Pain and Therapy最新文献

{"title":"Correction: Classical TAP vs. I TAP Using the Same Dose of Local Anesthetic in Elective Cesarean Section: A Randomized Controlled Trial.","authors":"Wessam Zakaria El-Amrawy, Ahmed Mohamed El-Attar","doi":"10.1007/s40122-024-00594-6","DOIUrl":"10.1007/s40122-024-00594-6","url":null,"abstract":"","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"509"},"PeriodicalIF":4.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11111625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140898980","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":"The Role of the Combination Paracetamol/Caffeine in Treatment of Acute Migraine Pain: A Narrative Review.","authors":"Piero Barbanti, Gianni Allais, Sabina Cevoli, Simona Guerzoni, Massimiliano Valeriani, Fabrizio Vernieri","doi":"10.1007/s40122-024-00581-x","DOIUrl":"10.1007/s40122-024-00581-x","url":null,"abstract":"<p><strong>Introduction: </strong>Thirty years ago, the first migraine-specific drugs (triptans) appeared. Today two new categories (gepants and ditans) are marketed for acute migraine treatment. That said, is there still a role for conventional therapy? The aim of the present narrative review is to provide an expert overview examining the possible role of the combination paracetamol/caffeine in treatment of acute migraine pain.</p><p><strong>Methods: </strong>To understand possible settings for more appropriate use of paracetamol/caffeine (1000 mg/130 mg) in treatment of acute migraine, a structured literature search was performed using the PubMed database by a panel of experts from major Italian headache centers; articles not referring to migraine pain were excluded from this review; review articles were prioritized.</p><p><strong>Results: </strong>Overall response, even to newer specific and selective trigeminal targeted drugs (TTTs), is not over 60%; thus, there is still room for conventional therapies in acute migraine treatment. The panel identified settings in which the use of paracetamol/caffeine combination to treat acute migraine attacks might offer benefit considering the consolidated use through years, despite the lack of studies directly addressing the efficacy of paracetamol/caffeine in the identified populations: subjects > 65 years of age; presence of cardiovascular (CV) comorbidities; TTTs non-responders; pregnancy and breastfeeding; subjects < 18 years of age; paracetamol/caffeine as add-on therapy.</p><p><strong>Conclusions: </strong>Paracetamol is included in the World Health Organization (WHO) essential drug list and has a high level of popularity among patients. Caffeine enhances the analgesic effect of other drugs including paracetamol. In early treatment of acute migraine pain, prescribing physicians might consider using the paracetamol/caffeine combination among other options.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"319-346"},"PeriodicalIF":4.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11111640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140040057","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 New Clinical Examination Algorithm to Prescribe Conservative Treatment in People with Hip-Related Pain.","authors":"Ángel González-de-la-Flor","doi":"10.1007/s40122-024-00604-7","DOIUrl":"10.1007/s40122-024-00604-7","url":null,"abstract":"<p><p>Hip-related pain is a common issue in active adults affecting their quality of life, mobility, and overall function, and it can lead to persistent disability. However, diagnosing hip-related pain is challenging due to the many potential sources and causes, including intra-articular and extra-articular pathology, and referred pain from other areas (lumbar or groin related pain). To address this, there is a need for a clinical algorithm based on the best available evidence and expert consensus. This algorithm could guide healthcare professionals in assessing and managing patients with hip-related pain, during the diagnosis, test selection, intervention, monitoring, and promoting collaboration among various healthcare providers. This clinical algorithm for hip-related pain is a comprehensive, flexible, adaptable to different settings, and regularly updated to incorporate new research findings. This literature review aims to establish a clinical algorithm specifically for prescribing exercise treatment to patients with hip-related pain, addressing their individual needs and enhancing their overall care.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"457-479"},"PeriodicalIF":4.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11111658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140870605","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":"Pacific Spine and Pain Society (PSPS) Evidence Review of Surgical Treatments for Lumbar Degenerative Spinal Disease: A Narrative Review.","authors":"Michael J Dorsi, Patrick Buchanan, Chau Vu, Harjot S Bhandal, David W Lee, Samir Sheth, Phil M Shumsky, Nolan J Brown, Alexander Himstead, Ryan Mattie, Steven M Falowski, Ramana Naidu, Jason E Pope","doi":"10.1007/s40122-024-00588-4","DOIUrl":"10.1007/s40122-024-00588-4","url":null,"abstract":"<p><strong>Introduction: </strong>Interventional treatment options for the lumbar degenerative spine have undergone a significant amount of innovation over the last decade. As new technologies emerge, along with the surgical specialty expansion, there is no manuscript that utilizes a review of surgical treatments with evidence rankings from multiple specialties, namely, the interventional pain and spine communities. Through the Pacific Spine and Pain Society (PSPS), the purpose of this manuscript is to provide a balanced evidence review of available surgical treatments.</p><p><strong>Methods: </strong>The PSPS Research Committee created a working group that performed a comprehensive literature search on available surgical technologies for the treatment of the degenerative spine, utilizing the ranking assessment based on USPSTF (United States Preventative Services Taskforce) and NASS (North American Spine Society) criteria.</p><p><strong>Results: </strong>The surgical treatments were separated based on disease process, including treatments for degenerative disc disease, spondylolisthesis, and spinal stenosis.</p><p><strong>Conclusions: </strong>There is emerging and significant evidence to support multiple approaches to treat the symptomatic lumbar degenerative spine. As new technologies become available, training, education, credentialing, and peer review are essential for optimizing patient safety and successful outcomes.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"349-390"},"PeriodicalIF":4.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11111626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140194392","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":"Correction: The Role of the Combination Paracetamol/Caffeine in Treatment of Acute Migraine Pain: A Narrative Review.","authors":"Piero Barbanti, Gianni Allais, Sabina Cevoli, Simona Guerzoni, Massimiliano Valeriani, Fabrizio Vernieri","doi":"10.1007/s40122-024-00605-6","DOIUrl":"10.1007/s40122-024-00605-6","url":null,"abstract":"","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"347-348"},"PeriodicalIF":4.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11111420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140865487","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":"Incorporation of \"Artificial Intelligence\" for Objective Pain Assessment: A Comprehensive Review.","authors":"Salah N El-Tallawy, Joseph V Pergolizzi, Ingrid Vasiliu-Feltes, Rania S Ahmed, JoAnn K LeQuang, Hamdy N El-Tallawy, Giustino Varrassi, Mohamed S Nagiub","doi":"10.1007/s40122-024-00584-8","DOIUrl":"10.1007/s40122-024-00584-8","url":null,"abstract":"<p><p>Pain is a significant health issue, and pain assessment is essential for proper diagnosis, follow-up, and effective management of pain. The conventional methods of pain assessment often suffer from subjectivity and variability. The main issue is to understand better how people experience pain. In recent years, artificial intelligence (AI) has been playing a growing role in improving clinical diagnosis and decision-making. The application of AI offers promising opportunities to improve the accuracy and efficiency of pain assessment. This review article provides an overview of the current state of AI in pain assessment and explores its potential for improving accuracy, efficiency, and personalized care. By examining the existing literature, research gaps, and future directions, this article aims to guide further advancements in the field of pain management. An online database search was conducted via multiple websites to identify the relevant articles. The inclusion criteria were English articles published between January 2014 and January 2024). Articles that were available as full text clinical trials, observational studies, review articles, systemic reviews, and meta-analyses were included in this review. The exclusion criteria were articles that were not in the English language, not available as free full text, those involving pediatric patients, case reports, and editorials. A total of (47) articles were included in this review. In conclusion, the application of AI in pain management could present promising solutions for pain assessment. AI can potentially increase the accuracy, precision, and efficiency of objective pain assessment.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"293-317"},"PeriodicalIF":4.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11111436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140013131","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":"Classical TAP vs. I TAP Using the Same Dose of Local Anesthetic in Elective Cesarean Section: A Randomized Controlled Trial.","authors":"Wessam Zakaria El-Amrawy, Ahmed Mohamed El-Attar","doi":"10.1007/s40122-023-00564-4","DOIUrl":"10.1007/s40122-023-00564-4","url":null,"abstract":"<p><strong>Introduction: </strong>The effectiveness of postoperative pain control following a Cesarean section influences mother-child attachment, improves early healing, and undoubtedly hastens discharge. Transverse abdominis plane (TAP) and ilioinguinal iliohypogastric (ILIH) blocks have been used to minimize postoperative opioid intake, although their relative effectiveness is unknown. The study aims to determine which procedure was more effective at reducing the need for postoperative rescue analgesics after lower segment Cesarean section (LSCS). TAP block or I TAP (TAP block plus ilioinguinal iliohypogastric nerve block). Both procedures used the same amount of local anesthetic.</p><p><strong>Methods: </strong>A sealed envelope technique was used to randomly assign 210 patients who received LSCS into two equal groups to receive either ultrasound (US)-guided TAP block or US-guided ILIH nerve block with US-guided TAP block at the conclusion of the procedure. As per the study protocol, the charge nurse in the postoperative ward gave rescue analgesics to patients who complained of discomfort. At hours 0, 2, 4, 6, 8, 10, and 24 following surgeries, a blinded observer checked on the patient and noted the effectiveness of pain management, the quantity of rescue analgesics used, and patient satisfaction.</p><p><strong>Results: </strong>While there was a substantial decrease in pain score while resting at 2, 3, 4, 8, 12, 16, 20, and 24 postoperative hours in the ITAP group, there was not a significant change in visual analogue scale (VAS) score at the first postoperative hour. However, there was a large delay in the first request for analgesia in the ITAP group (13.15 ± 1.85) as opposed to the TAP group (10.06 ± 1.61) and there was a significant decline in nalbuphine use as well as a higher satisfaction score in the ITAP group.</p><p><strong>Conclusions: </strong>Following LSCS, ITAP block offered better postoperative analgesia than TAP block in terms of quality.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"495-508"},"PeriodicalIF":4.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11111634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139651382","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":"Effects of Different Volumes of Ropivacaine for Pericapsular Nerve Group Block on Incidence of Quadriceps Weakness and Analgesic Efficacy Following Hip Arthroplasty: A Randomized Controlled Trial.","authors":"Huaichang Wen, Weihua Zhang, Yi Wang, Meijing Lu","doi":"10.1007/s40122-024-00590-w","DOIUrl":"10.1007/s40122-024-00590-w","url":null,"abstract":"<p><strong>Introduction: </strong>The pericapsular nerve group (PENG) block has been shown to be an effective approach to alleviating pain and reducing the need for opioids among older adults following hip surgery, with possible motor-sparing effects. No reports to date, however, have described appropriate ropivacaine volumes for use in the context of PENG block. The present prospective randomized controlled study was thus developed to assess the quadriceps muscle strength and analgesic efficacy associated with PENG block performed using three different volumes of 0.33% ropivacaine following general anesthesia in older adults undergoing hip arthroplasty.</p><p><strong>Methods: </strong>In this prospective randomized double-blind controlled clinical study, 60 patients were assigned at random to undergo ultrasound-guided PENG block for hip arthroplasty using different volumes of ropivacaine. Specifically, these patients were administered 10 ml (Group A, n = 20), 20 ml (Group B, n = 20), or 30 ml (Group C, n = 20) of 0.33% ropivacaine. Quadriceps muscle strength was evaluated at 6 h post-surgery. Visual analog scale (VAS) scores at rest and with movement were assessed at 4, 6, 12, and 24 h post-surgery. Block duration, adverse event incidence, and patient satisfaction were evaluated at 24 h post-surgery.</p><p><strong>Results: </strong>Quadriceps motor block incidence rates at 6 h post-surgery in the 10 ml, 20 ml, and 30 ml groups were 5%, 20%, and 75%, respectively. Quadriceps muscle weakness at 6 h post-surgery was significantly more common in the 30 ml group relative to the others (p < 0.001). Patients administered 10 ml 0.33% ropivacaine exhibited significantly higher VAS pain scores at rest and with movement relative to those patients in the 20 ml and 30 ml treatment groups at all time points (p < 0.05). No apparent differences in analgesic efficacy were observed when comparing the 20 ml and 30 ml groups at 4, 6, 12, and 24 h post-surgery. No significant differences in block duration, satisfaction, or adverse event incidence were observed among groups.</p><p><strong>Conclusions: </strong>The preservation of motor function in the 20 ml 0.33% ropivacaine group was superior to that in the 30 ml 0.33% ropivacaine group. Relative to the group that received 10 ml 0.33% ropivacaine during PENG block, those elderly patients administered 20 ml and 30 ml volumes of 0.33% ropivacaine experienced superior postoperative pain relief following hip arthroplasty.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"533-541"},"PeriodicalIF":4.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11111422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140120318","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":"Tumor Necrosis Factor and Interleukin Modulators for Pathologic Pain States: A Narrative Review.","authors":"Alan D Kaye, Dominique M Perilloux, Alison M Hawkins, Grace C Wester, Amanda R Ragaland, Sage V Hebert, Julian Kim, Michael Heisler, Rucha A Kelkar, Azem A Chami, Sahar Shekoohi, Adam M Kaye","doi":"10.1007/s40122-024-00603-8","DOIUrl":"10.1007/s40122-024-00603-8","url":null,"abstract":"<p><p>Chronic pain, a complex and debilitating condition, involves intricate interactions between central and peripheral inflammatory processes. Cytokines, specifically tumor necrosis factor (TNF) and interleukins (IL), are key mediators in the initiation and maintenance of chronic pain states. Sensory neurons expressing receptors for cytokines like TNF, IL-1, and IL-6 are implicated in peripheral sensitization, contributing to increased signaling of painful sensations. The potential of targeting TNF and IL for therapeutic intervention in chronic pain states is the focus of this review, with preclinical and clinical evidence supporting the use of TNF and IL modulators for pain management. The physiological and pathological roles of TNF in neuropathic pain is complex. Experimental evidence highlights the effectiveness of TNF modulation in mitigating pain symptoms in animal models and displays promising outcomes of clinical trials with TNF inhibitors, such as infliximab and etanercept. ILs, a diverse group of cytokines, including IL-1, IL-6, and IL-17, are discussed for their contributions to chronic pain through inflammation and peripheral sensitization. Specific IL modulators, such as secukinumab and tocilizumab, have shown potential in managing chronic neuropathic pain, as demonstrated in various studies and clinical trials. The pharmacokinetics, safety profiles, and challenges associated with TNF and IL modulators highlight the need for cautious medication monitoring in clinical practice. Comparative evaluations have revealed distinct efficacy and safety profiles among different cytokine modulators, emphasizing the need for personalized approaches based on the specific underlying causes of pain. Further research is necessary to elucidate the intricate mechanisms by which cytokines contribute to chronic pain, as well as to understand why they may affect pain differently in various contexts. Additionally, long-term safety profiles of cytokine modulators require more thorough investigation. This continued exploration holds the promise of enhancing our comprehension of cytokine modulation in chronic pain and shaping more potent therapeutic strategies for the future.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"481-493"},"PeriodicalIF":4.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11111651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140899027","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":"Ketamine as Treatment for Cluster Headache: A Systematic Review of Literature and a Case Series.","authors":"Johannes Neumann, Helmar Bornemann-Cimenti, Gudrun Rumpold-Seitlinger, Kordula Lang-Illievich, Christoph Klivinyi","doi":"10.1007/s40122-024-00606-5","DOIUrl":"10.1007/s40122-024-00606-5","url":null,"abstract":"<p><strong>Introduction: </strong>Cluster headache is a severe and debilitating neurological condition characterized by intense, excruciating pain with a significant impact on patients' wellbeing. Although different treatment options are available, many patients continue to experience inadequate relief. Therefore, experimental strategies are increasingly studied. One of the more promising approaches is the use of ketamine. We present the currently available evidence and our own data.</p><p><strong>Methods: </strong>In this mixed-methods paper, we first summarize the available evidence of ketamine for treatment of cluster headache based on a systematic review of literature in MEDLINE, EMBASE and the Cochrane library of systematic reviews. As the level of evidence is quite limited, we report our own cohort study with ten patients treated with ketamine infusions for cluster headache. They were followed up to investigate the patients' experience of treatment success and quality of life.</p><p><strong>Results: </strong>The search and review of literature identified four reports with a total of 68 patients. All were uncontrolled case series. The current literature suggests that ketamine might decrease cluster headache. However, as the applied regimes and reported outcomes are highly heterogeneous, further analysis was futile. Our own data show high patient satisfaction with ketamine treatment.</p><p><strong>Conclusion: </strong>Despite the limited evidence, ketamine might be considered a potential therapeutic approach for cluster headache. Therefore, further research including randomized controlled trials should be encouraged.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"651-662"},"PeriodicalIF":4.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11111424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140898984","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}