Pain and Therapy最新文献

{"title":"Multimodal Therapies for the Treatment of Neuropathic Pain: The Role of Lidocaine Patches in Combination Therapy: A Narrative Review.","authors":"Srinivas Nalamachu, Theresa Mallick-Searle, Jeremy Adler, Elaine K Chan, Wendy Borgersen, Dmitri Lissin","doi":"10.1007/s40122-025-00733-7","DOIUrl":"https://doi.org/10.1007/s40122-025-00733-7","url":null,"abstract":"<p><p>Neuropathic pain (NP) has a population presence of up to 10%. Both systemic agents and topical agents are recommended as first-line therapy for the treatment of NP but monotherapy provides adequate pain relief only in < 50% of the cases. This has created the need for multimodal combination therapy, a practice that is becoming more common. Combination therapy with multiple systemic agents has a risk for drug-drug interactions and adverse events (AEs), while add-on therapy with a topical agent such as lidocaine patches minimizes such risks. The focus of this review was to find if there is evidence from trials that combination therapy of the topical lidocaine patches with systemic agents will have better efficacy and/or less risk of AEs than the combination of two systemic agents. Since gabapentinoids are one of the most common systemic agents used in first-line NP therapy, the objective of this review was to summarize the safety and efficacy data and evaluate the benefit-risk ratio from three gabapentinoid combinations; gabapentinoid plus opioids, gabapentinoid plus antidepressants, and gabapentinoid plus topical lidocaine patches. Reviews of clinical trials of combinations of gabapentinoids plus other systemic agents (opioids or antidepressants) were associated with increased AEs and dropouts while improvement in analgesic efficacy was inconsistent. Clinical trials where the patients were provided topical lidocaine patches when their first treatment with a gabapentinoid was inadequate demonstrated improved analgesic efficacy with minimal additional AEs. This led to the conclusion that topical lidocaine patches-associated with minimal systemic adverse effects and proven benefits in various neuropathic pain (NP) conditions-can enhance the likelihood of achieving meaningful pain relief when used as adjuvant therapy for NP.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A National Cross-Sectional Survey on Real-World Experiences of Calcitonin Gene-Related Peptide (CGRP) Monoclonal Antibody Use in Adults with Migraine in Finland.","authors":"Caroline S Casey, Mari Pölkki, Elisa K Suvanen, Ilona Iso-Mustajärvi, Timo Purmonen, Essi J Peltonen, Camilla K Appel, Niraj J Patel, Lill-Brith Von Arx","doi":"10.1007/s40122-025-00719-5","DOIUrl":"https://doi.org/10.1007/s40122-025-00719-5","url":null,"abstract":"<p><strong>Introduction: </strong>Calcitonin gene-related peptide (CGRP) monoclonal antibodies (mAbs) were the first preventive migraine treatment group to target the underlying cause of migraine. This survey evaluated real-life experiences of adults with migraine in Finland before and after using their current subcutaneous CGRP mAb treatment.</p><p><strong>Methods: </strong>Adult users of a subcutaneous CGRP mAb for migraine prevention were recruited for an electronic cross-sectional survey by Finnish community pharmacies and Migraine Finland (a patient advocacy group) in 2023. The survey included questions regarding monthly migraine headache days, absenteeism, general disability, pain intensity, treatment patterns, and a validated Migraine-Specific Quality of Life (MSQoL) questionnaire.</p><p><strong>Results: </strong>The survey was completed by 383 users of subcutaneous CGRP mAb medication, of whom 78 (20.4%) were receiving galcanezumab. Users of galcanezumab, the latest CGRP mAb to be reimbursed in Finland, had more previous CGRP mAb treatment switches than users of other CGRP mAbs. Following any subcutaneous CGRP mAb use, changes were observed in the number of monthly migraine headache days (0-7 experienced by 17/379 participants [4.5%] with data before, versus 302/379 [79.7%] after using treatment; ≥ 12 experienced by 279/379 [73.6%] before, versus 34/379 [9.0%] after), monthly sick leave days (from 139/376 [37.0%] to 15/376 [4.0%] with ≥ 4 monthly sick leave days), overall ability to work or study (from 180/377 [47.7%] to 287/377 [76.1%] able to work or study full time) and average intensity of migraine pain (median [lower-upper quartile] from 8.0 [7.0-9.0] before to 6.0 [4.0-8.0] after). No differences were observed between total MSQoL scores for new (0-6 months CGRP mAb use) versus persistent (≥ 6 months use) users of any CGRP mAb.</p><p><strong>Conclusions: </strong>Patient experiences of using subcutaneous CGRP mAbs in Finland showed improvements in several migraine-related factors, supporting the potential for CGRP mAbs to improve the quality of life of adults with migraine.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vulvodynia and Chronic Vulvar Pain: Influencing Factors and Long-Term Success After Therapeutic Local Anesthesia (TLA).","authors":"Axel Gerhardt, Manuel Feisst, Thomas Strowitzki, Oliver Zivanovic, Stefan Weinschenk","doi":"10.1007/s40122-025-00725-7","DOIUrl":"https://doi.org/10.1007/s40122-025-00725-7","url":null,"abstract":"<p><strong>Introduction: </strong>Vulvodynia is a debilitating sexual disorder with a high prevalence of 7-11%. In the study reported here, we analyzed long-term results from a prospective, non-controlled observational study to enhance our understanding of the success of therapeutic local anesthesia (TLA) and to investigate factors that predict a response or failure of therapy, with the overall aim to gain new insights into the complex medical condition of vulvodynia.</p><p><strong>Methods: </strong>A total of 45 patients diagnosed with severe chronic vulvodynia or chronic vulvar pain (Numeric Analog Scale [NAS] ≥ 6, median 7.9, duration ≥ 6 months, median 65.2 months) and previously treated with TLA were re-evaluated 4.5-13 years after therapy. Therapy response was defined as NAS ≤ 4 for at least 6 months.</p><p><strong>Results: </strong>Of the 45 patients originally diagnosed with vulvodynia, 38 were available for follow-up (32 of the original 36 responders, and 4 of the 9 non-responders). The average follow-up period was 7.9 years (95.2 months, range 55-156 months) after the end of therapy. All responders remained symptom-free, and two of the non-responders also became responders. Factors associated with non-response were: the number of physicians seen previously, lichen sclerosus, previous traumata, relapses of recurrent cystitis, corticoid therapy, and psychological factors, including depression, psychotropic drug intake, and psychotherapy. Body mass index (BMI) was lower in non-responders. The number of deliveries, cesarean sections, abortions, age, hormonal status, other medication intake, and gynecological surgeries had no impact on the results.</p><p><strong>Conclusion: </strong>The long-term success of TLA supports the hypothesis that neuralgia of one or more nerves of the pelvic floor is an important component in the development of vulvodynia. This study provides evidence for the long-term effectiveness of TLA in women with vulvodynia, as well as potential obstacles to healing. Despite limitations imposed by a monocentric, non-controlled observational design, the robustness of this investigation lies in the long observation period after treatment and the substantial percentage of patients for whom TLA was successful. The long-term results emphasize the necessity of a holistic approach integrating the view of vulvodynia as a peripheral neuro-functional disorder.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Importance of Image Guidance in Common Spine Interventional Procedures for Pain Management: A Comprehensive Narrative Review.","authors":"Martina Rekatsina, Philip W H Peng","doi":"10.1007/s40122-025-00731-9","DOIUrl":"https://doi.org/10.1007/s40122-025-00731-9","url":null,"abstract":"<p><strong>Introduction: </strong>Image-guided spinal injections are commonly performed by pain physicians and supported by literature. A recent survey showed that half of the Canadian providers still perform landmark-guided injections. This comprehensive review aims to describe the evidence supporting imaging modalities (fluoroscopy, computed tomography (CT) and ultrasound) in improving the accuracy and safety in several commonly performed spine injections. Relevant anatomy and pitfalls of landmark-guided injections are also discussed.</p><p><strong>Methods: </strong>An extensive literature search was conducted in PubMed, Medline and Embase databases, complemented by a manual search. Search terms included all spine interventions and imaging modalities.</p><p><strong>Results: </strong>Literature shows that incorrect needle placement without imaging guidance can reach 50% in caudal, 30.4% in lumbar interlaminar and 53% in cervical interlaminar epidural steroid injections. Lumbar and cervical transforaminal steroid injections require imaging to identify intravascular or intradiscal needle placement; misplacement rates can be as high as 20% at cervical, 8% at thoracic, 6-15% at lumbar and 16.5-21% at sacral levels. Imaging techniques for sacroiliac joint steroid injections are superior to non-imaging techniques, while medial branch blocks and facet joint injections require image guidance.</p><p><strong>Conclusion: </strong>Image guidance is a mandatory requirement when performing spinal procedures for pain management. Fluoroscopy enhances the safety and accuracy of spinal injections, with stored images benefiting patient records. Ultrasound also has an increasingly important role either alone or with fluoroscopy. CT is also effective but with limited accessibility.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Real-World Use of Topical Diclofenac Sodium Gel 1% Using US Longitudinal Electronic Health Records Database: A study supporting OTC switch.","authors":"Nicholas M Sicignano, Frédérique Bariguian Revel, Richard Petruschke, Francis P Barbone, Karin Nicholson, Jess D Edison","doi":"10.1007/s40122-025-00723-9","DOIUrl":"https://doi.org/10.1007/s40122-025-00723-9","url":null,"abstract":"<p><strong>Introduction: </strong>Musculoskeletal conditions are a significant health challenge and second leading cause of disability worldwide. Diclofenac sodium topical gel 1% (DSG1%) provides effective relief of arthritis pain. While clinical studies show that DSG1% is safe and well-tolerated, long-term safety and tolerability in real-world settings are limited. This study aimed to profile users and prescribers of DSG1% and to evaluate its safety and tolerability over a screening period of 8.5 years with an average follow-up of nearly 1 year. The focus was on patients with risk factors and comorbidities, especially those taking concomitant medication in addition to topical nonsteroidal anti-inflammatory drugs (NSAIDs).</p><p><strong>Methods: </strong>This retrospective, longitudinal cohort study used the US Department of Defense (DoD) electronic health records (EHR) database. The database included 521,593 individuals with ≥ 1 prescription for DSG1% for either indicated or non-indicated conditions with mean (standard deviation; SD) follow-up of 348.4 (562.4) days. The primary outcome measure assessed the incidence of predefined events of interest (EOIs), including gastrointestinal, hepatic, renal diseases, cardiovascular events, hypertension, skin reaction, misuse, abuse, and death (all-cause mortality).</p><p><strong>Results: </strong>The average age of subjects was 56.7 years (SD = 18.1), with women comprising 60.4% of population. During study-period, 74.2% of subjects experienced no adverse EOIs after initiating treatment with DSG1%. Among the remaining 25.8%, average time to first EOI was 244.0 (SD = 368.6) days. Notably, the frequency of reported EOIs increased with age. Additionally, subjects with conditions such as rheumatoid arthritis, systemic lupus erythematosus, or diabetes had a higher incidence of cardiovascular EOIs.</p><p><strong>Conclusions: </strong>The study results indicate that DSG demonstrated a favorable safety profile, particularly for patients with comorbidities and high-risk factors and when used with other medications. Despite an older population and high baseline risk factors (93%), only 26% DSG1% users experienced a predefined EOI, observed on average 244.0 (368.6) days from index date. These findings confirm the long-term tolerability of topical DSG1% for musculoskeletal disorders.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Small Fibre Pathology in Fibromyalgia: A review.","authors":"Anne Marshall, Mohamed Elshafei, Frank G Preston, Jamie Burgess, Nicola Goodson, Nicholas Fallon, Bernhard Frank, Sizheng Steven Zhao, Uazman Alam","doi":"10.1007/s40122-024-00696-1","DOIUrl":"10.1007/s40122-024-00696-1","url":null,"abstract":"<p><p>Fibromyalgia syndrome (FMS) presents a complex and challenging disorder in both the diagnosis and treatment, with emerging evidence suggesting a role of small fibre pathology (SFP) in its pathophysiology. The significance of the role of SFP in FMS remains unclear; however, recent evidence suggests degeneration and dysfunction of the peripheral nervous system, particularly small unmyelinated fibres, which may influence pathophysiology and underlying phenotype. Both skin biopsy and corneal confocal microscopy (CCM) have consistently demonstrated that ~ 50% of people with FMS have SFP. CCM, a non-invasive measure of small nerve fibres has detected small fibre loss, correlating with neuropathic pain descriptors. Additionally, quantitative sensory testing has shown abnormalities, primarily in pain pressure/mechanical pain thresholds. This narrative review provides a comprehensive understanding of the pathophysiological dimensions of FMS with a clear focus on small nerve fibres and the peripheral nervous system, offering a roadmap for future research.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"461-478"},"PeriodicalIF":4.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11914468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142979477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Noninvasive Pulsed Electromagnetic Field Therapy for Joint and Soft Tissue Pain Management: A Prospective, Multi-center, Randomized Clinical Trial.","authors":"Joshua G Hackel, James M Paci, Sunny Gupta, David A Maravelas, Taylor J North, Adelina Paunescu","doi":"10.1007/s40122-025-00711-z","DOIUrl":"10.1007/s40122-025-00711-z","url":null,"abstract":"<p><strong>Introduction: </strong>Strategies to reduce pharmacologic use for pain are needed. Pulsed electromagnetic field (PEMF) therapy is a noninvasive, nonpharmacologic treatment for pain that modifies nitric oxide signaling to improve healing. This study examined whether PEMF decreased pain and pharmacologic use vs. standard-of-care (SOC) treatment for joint and soft tissue pain.</p><p><strong>Methods: </strong>This prospective, randomized controlled trial enrolled 120 patients presenting with joint or soft tissue pain at five orthopedic clinic sites. The PEMF group self-administered daily therapy from a commercially available device and the SOC group received standard treatment daily as prescribed by the clinician. Patients recorded their pain level, pharmacologic usage, and adverse events daily for 14 days. After 14 days, patients in the SOC group were given the option to crossover to PEMF therapy and continue for 16 days. The study was overseen by an independent clinical research organization. It was hypothesized that PEMF would be superior to SOC for pain management.</p><p><strong>Results: </strong>PEMF treatment provided significant analgesic benefits compared to SOC. Complete data was collected for 91 patients, 48 from the PEMF group and 43 from the SOC group. The least squares mean pain score change from baseline was - 1.8 (a 36% reduction) for the PEMF group, significantly surpassing - 0.46 (a 10% reduction) for the SOC group (p < 0.0001). Pharmacologic usage decreased from 40 to 18% for the PEMF group (a 55% reduction), while the SOC group decreased from 40 to 35% (a 12% reduction). In the crossover subgroup, patients experienced an additional 18% decrease in pain score and 63% decrease in pharmacologic use after switching from SOC to PEMF treatment.</p><p><strong>Conclusions: </strong>PEMF was significantly more effective than SOC at managing pain and reducing pharmacologic use. PEMF therapy should be considered for noninvasive, nonpharmacologic management of joint and soft tissue pain.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov ID NCT05244187.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"723-735"},"PeriodicalIF":4.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11914662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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 Obsessive-Compulsive Disorder: A Scoping Review.","authors":"Chad Sloley, Caroline Bell, Edward A Shipton, Jonathan Williman, Joanne L Jarvis","doi":"10.1007/s40122-024-00704-4","DOIUrl":"10.1007/s40122-024-00704-4","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;The aim of this study was to map the association between Chronic Pain (CP) and Obsessive-Compulsive Disorder (OCD) in the present literature.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A scoping review was conducted with a comprehensive search of literature in peer-reviewed journals. Search parameters included articles written in English, published at any time, and including terms associated with both CP and OCD. Databases searched for purposes of this study included Psychinfo, Medline, Embase, Emcare, CINAHL, Scopus, Web of Science, Cochrane, and Google Scholar.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The review included 87 records, comprising 49 primary research and 38 secondary research records. Extracted information from these were grouped into four broad classifications. The Prevalence and Severity classification included information from 39 records which comprised: (1) primary research detailing current OCD prevalence rates in CP conditions (differentiated between general population and Pain/Medical/Hospital clinics); (2) primary research detailing lifetime OCD prevalence rates in CP conditions; (3) primary research detailing CP prevalence rates in OCD; (4) primary research detailing relationships between OCD and CP through psychometric measures; and (5) secondary research relating to prevalence rates. The Neurobiology classification included information from 28 records (primary and secondary research) detailing convergent and divergent neurobiological/neurophysiological aspects as reported for both OCD and CP. The Psychological Models/Factors classification included information from 7 records (primary and secondary research) detailing pain-related anxiety, neuropsychological measures, catastrophic thinking, preservative thinking, early maladaptive schemas, schema modes, childhood trauma experiences, and conditional associative learning, as reported for OCD and CP. The Intervention classification included information from 32 records which comprised: (1) primary research on neurosurgical, medication, and psychotherapeutic interventions; (2) secondary research on Deep Brain Stimulation; (3) secondary research on Medication; (4) secondary research on lesion, cingulotomy, and other surgical procedures; and (5) secondary research on other interventional procedures.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;While there has been considerable and growing research in the fields of both OCD and CP over the years, focused research into their potential association has been limited and potentially overlooked. The results of this review, however, suggest a complex relationship between CP and OCD. Prevalence rates between the two conditions vary widely across different populations, although the underlying reason for this remains unclear at this stage. There are commonalities in terms of alterations in pain processing, the dysregulation of certain brain regions, and the abnormalities in neurotransmitter systems in both conditions. In their treatmen","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"513-587"},"PeriodicalIF":4.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11914481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bayesian Network Meta-Analysis of Postoperative Analgesic Techniques in Thoracoscopic Lung Resection Patients.","authors":"Fang Yue, Yongye Xie, Xiangdong Chen, Ruifen Xu, Hui Wang, Ning Bai, Minna Hou, Jiao Guo","doi":"10.1007/s40122-025-00712-y","DOIUrl":"10.1007/s40122-025-00712-y","url":null,"abstract":"<p><strong>Introduction: </strong>Postoperative analgesia in thoracoscopic lung resection is crucial, with several nerve block techniques-including thoracic epidural anesthesia (TEA), paravertebral block (PVB), erector spinae plane block (ESPB), intercostal nerve block (INB), and serratus anterior plane block (SAPB)-commonly employed. However, there remains ongoing debate regarding the optimal technique.</p><p><strong>Methods: </strong>To evaluate and compare the effectiveness of these analgesia methods, a systematic review was conducted across multiple databases, including PubMed, Embase, Web of Science, and the Cochrane Library, identifying relevant randomized clinical trials (RCTs). A Bayesian network meta-analysis was performed to assess postoperative pain management, with subgroup analyses and meta-regression conducted to examine key factors influencing outcomes, such as the risk of bias, continuous catheter analgesia, and patient-controlled analgesia (PCA).</p><p><strong>Results: </strong>The results revealed that for 12-h resting visual analog scale (VAS) scores, the surface under the cumulative ranking curve (SUCRA) ranking was TEA > PVB > ESPB > control > INB > SAPB, whereas at 24 h, it shifted to PVB > TEA > ESPB > INB > control > SAPB. For 12-h coughing VAS scores, TEA ranked highest, followed by PVB, SAPB, ESPB, and control. At 24 h, PVB ranked highest, followed by TEA, ESPB, SAPB, INB, and control. The inconsistency test showed good consistency, with minimal publication bias, and meta-regression revealed that neither study quality nor local anesthetic infiltration at the incision site significantly impacted the outcomes. Excluding studies without PCA did not change the SUCRA rankings. PVB consistently ranked highest for 24-h resting and coughing VAS scores. Clustered ranking plots indicated that PVB and ESPB were the most suitable techniques for postoperative analgesia.</p><p><strong>Conclusion: </strong>PVB and ESPB emerged as the most suitable analgesic techniques for thoracoscopic lung resection. While PVB showed superior analgesic efficacy, ESPB offered fewer side effects, providing a safety advantage. TEA was considered less suitable due to its excessive side effects.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"617-637"},"PeriodicalIF":4.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11914711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Long-Term Retrospective Observational Clinical Study Evaluating the Efficacy of Plasma Rich in Growth Factors (PRGF) in the Treatment of Back Pain.","authors":"Eduardo Anitua, Isidro Milani, Àlex Martínez, Freddy Cabello, Roberto Prado, Sabino Padilla, Luis Sanado","doi":"10.1007/s40122-024-00699-y","DOIUrl":"10.1007/s40122-024-00699-y","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic back pain is a long-lasting disorder that is significantly associated with a reduction in the quality of life. Previously, the efficacy of intradiscal and epidural injections of plasma rich in growth factors (PRGF) was demonstrated at 6 months. The objective of this study was to retrospectively examine the medical records of these patients in order to determine whether the observed improvement at the 6-month follow-up was sustained over time.</p><p><strong>Methods: </strong>PRGF efficacy was evaluated using validated questionnaires: Core Outcome Measure Index (COMI) Pain score, COMI Disability score, COMI total score, and Oswestry Disability Index (ODI). Furthermore, an evaluation was conducted to determine whether the patients had undergone additional treatments.</p><p><strong>Results: </strong>the results demonstrated that 85.2% of the 27 patients who were enrolled exhibited sustained improvement across all scales over a median follow-up period of 24 months. The results of all questionnaires administered at 24 months exhibited statistically significant differences when compared to the baseline data (p < 0.01). Furthermore, there were no statistically significant differences between the results reported at 6 months and those at 24 months (p > 0.05).</p><p><strong>Conclusions: </strong>the results of this retrospective study demonstrate that treatment of chronic back pain with PRGF was effective in maintaining pain reduction and improving function for at least 24 months after the end of treatment.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"675-690"},"PeriodicalIF":4.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11914421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}