Pain Medicine最新文献

{"title":"Advanced three-dimensional anatomical mapping of saphenous and inferior medial genicular nerve branching: enhancing precision in knee joint denervation.","authors":"Paula J Yu, Eldon Loh, Anne M R Agur, John Tran","doi":"10.1093/pm/pnae102","DOIUrl":"10.1093/pm/pnae102","url":null,"abstract":"<p><strong>Background: </strong>Radiofrequency ablation is a common non-opioid treatment to manage chronic knee pain. The inferior medial genicular nerve is conventionally targeted. It has been suggested that the infrapatellar branch (saphenous nerve) should also be targeted. There is controversy regarding the contribution of the infrapatellar branch to the innervation of the knee joint capsule.</p><p><strong>Objective: </strong>(1) Identify the frequency of the branching pattern(s) of the infrapatellar branch in three-dimensional (3D); (2) Assess spatial relationships of branches of infrapatellar branch to the inferior medial genicular nerve; (3) Determine if capturing infrapatellar branch could result in additional benefit to the existing protocol.</p><p><strong>Design: </strong>Anatomical study.</p><p><strong>Methods: </strong>The infrapatellar branch and inferior medial genicular nerve were serially dissected, digitized, and modelled in 3D in 7 specimens (mean age 91.3 ± 6.5; 2F/5M) and their relationship documented. The spatial relationship of the nerves was used to assess the anatomical efficacy of including the infrapatellar branch in the protocol.</p><p><strong>Results: </strong>The infrapatellar branch is most frequently a cutaneous nerve. This nerve was variable and found to be unbranched or have 2-3 branches and in all specimens was located superficial to the branches of inferior medial genicular nerve. When the infrapatellar branch (1) coursed more distally, the strip lesion would not capture the infrapatellar branch but would capture inferior medial genicular nerve consistently; (2) overlapped with the inferior medial genicular nerve, the strip lesion would capture both nerves.</p><p><strong>Conclusions: </strong>Proposed protocol targeting the infrapatellar branch is likely to capture the inferior medial genicular consistently regardless of the anatomical variation of the infrapatellar branch.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"8-13"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142471849","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":"Time to unlock pain relief? A critical review of the patient-controlled analgesia 4-hour lockout parameter.","authors":"Alexander M Kiel, Nafisseh S Warner, Nathan T Smith","doi":"10.1093/pm/pnae087","DOIUrl":"10.1093/pm/pnae087","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"1-2"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142018258","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":"Acknowledgement of reviewers (2024).","authors":"","doi":"10.1093/pm/pnae117","DOIUrl":"https://doi.org/10.1093/pm/pnae117","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":"26 1","pages":"51"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931367","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":"Personalized outcomes in neuropathic pain: a clinical relevance and assay sensitivity analysis from a randomized controlled trial.","authors":"Karim Saab, Umang Gada, Eva Culakova, Brian Burnette, Carla Jorgensen, Dhaval Shah, Gary Morrow, Karen Mustian, Michael B Sohn, Robert R Edwards, Roy Freeman, Dale J Langford, Michael P McDermott, Jennifer S Gewandter","doi":"10.1093/pm/pnae095","DOIUrl":"10.1093/pm/pnae095","url":null,"abstract":"<p><strong>Objective: </strong>To explore the clinical relevance and assay sensitivity of using personalized outcomes using data from a randomized clinical trial (RCT) in people with chemotherapy-induced peripheral neuropathy (CIPN).</p><p><strong>Design: </strong>This study is a secondary analysis that leveraged data from a RCT of transcutaneous electrical stimulation for CIPN to test whether personalized outcomes could minimize potential floor effects and increase the assay sensitivity of pain clinical trials (ie, ability to detect a true treatment effect).</p><p><strong>Setting: </strong>Participants were recruited for a RCT from community oncology clinics in the United States.</p><p><strong>Participants: </strong>Adults with CIPN (N = 72) who reported on average ≥4 intensity (measured via a 7-day baseline diary) for at least 1 of the following pain qualities: hot/burning pain, sharp/shooting pain, and/or cramping.</p><p><strong>Methods: </strong>Personalized outcomes were defined based on participants' unique presentation of pain qualities at baseline, measured via 0-10 numeric rating scales (NRS), or ranking of the distress caused by the pain qualities. Analysis of covariance models estimated the treatment effect as measured by personalized and non-personalized outcomes.</p><p><strong>Results: </strong>The adjusted mean difference between groups was higher using personalized outcomes (ie, 1.21-1.25 NRS points) compared to a non-personalized outcome (ie, 0.97 NRS points), although the standardized effect sizes were similar between outcomes (0.49-0.54).</p><p><strong>Conclusions: </strong>These results suggest that personalized pain quality outcomes could minimize floor effects, while providing similar assay sensitivity to non-personalized pain quality outcomes. Personalized outcomes better reflect an individual's unique experience, inherently providing more clinically relevant estimates of treatment effects. Personalized outcomes may be advantageous, particularly for clinical trials in populations with high inter-individual variability in pain qualities.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"22-29"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142375784","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":"Trigger point injections for myofascial pain in terminal cancer: a randomized trial.","authors":"Hideaki Hasuo, Hiroto Ishiki, Yoshinobu Matsuda, Hiromichi Matsuoka, Kazuhiro Kosugi, Mei Xing, Yasushi Akiyama, Yoshihisa Matsumoto, Hideki Ishikawa","doi":"10.1093/pm/pnae084","DOIUrl":"10.1093/pm/pnae084","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to evaluate the efficacy and safety of a single trigger point injection (TPI) of a local anesthetic for the treatment of myofascial pain syndrome (MPS) in patients with incurable cancer.</p><p><strong>Methods: </strong>This multicenter, exploratory, open-label, randomized comparative trial was conducted in five specialized palliative care departments. Hospitalized patients with incurable cancer who had been experiencing pain related to MPS were randomized to receive either a TPI of 1% lidocaine plus conventional care (TPI group) or conventional care alone (control group). The short-term efficacy and occurrence of adverse events (AEs) were compared between groups. The primary endpoint was the percentage of patients who experienced a reduction in pain scores of ≥50%, assessed using an 11-point Numerical Rating Scale, at 3 days post-intervention. Adverse events were assessed using the Common Terminology Criteria for AEs v5.0.</p><p><strong>Results: </strong>Fifty patients were enrolled, and the trial completion rate was 100%. The proportion of patients who experienced an improvement in Numerical Rating Scale pain scores of ≥50% was 70.8% (95% confidence interval, 52.4%-89.2%) in the TPI group and 0.0% in the control group; the difference was statistically significant (P < .001). In the TPI group, one case (4.2%) of Grade 1 nausea and 1 case (4.2%) of Grade 1 somnolence were reported.</p><p><strong>Conclusion: </strong>A single TPI of a local anesthetic is safe and efficacious in inducing an immediate reduction in MPS-related pain in patients with incurable cancer. Clinical trials registration number: This study was registered with the Japan Registry of Clinical Trials (approval number: jRCTs051210132) on December 16, 2021. https://jrct.niph.go.jp/en-latest-detail/jRCTs051210132.Approval of the research protocol by a Certified Review Board: The present study was approved by the Wakayama Medical University (reference number: CRB5180004. Registered 26 May 2021).</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"14-21"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142471856","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":"Pudendal nerve entrapment syndrome: clinical features, diagnosis, and management.","authors":"Rayan Fawaz, Aicha Ltaief-Boudrigua, Manon Duraffourg","doi":"10.1093/pm/pnae092","DOIUrl":"10.1093/pm/pnae092","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"39-42"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142133414","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":"Quantitative assessment of conflicts of interest in reviews of spinal cord stimulation research.","authors":"Mustafa Broachwala, Nathaniel M Schuster","doi":"10.1093/pm/pnae088","DOIUrl":"10.1093/pm/pnae088","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"45-47"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142018257","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":"Cerebrospinal Fluid Metabolomics of Pain in Patients with Spinal Muscle Atrophy.","authors":"Abby Pei-Ting Chiu, G A Nagana Gowda, Wentao Zhu, Lars Arendt-Nielsen, Daniel Raftery, Michele Curatolo","doi":"10.1093/pm/pnae129","DOIUrl":"https://doi.org/10.1093/pm/pnae129","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824326","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":"Peripheral Nerve Stimulation for Post-Spinal Fusion Sacroiliac Joint Pain.","authors":"Changho Yi, Evgeny Bulat, Oranicha Jumreornvong, Sravya Madabhushi, Sudhir Diwan, Alan David Kaye, Reda Tolba, Erkan Kurt, Michael E Schatman, R Jason Yong, Christopher L Robinson, Jamal Hasoon","doi":"10.1093/pm/pnae125","DOIUrl":"https://doi.org/10.1093/pm/pnae125","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818802","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":"Tele-collaborative outreach to rural patients with chronic pain: pragmatic effectiveness trial protocol for the CORPs study.","authors":"Benjamin J Morasco, Natassja Pal, Sarah S Ono, Sterling M McPherson, Frances L Lynch, John F Dickerson, Steven K Dobscha, Erin E Krebs, Una E Makris, Amanda S Mixon, Patricia Maloy, Melinda M Davis, Travis I Lovejoy","doi":"10.1093/pm/pnae075","DOIUrl":"10.1093/pm/pnae075","url":null,"abstract":"<p><strong>Background: </strong>Despite the increased availability of evidence-based treatments for chronic pain, many patients in rural areas experience poor access to services. Patients receiving care through the VA may also need to navigate multiple systems of care.</p><p><strong>Objective: </strong>To examine the effectiveness of a remotely delivered collaborative care intervention for improving pain interference among veterans with high-impact chronic pain living in rural areas.</p><p><strong>Design: </strong>We will conduct a four-site pragmatic effectiveness trial of remotely delivered collaborative care for high-impact chronic pain. Participants (n = 608) will be randomized to the Tele-Collaborative Outreach to Rural Patients (CORPs) intervention or to minimally enhanced usual care (MEUC). Participants randomized to CORPs will complete a biopsychosocial assessment and five follow-up sessions with a nurse care manager (NCM), who will collaborate with a consulting clinician to provide personalized recommendations and care management. CORP participants will also be invited to a virtual 6-session pain education group class. Participants randomized to MEUC will receive a one-time education session with the NCM to review available pain services. All participants will complete quarterly research assessments for one year. The primary study outcome is pain interference. This trial will oversample veterans of female birth sex and minoritized race or ethnicity to test heterogeneity of treatment effects across these patient characteristics. We will conduct an implementation process evaluation and incremental cost-effectiveness analysis.</p><p><strong>Discussion: </strong>This pragmatic trial will test the real-world effectiveness of a remotely delivered collaborative care intervention for chronic pain. Study findings will inform future implementation efforts to support potential uptake of the intervention.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":"25 Supplement_1","pages":"S91-S98"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11548859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142605941","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}