lower odds of direct-to-home discharge (OR 0.21, 95% CI 0.14-0.32, P<0.001).</p><p><strong>Conclusion: </strong>Acute pain in surgical/trauma ICU patients is highly heterogeneous. Higher-risk pain trajectory phenotypes were associated with kinesiophobia, which may represent a psychological barrier to functional recovery. Prospectively testing PERMA-informed strategies-particularly family support, meaning-oriented reframing, and goal-based achievement-may help clarify whether this approach can disrupt the pain-fear-immobility cycle.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"19 ","pages":"620341"},"PeriodicalIF":3.1,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13635630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive Behavioral Therapy and Pain Chronification: Neuroimmune Rationale, Evidence Boundaries, and Trial Design Priorities: A Structured Narrative Review.","authors":"Yi Xi, Tianqi Zhang, Xingwei Zhao, Xia Xiong, Cehua Ou","doi":"10.2147/JPR.S635577","DOIUrl":"https://doi.org/10.2147/JPR.S635577","url":null,"abstract":"<p><strong>Background: </strong>Pain chronification is a dynamic transition in which persistent pain may be shaped by interacting nociceptive, peripheral, spinal, supraspinal, neuroimmune, endocrine and cognitive-affective processes. Cognitive Behavioral Therapy (CBT) has clinical value in chronic pain, but claims about glial modulation and disease modification require careful qualification.</p><p><strong>Objective: </strong>To evaluate CBT as an early, mechanism-informed and hypothesis-generating intervention while distinguishing clinical efficacy, neuroimmune plausibility, prevention hypotheses and disease-modifying claims.</p><p><strong>Methods: </strong>We conducted a structured narrative review using prespecified evidence domains. PubMed/MEDLINE searches covering January 2014 to September 10, 2026 were complemented by citation chasing and selected landmark mechanistic articles. Sources were organized by evidence domain, study type and interpretive role, including pain chronification, neuroimmune and glial mechanisms, brain-network mechanisms, CBT outcomes, psychoneuroimmune pathways, perioperative prevention hypotheses, risk phenotyping and scalable delivery. No quantitative pooling or formal systematic/scoping-review workflow was performed.</p><p><strong>Results: </strong>Experimental and translational studies support neuroimmune contributions to central sensitization and pain maintenance, whereas human evidence for direct CBT effects on microglial or astrocytic activation remains insufficient. CBT produces reproducible, generally small effects on pain intensity and more consistent benefits for interference, disability, distress, coping, sleep and function.</p><p><strong>Conclusion: </strong>CBT should be presented as a clinically valuable component of multimodal care and as a testable psychoneuroimmune hypothesis, not as a proven preventive, glial-targeting or disease-modifying treatment. Risk-stratified, early, component-specific and mechanism-embedded trials are needed before prevention claims are made.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"19 ","pages":"635577"},"PeriodicalIF":3.1,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13634229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rethinking the Boundaries of Local Anesthetic Systemic Toxicity in the Era of Sustained-Release Formulations.","authors":"Ming Liu, Xiangyang Guo, Zhengqian Li","doi":"10.2147/JPR.S644528","DOIUrl":"https://doi.org/10.2147/JPR.S644528","url":null,"abstract":"<p><p>Sustained-release local anesthetic formulations introduce prolonged and dynamic exposure patterns that challenge current frameworks for assessing local anesthetic systemic toxicity (LAST). Recent pharmacovigilance findings, pharmacokinetic evidence, and reports of delayed and recurrent LAST further support the need to re-evaluate LAST across three conceptual boundaries. First, the exposure boundary challenges the use of recommended maximum doses as stand-alone safety thresholds. Co-administration, formulation stability, and the local tissue microenvironment may influence drug release and systemic exposure. Second, the temporal boundary emphasizes that a lower initial peak plasma concentration does not necessarily imply a shorter window of vulnerability, particularly when systemic exposure is prolonged or follows a bimodal pattern. Third, the resuscitation endpoint boundary highlights that return of spontaneous circulation (ROSC) does not necessarily indicate resolution of the underlying toxicological process, as hemodynamic instability may recur after initial ROSC. Assessment of LAST associated with sustained-release formulations should not be limited to administered dose or peak plasma concentration but should consider the entire exposure trajectory. Future guidelines should also define long-term monitoring windows, specific triggers for continuous infusion of lipid emulsion, and safe upper limits for lipid emulsion dosing.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"19 ","pages":"644528"},"PeriodicalIF":3.1,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13634934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence Chatbots as Sources of Cancer Pain Information: A Comparative Evaluation of Quality, Transparency, and Readability.","authors":"Qianpeng Li, Shuai Zhang, Xiao Ma, Shengjie Yang","doi":"10.2147/JPR.S643383","DOIUrl":"https://doi.org/10.2147/JPR.S643383","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the quality, transparency, educational value, and readability of cancer pain information generated by four AI chatbots and to assess whether the outputs met prespecified readability benchmarks for patient education.</p><p><strong>Methods: </strong>This online cross-sectional comparative study was conducted on July 22, 2026. Nine unmodified Google-Trends-derived cancer-pain-related queries were submitted to ChatGPT 5.5, Microsoft Copilot, Google Gemini 3.5 Flash, and Perplexity, yielding 36 responses. Two oncology clinicians independently assessed the responses using DISCERN, Ensuring Quality Information for Patients (EQIP), Journal of the American Medical Association (JAMA) benchmark criteria, and the Global Quality Score (GQS). Six established indices assessed readability. Matched model comparisons used Friedman tests with query as the repeated unit and Kendall's W as the omnibus effect size; significant quality outcomes were followed by Holm-adjusted paired Wilcoxon signed-rank tests.</p><p><strong>Results: </strong>DISCERN did not differ significantly across models (χ²(3)=6.682, P=0.083, W=0.247). EQIP differed across models (χ²(3)=20.721, P<0.001, W=0.767), with Copilot scoring higher than ChatGPT, Gemini, and Perplexity (Holm-adjusted P=0.023 for each). JAMA also differed (χ²(3)=19.645, P<0.001, W=0.728); Copilot and Perplexity scored higher than Gemini (Holm-adjusted P=0.023 and.039, respectively). GQS differed overall (χ²(3)=10.500, P=0.015, W=0.389), although no pairwise comparison remained significant after Holm adjustment. All six readability indices differed overall across models after Holm correction; descriptively, Gemini showed the greatest estimated reading difficulty. Model medians exceeded the prespecified grade-level benchmarks, and FRES medians were below 80.</p><p><strong>Conclusion: </strong>The four chatbots differed across information quality, source transparency, educational utility, and formula-based readability. Claim-level clinical accuracy and safety were not evaluated in this study and warrant separate guideline-based assessment.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"19 ","pages":"643383"},"PeriodicalIF":3.1,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barbed Double-Needle Suture for Cesarean Section Uterine Incision Closure: Postoperative Pain and 12-Month Scar Outcomes.","authors":"Hongyan Wang, Haixing Wang, Yunyan Zhai","doi":"10.2147/JPR.S639476","DOIUrl":"https://doi.org/10.2147/JPR.S639476","url":null,"abstract":"<p><strong>Background: </strong>The optimal suture technique for uterine incision closure during cesarean section remains debated due to concerns regarding long-term scar healing. This study aimed to compare postoperative pain and scar outcomes between barbed double-needle sutures (BDNS) and traditional sutures (TS).</p><p><strong>Methods: </strong>This retrospective cohort study included women undergoing elective term cesarean delivery from September 2022 to September 2024, grouped by uterine closure suture type. Assessed parameters included uterine closure time, blood loss, postoperative visual analog scale pain scores, analgesic use, time to first flatus and ambulation, hospital stay, 12-month sonographic residual myometrial thickness and niche incidence, and long‑term pelvic symptoms.</p><p><strong>Results: </strong>Overall, 236 patients were analyzed (TS group, 124; BDNS group, 112). BDNS group demonstrated significantly shorter uterine closure time (3.85±0.72 vs 4.76±1.34 min, P<0.001) and reduced blood loss (285.52±54.18 vs 302.45±68.32 mL, P=0.035). Postoperative resting and activity pain scores were lower (P<0.05), with decreased analgesic requirements (P=0.024). At 12-months, residual myometrial thickness was greater (6.25±1.28 vs 5.82±1.15 mm, P=0.008), niche incidence lower (10.71% vs 24.19%, P=0.007). At 12-months postoperatively, the BDNS group showed significant improvements in SF‑36 bodily pain (P<0.001) and physical function (P=0.014) scores, while chronic pelvic pain and deep dyspareunia (P>0.05) rates did not differ significantly between groups.</p><p><strong>Conclusion: </strong>Barbed double-needle suture closure for cesarean section is associated with improved intraoperative efficiency, reduced postoperative pain, and better uterine scar morphology compared with traditional smooth suture closure.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"19 ","pages":"639476"},"PeriodicalIF":3.1,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Proposed Mechanisms of Electroacupuncture in Animal Models of Chemotherapy-Induced Peripheral Neuropathy: A Systematic Review and Meta-Analysis.","authors":"Mingjie Tang, Hang Xu, Shiyi Zheng, Yinghong Li, Tianyi Zhu, Zhongqi Xie, Zhaoming Chen","doi":"10.2147/JPR.S641678","DOIUrl":"https://doi.org/10.2147/JPR.S641678","url":null,"abstract":"<p><strong>Background: </strong>Chemotherapy-induced peripheral neuropathy (CIPN) is a common dose-limiting toxicity of chemotherapy with few effective treatment options. Electroacupuncture (EA) has demonstrated promising clinical efficacy, yet its preclinical evidence remains fragmented, limiting mechanistic understanding and translational application. This systematic review and meta-analysis evaluated the efficacy of EA in animal models of CIPN and synthesized the underlying mechanisms.</p><p><strong>Methods: </strong>Seven databases were systematically searched from inception to June 24, 2026, for controlled animal studies investigating EA for CIPN. The primary outcome was mechanical withdrawal threshold (MWT); secondary outcomes included thermal withdrawal latency (PWL), adhesive removal test (ART) responsive time, sciatic nerve conduction velocity (SNCV), and intra-epidermal nerve fiber density (IENFs). Methodological quality was assessed using SYRCLE, and reporting quality using ARRIVE 2.0. Meta-analyses were conducted by Stata 18.0 and R 4.5.2.</p><p><strong>Results: </strong>21 studies involving 451 animals were included. SYRCLE scores ranged from 6 to 7, and ARRIVE scores from 9.5 to 15.5, indicating moderate quality. Meta-analysis revealed that EA significantly increased MWT (standardized mean difference [SMD] = 4.34, 95% confidence interval [CI]: 3.34 to 5.34, <i>I</i> ² = 78.5%) and PWL (SMD = 5.86, 95% CI: 3.97 to 7.75, <i>I</i> ² = 78.2%) compared to model group. EA also significantly shortened ART responsive time (SMD = -3.76, 95% CI: -6.69 to -0.83, <i>I</i> ² = 88.0%), improved SNCV (SMD = 5.56, 95% CI: 4.10 to 7.02, <i>I</i> ² = 0%) and preserved IENFs (SMD = 3.39, 95% CI: 2.34 to 4.45, <i>I</i> ² = 0%). Mechanistically, EA attenuated neuroinflammation, modulated ion channels, activated antioxidant pathways, and regulated neurotransmitter release.</p><p><strong>Conclusion: </strong>Preclinical evidence demonstrates that EA effectively alleviates pain-like behaviors, improves sensory recovery, and enhances neurological function in CIPN models through multi-target mechanisms. These findings support EA as a promising intervention warranting further research.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"19 ","pages":"641678"},"PeriodicalIF":3.1,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13635300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic Pain and Newly Reported Frequent Feelings of Depression: A Nationally Representative Longitudinal Study in 2019-2020.","authors":"Han Zang, Tianchun Li, Yuelun Zhang, Lu Che, Quexuan Cui, Cheng Xiao, Bei Wen, Li Xu","doi":"10.2147/JPR.S625218","DOIUrl":"https://doi.org/10.2147/JPR.S625218","url":null,"abstract":"<p><strong>Purpose: </strong>Nationally representative longitudinal evidence on the association of chronic pain and pain-related activity limitation with newly reported frequent feelings of depression remains limited. We examined the association using the 2019-2020 National Health Interview Survey follow-back cohort.</p><p><strong>Methods: </strong>The longitudinal cohort used nationally representative data from the 2019-2020 National Health Interview Survey to examine the relationship between chronic pain and newly reported frequent feelings of depression among US adults. The primary outcome was newly reported frequent feelings of depression in 2020. Weighted modified Poisson regression models with robust standard errors were used to estimate risk ratios, adjusting for demographic and health-related covariates.</p><p><strong>Results: </strong>Among adults with chronic pain and nonchronic pain in 2019, the cumulative incidence of newly reported frequent feelings of depression in 2020 was 9.0% (95% CI, 7.3-10.7%) and 5.5% (95% CI, 4.4-6.5%), respectively. Chronic pain was associated with a higher likelihood of newly reported frequent feelings of depression after adjusting for demographic and health-related characteristics (adjusted risk ratio, 2.32 [95% CI, 1.71-3.15]). A similar association was observed between high-impact chronic pain and increased likelihood of newly reported frequent feelings of depression (adjusted risk ratio, 2.86 [95% CI, 1.96-4.16]).</p><p><strong>Conclusion: </strong>We found that chronic pain exposure was associated with a higher likelihood of newly reported frequent feelings of depression. These findings suggest that psychological treatment should also be considered in the management of chronic pain.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"19 ","pages":"625218"},"PeriodicalIF":3.1,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Compression Therapy for the Prevention of Taxane-Induced Peripheral Neuropathy: A Systematic Review and Meta-Analysis.","authors":"Nana Jiao, Hailing Ren, Feifei Yang, Jingping Wu, Yingjie Sun, Yang Li, Chenyang Wang","doi":"10.2147/JPR.S621888","DOIUrl":"https://doi.org/10.2147/JPR.S621888","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the prophylactic efficacy of compression therapy for taxane-induced peripheral neuropathy (TIPN).</p><p><strong>Methods: </strong>Systematically searched Cochrane Library, PubMed, EMBASE, Web of Science, CNKI, Wan Fang, CBM, and VIP databases from inception to January 30, 2026. Included Randomized clinical trial (RCT) and quasi-Randomized clinical trials (quasi-RCTs). Two investigators independently screened studies, extracted data, and assessed the risk of bias using the Cochrane risk of bias tool (RoB 1.0) for RCTs and the Joanna Briggs Institute (JBI) critical appraisal checklist for quasi-RCTs. Data were analyzed using Rev Man version 5.3, with subgroup analyses conducted according to study design, chemotherapy regimen, compression modality, and chemotherapy cycles.</p><p><strong>Results: </strong>Eleven studies were included, comprising six RCTs and five quasi-RCTs and involving a total of 737 patients. Compression therapy reduced overall TIPN incidence (RR=0.63, 95% CI: 0.47-0.83) and the incidence of CTCAE grade ≥2 and PNQ grade ≥D sensory and motor neuropathy. The single quasi-RCT assessing overall TIPN also reported a lower incidence with compression therapy (1/94 vs 10/94). Among the quasi-RCTs, compression therapy reduced CTCAE grade ≥2 motor neuropathy (RR=0.56, 95% CI: 0.35-0.89), whereas the sensory and PNQ outcomes were not statistically significant. CIPNAT scores were lower with compression therapy (MD=-34.72, 95% CI: -52.16 to -17.29). No subgroup differences were found by chemotherapy regimen, compression modality, or number of chemotherapy cycles. Compression therapy was generally well tolerated.</p><p><strong>Conclusion: </strong>Compression therapy may reduce the incidence of TIPN, but the findings should be interpreted cautiously because of the inclusion of quasi-RCTs, limited blinding, and heterogeneity in outcome measures. Further well-designed randomized controlled trials are needed to confirm these findings.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"19 ","pages":"621888"},"PeriodicalIF":3.1,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13632629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Different Electroacupuncture Frequencies in Young Adults with Chronic Neck Pain: A Randomized Controlled Trial.","authors":"Qiu-Yue Tu, Zi-Yi He, Jian-Peng Huang, Jian-Hua Liu","doi":"10.2147/JPR.S638747","DOIUrl":"https://doi.org/10.2147/JPR.S638747","url":null,"abstract":"<p><strong>Background: </strong>Chronic neck pain (CNP) is a common musculoskeletal disorder and a major contributor to disability. Although acupuncture is beneficial for CNP, evidence on the optimal treatment frequency, particularly in young adults, remains limited.</p><p><strong>Objective: </strong>To compare the clinical efficacy of different electroacupuncture treatment frequencies in young adults with CNP.</p><p><strong>Methods: </strong>In this single-center, three-arm randomized controlled trial, 90 young adults with CNP were randomized 1:1:1 to three sessions per week (TSWA), one session per week (OSWA), or a waiting-list control (WL). Both acupuncture groups received bilateral electroacupuncture at Jingbailao (EX-HN15) and Jianzhongshu (SI15) for 30 min per session for 4 weeks. Participants and the treating acupuncturist were not blinded; outcome assessors and statisticians were blinded. The primary outcome was the Northwick Park Questionnaire (NPQ). Secondary outcomes were VAS, SF-MPQ, PPT, and PTO. Analyses followed the intention-to-treat principle with multiple imputation.</p><p><strong>Results: </strong>All 90 randomized participants were included in the analysis. Significant group-by-time interactions were observed for all outcomes (all P < 0.001). At week 4, both acupuncture groups were superior to WL. TSWA was also superior to OSWA for NPQ (P = 0.0196), VAS (P = 0.0042), SF-MPQ (P = 0.0200), and PTO (P = 0.0038), but not PPT (P = 0.0869). At 4-week follow-up, TSWA remained superior to OSWA only for VAS (P = 0.007); NPQ and SF-MPQ no longer differed significantly between groups.</p><p><strong>Conclusion: </strong>Both treatment frequencies improved pain, functional disability, and selected pain-threshold outcomes compared with WL. Three sessions per week produced greater short-term benefit, but its longer-term advantage was limited and was retained only for VAS at follow-up.</p><p><strong>Trial registration: </strong>International Traditional Medicine Clinical Trial Registry, ITMCTR2025001658.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"19 ","pages":"638747"},"PeriodicalIF":3.1,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13632621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Perioperative Intranasal Dexmedetomidine Spray on Clinical Outcomes of Pulsed Radiofrequency in Patients with Zoster-Associated Pain: A Randomized Controlled Trial.","authors":"Yi Wang, Mengjuan Dong, Miaomaio Xu, Huaichang Wen","doi":"10.2147/JPR.S640449","DOIUrl":"https://doi.org/10.2147/JPR.S640449","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effects of perioperative intranasal dexmedetomidine spray on hemodynamic stability, postoperative analgesia and sleep quality in patients with zoster-associated pain (ZAP) undergoing pulsed radiofrequency (PRF), and assess its clinical efficacy and safety.</p><p><strong>Methods: </strong>A single-center, randomized, double-blind, parallel-controlled trial was conducted. Sixty-eight ZAP patients receiving dorsal root ganglion PRF were randomly assigned (1:1) to the dexmedetomidine (Dex) group or control group. The Dex group received intranasal dexmedetomidine 40 μg 30 min preoperatively, followed by 40 μg twice daily for 3 postoperative days; the control group received equal-volume normal saline at matched time points. Perioperative mean arterial pressure (MAP) and heart rate (HR) were recorded. Pain intensity (VAS) and sleep quality (PSQI) were assessed at baseline and on postoperative days 1, 3, 7 and 14. The primary outcome was change in MAP from baseline to PRF treatment stage. Linear mixed-effects models were used for longitudinal analyses.</p><p><strong>Results: </strong>Baseline characteristics were comparable between groups (all <i>P</i>>0.05). The Dex group showed significantly smaller MAP and HR fluctuations during puncture, nerve stimulation and PRF treatment (group × time interaction, all <i>P</i><0.001). VAS and PSQI scores were markedly lower in the Dex group at all postoperative time points (all <i>P</i><0.001 after Bonferroni correction). No severe adverse events occurred; mild-to-moderate transient bradycardia and hypotension in the Dex group required no specific intervention.</p><p><strong>Conclusion: </strong>Perioperative intranasal dexmedetomidine spray effectively stabilizes perioperative hemodynamics, improves postoperative analgesia and sleep quality in ZAP patients undergoing PRF, with no serious safety signals observed in this study population. It provides evidence for optimized perioperative management strategies in this population.</p><p><strong>Trial registration: </strong>Chinese Clinical Trial Registry, ChiCTR2500098608, first posted 11/03/2025.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"19 ","pages":"640449"},"PeriodicalIF":3.1,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}