{"title":"Effect of dual direct and alternating currents on pain induced by blood sampling and intramuscular injection processes.","authors":"Ebrahim Ezzati, Roghaye Mahooti, Saeed Mohammadi, Rasoul Kavyannejad","doi":"10.1080/17581869.2025.2544525","DOIUrl":"10.1080/17581869.2025.2544525","url":null,"abstract":"<p><strong>Objective: </strong>This study investigates the effects of cathodal, anodal, and intermittent electrical stimulation on pain intensity associated with arterial blood sampling, venous blood sampling, and intramuscular injection.</p><p><strong>Methods: </strong>In a triple-blind clinical trial, 160 patients requiring arterial, venous blood sampling, and intramuscular injection were randomly divided into four groups. Three intervention groups received 5 mA anodal, cathodal direct, or alternating currents during the procedure, while the control group received only a topical eutectic mixture of local anesthetics (EMLA). Pain intensity was measured using the visual analog scale (VAS) immediately after the procedure, while procedure duration, number of attempts, and heart rate changes were recorded as secondary outcome.</p><p><strong>Results: </strong>All forms of electrical stimulation significantly reduced procedural pain compared to EMLA. Cathodal direct current demonstrated the greatest analgesic effect, with mean VAS score reductions of 2-3 points across all procedures. The time required for arterial blood sampling in the cathodal group was significantly less than with EMLA, while no difference was observed in the procedure time and frequency of attempts in other processes. Furthermore, electrical stimulation groups, particularly the cathodal mode, exhibited lower post-procedure heart rates, suggesting attenuated physiological stress responses.</p><p><strong>Conclusion: </strong>We found that applying electric currents during the procedure reduces the pain of blood sampling or injections. The greatest analgesia was observed with cathodal direct current stimulation compared to other groups.</p><p><strong>Clinical trial registration: </strong>Date of registration: 27 January 2024. Clinical Trials.gov Identifier: IRCT20240123060780N1. URL: https://irct.behdasht.gov.ir/trial/75119.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"807-818"},"PeriodicalIF":1.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144837295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pain managementPub Date : 2025-11-01Epub Date: 2025-09-03DOI: 10.1080/17581869.2025.2552633
Nourhan Mohamed Elsherbiny, Mona Gad Mostafa Elebieby, Aboelnour Elmorsy Badran, Mohammed N Mohammed
{"title":"Superficial and deep cervical plexus blocks versus patient-controlled analgesia in total laryngectomy; a randomized trial.","authors":"Nourhan Mohamed Elsherbiny, Mona Gad Mostafa Elebieby, Aboelnour Elmorsy Badran, Mohammed N Mohammed","doi":"10.1080/17581869.2025.2552633","DOIUrl":"10.1080/17581869.2025.2552633","url":null,"abstract":"<p><strong>Introduction: </strong>The cervical plexus block (CPB) delivers analgesia for surgeries in the head and neck . Patient-controlled analgesia (PCA) has been utilized to enhance pain management. This study evaluates combined bilateral superficial and deep CPB versus PCA in postoperative pain management after total laryngectomy.</p><p><strong>Materials and methods: </strong>Randimized two equal groups: the CPB group (<i>n</i> = 25), who received combined bilateral US-guided superficial and deep CBP, and the PCA group (<i>n</i> = 25), who received PCA. The primary outcome was postoperative visual analog scale (VAS) . The secondary outcomes were hemodynamic changes, fentanyl consumption, first rescue analgesia, hospital stay, and postoperative complications.</p><p><strong>Results: </strong>Postoperative VAS scores (at 2 and 4 h) were greater in the PCA group compared to the CPB group, <i>p</i> values (0.031, 0.044), respectively. The results were comparable at 6 and 12 h; while at 18 and 24 h, they were elevated in the CPB. The intraoperative hemodynamics were elevated in the PCA group at skin incision and after 30 min. Fentanyl consumption, first rescue analgesia, hospital stay, and postoperative complications were comparable.</p><p><strong>Conclusion: </strong>Ultrasound-guided combined bilateral superficial and deep CPB provided superior analgesia in the early postoperative period compared to PCA.</p><p><strong>Clinical trial registration: </strong>https://pactr.samrc.ac.za PACTR202403682323400.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"845-853"},"PeriodicalIF":1.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Recovery indicators from the perspective of patients with chronic low back pain: a cross-sectional survey.","authors":"Razieh Javadian Kootenayi, Razieh Mofateh, Maryam Seyedtabib","doi":"10.1080/17581869.2025.2552631","DOIUrl":"10.1080/17581869.2025.2552631","url":null,"abstract":"<p><strong>Aims: </strong>In low back pain (LBP) research, recovery is commonly used as an outcome measure. However, there is no method used to measure recovery or acceptable definition for recovery. This research aims to investigate patients' perceptions of recovery from LBP.</p><p><strong>Materials & methods: </strong>A cross-sectional survey was conducted in which 350 patients with chronic LBP participated. Demographic and clinical information was collected by a comprehensive and inclusive questionnaire. A checklist of improvement indicators was given to the patients and completed by them. It was aimed to identify the most important criteria for recovery in patients with chronic LBP.</p><p><strong>Results: </strong>The results showed that pain reduction alone is not a reliable indicator of recovery. The patients' view about the recovery from chronic LBP includes a wide range of factors in different areas of symptomatic improvement, fear of recurrence injury, functional disability, fatigue and reduced energy level. Also, a significant correlation was observed between recovery indicators and pain duration, body mass index, and pain intensity in patients with chronic LBP.</p><p><strong>Conclusions: </strong>The framework of recovery for patients with chronic LBP is complicated and is a highly individual structure. It is determined by the impact of symptoms on activities of daily living factors.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"835-843"},"PeriodicalIF":1.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pain managementPub Date : 2025-11-01Epub Date: 2025-09-05DOI: 10.1080/17581869.2025.2555800
Sarah Grunberg Almeida Prado, Lígia Del' Agnolo Mazer, Paulo Henrique Pires de Aguiar, Silvia de Oliveira
{"title":"Mesencephalotomy for the treatment of facial cancer pain: a systematic review of the literature.","authors":"Sarah Grunberg Almeida Prado, Lígia Del' Agnolo Mazer, Paulo Henrique Pires de Aguiar, Silvia de Oliveira","doi":"10.1080/17581869.2025.2555800","DOIUrl":"10.1080/17581869.2025.2555800","url":null,"abstract":"<p><strong>Aims: </strong>This systematic review aims to analyze and explore the risks, benefits, and efficacy of performing Mesencephalotomy in patients with unilateral facial pain secondary to cancer.</p><p><strong>Methods: </strong>This study followed PRISMA guidelines and used the PubMed and \"<i>Biblioteca Virtual em Saúde</i>\" (BVS) databases. The risk of bias for all included studies was assessed individually with the \"Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I)\" tool.</p><p><strong>Results: </strong>Six articles were included in this review. The surgical outcomes were promising, supporting the safety and efficacy of mesencephalotomy for malignant facial pain and surpassing the general efficacy reported in the literature.</p><p><strong>Conclusions: </strong>Mesencephalotomy should be considered a viable approach to pain management in patients with facial pain secondary to malignant neoplasms. This intervention has the potential for broader application within the field of palliative Care. This research is not registered in any database.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"877-884"},"PeriodicalIF":1.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pain managementPub Date : 2025-11-01Epub Date: 2025-09-08DOI: 10.1080/17581869.2025.2552636
Eva M Monzón, Alberto Rios, Javier Carrascoso, Pedro Moreno, David Abejón
{"title":"Epiduroscopy in spinal stenosis. Description of the procedure and safety measures to reduce complications.","authors":"Eva M Monzón, Alberto Rios, Javier Carrascoso, Pedro Moreno, David Abejón","doi":"10.1080/17581869.2025.2552636","DOIUrl":"10.1080/17581869.2025.2552636","url":null,"abstract":"<p><strong>Aims: </strong>The aim of this observational study is to describe the use of epiduroscopy to decrease the enlargement of the ligamentum flavum (LF) in patients with spinal stenosis, as well as the selection of the appropriate patient and the safety measures that enhance procedural success.</p><p><strong>Materials & methods: </strong>We introduce the patient selection protocol, define the appropriate indication and the safety measures to use the epiduroscopy as a tool to decrease the size of the LF and increase space, reducing possible complications.</p><p><strong>Results: </strong>Among patients included in the study, there were no cases of access difficulty or coccydynia, and one case of urinary incontinence occurred in a patient with Schizas grade D (very severe) stenosis. In patients with grade C or lower stenosis, we have not found any case of sphincter incontinence.In four patients, we found paresthesias and in one patient a transient increase in pain. Dural puncture was performed in three patients, none developed headache.</p><p><strong>Conclusions: </strong>Exclusion of patients with very severe canal stenosis according to magnetic resonance imaging (MRI) criteria, the use of sacral hiatus measurements and the neurophysiological monitoring helps diminish the occurrence of neurological complications of epiduroscopy in patients with spinal stenosis.</p><p><strong>Clinical trial registration: </strong>https://www.clinicaltrials.gov identifier is NCT03863067.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"827-834"},"PeriodicalIF":1.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pain managementPub Date : 2025-11-01Epub Date: 2025-09-18DOI: 10.1080/17581869.2025.2561394
Jordan J Ryan, Emma Bowden, Matthew M Hancock, Kali Power, N Wesley Edwards, Emily White, David T Fullwood, Ulrike Mitchell, Jennifer A Bowden, Anton E Bowden
{"title":"Wearable sensor technologies for individuals with back pain: a scoping review.","authors":"Jordan J Ryan, Emma Bowden, Matthew M Hancock, Kali Power, N Wesley Edwards, Emily White, David T Fullwood, Ulrike Mitchell, Jennifer A Bowden, Anton E Bowden","doi":"10.1080/17581869.2025.2561394","DOIUrl":"10.1080/17581869.2025.2561394","url":null,"abstract":"<p><p>Recent advancements in wearable data measurement technologies have allowed for real-time collection of biosignals related to spinal function and back pain. These data also have the potential to completely transform back pain treatment paradigms, to improve diagnostic movement phenotyping and to track treatment effectiveness longitudinally. The primary objective of the present scoping review was to investigate the status of development and trends in the use of wearable sensor technologies employed to measure biosignals related to spinal function and back pain, to identify the major developments and future trends for this field.Until recently, much of the wearable sensor data related to spinal function and back pain have come from a relatively small number of technologies, were sampled by a judiciously placed single device, and were analyzed using traditional statistical modeling techniques. However, based on the state of the literature, the field of wearable sensors for spine appears to have reached an inflection point where the previous limiting factors are no longer significant barriers. The growing number of wearable sensor types, combined with real-time interpretation using machine-learning algorithms, is paving the way for objective and comprehensive evaluations of spinal movements that can guide both research and clinical practice.<b>Literature Search:</b> PubMed, Web of Science and EMBASE, all articles prior to 9 April 2025.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"855-876"},"PeriodicalIF":1.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pain managementPub Date : 2025-11-01Epub Date: 2025-09-09DOI: 10.1080/17581869.2025.2556648
Kathryn Edmonds, Kiley Hunkler, Christopher Creedon, Sara Drayer, Scott Endicott, Kathryn Eliasen, Candice Jones-Cox
{"title":"Impact of preoperative quadratus lumborum block on postoperative opioid consumption after laparoscopic hysterectomy: a double-blind randomized controlled trial.","authors":"Kathryn Edmonds, Kiley Hunkler, Christopher Creedon, Sara Drayer, Scott Endicott, Kathryn Eliasen, Candice Jones-Cox","doi":"10.1080/17581869.2025.2556648","DOIUrl":"10.1080/17581869.2025.2556648","url":null,"abstract":"<p><strong>Background: </strong>Gynecologic enhanced recovery after surgery (ERAS) pathways have been developed to reduce postoperative narcotic use through multimodal pain management. While incisional injection of local anesthetic is standard practice, regional nerve blockades using liposomal agents are emerging as a promising adjunct technique for post-laparoscopy pain. Current data are conflicting regarding the benefits of regional nerve blocks on postoperative pain after laparoscopic hysterectomy.</p><p><strong>Objectives: </strong>To determine the impact of preoperative quadratus lumborum (QL) block on postoperative pain following laparoscopic hysterectomy. Our primary outcomes will be intraoperative and immediate postoperative opioid use (within 24 hours). Secondary outcomes will include pain scores, functional impact of pain, and postoperative complications.</p><p><strong>Study design: </strong>This is a prospective, double-blind, randomized-controlled trial comparing opioid use in women undergoing laparoscopic hysterectomy who receive a preoperative QL block to local injection. Seventy-six patients undergoing laparoscopic or robotic hysterectomy will be randomized to the study arm, preoperative QL block with liposomal bupivacaine and intraoperative placebo incisional injection of 0.9% saline, or the control arm, preoperative sham QL block with 0.9% saline and intraoperative incisional injection of 0.25% bupivacaine. Outcomes will be measured at several timepoints: intraoperative, postoperative prior to discharge, and 1, 3, 5, 14 days, and 4-6 weeks postoperatively.</p><p><strong>Clinical trial registration: </strong>www.clinicaltrials.gov identifier is NCT06709716.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"783-790"},"PeriodicalIF":1.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pain managementPub Date : 2025-11-01Epub Date: 2025-09-15DOI: 10.1080/17581869.2025.2555163
Colin Key Chen, Michael Anthony Erdek
{"title":"Celiac plexus block and neurolysis procedure: treatment of chronic pain in pancreatic cancer.","authors":"Colin Key Chen, Michael Anthony Erdek","doi":"10.1080/17581869.2025.2555163","DOIUrl":"10.1080/17581869.2025.2555163","url":null,"abstract":"","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"779-781"},"PeriodicalIF":1.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pain managementPub Date : 2025-11-01Epub Date: 2025-09-09DOI: 10.1080/17581869.2025.2555162
Tomás Caroço, Renaud Bollens, Diogo Portugal
{"title":"Botulinum toxin injection of the piriformis muscle for refractory pudendal neuralgia after decompression surgery: case report.","authors":"Tomás Caroço, Renaud Bollens, Diogo Portugal","doi":"10.1080/17581869.2025.2555162","DOIUrl":"10.1080/17581869.2025.2555162","url":null,"abstract":"<p><p>Pudendal neuropathy is a cause of pelvic pain, specifically pudendal neuralgia. The pudendal nerve is related to sensory, motor, and autonomic functions. We present the case of a 41-year-old man who suffered from chronic pelvic pain. In detail, the patient described stinging burning pain in the glans penis, proctalgia, lower urinary tract symptoms, sensation of \"muscle tension\" and squeezing pain. He was diagnosed with prostatitis and, following, pudendal neuralgia. Our patient was treated with antibiotics and analgesics, without improvement of symptoms. He was then submitted to decompression surgery of the pudendal nerve, with partial improvement. The patient started a rehabilitation program and was treated with OnabotulinumtoxinA (BoNT-A) injections into the piriformis muscle with benefit. BoNT-A positive effects on pain relief may corroborate piriformis muscle compression of the pudendal nerve. BoNT-A may also reduce the release of neurotransmitters from the pain pathways. Early identification of pudendal neuralgia could have prevented the progression to chronic pain. There is still not an established role for BoNT-A in post-operative pudendal nerve decompression patients. Our case corroborates that more studies should be performed to explore BoNT-A administration in these patients.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"801-806"},"PeriodicalIF":1.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pain managementPub Date : 2025-11-01Epub Date: 2025-09-01DOI: 10.1080/17581869.2025.2550923
Dimos Mitsikostas, Srdjan Ljubisavljevic
{"title":"Fremanezumab for the treatment of migraine.","authors":"Dimos Mitsikostas, Srdjan Ljubisavljevic","doi":"10.1080/17581869.2025.2550923","DOIUrl":"10.1080/17581869.2025.2550923","url":null,"abstract":"<p><p>Fremanezumab is a monoclonal antibody inhibiting the CGRP signaling leading to migraine prophylaxis. Its efficacy and potential safety concerns are updated here. All available data on fremanezumab were searched in PubMed with emphasis on the mechanisms of action, efficacy, tolerability, and safety. There is class I evidence for the efficacy of fremanezumab in the prophylaxis of both EM and CM, by reducing 1 to 2 monthly migraine days over placebo, but in real-world studies the magnitude of efficacy was greater. Though the size of efficacy looks like that of some repurposed anti-migraine treatments, its excellent tolerably highly improves the likelihood to help versus harm outcome over all traditional medications. Fremanezumab works in people with migraine and medication overuse, in people with previous treatment failures, as well as in people with concomitant depression, improving both migraine and depression measures. The latest data, along with the recent approval for use in children and adolescents, are unique among all migraine treatments. Alone or in combination with botulinumtoxin A may improve resistance to migraine. Mild reactions at the injection site are the most common side effects. Thus, fremanezumab represents an optimal treatment for people with migraine and should be considered as first-line choice.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"791-800"},"PeriodicalIF":1.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}