Pain Medicine最新文献

{"title":"Subdural hematoma after spinal anesthesia.","authors":"Michael Beeler, Paul Porensky, Rintaro Kinjo, Scott Hughey","doi":"10.1093/pm/pnae108","DOIUrl":"10.1093/pm/pnae108","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"112-113"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Noninvasive brain stimulation beyond the motor cortex: a systematic review and meta-analysis exploring effects on quantitative sensory testing in clinical pain.","authors":"Andrew Flood, Rocco Cavaleri, We-Ju Chang, Jason Kutch, Constantino Toufexis, Simon J Summers","doi":"10.1093/pm/pnae103","DOIUrl":"10.1093/pm/pnae103","url":null,"abstract":"<p><strong>Background: </strong>Noninvasive brain stimulation (NIBS) has been investigated increasingly as a means of treating pain. The effectiveness of NIBS in the treatment of pain has traditionally focused on protocols targeting the primary motor cortex (M1). However, over time, the effectiveness of M1 NIBS has been attributed to effects on interconnected cortical and subcortical sites rather than on M1 itself. Although previous reviews have demonstrated the effectiveness of non-M1 NIBS in improving subjective reports of pain intensity, the neurophysiological mechanisms underlying these effects remain incompletely understood. As chronic pain is associated with pain hypersensitivity and impaired endogenous descending pain modulation, it is plausible that non-M1 NIBS promotes analgesic effects by influencing these processes.</p><p><strong>Objective: </strong>The aim of this systematic review and meta-analysis was therefore to evaluate the effect of NIBS over non-M1 sites on quantitative sensory testing measures in clinical pain populations.</p><p><strong>Methods: </strong>A systematic search of electronic databases was conducted from inception to January 2024. Included articles (13 trials, n = 565 participants) were appraised with the Physiotherapy Evidence Database (PEDro) scale and Grading of Recommendations, Assessment, Development, and Evaluation (GRADE), and a random-effects model was used to meta-analyze outcomes where possible.</p><p><strong>Results: </strong>A small number of studies found that NIBS applied to the dorsolateral prefrontal cortex might improve pain modulation in patients with fibromyalgia and that stimulation of the posterior superior insula and prefrontal cortex could improve pain sensitivity in chronic neuropathic and osteoarthritic pain, respectively. However, findings varied among studies, and there remains a paucity of primary research.</p><p><strong>Conclusion: </strong>This review indicates that current literature does not provide clear evidence that NIBS over non-M1 sites influences pain processing.</p><p><strong>Study registration: </strong>PROSPERO (CRD42020201076).</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"98-111"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11789781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142471855","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":"Identifying factors associated with persistent opioid use after total joint arthroplasty: a retrospective review.","authors":"Aurora Quaye, John DiPalazzo, Kristin Kostka, Janelle M Richard, Blaire Beers-Mulroy, Meredith Peck, Robert Krulee, Yi Zhang","doi":"10.1093/pm/pnae120","DOIUrl":"10.1093/pm/pnae120","url":null,"abstract":"<p><strong>Objective: </strong>To identify predictors of persistent opioid use in opioid-naïve individuals undergoing total joint arthroplasty.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Maine Health System.</p><p><strong>Subjects: </strong>Opioid-naïve patients who underwent at least one total joint arthroplasty (knee, hip, or shoulder) between 2015 and 2020.</p><p><strong>Methods: </strong>Least Absolute Shrinkage and Selection Operator (LASSO) logistic regression was used to create a predictive model for persistent opioid use after surgery from a US Electronic Health Record dataset in the Observational Medical Outcomes Partnership Common Data Model format. 75% of the data was used to build the LASSO model using 10-fold cross-validation and 25% of the data was used to determine the optimal probability threshold for predicting the binary outcome.</p><p><strong>Results: </strong>Out of 6432 patients, 12.3% (792) were identified as having persistent opioid use across combined total joint arthroplasties defined as at least one opioid prescription between 90 days and 1 year after surgery. Patients with persistent opioid use were more likely to be current smokers (OR 1.65), use antidepressants (OR 1.76), or have a diagnosis of post-traumatic stress disorder (OR 2.07) or a substance-related disorder (OR 1.69). Other factors associated with persistent opioid use included back pain (OR 1.43), dementia (OR 1.65), and body mass index over 40 (OR 2.50). The probability of persistent opioid use was not associated with age, sex, or ethnicity.</p><p><strong>Conclusions: </strong>This predictive model for persistent opioid use after total joint arthroplasty shows promise as an evidence-based, validated, and standardized tool for identifying high-risk patients before surgery in order to target strategies and interventions to reduce the reliance on opioids for postoperative pain control.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"53-62"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11789782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682448","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":"The use of vaginal estrogen for provoked vestibulodynia in breast cancer survivors: a delicate balance of risk and relief.","authors":"Carlos Agustín Zapata-Caballero, Cintia Indira Velasquez Chavarría, Claudia Melina Robellada-Zárate, Rebeca Rodriguez-Lane, Jaime Ignacio Cevallos-Bustillos, Viridiana Gorbea-Chávez, Verónica Granados-Martínez","doi":"10.1093/pm/pnae099","DOIUrl":"10.1093/pm/pnae099","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"117-119"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142392317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of a novel nerve ablation technique to relieve lower back pain: a cadaveric feasibility pilot study.","authors":"Charlotte Jones-Whitehead, John Tran, Timothy D Wilson, Eldon Loh","doi":"10.1093/pm/pnae112","DOIUrl":"10.1093/pm/pnae112","url":null,"abstract":"<p><strong>Introduction: </strong>Radiofrequency ablation is a treatment for facetogenic low back pain that targets medial branches of lumbar dorsal rami to denervate facet joints. Clinical outcomes vary; optimizing cannula placement to better capture the medial branch could improve clinical outcomes. A novel parasagittal technique was proposed from an anatomic model; this technique was proposed to optimize capture of the medial branch. The anatomic feasibility of the novel technique has not been evaluated.</p><p><strong>Objective: </strong>To simulate and evaluate the proposed parasagittal technique in its ability to achieve proper cannula placement and proximity of uninsulated cannula tips to the medial branches of the dorsal rami in cadaveric specimens.</p><p><strong>Methods: </strong>Under fluoroscopic guidance, the parasagittal technique was used to place 14 cannulae targeting the lumbar medial branches of 2 cadavers. Meticulous dissection was undertaken to assess cannula alignment and measure proximities to target nerves with a digital caliper.</p><p><strong>Results: </strong>The novel parasagittal technique was successfully performed in a cadaveric model in 12 of 14 attempts. The technique achieved close proximity of cannula tips to medial branches (0.8 ± 1.1 mm). In 2 instances, cannulae were placed unsuccessfully; in one instance, the cannula was too far anterior, and in the other, it was too far retracted.</p><p><strong>Conclusion: </strong>In this cadaveric simulation study, the feasibility of performing the parasagittal technique for lumbar radiofrequency ablation was evaluated. This study suggests that the parasagittal technique is a feasible option for lumbar medial branch radiofrequency ablation.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"70-75"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11789780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590714","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":"Comments on: Buprenorphine for acute pain in older adults: a systematic review with meta-analysis.","authors":"Daniel B Larach","doi":"10.1093/pm/pnae106","DOIUrl":"10.1093/pm/pnae106","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"124-125"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11789778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142471852","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":"Chemical neurolysis of genicular nerves for chronic non-cancer knee pain: a scoping review.","authors":"Matthew Rong Jie Tay, Nimish Mittal, Samantha Yao, Jordan Farag","doi":"10.1093/pm/pnae109","DOIUrl":"10.1093/pm/pnae109","url":null,"abstract":"<p><strong>Objective: </strong>Chemical neurolysis of the genicular nerves is a treatment option for intractable non-cancer knee pain. This scoping review synthesizes the available literature on the effectiveness, adverse events, and procedural techniques of chemical neurolysis of genicular nerves for the management of knee pain.</p><p><strong>Design: </strong>Scoping review.</p><p><strong>Setting: </strong>All clinical and research settings.</p><p><strong>Subjects: </strong>Adult participants with chronic non-cancer knee pain undergoing chemical neurolysis of genicular nerves.</p><p><strong>Methods: </strong>A literature search in MEDLINE, EMBASE, and Cochrane Library was conducted up to September 4, 2023. Articles were searched via terms and keywords relating to \"knee,\" \"pain,\" \"knee osteoarthritis,\" \"ablation,\" \"alcohol,\" \"phenol,\" and \"chemical neurolysis.\" Included articles were full-text primary studies and in English. Data were extracted by 2 independent reviewers using an electronic database.</p><p><strong>Results: </strong>Eight studies were included in this review (including 1 randomized controlled trial), comprising 192 patients. Of the 8 studies, 4 used phenol, 3 used alcohol, and 1 used either alcohol or phenol for chemical neurolysis. Fluoroscopy, ultrasound guidance, or both were used for nerve target identification. All studies demonstrated that chemical neurolysis resulted in improved pain or functional outcomes, with no serious adverse events reported.</p><p><strong>Conclusions: </strong>Chemical neurolysis of the genicular nerves is a promising treatment strategy for chronic knee pain. Interpretation of the available studies is limited by study heterogeneity and small sample sizes. High-quality randomized controlled trials are required to clarify the selection of appropriate nerve targets and choice of image guidance and to compare with other ablative modalities.</p><p><strong>Study registration: </strong>Open Science Framework (https://osf.io/jg8wh).</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"76-89"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Authors' response to letter to the editor regarding \"Buprenorphine for acute pain in older adults: a systematic review with meta-analysis\".","authors":"Katherine Selman, Sarah Perelman, Caroline Blatcher, David Fett, Amanda Adams, Brian Roberts","doi":"10.1093/pm/pnae107","DOIUrl":"10.1093/pm/pnae107","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"126-127"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142471850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Virtual reality communication training in pain medicine: effects on medical students' racial bias, empathy, and interview performance with virtual patients.","authors":"Jordan N Kohn, Emily A Troyer, Kathleen L Wilson, Rajiv Reddy, Cassandra Vieten, Erik Viirre, Weena Joshi, Joseph Unger, Trisha Williams, Dimitri J Gonzales, Suzi Hong","doi":"10.1093/pm/pnae100","DOIUrl":"10.1093/pm/pnae100","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"120-123"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142392318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building Community Through Data: The value of a Researcher Driven Open Science Ecosystem.","authors":"Meredith C B Adams, Carla M Bann, Emine Ozgur Bayman, Maria Chao, Georgene W Hergenroeder, Charles Knott, Martin A Lindquist, Z David Luo, Rosemarie Martin, Maryann E Martone, John McCarthy, Micah McCumber, Sharon B Meropol, Ty A Ridenour, Lissette M Saavedra, Abeed Sarker, Kevin J Anstrom, Wesley K Thompson","doi":"10.1093/pm/pnaf003","DOIUrl":"10.1093/pm/pnaf003","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}