Pain and Therapy最新文献

{"title":"Liposomal Bupivacaine vs. Plain Bupivacaine with Dexamethasone for Rhomboid Intercostal Block in the Management of Postoperative Pain After Video-Assisted Thoracoscopic Surgery: A Randomized Non-inferiority Trial.","authors":"Lei Xie, Yazhi Xi, Xinyao He, Mingzi An, Xiaoyu Jia, Zhenping Li, Tao Chen, Qinghe Zhou","doi":"10.1007/s40122-025-00763-1","DOIUrl":"10.1007/s40122-025-00763-1","url":null,"abstract":"<p><strong>Introduction: </strong>Effective and sustained postoperative analgesia is essential to enhance recovery after video-assisted thoracoscopic surgery (VATS). Liposomal bupivacaine, a multivesicular formulation enabling extended local anesthetic release, offers a mechanistic advantage over conventional agents. However, prior comparisons with adjuvant-enhanced regimens such as plain bupivacaine plus dexamethasone were confounded by pharmacological and dose inequivalence. This equivalence-dose randomized controlled trial evaluated whether liposomal bupivacaine provides non-inferior analgesia to the standard combination when administered via rhomboid intercostal block (RIB).</p><p><strong>Methods: </strong>In this double-blind randomized controlled trial, 90 VATS patients were randomly assigned to receive either: a 20-ml premixed solution containing 93 mg of liposomal bupivacaine combined with 25 mg of plain bupivacaine (liposomal bupivacaine group), or a 20-ml admixture of 105 mg of plain bupivacaine and 5 mg of dexamethasone (plain bupivacaine with dexamethasone group). The primary outcome assessed was the area under the curve (AUC) of the 48-h resting pain numeric rating scale (NRS). Secondary outcomes consisted of opioid consumption, dermatomal spread, and Quality of Recovery-15 scores (QoR-15).</p><p><strong>Results: </strong>Liposomal bupivacaine was shown to be non-inferior to plain bupivacaine with dexamethasone, with a 48-h NRS AUC of 105.5 ± 13.6 vs. 113.1 ± 16.3 (mean difference - 7.6; 95% CI - 13.9 to - 1.2, upper limit < non-inferiority margin 3.7). Opioid use and dermatomal spread were comparable within the first 24 h (P > 0.05). There was a notable contrast in sustained dermatome blockade at 48 and 72 h between the two groups (P < 0.001). The liposomal bupivacaine group demonstrated a significantly reduced opioid requirement (P = 0.016) within 24-48 h and superior QoR-15 scores on postoperative day 2 (POD2) (P < 0.001). Safety profiles were comparable, with no between-group differences in postoperative nausea and vomiting or other severe complications (P > 0.05).</p><p><strong>Conclusions: </strong>Rhomboid intercostal block with liposomal bupivacaine provided similar analgesia to plain bupivacaine with dexamethasone for postoperative pain after VATS.</p><p><strong>Trial registration: </strong>The trial was registered on ClinicalTrials.gov (NCT06392191). Graphical Abstract available in the Supplementary Materials for this article.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"1513-1530"},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12484463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775947","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":"VER-01 Shows Enhanced Gastrointestinal Tolerability, Superior Pain Relief, and Improved Sleep Quality Compared to Opioids in Treating Chronic Low Back Pain: A Randomized Phase 3 Clinical Trial.","authors":"Winfried Meissner, Charles Argoff, Sabine Sator, Volker Schoder, Matthias Karst","doi":"10.1007/s40122-025-00773-z","DOIUrl":"https://doi.org/10.1007/s40122-025-00773-z","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic low back pain (CLBP) affects over half a billion people worldwide. Current pharmacologic treatments, comprising mainly non-steroidal anti-inflammatory drugs and opioids, offer limited efficacy and pose significant risks, warranting the development of tolerable, safe and effective alternatives.</p><p><strong>Methods: </strong>This randomized controlled trial on adults with CLBP was designed to confirm the superior efficacy and gastrointestinal tolerability of VER-01, a novel, standardized full-spectrum extract from Cannabis sativa DKJ127 L., over opioids. Subjects were randomized (1:1) to receive VER-01 or a range of commercially available opioids. After a 3-week titration, subjects underwent 24 weeks of treatment, followed by 2 weeks of wash-out. The primary endpoint was the relative risk of constipation occurrence after 27 weeks treatment. Secondary endpoints included changes in pain and sleep scores, determined using an 11-point numeric rating scale (NRS), with key secondary endpoints defined for week 27.</p><p><strong>Results: </strong>A total of 384 individuals were randomized to receive VER-01 (n = 192) or opioids (n = 192). Subjects receiving VER-01 were fourfold less likely to develop constipation than those receiving opioids (relative risk [RR] VER-01/opioids 0.25; 95% confidence interval [CI] 0.09-0.69; p = 0.007) and threefold less likely to use laxatives (RR 0.34; 95% CI 0.18-0.65; p < 0.001). Longitudinal analysis revealed that VER-01 was superior to opioids in terms of pain reduction over 6 months of treatment, although differences in secondary endpoints limited to week 27 alone were not significant. Throughout the 6 months of treatment, mean pain reduction was 2.50 NRS points with VER-01 versus 2.16 with opioids (mean difference [MD] 0.34; 95% CI 0.00-0.67; p = 0.048), and sleep improved by 2.52 points with VER-01 versus 2.07 with opioids (MD 0.45; 95% CI 0.11-0.79; p = 0.009). These benefits were particularly pronounced in participants with severe pain, with greater pain reduction (MD 0.58; 95% CI 0.01-1.15) and sleep improvement (MD 0.66, 95% CI 0.05-1.27) compared to opioids.</p><p><strong>Conclusions: </strong>VER-01 demonstrated superiority over opioids in treating CLBP, both in terms of efficacy and gastrointestinal tolerability.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov ID: NCT05610813; EudraCT ID: 2022-001358-41.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145200751","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":"Thickening of the Intramuscular Fascia of the Iliacus Muscle as Evidence of Myofascial Pathology: A New Hip Pain Syndrome.","authors":"Salvatore Massimo Stella, Annarita Saponara, Roberta Gualtierotti, Fabio Vita, Mario Miccoli, Marco Becciolini, Stefano Galletti, Filippo Cotellessa, Carlo Trompetto","doi":"10.1007/s40122-025-00777-9","DOIUrl":"https://doi.org/10.1007/s40122-025-00777-9","url":null,"abstract":"<p><strong>Introduction: </strong>Hip/inguinal pain is a common symptom in athletes. Ultrasound (US) examination may discriminate causes, among which the iliopsoas muscle is often neglected. In the present case series study, we describe five patients with hip/inguinal pain where an accurate US evaluation of the iliopsoas muscle showed that the origin of the pain was due to alterations of the iliopsoas muscle complex, particularly of the fascia surrounding the medial fibers of the iliacus muscle (MFIM). We describe a novel pathological entity characterized by myofascial rigidity and hip/inguinal pain with thickening of the intramuscular fascia of the iliacus muscle and its epimysium, with increased stiffness of the muscle.</p><p><strong>Methods: </strong>We studied five athletes with hip/inguinal pain on hip flexion-extension in the absence of hip and visceral pathologies. US was performed with linear probes studying the affected hip at the inguinal level, using longitudinal and axial scans. The examination was completed with power Doppler (PD), strain elastosonography (ELS), and strain ratio (SR) evaluation of the lateral and medial belly of the iliacus muscle.</p><p><strong>Results: </strong>In all patients, we observed a thickening of the intramuscular fascia that surrounds the medial belly of the iliacus muscle. The mean ± standard deviation thickness of the intramuscular fascia of the iliacus muscle varied significantly between the affected and non-affected sides (2.70 ± 0.41 mm vs. 1.02 ± 0.15 mm, p value 0.012). In two out of five cases, an increase in the intramuscular perifascial vascular signals at PD was detected. All cases showed stiffness of the MFIM on ELS and altered SR in MFIM compared with the lateral ones in three out of five patients.</p><p><strong>Conclusions: </strong>We describe a novel cause of a pathological condition of the iliopsoas muscle due to the thickening of the medial belly of the iliacus muscle, easily verifiable with US. All subjects responded to physical therapy with high-energy laser and stretching of the muscle unit. Video available for this article.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145125627","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":"Practice Patterns and Perspectives on Epidural Steroid Injections by Interventional Pain Physicians.","authors":"Sara Abdullah, Jun Beom Ku, Olivia Sutton, Jatinder Gill, Robert J Yong, Omar Viswanath, Christopher L Robinson, Jamal Hasoon","doi":"10.1007/s40122-025-00772-0","DOIUrl":"https://doi.org/10.1007/s40122-025-00772-0","url":null,"abstract":"<p><strong>Introduction: </strong>Epidural steroid injections (ESIs) are commonly used to manage chronic spinal pain. However, variations in ESI practices remain prevalent among interventional pain physicians. This study evaluates current practice patterns and perceptions of ESI efficacy to identify areas for potential standardization in clinical application.</p><p><strong>Methods: </strong>A structured survey was distributed to interventional pain physicians via email and social media outlets, collecting data on several aspects of ESI practice: (1) the importance of precise injectate placement, (2) perceived effectiveness for axial versus limb pain, and (3) preference for fixed versus variable injectate volume based on contrast pattern spread. Responses were collected and analyzed to understand prevailing practice trends. The survey included a diverse group of pain management physicians representing different primary specialties and practice settings.</p><p><strong>Results: </strong>Of the 94 respondents, 77.7% (73/94) selected that precise injectate placement is crucial for optimal outcomes, while 22.3% (21/94) did not view it as essential. Regarding pain type, 61.7% (58/94) selected that ESIs help with axial and limb pain, while 36.2% (34/94) found ESIs primarily effective for limb pain. Only 1.1% (1/94) selected that ESIs were beneficial solely for axial back pain, with one respondent selecting ineffectiveness for either pain type. For injectate volume, 69.2% (65/94) selected that they use a fixed volume for injection, while 30.9% (29/94) adjusted injectate volume based on contrast spread.</p><p><strong>Conclusion: </strong>This survey highlights practice patterns among interventional pain physicians regarding ESIs, underscoring the value placed on targeted injectate placement and the perceived broad efficacy of ESIs for axial and limb pain. However, the variability in volume administration suggests a need for further research to explore the impact of fixed versus variable injectate volumes on clinical outcomes. These findings may influence future standardization efforts in ESI practice.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086801","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":"Opioid Use among People with Migraine: Results of the OVERCOME (US) Study.","authors":"Sait Ashina, Elizabeth Johnston, E Jolanda Muenzel, Gilwan Kim, Dawn C Buse, Michael L Reed, Robert E Shapiro, Susan Hutchinson, Anthony J Zagar, Robert A Nicholson, Richard B Lipton","doi":"10.1007/s40122-025-00774-y","DOIUrl":"https://doi.org/10.1007/s40122-025-00774-y","url":null,"abstract":"<p><strong>Introduction: </strong>Despite expert recommendations against using opioids for migraine treatment, their use remains common in the USA. We aimed to evaluate the use of opioids among people with active migraine using data from the Observational Survey of the Epidemiology, Treatment, and Care of Migraine (OVERCOME) (US) study.</p><p><strong>Methods: </strong>This observational, longitudinal, web-based survey study included a demographically representative sample of adults with migraine in the USA (2018-2020). Participants with migraine (International Classification of Headache Disorders, third edition [ICHD-3]) and ≥ 1 headache in the previous 12 months were identified via a questionnaire and/or self-reported diagnosis. Information on opioid use for acute migraine treatment was collected. Demographics, clinical, and migraine-related characteristics among those with current opioid use and those with non-use were evaluated in the cross-sectional analysis using standardized mean difference (SMD). Multivariable analysis was conducted using machine learning (least absolute shrinkage and selection operator regression, random forest) and logistic regression models to assess factors associated with current opioid use.</p><p><strong>Results: </strong>Of 61,932 respondents with active migraine, 13,331 (21.5%) reported currently using opioids to treat migraine. Among those using opioids, 68.0% were female, 64.3% identified as White, and 13.7% identified as Hispanic. Those currently using opioids differed from those not using opioids in various characteristics, including higher tobacco/marijuana use, more comorbidities, higher migraine-related disability, and higher interictal burden (all SMD > 0.2). The factors most associated with current opioid use were \"currently taking recommended acute medications for migraine\" (odds ratio [OR], 10.1; confidence interval [CI], 9.47, 10.78), \"currently taking barbiturates for migraine\" (OR, 2.2; CI, 2.03, 2.34), and \"sought care at an Emergency Department/Urgent Care for migraine in the previous 12 months\" (OR, 1.7; CI, 1.67, 1.85).</p><p><strong>Conclusions: </strong>This study shows that opioid use for migraine is associated with using recommended acute medications, barbiturates, and emergency department care for migraine. Understanding how to limit these factors is key to developing interventions to reduce opioid use in migraine.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086780","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":"Neurotransmitter Imbalance in Cluster Headache: A Systematic Review of Mechanisms and Therapeutic Targets.","authors":"Lanfranco Pellesi, Anas Mohammad, Wei Wang, Paolo Martelletti","doi":"10.1007/s40122-025-00778-8","DOIUrl":"https://doi.org/10.1007/s40122-025-00778-8","url":null,"abstract":"<p><strong>Introduction: </strong>Cluster headache (CH) causes brief but extremely severe head pain, yet we still do not fully understand the molecules that trigger these attacks. Many studies have looked at changes in neurotransmitters and neuropeptides, but their results do not always agree. This systematic review brings together all the available data on neurochemical changes in CH, with the goal of clarifying current knowledge gaps and highlighting promising targets for future research.</p><p><strong>Methods: </strong>We searched PubMed, Embase (Ovid), and Scopus for studies reporting quantitative measurements of neurotransmitters in human biological samples from individuals with CH, as well as provocation studies in which neurotransmitters or neurotransmitter-related compounds were administered to trigger attacks. Thirty-eight eligible studies were identified. For each, we extracted information on design, participant characteristics, sampling matrix (e.g., plasma, saliva, cerebrospinal fluid, platelets), and the neuromodulators assayed, and then synthesized the findings narratively.</p><p><strong>Results: </strong>Altered levels of histamine and sensory neuropeptides such as calcitonin gene-related peptide (CGRP) and substance P were documented, especially during active headache attacks. Conflicting data were reported for serotonin, whereas nitric oxide (NO), pituitary adenylate cyclase-activating peptide (PACAP), and vasoactive intestinal peptide (VIP) provoked CH attacks in experimental studies. Data on orexins and their receptors were inconclusive.</p><p><strong>Conclusions: </strong>The evidence emphasize several potential therapeutic targets, including CGRP, substance P, histamine, VIP, and PACAP. However, interpretation is hampered by heterogeneity across studies and methodological limitations, particularly the large variance and uncertainties of CGRP assays, which make cross-study comparisons difficult. Further research is needed to elucidate the exact molecular mechanisms driving CH and to identify effective therapeutic interventions.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086824","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":"Calcium Channel α₂δ Ligands Mirogabalin, Pregabalin, and Gabapentin: Advancements in Diabetic Peripheral Neuropathic Pain Therapeutics.","authors":"Yiming Wu, Xiaohui Guo, Junqing Zhang","doi":"10.1007/s40122-025-00771-1","DOIUrl":"https://doi.org/10.1007/s40122-025-00771-1","url":null,"abstract":"<p><p>Diabetic peripheral neuropathic pain (DPNP) is becoming increasingly prevalent as the global burden of diabetes continues to rise. DPNP manifests moderate-to-severe pain with burning, shooting, and tingling sensations, which increase clinical and economic burden and reduce the quality of life (QoL). α₂δ ligands were developed on the basis of their mechanism of action involving the modulation of voltage-gated calcium channels (VGCCs). These ligands bind to the α₂δ subunit of VGCCs, which reduces calcium influx and subsequently decreases the release of excitatory neurotransmitters. A majority of the clinical trials have demonstrated the efficacy of α₂δ ligands in providing pain relief and improvement in the QoL for patients with DPNP. Furthermore, α₂δ ligands have a tolerable safety profile, with somnolence and dizziness being the most frequently reported adverse events. Currently, most guidelines recommend calcium channel α₂δ ligands as first-line treatment for DPNP. With the development of drug research, mirogabalin, an emerging novel α₂δ ligand, was developed and validated. This review aims to summarize the latest status of α₂δ ligand development and provide a comprehensive evaluation of α₂δ ligands for the management of DPNP, emphasizing the potential mechanism of action, clinical efficacy, safety profile, and pharmacoeconomics. Further perspectives are warranted for treatment strategies to address individual patient care.A Graphical Abstract is availible for this article.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086863","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":"Letter to the Editor regarding \"Effects of TTP-PECS Block Under Opioid-Sparing General Anesthesia on Postoperative Analgesia and Early Recovery Quality in Patients Undergoing Modified Radical Mastectomy\".","authors":"Zhi-Bin Huang, Dan-Feng Wang, Fu-Shan Xue","doi":"10.1007/s40122-025-00743-5","DOIUrl":"10.1007/s40122-025-00743-5","url":null,"abstract":"","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"1431-1433"},"PeriodicalIF":4.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12279632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987198","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":"Efficacy of Combined High-Intensity Laser Therapy and Collagenase Chemonucleolysis in Lumbar Disc Herniation Management: a Prospective Randomized Controlled Trial.","authors":"Peng Song, Chao Ma, Chenchen Xu, Yongjun Zhang, Yan Yuan","doi":"10.1007/s40122-025-00756-0","DOIUrl":"10.1007/s40122-025-00756-0","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Lumbar disc herniation (LDH) is a prevalent degenerative spinal disorder. While collagenase chemonucleolysis is effective in long-term LDH management, delayed symptom relief remains a limitation. Recent studies suggest that high-intensity laser therapy (HILT) may enhance tissue repair and pain modulation, providing a rationale for exploring its synergistic effects with collagenase therapy. This study aimed to investigate whether combining HILT with collagenase chemonucleolysis could accelerate early postoperative recovery in patients with lumbar disc herniation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This single-blind randomized controlled trial was conducted at the Department of Pain Management, The First People's Hospital of Changzhou, between October 2023 and October 2024. This single-center, single-blind randomized controlled trial finally enrolled 60 eligible patients with lumbar disc herniation; participants were randomly assigned to the experimental (HILT + collagenase) or control (collagenase alone) group using a computer-generated randomization sequence with 1:1 allocation. Group assignments were concealed in sealed opaque envelopes until intervention initiation. All participants underwent collagenase chemonucleolysis, with the control group receiving standard postoperative care combined with sham laser therapy, while the experimental group received additional high-intensity laser irradiation alongside conventional treatment. The primary endpoints comprised visual analog scale (VAS) pain scores and clinical efficacy rates evaluated using modified MacNab criteria, while secondary outcomes included the Oswestry Disability Index (ODI), straight-leg-raising angle measurements, and 36-Item Short Form Health Survey (SF-36) quality of life assessments, with standardized evaluations conducted at five predefined intervals: preoperative baseline, 1 week, 1 month, 3 months, and 6 months postoperatively. Statistical analyses were performed using SPSS 20.0. Continuous variables were compared via independent t-tests or Mann-Whitney U tests, while categorical variables were analyzed using chi-squared tests. All tests were two-tailed, with P &lt; 0.05 considered statistically significant.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 60 patients (30 per group) with a mean age of 57.15 ± 9.18 years completed the study. Baseline characteristics including age, gender, body mass index (BMI), herniation level, and symptom duration showed no significant intergroup differences (all P &gt; 0.05). No significant baseline differences were observed between groups regarding age (58.00 ± 7.13 versus 57.06 ± 9.08 years), gender distribution (male: 53.3% versus 50.0%), or disease duration (5.17 ± 3.45 versus 5.73 ± 3.07 months) (all P &gt; 0.05). The results showed that there was no statistically significant difference in baseline data between the two groups of patients. At 1 week and 1 month postoperatively, the experimental group demonstrated signific","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"1379-1398"},"PeriodicalIF":4.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12279629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275579","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":"Expanding Horizons of Buprenorphine: A Comprehensive Narrative Review of Its Pharmacological Properties and Clinical Applications in Chronic Pain.","authors":"Diego Fornasari, Arturo Cuomo","doi":"10.1007/s40122-025-00753-3","DOIUrl":"10.1007/s40122-025-00753-3","url":null,"abstract":"<p><p>Buprenorphine has gained significant attention for its unique pharmacological properties, making it a valuable tool in chronic pain management. Unlike traditional opioids, buprenorphine's partial and biased agonist actions at the μ-opioid receptor provide potent analgesia while minimizing risks such as respiratory depression, tolerance, and dependence. Its favorable pharmacokinetic profile provides the potential for expanding its clinical use in different patient populations. A literature search was conducted in PubMed, Web of Science, and Google Scholar to identify peer-reviewed studies on recent developments in the pharmacological features and new clinical applications of buprenorphine, including original research, reviews, and consensus statements. This comprehensive review explores the expanding clinical applications of buprenorphine, emphasizing its role in managing chronic pain in elderly patients, individuals with cardiac conditions, and those with renal impairments. Emerging evidence highlights its utility in addressing chronic pain in younger adults and its potential in mitigating side effects associated with aromatase inhibitor therapy in patients with breast cancer. Additionally, buprenorphine's lower endocrine side-effect profile and antidepressant properties open new therapeutic avenues for pain-associated depression. With its unique pharmacodynamics, transdermal formulations for sustained drug release, and reduced adverse effects, buprenorphine represents a promising option for tailored, multimodal pain management strategies, especially in populations with complex medical needs. Further studies are warranted to confirm its broad therapeutic potential.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"1247-1261"},"PeriodicalIF":4.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12279635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369125","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}