Pain Medicine最新文献

{"title":"Comments on: Ultrasound-guided genicular nerve radiofrequency treatment: prospective randomized comparative trial of a 3-nerve protocol versus a 5-nerve protocol.","authors":"Mauricio Forero, Laura J Olejnik","doi":"10.1093/pm/pnad157","DOIUrl":"10.1093/pm/pnad157","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139098447","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":"Approach to a patient with chemotherapy-induced peripheral neuropathy: problem-based learning discussion.","authors":"Mark P Pressler, Brian Brenner, Ariunzaya Amgalan, Andrew M Mendelson","doi":"10.1093/pm/pnad164","DOIUrl":"10.1093/pm/pnad164","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138830801","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":"Weekly pain trajectories among people with knee or hip osteoarthritis participating in a digitally delivered first-line exercise and education treatment.","authors":"Ali Kiadaliri, Helena Hörder, L Stefan Lohmander, Leif E Dahlberg","doi":"10.1093/pm/pnad167","DOIUrl":"10.1093/pm/pnad167","url":null,"abstract":"<p><strong>Objective: </strong>Digital self-management programs are increasingly used in the management of osteoarthritis (OA). Little is known about heterogeneous patterns in response to these programs. We describe weekly pain trajectories of people with knee or hip OA over up to 52-week participation in a digital self-management program.</p><p><strong>Methods: </strong>Observational cohort study among participants enrolled between January 2019 and September 2021 who participated at least 4 and up to 52 weeks in the program (n = 16 274). We measured pain using Numeric Rating Scale (NRS 0-10) and applied latent class growth analysis to identify classes with similar trajectories. Associations between baseline characteristics and trajectory classes were examined using multinomial logistic regression and dominance analysis.</p><p><strong>Results: </strong>We identified 4 pain trajectory classes: \"mild-largely improved\" (30%), \"low moderate-largely improved\" (34%), \"upper moderate-improved\" (24%), and \"severe-persistent\" (12%). For classes with decreasing pain, the most pain reduction occurred during first 20 weeks and was stable thereafter. Male sex, older age, lower body mass index (BMI), better physical function, lower activity impairment, less anxiety/depression, higher education, knee OA, no walking difficulties, no wish for surgery and higher physical activity, all measured at enrolment, were associated with greater probabilities of membership in \"mild-largely improved\" class than other classes. Dominance analysis suggested that activity impairment followed by wish for surgery and walking difficulties were the most important predictors of trajectory class membership.</p><p><strong>Conclusions: </strong>Our results highlight the importance of reaching people with OA for first-line treatment prior to developing severe pain, poor health status and a wish for surgery.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138830803","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":"Chronic pain and opioid use disorder workshop for medical students: a biopsychosocial and multidisciplinary approach.","authors":"Benjamin Lai, Tyler Oesterle, Sydney Kelpin, Eleshia Morrison, Audrey Elegbede, Nafisseh Warner","doi":"10.1093/pm/pnad151","DOIUrl":"10.1093/pm/pnad151","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89719143","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":"Lumbar erector spinae plane block versus infrainguinal fascia iliaca compartment block for pain management after total hip arthroplasty: a randomized clinical trial.","authors":"Ahmet Kaciroglu, Mursel Ekinci, Mustafa Dikici, Omer Aydemir, Oznur Demiroluk, Dilek Erdogan, Birzat Emre Golboyu, Selcuk Alver, Bahadir Ciftci, Hande Gurbuz","doi":"10.1093/pm/pnad166","DOIUrl":"10.1093/pm/pnad166","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to evaluate the effectiveness of ultrasound-guided facia iliaca compartment (FIC) and erector spinae plane (ESP) blocks in managing postoperative pain after total hip arthroplasty surgery.</p><p><strong>Methods: </strong>A total of 60 patients were randomized into 2 groups (n = 30): one that received FIC blocks and one that received ESP blocks. FIC and ESP blocks were performed with 30 mL 0.25% bupivacaine at the end of the surgery. The patients received intravenous tramadol and patient-controlled postoperative analgesia. The pain scores, opioid consumption, and adverse events were recorded.</p><p><strong>Results: </strong>The dynamic pain scores on movement in the postoperative first hour were significantly lower in the ESP block group than in the FIC block group (3 [2-4] vs 4 [2-5], respectively; P = .035). Data are expressed as median (25th-75th percentiles). Postoperative opioid consumption within the first postoperative 8 hours was significantly higher in the FIC block group than in the ESP block group (80 mg [61-100] vs 100 mg [80-120], respectively; P = .010). The adverse effects of opioids did not differ between the 2 groups.</p><p><strong>Conclusion: </strong>ESP and infrainguinal FIC blocks provided similar postoperative analgesia 24 hours after total hip arthroplasty. The ESP block is more beneficial than the FIC block in terms of pain scores and opioid consumption in the early hours of the postoperative period.</p><p><strong>Trial registration: </strong>www.ClinicalTrials.gov (ID: NCT05621161).</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138830802","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":"Pain relief in refractory fibromyalgia after vestibulocortical stimulation: an open-label pilot trial.","authors":"Michael H Kaplan, Celine H Zhou, Emily Carroll, Alan D Weinberg, Daniel J Clauw, Trung Thành Ngô, Ioannis Tassiulas","doi":"10.1093/pm/pnad145","DOIUrl":"10.1093/pm/pnad145","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71484658","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":"Opioid therapy trajectories of patients with chronic non-cancer pain over 1 year of follow-up after initiation of short-acting opioid formulations.","authors":"Mahip Acharya, Corey J Hayes, Chenghui Li, Jacob T Painter, Lindsey Dayer, Bradley C Martin","doi":"10.1093/pm/pnad169","DOIUrl":"10.1093/pm/pnad169","url":null,"abstract":"<p><strong>Objective: </strong>This study compared opioid utilization trajectories of persons initiating tramadol, short-acting hydrocodone, or short-acting oxycodone, and it characterized opioid dose trajectories and type of opioid in persistent opioid therapy subsamples.</p><p><strong>Methods: </strong>A retrospective cohort study of adults with chronic non-cancer pain who were initiating opioid therapy was conducted with the IQVIA PharMetrics® Plus for Academics data (2008-2018). Continuous enrollment was required for 6 months before (\"baseline\") and 12 months after (\"follow-up\") the first opioid prescription (\"index date\"). Opioid therapy measures were assessed every 7 days over follow-up. Group-based trajectory modeling (GBTM) was used to identify trajectories for any opioid and total morphine milligram equivalent measures, and longitudinal latent class analysis was used for opioid therapy type.</p><p><strong>Results: </strong>A total of 40 276 tramadol, 141 023 hydrocodone, and 45 221 oxycodone initiators were included. GBTM on any opioid therapy identified 3 latent trajectories: early discontinuers (tramadol 39.0%, hydrocodone 54.1%, oxycodone 61.4%), late discontinuers (tramadol 37.9%, hydrocodone 39.4%, oxycodone 33.3%), and persistent therapy (tramadol 6.7%, hydrocodone 6.5%, oxycodone 5.3%). An additional fourth trajectory, intermittent therapy (tramadol 16.4%), was identified for tramadol initiators. Of those on persistent therapy, 2687 individuals were on persistent therapy with tramadol, 9169 with hydrocodone, and 2377 with oxycodone. GBTM on opioid dose resulted in 6 similar trajectory groups in each persistent therapy group. Longitudinal latent class analysis on opioid therapy type identified 6 latent classes for tramadol and oxycodone and 7 classes for hydrocodone.</p><p><strong>Conclusion: </strong>Opioid therapy patterns meaningfully differed by the initial opioid prescribed, notably the presence of intermittent therapy among tramadol initiators and higher morphine milligram equivalents and prescribing of long-acting opioids among oxycodone initiators.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10906713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139502987","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, tolerability, and response predictors of preventive anti-CGRP mAbs for migraine in patients over 65 years old: a multicenter real-world case-control study.","authors":"Alicia Gonzalez-Martinez, Ancor Sanz-García, David García-Azorín, Jaime Rodríguez-Vico, Alex Jaimes, Andrea Gómez García, Javier Casas-Limón, Javier Díaz de Terán, María Sastre-Real, Javier Membrilla, Germán Latorre, Carlos Calle de Miguel, Sendoa Gil Luque, Cristina Trevino-Peinado, Sonia Quintas, Patricia Heredia, Ana Echavarría-Íñiguez, Ángel Guerrero-Peral, Álvaro Sierra, Nuria González-García, Jesús Porta-Etessam, Ana Beatriz Gago-Veiga","doi":"10.1093/pm/pnad141","DOIUrl":"10.1093/pm/pnad141","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate clinical characteristics, effectiveness, and tolerability of preventive anti- calcitonin gene-related peptide (CGRP) monoclonal antibodies (mAbs) in the elderly. Anti-CGRP mAbs have demonstrated efficacy and safety in patients with migraine although there is limited information regarding the elderly.</p><p><strong>Design: </strong>We performed a multicenter case-control study of cases (patients over 65 years old) and controls (sex-matched patients under 55 years old) with migraine receiving anti-CGRP mAbs.</p><p><strong>Methods: </strong>We included the demographic characteristics, effectiveness-reduction in the number of monthly headache days (MHD) and monthly migraine days (MMD), 30%, 50%, and 75% responder rates-and treatment emergent adverse events (TEAEs). The primary endpoint was the 50% response rate regarding MHD at weeks 20-24; exploratory 50% response predictors in the elderly were evaluated.</p><p><strong>Results: </strong>In total, 228 patients were included: 114 cases , 114 controls-. Among cases 84.2% (96/114) were women, 79.8% (91/114) CM; mean age of cases 70.1 years old (range: 66-86); mean age of controls was 42.9 years old(range: 38-49). Cases had a higher percentage of vascular risk factors (P < .05),older age of onset (P < .001) and more reported prior preventive treatments (P < .001). Regarding effectiveness in cases, 50% response rate was achieved by 57.5% (42/73) at 20-24 weeks, with lower reduction in the MHD at 8-12 weeks (5 [7.2], 8 [9.1]; P = .001) and a higher reduction in MMD at 20-24 weeks (10.7 [9.1], 9.2 [7.7]; P = .04) compared to the control group. The percentage of TEAEs was similar in the 2 groups. Diagnosis of episodic migraine (EM) (P = .03) and lower number of MHD at baseline (P = .001) were associated with a 50% response in the elderly in univariate analysis.</p><p><strong>Conclusions: </strong>Our study provides real world evidence of effectiveness and safety of anti-CGRP mAbs for migraine in patients without upper age-limit and possible predictors of anti-CGRP response in the elderly.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41237429","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":"Ultrasound-guided selective glossopharyngeal nerve block: posterior mandibular ramus approach.","authors":"Yuki Kojima, Songi Okamoto, Kazuya Hirabayashi","doi":"10.1093/pm/pnad143","DOIUrl":"10.1093/pm/pnad143","url":null,"abstract":"<p><strong>Objective: </strong>Glossopharyngeal nerve block is a useful interventional technique for pain management of the head and neck. It is performed with landmark techniques or ultrasound guidance. We propose a novel ultrasound-guided glossopharyngeal nerve block technique.</p><p><strong>Methods: </strong>This new approach was performed in 3 patients in their twenties and thirties. A needle was inserted deeply under the stylohyoid muscle through the sternocleidomastoid muscle. Subsequently, an ultrasound-guided nerve block was performed with 1 mL of 1% xylocaine. The performance of our technique was evaluated with 2 tests: a cold sensitivity test and a gag reflex test.</p><p><strong>Results: </strong>The effect of the nerve block was observed in the posterior third of the tongue on both sides, the tonsils, and the pharyngeal region. The effect lasted for approximately 1.5 hour. Motor efferent block was not observed.</p><p><strong>Conclusions: </strong>We designated the technique as ultrasound-guided selective glossopharyngeal nerve block: posterior mandibular ramus approach. No complications occurred during the bilateral application. This novel approach can be performed at a very shallow position, compared with conventional methods. There is no damage to tissues other than the muscles, which reduces postoperative complications and patient distress. Although our technique requires further safety assessments and technical refinements, it could represent a simpler alternative to conventional methods in daily clinical practice.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54230415","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":"Increasing buprenorphine access for patients with chronic pain: a quality improvement initiative.","authors":"Danielle M Wesolowicz, Juliette F Spelman, Sara N Edmond, Amy R Schwartz, Jeffrey D Kravetz, Ellen L Edens, William C Becker","doi":"10.1093/pm/pnad140","DOIUrl":"10.1093/pm/pnad140","url":null,"abstract":"<p><strong>Objective: </strong>Buprenorphine is effective for chronic pain and safer than full-agonist opioids; however, limited education about and support for buprenorphine can result in under-prescribing in primary care and reduced access in specialty pain clinics. The purpose of this quality improvement initiative was to optimize and evaluate procedures for transferring patients stable on buprenorphine for chronic pain from a specialty pain clinic back to primary care.</p><p><strong>Setting: </strong>Eight primary care clinics within a Veterans Health Administration health care system.</p><p><strong>Methods: </strong>A standard operating procedure for facilitated transfer of prescribing was developed after a needs assessment and was introduced during an educational session with primary care providers, and providers completed a survey assessing attitudes about buprenorphine prescribing. Success of the initiative was measured through the number of patients transferred back to primary care over the course of 18 months.</p><p><strong>Results: </strong>Survey results indicated that primary care providers with previous experience prescribing buprenorphine were more likely to view buprenorphine prescribing for pain as within the scope of their practice and to endorse feeling comfortable managing a buprenorphine regimen. Providers identified systemic and educational barriers to prescribing, and they identified ongoing support from specialty pain care and primary care as a facilitator of prescribing. Metrics suggested that the standard operating procedure was generally successful in transferring and retaining eligible patients in primary care.</p><p><strong>Conclusion: </strong>This quality improvement initiative suggests that a facilitated transfer procedure can be useful in increasing buprenorphine prescribing for pain in primary care. Future efforts to increase primary care provider comfort and address systemic barriers to buprenorphine prescribing are needed.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41237430","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}