Gupta Saloni, G. Deepak, M. Preeti, Garg Shobit, Singhal Tushar
{"title":"Efficacy of transcranial direct current stimulation on tension-type headache and migraine: A systematic review","authors":"Gupta Saloni, G. Deepak, M. Preeti, Garg Shobit, Singhal Tushar","doi":"10.4103/ijpn.ijpn_24_22","DOIUrl":"https://doi.org/10.4103/ijpn.ijpn_24_22","url":null,"abstract":"Introduction: Headache is one of the most common conditions troubling nearly 68% of the world's population. Tension-type headache (TTH) & migraine are the most common forms of classical headaches, which is nowadays mostly neglected, associated with frequent, severe pain and significant functional impairment. Transcranial direct current stimulation (tDCS), is a non-invasive, painless brain stimulation treatment that uses direct electrical currents to stimulate specific parts of the brain. Various studies demonstrated tDCS as a valued device to treat neuropsychiatric conditions such as chronic headache & associated anxiodepressive condition. Objective: The aim of this the current review was to evaluate the effectiveness of tDCS in the management of TTH and Migraine. Results generated from various studies for the effectiveness of tDCS in TTH & Migraine. Methods: We programmed our search strategy, to identify studies pertaining to use of tDCS and pain management in TTH & migraine, within the Database of the Cochrane Library of Systematic Reviews, & various author manuscripts in PMC, MEDLINE, EMBASE, NLM, PsycINFO, Other indexed citations from inception to December 2021 and potentially relevant studies. Outcomes: The outcomes of interest include: Effective pain management, in terms of headache intensity, frequency, its episodes, associated depression, anxiety, in target population prioritised by the individual reviews. The evidences were mapped and synthesised with appropriate health problem, patient subgroups, intervention type, context and outcome.Conclusions: We found a significant reduction of pain intensity in patients receiving tDCS treatment, also the pain intensity and duration were significantly improved from baseline after tDCS treatment and during a follow-up period. There was a significant reduction of pain intensity by both anodal and cathodal stimulation conditions, with noteworthy decrease in episodic headaches equally by both 1mA and 2mA current intensities. The aforementioned works support the utility of tDCS in the pain management of TTH and migraine offering a hope for patients with this debilitating disease. However, the review shows promising results in the pain management by tDCS, but the included studies must be analysed critically since most of them were pilot studies, with some having adapted an open-label design.","PeriodicalId":32328,"journal":{"name":"Indian Journal of Pain","volume":"36 1","pages":"128 - 134"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42330162","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}
Priyanka Shelwatkar, Sujit Kshirsagar, P. Bhalerao
{"title":"Preemptive analgesia with wound infiltration using bupivacaine with dexmedetomidine and bupivacaine alone for postoperative analgesia in abdominal hysterectomy: A prospective randomized analytical study","authors":"Priyanka Shelwatkar, Sujit Kshirsagar, P. Bhalerao","doi":"10.4103/ijpn.ijpn_47_22","DOIUrl":"https://doi.org/10.4103/ijpn.ijpn_47_22","url":null,"abstract":"Background: The administration of local anesthetics into the wound before the incision (preemptive analgesia) has been demonstrated to reduce postoperative pain. Aims: The aim of this study was to determine the quality of postoperative analgesia in abdominal hysterectomy by visual analog scale (VAS) in the group of 0.125% bupivacaine 15 ml with dexmedetomidine 1 μg/kg and in the group of 0.125% bupivacaine 15 ml alone. Settings and Design: A prospective observational analytical study was conducted in a tertiary care government hospital including 80 patients undergoing hysterectomy divided into two groups of 40 each. Subjects and Methods: Group A included those patients who received 0.125% bupivacaine 15 ml with dexmedetomidine 1 μg/kg and Group B patients received bupivacaine 15 ml alone. The pain was assessed by VAS. Rescue analgesia was given with diclofenac sodium 75 mg intramuscular on demand or whenever the VAS score was ≥4. The level of sedation was assessed using the four-point Sedation Scale. Nausea and vomiting were assessed by four-point categorical scales. Statistical Analysis: Mean and standard deviation were used to depict quantitative data, and paired t-test was used to compare the groups. Results: The combination of bupivacaine with dexmedetomidine has a better and longer anesthetic effect than bupivacaine alone (P < 0.001). The total diclofenac consumption in Group A was less (95.63 [±33.92] mg) than in Group B (150 [±0.0] mg), P < 0.01. Group A rescue analgesia was required after 2 h in only one (2.5%) patient, whereas in Group B, rescue analgesia was required immediately at 0 h in six (15%) patients (P < 0.001). Conclusions: The duration of analgesia was longer, and number of doses of rescue analgesia during the first 24 h after operation was significantly less in the group who received bupivacaine with dexmedetomidine when compared with bupivacaine alone.","PeriodicalId":32328,"journal":{"name":"Indian Journal of Pain","volume":"36 1","pages":"147 - 151"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48250381","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}
Sargam Goel, Sumana Choudhary, A. Saxena, Mayank Sonkar
{"title":"The myth and half-truths of fetal pain decrypted: A metaverse","authors":"Sargam Goel, Sumana Choudhary, A. Saxena, Mayank Sonkar","doi":"10.4103/ijpn.ijpn_5_22","DOIUrl":"https://doi.org/10.4103/ijpn.ijpn_5_22","url":null,"abstract":"Fetal pain is one of the most controversial topics in medicine because of the disagreement between people whether the fetus can perceive pain or not and the absence of any direct objective method for the assessment of fetal pain. Although fetus is incapable of declaring pain, various studies have shown that the mere experience of pain without the aptitude of self-contemplation is worth paying attention to, and that the pain in fetus need not be comparable to that of a mature adult to matter. Furthermore, refusing to acknowledge fetal pain in late preterm fetuses would jeopardize the advances in neonatal care because it would question the use of analgesia in neonates of similar gestational age. This systematic review article examines the neuroanatomical and physiological evidence of nociception in the fetus and its implications, which compel the need for its alleviation. It looks into the adequacy of International Association for the Study of Pain definition of pain to define fetal pain. The article also provides a brief overview of the existing literature on whether safe analgesia and anesthesia techniques exist for abortions and therapeutic fetal procedures. We performed a literature search for English-language articles using the electronic database with keywords: controversy in fetal pain, fetal anaesthesia, fetal analgesia, fetal pain, fetus, neuroanatomy of fetal pain, neurophysiology of fetal pain, nociception, and recent advances in understanding of fetal pain","PeriodicalId":32328,"journal":{"name":"Indian Journal of Pain","volume":"36 1","pages":"120 - 127"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45376383","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}
Saloni Gupta, D. Goel, Shobit Garg, S. Tikka, Preeti Mishra, Priya Tyagi
{"title":"Effect of adjunctive transcranial direct current stimulation and cognitive behavior therapy on headache disability in episodic frequent or chronic tension-type headache: A pilot, exploratory study","authors":"Saloni Gupta, D. Goel, Shobit Garg, S. Tikka, Preeti Mishra, Priya Tyagi","doi":"10.4103/ijpn.ijpn_52_22","DOIUrl":"https://doi.org/10.4103/ijpn.ijpn_52_22","url":null,"abstract":"Background: Literature suggests that non-pharmacological treatments like non-invasive brain stimulation and cognitive behavioural therapy (CBT) may be used as augments in the management of Tension-Type Headache (TTH). Aims and Objectives: To assess the efficacy of Transcranial Direct Current Stimulation (tDCS) and Cognitive Behavioral Therapy (CBT) compared to treatment as usual (TAU) on headache-related disability and the psychological impact of headache on life of patients suffering from TTH. Materials and Methods: Thirty right-handed TTH patients HDI (headache disability index) > 30 were randomly allocated to group A (tDCS + TAU), group B (CBT + TAU), and group C (TAU). While the primary outcome measure was headache related disability (Headache Disability Index(HDI)), somatic symptoms (Somatic Symptom Severity (SSS-8)), anxiety & depression (Hospital Anxiety and Depression Scale (HADS)) and sleep quality (Pittsburgh Sleep Quality Index (PSQI). Assessments were done at baseline, end of the third and sixth month. Results: We found a statistically significant reduction in HDI (F=12.419, p <0.001), SSS-8 (F=4.587, p=0.010), and HADS-anxiety (F=4.810, p=0.002). tDCS showed better efficacy than CBT, while these two were significantly better than TAU on HDI and SSS-8. On HADS-A also both tDCS and CBT were better than TAU, but showed no significant difference between them. Conclusion: Supplementing non-pharmacological techniques like tDCS and CBT will be effective in reducing headache-related disability and associated psychological symptoms.","PeriodicalId":32328,"journal":{"name":"Indian Journal of Pain","volume":"36 1","pages":"140 - 146"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70764561","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}
C. Aragón-Benedí, A. Rocha-Romero, M. Fajardo-Pérez, Carmen Heredia-Coca
{"title":"A novel approach to vagus nerve stimulation in fibromyalgia","authors":"C. Aragón-Benedí, A. Rocha-Romero, M. Fajardo-Pérez, Carmen Heredia-Coca","doi":"10.4103/ijpn.ijpn_77_22","DOIUrl":"https://doi.org/10.4103/ijpn.ijpn_77_22","url":null,"abstract":"This manuscript aims to report the successful treatment of a patient with fibromyalgia using a novel approach to vagus nerve (VN) stimulation. The patient reported significant pain relief and improved performance after almost 3 months of follow-up. VN stimulation has been Food and Drug Administration approved for epilepsy and depression, but recent studies have shown its usefulness for pain management. Our novel approach is minimally-invasive compared to surgical techniques; it provides long-lasting analgesia within a single session and is cheaper than current methods. This technique should be evaluated in clinical trials to clarify the optimal parameters and treatment intervals.","PeriodicalId":32328,"journal":{"name":"Indian Journal of Pain","volume":"36 1","pages":"165 - 167"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46213851","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":"A rotator cuff injury affecting the prognosis of a patient with myofascial pain","authors":"S. Naz, S. Sibha","doi":"10.4103/ijpn.ijpn_51_22","DOIUrl":"https://doi.org/10.4103/ijpn.ijpn_51_22","url":null,"abstract":"Shoulder pathology occurs most commonly in food service workers, who repetitively perform motions of the upper limbs. About 85% of patients who visit pain clinics complain of nonarticular musculoskeletal impairments. Myofascial pain syndrome is one of the common, painful musculoskeletal disorders characterized by the presence of trigger points in muscles at discrete places. Here is a case presenting with symptoms of myofascial pain of the upper trapezius; on clinical examination, ultrasonographic findings were diagnosed with a rotator cuff injury delaying her recovery. This also highlights the importance of clinical examination of ipsilateral shoulder joint whenever the patient presents with myofascial pain involving upper back.","PeriodicalId":32328,"journal":{"name":"Indian Journal of Pain","volume":"36 1","pages":"162 - 164"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42061563","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":"A case report on botox for neurogenic thoracic outlet syndrome – An alternative to surgery","authors":"M. Chandra, Sudheer Dara, R. Varma","doi":"10.4103/ijpn.ijpn_88_21","DOIUrl":"https://doi.org/10.4103/ijpn.ijpn_88_21","url":null,"abstract":"Thoracic outlet syndrome (TOS) remains one of the underdiagnosed conditions due to the unavailability of specific tests. The pain of TOS may mimic shoulder pain and or cervical radicular pain. Understanding the pathology and type of TOS is the key to successful management. Although surgery remains the final permanent solution in a conformed case of TOS, conservative therapies do provide great relief from pain. Botox remains one of the modalities in managing TOS pain by relieving the spasm of the scalene group of muscles and thereby alleviating the compression symptoms.","PeriodicalId":32328,"journal":{"name":"Indian Journal of Pain","volume":"36 1","pages":"159 - 161"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41475448","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":"From the desk of new editor-in-chief","authors":"Samarjit Dey","doi":"10.4103/ijpn.ijpn_75_22","DOIUrl":"https://doi.org/10.4103/ijpn.ijpn_75_22","url":null,"abstract":"","PeriodicalId":32328,"journal":{"name":"Indian Journal of Pain","volume":"36 1","pages":"69 - 69"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42594441","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}
Bhavna Hooda, Shalendra Singh, D. Dwivedi, R. Goyal
{"title":"Block: Component of a multimodal approach to taming the stress response in pheochromocytoma resection","authors":"Bhavna Hooda, Shalendra Singh, D. Dwivedi, R. Goyal","doi":"10.4103/ijpn.ijpn_98_21","DOIUrl":"https://doi.org/10.4103/ijpn.ijpn_98_21","url":null,"abstract":"","PeriodicalId":32328,"journal":{"name":"Indian Journal of Pain","volume":"36 1","pages":"114 - 115"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48698229","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}