Pain management最新文献_第3页

Effectiveness and safety of anti-CGRP monoclonal antibodies for migraine in patients over 65 years: a systematic review. 抗cgrp单克隆抗体治疗65岁以上偏头痛患者的有效性和安全性：一项系统综述

IF 1.4

Pain management Pub Date : 2025-03-01 Epub Date: 2025-03-03 DOI: 10.1080/17581869.2025.2470615

Albert Muñoz-Vendrell, Alba López-Bravo, Almudena Layos-Romero, Francisco J Alberola-Amores, María Obdulia Lozano Caballero, Antonio Sánchez-Soblechero, Cristian Morales-Hernández, María Victoria Castro-Sánchez, María Pilar Navarro-López, María Rocío Córdova-Infantes, Edoardo Caronna, Pablo Irimia, Alicia Gonzalez-Martinez

{"title":"Effectiveness and safety of anti-CGRP monoclonal antibodies for migraine in patients over 65 years: a systematic review.","authors":"Albert Muñoz-Vendrell, Alba López-Bravo, Almudena Layos-Romero, Francisco J Alberola-Amores, María Obdulia Lozano Caballero, Antonio Sánchez-Soblechero, Cristian Morales-Hernández, María Victoria Castro-Sánchez, María Pilar Navarro-López, María Rocío Córdova-Infantes, Edoardo Caronna, Pablo Irimia, Alicia Gonzalez-Martinez","doi":"10.1080/17581869.2025.2470615","DOIUrl":"10.1080/17581869.2025.2470615","url":null,"abstract":"Background: Migraine patients over 65 years have been excluded from pivotal anti-CGRP monoclonal antibody trials leaving limited real-life data on effectiveness and safety in this population. This review aims to summarize available evidence on treatment response and safety for older patients.Methods: A PubMed and Cochrane Controlled Register of Trials (CENTRAL) search identified studies on anti-CGRP monoclonal antibodies in patients with migraine over 65 up to October 2024. The review focuses on headache outcomes like reduction in monthly migraine days or monthly headache days, response rates (30%, 50%, 75%) and adverse effects of this specific population and/or against placebo, standard care, or younger patients. The quality of evidence was assessed using the GRADE tool.Results: All eligible studies were included, along with additional articles presented narratively. Data from clinical trials and post-hoc analyses show comparable efficacy and safety between older and younger patients. Similarly, early real-life studies support the use of anti-CGRP monoclonal antibodies in patients over 65 years, showing similar response rates, reductions in monthly migraine days and adverse effects.Discussion: Anti-CGRP monoclonal antibodies should likely be offered to patients over 65 although available evidence remains limited. Further studies analyzing specific data from this subgroup are necessary.","PeriodicalId":20000,"journal":{"name":"Pain management","volume":"15 3","pages":"161-171"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11916378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Posterior scalp block with bupivacaine and dexmedetomidine for pain management in posterior fossa surgeries: a prospective, double blind randomized controlled trial. 布比卡因和右美托咪定后头皮阻滞治疗后颅窝手术疼痛：一项前瞻性、双盲、随机对照试验。

IF 1.4

Pain management Pub Date : 2025-03-01 DOI: 10.1080/17581869.2025.2470607

Sheethal N, Ashwin Pai V, Ramya Kateel, Arjun Balakrishnan, Raghavendra Nayak, Girish R Menon, Sunitha M, Ravitej Bhat

{"title":"Posterior scalp block with bupivacaine and dexmedetomidine for pain management in posterior fossa surgeries: a prospective, double blind randomized controlled trial.","authors":"Sheethal N, Ashwin Pai V, Ramya Kateel, Arjun Balakrishnan, Raghavendra Nayak, Girish R Menon, Sunitha M, Ravitej Bhat","doi":"10.1080/17581869.2025.2470607","DOIUrl":"10.1080/17581869.2025.2470607","url":null,"abstract":"Background: Pain management in posterior fossa surgeries poses significant challenges, with opioid-based approaches causing unwanted side effects. This study evaluates the efficacy of posterior scalp block using bupivacaine and dexmedetomidine compared to skin infiltration for managing perioperative pain.Methods: In this prospective, double-blind, randomized controlled trial, 34 adult patients undergoing elective posterior fossa surgeries were equally assigned to either posterior scalp block or skin infiltration groups. Outcomes measured included hemodynamic parameters, pain scores, opioid consumption, time to first analgesic, and sedation levels.Results: The posterior scalp block group showed significantly lower opioid consumption (211.47 ± 101.95 mcg vs 305.88 ± 117.10 mcg; p < 0.01) and pain scores (VAS 2.29 ± 0.9 vs 5.06 ± 1.3; p < 0.001) at 24 hours post-surgery. This group also demonstrated better hemodynamic stability and fewer rescue opioid requirements (9 vs 15 patients; p < 0.009).Conclusions: Posterior scalp block with bupivacaine and dexmedetomidine significantly improves pain management, reduces opioid use, and provides better hemodynamic stability compared to skin infiltration in posterior fossa surgeries.Clinical trial registration: CTRI/2023/07/0554959.","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"131-140"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Low health literacy impact on headache diagnosis. 低健康素养对头痛诊断的影响。

IF 1.4

Pain management Pub Date : 2025-03-01 Epub Date: 2025-02-22 DOI: 10.1080/17581869.2025.2463874

Joseph V Pergolizzi, Jo Ann LeQuang

{"title":"Low health literacy impact on headache diagnosis.","authors":"Joseph V Pergolizzi, Jo Ann LeQuang","doi":"10.1080/17581869.2025.2463874","DOIUrl":"10.1080/17581869.2025.2463874","url":null,"abstract":"Health literacy has a broad range of impacts, including whether and where a person seeks treatment and how well that patient interprets and applies clinical recommendations. Patients with headache may not seek treatment, may fail to disclose even severe pain to their physician, and may not understand or adhere to treatment. Universal precautions can be a helpful initial approach, and information styles can be modified as needed over time. Patients should be asked about headache and explanations about headache causes and treatment should be given in everyday language. The teach-back method can confirm if patients understand instructions. Health literacy can impact how patients perceive their headaches and how well they adhere to treatments. Health literacy is a two-way street; it depends on the patient's ability to understand and act on clinical information and the clinician's ability to give clear information. Language and cultural barriers can adversely impact health literacy, even in patients who otherwise have good understanding of medical advice. While health literacy can impact outcomes, those with low or very high health literacy are most likely to be non-adherent, albeit for different reasons. Clinical action plans can be valuable for those with severe headache.","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"141-147"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Open label placebo for chronic low back pain: a systematic review and meta-analysis of randomized controlled trials. 开放标签安慰剂治疗慢性腰痛：随机对照试验的系统回顾和荟萃分析。

IF 1.4

Pain management Pub Date : 2025-03-01 Epub Date: 2025-02-17 DOI: 10.1080/17581869.2025.2467025

Victor Hugo Palhares Flávio-Reis, Yago Marcos Pessoa-Gonçalves, Camilo André Viana Diaz, Antonieta Santos Andrade Lamoglia, Chamberttan Souza Desidério, Carlo José Freire Oliveira

{"title":"Open label placebo for chronic low back pain: a systematic review and meta-analysis of randomized controlled trials.","authors":"Victor Hugo Palhares Flávio-Reis, Yago Marcos Pessoa-Gonçalves, Camilo André Viana Diaz, Antonieta Santos Andrade Lamoglia, Chamberttan Souza Desidério, Carlo José Freire Oliveira","doi":"10.1080/17581869.2025.2467025","DOIUrl":"10.1080/17581869.2025.2467025","url":null,"abstract":"Aim: To assess the therapeutic potential of Open-Label Placebo (OLP) for chronic low back pain (CLBP).Materials & methods: A systematic literature search was conducted on 12 September 2024. Data extraction focused on follow-up and change-from-baseline data of the placebo or control groups. The effect sizes were calculated using the inverse variance statistical method.Results: A meta-analysis of four articles involving 171 OLP patients and 161 controls demonstrated a modest reduction in pain on the numerical rating scale (Mean difference = -0.62; 95% confidence interval: -1.09 to -0.14; p = 0.01; I2 = 31%). However, according to GRADE, the certainty of evidence for this finding is very low due to methodological limitations of the included studies and potential biases. These findings, even if small, suggest potential benefits of OLP for pain reduction, with clinical relevance of the effect size being important depending on the clinical context and the patient's perspective.Conclusions: OLP demonstrated a reduction in pain, with a slightly greater improvement observed during shorter intervention periods. However, the certainty of this evidence remains very low, indicating that these findings should be interpreted cautiously. Future clinical trials are needed to further explore the potential and limitations of this intervention.Protocol registration: www.crd.york.ac.uk/prospero identifier is CRD42024568302.","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"149-160"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Negative expectations and related nocebo effects in shoulder pain: a perspective for clinicians and researchers. 肩痛的负面预期和相关的反安慰剂效应：临床医生和研究人员的观点。

IF 1.4

Pain management Pub Date : 2025-02-01 Epub Date: 2025-02-20 DOI: 10.1080/17581869.2025.2467022

Enrique Lluch-Girbés, Lirios Dueñas, Filip Struyf, Eleonora Maria Camerone, Giacomo Rossettini

{"title":"Negative expectations and related nocebo effects in shoulder pain: a perspective for clinicians and researchers.","authors":"Enrique Lluch-Girbés, Lirios Dueñas, Filip Struyf, Eleonora Maria Camerone, Giacomo Rossettini","doi":"10.1080/17581869.2025.2467022","DOIUrl":"10.1080/17581869.2025.2467022","url":null,"abstract":"The nocebo effect, a phenomenon wherein negative expectations can worsen symptoms, is increasingly acknowledged within the context of musculoskeletal conditions. While experimental evidence has, to some extent, examined negative expectations in shoulder pain, their specific relationship with nocebo effects and their manifestation in clinical practice remains unexplored. In this perspective, clinicians and researchers are guided by first examining the psychobiology and neurophysiology underlying nocebo effects from a basic science standpoint, thereby equipping clinicians with a robust understanding of the phenomenon. What are considered the primary potential sources of nocebo effects in individuals with shoulder pain are then outlined - namely, diagnostic labels, diagnostic imaging and special tests, the medicalization of normality, and overtreatment. Practical clinical strategies are subsequently proposed to mitigate nocebo effects arising from these sources. Finally, the research implications for advancing the study of nocebo effects in people with shoulder pain are discussed. Overall, this perspective provides a comprehensive overview of the impact of negative expectations and associated nocebo effects on shoulder pain outcomes. By identifying potential sources of nocebo effects that may emerge in everyday clinical practice, guidance on mitigating related negative expectations in patients with shoulder pain is offered.","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"93-104"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11853614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Turning back the clock: reintroducing 'SAFE' principles to spinal cord stimulation for long-term therapy preservation. 时钟倒转：重新引入“安全”原则脊髓刺激长期治疗保存。

IF 1.4

Pain management Pub Date : 2025-02-01 Epub Date: 2025-01-21 DOI: 10.1080/17581869.2025.2455372

Krishnan Chakravarthy, Maja Green

引用次数: 0

Problems accessing pain care, and the adverse outcomes among adults with chronic pain: a cross-sectional survey study. 成人慢性疼痛患者获得疼痛护理的问题和不良后果：一项横断面调查研究。

IF 1.4

Pain management Pub Date : 2025-02-01 Epub Date: 2025-02-12 DOI: 10.1080/17581869.2025.2463865

Matthew Carrillo, Jessica Yingst, Wen-Jan Tuan, David Giampetro, Jennifer E Nyland, Aleksandra E Zgierska

{"title":"Problems accessing pain care, and the adverse outcomes among adults with chronic pain: a cross-sectional survey study.","authors":"Matthew Carrillo, Jessica Yingst, Wen-Jan Tuan, David Giampetro, Jennifer E Nyland, Aleksandra E Zgierska","doi":"10.1080/17581869.2025.2463865","DOIUrl":"10.1080/17581869.2025.2463865","url":null,"abstract":"Aims: Prescribing restrictions have significantly impacted patients with chronic pain, leading to opioid medication tapering and reduced access. This study examines the consequences of these restrictions and their impact on patient health and pain management strategies.Patients & methods/materials & methods: This research explores barriers to pain care, especially opioid therapy, adverse health outcomes resulting from reduced access to pain medications, and alternative pain management strategies. The study analyzes data from a cross-sectional survey conducted by the American Chronic Pain Association (ACPA) between November 2014 and January 2015. The survey gathered quantitative data on demographics, healthcare access, pain management strategies, and challenges in obtaining prescribed medications, alongside qualitative responses. Descriptive statistics summarized quantitative findings; chi-square and t-tests compared those with and without medication access difficulties. Thematic analysis revealed recurring themes in qualitative responses.Results: The study reveals that over half of the respondents faced difficulties obtaining prescribed pain medications, leading to significant adverse health consequences, including unmanaged pain, psychological distress, and suicidal ideation.Conclusion: These findings highlight the urgent need to address systemic and personal barriers to pain medication access, and the need for patient-centered care that incorporates evidence-based, holistic pain management strategies and shared decision-making between clinicians and patients.","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"81-91"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11853623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The acceptability of combined management of comorbid obesity and back pain in a rural population: a mediation analysis. 农村人群合并肥胖和背痛的可接受性：一项中介分析。

IF 1.4

Pain management Pub Date : 2025-02-01 Epub Date: 2025-02-03 DOI: 10.1080/17581869.2025.2460961

Treah Haggerty, Courtney S Pilkerton, Patricia Dekeseredy, Abigail Cowher, Cara L Sedney

{"title":"The acceptability of combined management of comorbid obesity and back pain in a rural population: a mediation analysis.","authors":"Treah Haggerty, Courtney S Pilkerton, Patricia Dekeseredy, Abigail Cowher, Cara L Sedney","doi":"10.1080/17581869.2025.2460961","DOIUrl":"10.1080/17581869.2025.2460961","url":null,"abstract":"Aims: We do not know if patients find the coordinated treatment of comorbid obesity and low back pain acceptable in clinical practice. The primary purpose of this study is to evaluate patient-level interest in a combined back pain and obesity specialty treatment clinic.Methods: A survey was sent to patients over 18 with a diagnosis of back pain and a BMI over 30 through their electronic medical records. Statistical analysis was carried out to examine the role of weight and pain stigma in mediating beliefs about weight and back pain on interest in a combined clinic.Results: 1290 people responded. Respondents reported moderate levels of experienced stigma relating to pain (9.4 ± 6.6) using the 32-point Stigma Scale for Chronic Illness and obesity (3.5 ± 1.1) using the 6-point Weight Bias Internalization Scale. Respondents expressed a moderate belief that back pain and weight were related (70.8% ± 21.7). Most patients (69.2%) were interested in a joint clinic.Conclusions: In a target population of patients with obesity and back pain, a combined clinic treatment plan is desirable. These results support the need to explore the feasibility and sustainability of innovative, combined, holistic care clinics to treat people with obesity and back pain.","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"73-80"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11853547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Risk factors affecting the therapeutic effect of onabotulinum toxin a on chronic migraine. 影响肉毒杆菌毒素a治疗慢性偏头痛疗效的危险因素。

IF 1.4

Pain management Pub Date : 2025-02-01 Epub Date: 2025-01-27 DOI: 10.1080/17581869.2025.2458448

Leonor Mendes-Andrade, Inês Mendes-Andrade, Beatriz Medeiros, Madalena Pinto, Andreia Costa

{"title":"Risk factors affecting the therapeutic effect of onabotulinum toxin a on chronic migraine.","authors":"Leonor Mendes-Andrade, Inês Mendes-Andrade, Beatriz Medeiros, Madalena Pinto, Andreia Costa","doi":"10.1080/17581869.2025.2458448","DOIUrl":"10.1080/17581869.2025.2458448","url":null,"abstract":"Background: OnabotulinumtoxinA demonstrates effectiveness in chronic migraine prevention but is hindered by variable patient responses. This study aims to identify modifiable and non-modifiable risk factors influencing the response to onabotulinumtoxinA.Methods: We conducted a retrospective cohort study at a tertiary hospital involving chronic migraine patients treated with onabotulinumtoxinA. Data on risk factors and patient perceptions were collected through medical records and questionnaires.Results: A total of 131 patients were included. At 12 months, a significant reduction in headache frequency was observed: from 26 episodes pre-treatment to 13 at 3 months, 12 at 6 months, 11 at 9 months, and 10 at 12 months. A third of patients stopped overusing medication after treatment. Univariate logistic regressions revealed that fibromyalgia was associated with a reduced likelihood of achieving ≥50% response to onabotulinumtoxinA (OR (odds ratio) = 0.213, p = 0.031), while secondary education was associated with an increased likelihood of response (OR = 4.400, p = 0.029). Adjusted logistic regression confirmed that fibromyalgia significantly reduced the likelihood of ≥50% response (aOR (adjusted odds ratio) = 0.064, p = 0.033).Conclusions: This study confirms the real-world effectiveness of onabotulinumtoxinA in reducing headache frequency. Furthermore, patients with fibromyalgia may have a diminished likelihood of responding positively, underscoring the importance of personalized treatment strategies.","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"65-71"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11864016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Peripheral nerve field stimulation following dorsal root entry zone lesion: a technical note. 背根进入区病变后周围神经野刺激：技术说明。

IF 1.4

Pain management Pub Date : 2025-02-01 Epub Date: 2025-02-13 DOI: 10.1080/17581869.2025.2463875

Rayan Fawaz, Audrey Thomas, Muriel Curtet, Anne-Marie Giner, Manon Duraffourg

引用次数: 0