Clinical Journal of Pain最新文献

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Longitudinal Associations Between Pain, Risk for Posttraumatic Stress Disorder, Posttraumatic Stress Symptoms, and Pain Characteristics in Children After Unintentional Injury. 意外伤害后儿童的疼痛、创伤后应激障碍风险、创伤后应激症状和疼痛特征之间的纵向关联。
IF 2.6 3区 医学
Clinical Journal of Pain Pub Date : 2024-07-01 DOI: 10.1097/AJP.0000000000001212
Anna Monica Agoston, John Bleacher, Alexis Smith, Susanne Edwards, Maia Routly
{"title":"Longitudinal Associations Between Pain, Risk for Posttraumatic Stress Disorder, Posttraumatic Stress Symptoms, and Pain Characteristics in Children After Unintentional Injury.","authors":"Anna Monica Agoston, John Bleacher, Alexis Smith, Susanne Edwards, Maia Routly","doi":"10.1097/AJP.0000000000001212","DOIUrl":"10.1097/AJP.0000000000001212","url":null,"abstract":"<p><strong>Objectives: </strong>Approximately 20% of children demonstrate persistent posttraumatic stress symptoms (PTSS) after unintentional injury, with more severe pain intensity predicting concurrent and later PTSS. Examining additional pain characteristics like pain behaviors, impairment related to pain, and subjective experiences of pain might provide additional insight into the mechanisms that reinforce relationships between risk for posttraumatic stress disorder (PTSD), PTSS, and pain.</p><p><strong>Methods: </strong>During hospitalization for unintentional injury, the Screening Tool for Predictors of PTSD (STEPP) was administered and the highest pain score was collected. One month later, the Child PTSD Symptom Scale and PROMIS questionnaires assessed PTSS and pain characteristics respectively, including intensity, interference, behaviors, and quality.</p><p><strong>Results: </strong>Correlations between PTSS and PROMIS questionnaires were significant. STEPP predicted future PTSS and all PROMIS questionnaires. The highest pain score predicted future PTSS, as well as pain interference and pain behavior, and did not predict pain intensity and pain quality. When STEPP and highest pain score were combined into a single regression, STEPP and highest pain score predicted future PTSS but only STEPP continued to predict all PROMIS questionnaires.</p><p><strong>Discussion: </strong>PTSD risk significantly predicted PTSS and pain characteristics 1 month later. The highest pain score predicted future PTSS and several pain characteristics but no longer had predictive value for pain-related outcomes when combined with PTSD risk. These results indicate that risk factors for PTSD are stronger predictors than pain-related risk factors in predicting pain outcomes. Addressing PTSD risk, as well as pain intensity during hospitalization, may result in improved outcomes for children with unintentional injury.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":"400-408"},"PeriodicalIF":2.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140159463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Perceived Injustice and Anger in Fibromyalgia With and Without Comorbid Mental Health Conditions: A Hebrew Validation of the Injustice Experience Questionnaire. 伴有或不伴有精神疾病的纤维肌痛患者的不公正感和愤怒:不公正体验问卷的希伯来语验证。
IF 2.6 3区 医学
Clinical Journal of Pain Pub Date : 2024-06-01 DOI: 10.1097/AJP.0000000000001204
Gadi Gilam, Jemma Silvert, Sheer Raev, Din Malka, Inbar Gluzman, Melissa Rush, Odelia Elkana, Valerie Aloush
{"title":"Perceived Injustice and Anger in Fibromyalgia With and Without Comorbid Mental Health Conditions: A Hebrew Validation of the Injustice Experience Questionnaire.","authors":"Gadi Gilam, Jemma Silvert, Sheer Raev, Din Malka, Inbar Gluzman, Melissa Rush, Odelia Elkana, Valerie Aloush","doi":"10.1097/AJP.0000000000001204","DOIUrl":"10.1097/AJP.0000000000001204","url":null,"abstract":"<p><strong>Objectives: </strong>Perceived injustice (PI), assessed by the Injustice Experience Questionnaire (IEQ), is an important trigger of anger. Both PI and anger are associated with adverse chronic pain outcomes, and with comorbid mental health severity. We aimed examined the roles of PI and anger in mediating pain across Fibromyalgia patients, with and without comorbid anxiety/depression (FM+A/D, FM-A/D, respectively), as well as rheumatoid arthritis (RA), and pain-free controls (PFC). We hypothesized the highest levels of PI, anger, and pain in FM+A/D patients, followed by FM-A/D, RA, and PFC, thus also validating a Hebrew version of the IEQ.</p><p><strong>Methods: </strong>We translated the IEQ using the forward-backward method and collected data online. Based on self-reported anxiety/depression, the sample comprised 66 FM+A/D patients, 64 FM-A/D, 34 RA, and 32 PFCs. Assessments included the IEQ, state and trait anger, pain intensity, anxiety, depression, and pain catastrophizing. The structure and reliability of the Hebrew IEQ were examined using factor analysis and Cronbach alpha. Bootstrapped-based modeling was used to test the roles of state and trait anger in mediating and moderating the relationship between PI and pain intensity.</p><p><strong>Results: </strong>We confirmed a one-factor structure of the IEQ, with excellent reliability. FM+A/D patients demonstrated the highest scores in all measures. Within this group, trait anger moderated the mediating effect of state anger in the relationship between PI and pain intensity.</p><p><strong>Discussion: </strong>Our findings validate a Hebrew IEQ and highlight the importance of PI and state and trait anger in the differential manifestation of mental health comorbidity in FM.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":"356-366"},"PeriodicalIF":2.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139724876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Prescription Opioid Decision-making and Use Behaviors in Adolescents With Acute Pain: A Qualitative Study. 急性疼痛青少年的阿片类处方决策和使用行为:一项定性研究。
IF 2.6 3区 医学
Clinical Journal of Pain Pub Date : 2024-06-01 DOI: 10.1097/AJP.0000000000001205
Flavia P Kapos, Grace O Gordon, Cornelius B Groenewald, Katherine Slack, Vienna Wang, Tonya M Palermo, Anna C Wilson, Jennifer A Rabbitts
{"title":"Prescription Opioid Decision-making and Use Behaviors in Adolescents With Acute Pain: A Qualitative Study.","authors":"Flavia P Kapos, Grace O Gordon, Cornelius B Groenewald, Katherine Slack, Vienna Wang, Tonya M Palermo, Anna C Wilson, Jennifer A Rabbitts","doi":"10.1097/AJP.0000000000001205","DOIUrl":"10.1097/AJP.0000000000001205","url":null,"abstract":"<p><strong>Objectives: </strong>Understanding adolescent perspectives on prescribed opioids in the context of medical care for acute pain is needed to prevent opioid-related adverse outcomes. We explored factors that may influence opioid decision-making and use behaviors among adolescents prescribed opioids for acute pain.</p><p><strong>Methods: </strong>We conducted semistructured interviews with 19 adolescents (63% females, ages 12 to 17) prescribed opioids upon discharge from surgery or intensive care unit admission. Interview transcripts were coded using inductive thematic analysis.</p><p><strong>Results: </strong>Five themes were identified: \"Opioid use to reduce extreme pain and facilitate acute recovery\"; \"Familiarity with risks and negative effects of opioids\"; \"Assessment of opioid risk based on individual characteristics and use behaviors\"; \"Careful balance of risks, benefits, and symptoms when taking opioids\"; \"Importance of trusted adults for adolescent opioid management\". Adolescents commonly believe opioids are only appropriate for severe pain that cannot be managed with other strategies. Most (but not all) adolescents were aware of addiction and other potential opioid harms and generally disapproved of misuse. However, a few adolescents would consider taking unprescribed opioids for severe pain. Adolescents wanted to be well informed for opioid decision-making, considering guidance from trusted adults.</p><p><strong>Discussion: </strong>Adolescents often demonstrated active and sound participation in shared opioid decision-making, influenced by complex integration of inputs and self-reflection. Conversely, potential factors that could contribute to risky behaviors included low personal risk perceptions, uncertainty about what constitutes opioid misuse, and avoidance of prescribed opioids despite extreme pain. Future studies may explore associations of adolescents' opioid decision-making with longer-term pain and opioid-related outcomes.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":"333-340"},"PeriodicalIF":2.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11087202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139724877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact of Preoperative Aripiprazole on Postoperative Analgesia in Laparoscopic Hysterectomy: A Randomized Double-blind Placebo-controlled Trial. 腹腔镜子宫切除术中术前阿立哌唑对术后镇痛的影响:随机双盲安慰剂对照试验》。
IF 2.6 3区 医学
Clinical Journal of Pain Pub Date : 2024-06-01 DOI: 10.1097/AJP.0000000000001210
Amin Mohamed Alansary, Marwa Ahmed Khairy Elbeialy
{"title":"Impact of Preoperative Aripiprazole on Postoperative Analgesia in Laparoscopic Hysterectomy: A Randomized Double-blind Placebo-controlled Trial.","authors":"Amin Mohamed Alansary, Marwa Ahmed Khairy Elbeialy","doi":"10.1097/AJP.0000000000001210","DOIUrl":"10.1097/AJP.0000000000001210","url":null,"abstract":"<p><strong>Objectives: </strong>Aripiprazole is a second-generation atypical antipsychotic with worldwide clinical approval. Nevertheless, its perioperative antinociceptive application has not been studied. As a result, the purpose of this study was to investigate the analgesic effects of perioperative aripiprazole on reducing postoperative pain, as well as the possible adverse effects.</p><p><strong>Patients and methods: </strong>This randomized controlled study enrolled 80 female patients scheduled for laparoscopic hysterectomy who were assigned randomly into 2 equal groups in 1:1; aripiprazole group (n = 40), patients received an aripiprazole 30 mg tablet orally 3 hours before surgery and placebo group (n = 40), patients received a placebo tablet 3 hours before surgery. The 24-hour morphine consumption postoperatively was the primary outcome, and the time to the first analgesic request, sedation scores, and the incidence of perioperative adverse events were the secondary outcomes.</p><p><strong>Results: </strong>The mean 24-hour morphine consumption was significantly lower with aripiprazole (2.5 ± 0.5 mg) than with placebo (23.7 ± 1.6 mg; mean ± SE -21.2 ± 0.3, 95% CI: -21.7 to -20.6, P < 0.001). In addition, the mean time to the first analgesic request was significantly longer with aripiprazole (212.2 ± 14.7 min) than with placebo (27.0 ± 2.0 min; mean ± SE 185.2 ± 2.3, 95% CI: 180.5 to 189.8, P < 0.001). Furthermore, the aripiprazole group reported higher sedation scores ( P < 0.001). Bradycardia and hypotension were reported more frequently among patients in the aripiprazole group ( P < 0.05).</p><p><strong>Conclusion: </strong>Aripiprazole was effective in reducing pain after laparoscopic hysterectomy. Although self-limited, side effects should be taken into consideration when using the medication perioperatively.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":"341-348"},"PeriodicalIF":2.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140050928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Higher Neck Pain Intensity and Pain Catastrophizing Soon After A Whiplash Injury Partially Explain the Presence of Persistent Headache: A Prospective Study. 颈部疼痛强度较高和颈部闪挫伤后不久疼痛加重可部分解释持续性头痛的存在:一项前瞻性研究
IF 2.6 3区 医学
Clinical Journal of Pain Pub Date : 2024-06-01 DOI: 10.1097/AJP.0000000000001209
Ernesto Anarte-Lazo, Deborah Falla, Cleofas Rodriguez-Blanco, Carlos Bernal-Utrera
{"title":"Higher Neck Pain Intensity and Pain Catastrophizing Soon After A Whiplash Injury Partially Explain the Presence of Persistent Headache: A Prospective Study.","authors":"Ernesto Anarte-Lazo, Deborah Falla, Cleofas Rodriguez-Blanco, Carlos Bernal-Utrera","doi":"10.1097/AJP.0000000000001209","DOIUrl":"10.1097/AJP.0000000000001209","url":null,"abstract":"<p><strong>Objective: </strong>To understand whether pain-related factors soon after a whiplash injury can explain the presence of chronic headache.</p><p><strong>Materials and methods: </strong>A prospective study with a follow-up of 6 months was performed, including 42 patients with acute whiplash-associated disorders. Neck pain intensity, the Neck Disability Index, the Tampa Scale of Kinesiophobia, the Pain Catastrophizing Scale, and the Anxiety State-Trait Scale were assessed at baseline. Differences in clinical characteristics between those with and without headache at 6 months were determined. The relative risk of presenting with headache was evaluated. A logistic regression model was performed to assess which factors at baseline could explain the presence of headache at 6 months.</p><p><strong>Results: </strong>At 6 months, one-third of the sample presented with chronic headache. Significant differences were found for several outcome measures when people with and without headache were compared ( P <0.001). The highest relative risk of presenting with headache was found for moderate/severe levels of pain catastrophizing during the acute phase (RR=15.00, 95% CI=3.93, 57.22). The level of neck pain intensity and pain catastrophizing at baseline partially explained the presence of headache at 6 months ( R2 =0.627).</p><p><strong>Discussion: </strong>The risk of presenting with persistent headache attributed to a whiplash injury is increased when people present with higher neck pain intensity and pain catastrophizing soon after a whiplash injury. Evaluating neck pain intensity and pain catastrophizing at baseline may assist in identifying those more likely to develop chronic headache, potentially providing an opportunity for early targeted interventions.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":"349-355"},"PeriodicalIF":2.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140095051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparison of Analgesic Effects of Continuous Femoral Nerve Block, Femoral Triangle Block, and Adductor Block After Total Knee Arthroplasty: A Randomized Clinical Trial. 全膝关节置换术后连续股神经阻滞、股三角区阻滞和内收肌阻滞的镇痛效果比较:随机临床试验。
IF 2.6 3区 医学
Clinical Journal of Pain Pub Date : 2024-06-01 DOI: 10.1097/AJP.0000000000001211
Minghe Tan, Bozhou Chen, Qingshu Li, Siqi Wang, Daiyu Chen, Maoji Zhao, Jun Cao
{"title":"Comparison of Analgesic Effects of Continuous Femoral Nerve Block, Femoral Triangle Block, and Adductor Block After Total Knee Arthroplasty: A Randomized Clinical Trial.","authors":"Minghe Tan, Bozhou Chen, Qingshu Li, Siqi Wang, Daiyu Chen, Maoji Zhao, Jun Cao","doi":"10.1097/AJP.0000000000001211","DOIUrl":"10.1097/AJP.0000000000001211","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to compare the analgesic effects of continuous femoral nerve block (FNB), femoral triangle block (FTB), and adductor canal block (ACB) following total knee arthroplasty (TKA). The goal was to identify the most effective nerve block technique among these.</p><p><strong>Methods: </strong>Patients undergoing TKA were randomly assigned to 1 of 3 groups: FNB, FTB, or ACB. Nerve blocks were administered preoperatively, with catheters placed for patient-controlled nerve analgesia (PCNA). The primary end point was the Numeric Rating Scale (NRS) score at movement at 24 hours postsurgery. Secondary end points included NRS scores at rest and movement, quadriceps strength, Timed Up and Go (TUG) test performance, range of motion, effective PCNA utilization, and opioid consumption at various postsurgery time points.</p><p><strong>Results: </strong>Of the 94 valid data sets analyzed (FNB: 31, FTB: 31, ACB: 32), significant differences were observed in the primary end point (H=7.003, P =0.03). Post hoc analysis with Bonferroni correction showed that the FNB group had a significantly lower median pain score (3 [2 to 4]) compared with the ACB group (4 [3 to 5], Bonferroni-adjusted P =0.03). Regarding secondary end points, both the FNB and FTB groups had significantly lower NRS scores than the ACB group at various time points after surgery. Quadriceps strength and TUG completion were better in the FTB and ACB groups. There were no statistically significant differences among the groups for the other end points.</p><p><strong>Discussion: </strong>Continuous FTB provides postoperative analgesia comparable to FNB but with the advantage of significantly less impact on quadriceps muscle strength, a benefit not seen with FNB. Both FTB and ACB are effective in preserving quadriceps strength postoperatively.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":"373-382"},"PeriodicalIF":2.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11081475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140177495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Efficacy and Safety of Botulinum Toxin Type A in the Treatment of Trigeminal Neuralgia: An Update on Systematic Review With Meta-analyses. A 型肉毒杆菌毒素治疗三叉神经痛的有效性和安全性:带荟萃分析的最新系统综述。
IF 2.6 3区 医学
Clinical Journal of Pain Pub Date : 2024-06-01 DOI: 10.1097/AJP.0000000000001207
Xinyu Hu, Yun Xia, Jingwen Li, Xinyi Wang, Hanshu Liu, Jichuan Hu, Juan Bi, Jing Wu, Tao Wang, Zhicheng Lin, Nian Xiong
{"title":"Efficacy and Safety of Botulinum Toxin Type A in the Treatment of Trigeminal Neuralgia: An Update on Systematic Review With Meta-analyses.","authors":"Xinyu Hu, Yun Xia, Jingwen Li, Xinyi Wang, Hanshu Liu, Jichuan Hu, Juan Bi, Jing Wu, Tao Wang, Zhicheng Lin, Nian Xiong","doi":"10.1097/AJP.0000000000001207","DOIUrl":"10.1097/AJP.0000000000001207","url":null,"abstract":"<p><strong>Objective: </strong>Pain management in patients with TN is challenging, as facial pain often does not respond well to conventional therapies. Botulinum toxin type A (BTX-A) has been suggested as a potential treatment option, but there is limited evidence regarding its long-term efficacy. This review aimed to analyze the current data for the use of in the treatment of trigeminal neuralgia (TN) and highlight the evidence for its efficacy and safety.</p><p><strong>Methods: </strong>A comprehensive search was conducted in various databases (PubMed, Scopus, Embase, ClinicalTrials, and Cochrane Library) to identify clinical studies evaluating the use of BTX-A in TN until October 2023. Randomized controlled trials (RCTs), single-arm studies, and stratified studies were included in the analysis. The mean difference (MD), effect size (ES), and 95% confidence interval (CI) were estimated for visual analogue scale (VAS) scores, pain episode frequency, and the proportion of responders.</p><p><strong>Results: </strong>The analysis included 23 studies, including 4 RCTs, 14 single-arm studies, and 5 stratified studies. In the RCTs, BTX-A was found to significantly reduce mean VAS scores compared with baseline (ES: -4.05; 95% CI: -6.13, -1.97; P =0.002). In 19 non-RCTs, the pooled single-arm analysis revealed that BTX-A decreased VAS scores (ES: -5.19, 95% CI: -6.05, -4.33, P <0.001) and pain attack frequency (ES: -17.85, 95% CI: -23.36, -12.34, P <0.001) from baseline to the end of follow-up. The overall proportion of responders to BTX-A treatment was also significant (95% CI: 0.653, 0.761, P =0.003).</p><p><strong>Discussion: </strong>Current evidence indicates that BTX-A injection is an effective and safe option for patients with refractory TN or not responding to medical or surgical management. However, more high-quality studies are needed to further confirm its efficacy.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":"383-392"},"PeriodicalIF":2.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139934029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Safety and Complications of Landmark-based Paravertebral Blocks: A Retrospective Analysis of 979 Patients and 4983 Injections. 以地标为基础的椎旁阻滞的安全性和并发症:对 979 名患者和 4983 次注射的回顾性分析。
IF 2.6 3区 医学
Clinical Journal of Pain Pub Date : 2024-06-01 DOI: 10.1097/AJP.0000000000001208
Alberto E Ardon, Emma Curley, Roy Greengrass
{"title":"Safety and Complications of Landmark-based Paravertebral Blocks: A Retrospective Analysis of 979 Patients and 4983 Injections.","authors":"Alberto E Ardon, Emma Curley, Roy Greengrass","doi":"10.1097/AJP.0000000000001208","DOIUrl":"10.1097/AJP.0000000000001208","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to determine the incidence of complications after landmark-based paravertebral blocks for breast surgery.</p><p><strong>Methods: </strong>The medical records of patients who received a paravertebral block for breast surgery between 2019 and 2022 were reviewed. Patient age, sex, type of procedure, number of injections, volume of injected anesthetic, and possible complications were noted. A record was identified as a possible serious block-related complication if there was concern or treatment for local anesthetic systemic toxicity, pneumothorax, altered mental status, or intrathecal/epidural spread. Other complications recorded were immediate postblock hypotension and nausea/vomiting requiring treatment and unanticipated postsurgical admission. Patients receiving ultrasound-guided paravertebral blocks were excluded from this study.</p><p><strong>Results: </strong>Over a 3-year period, 979 patients received paravertebral blocks using the landmark technique for breast surgery, totaling 4983 injections. Overall, 6 patients required assessment for postblock issues (0.61%), including hypotension (2 patients), nausea (3 patients), and hypotension + altered mental status (1 patient). This latter patient was identified as having a serious complication related to the paravertebral block (0.1%). This patient had unintentional intrathecal spread and altered mental status that required mechanical ventilation. The incidence of block-related hypotension and nausea requiring treatment was thus 0.31% and 0.31% respectively. Four patients required unanticipated admission, but none were for block-related reasons. No patients in this study were found to have local anesthetic systemic toxicity or pneumothorax.</p><p><strong>Conclusion: </strong>Our study suggests that landmark-based paravertebral blocks for breast surgery result in a very low complication rate and are a safe technique for postsurgical analgesia.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":"367-372"},"PeriodicalIF":2.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139900768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Combined Therapy of Paravertebral Nerve Pulsed Radiofrequency and Subcutaneous Block for Acute/Subacute Herpetic Neuralgia: A Retrospective Study. 椎旁神经脉冲射频和皮下阻滞联合疗法治疗急性/亚急性带状疱疹神经痛:回顾性研究。
IF 2.6 3区 医学
Clinical Journal of Pain Pub Date : 2024-05-01 DOI: 10.1097/AJP.0000000000001202
Wei Zhang, Bin Yu, Zipu Jia, Chunmei Zhao, Fang Luo
{"title":"Combined Therapy of Paravertebral Nerve Pulsed Radiofrequency and Subcutaneous Block for Acute/Subacute Herpetic Neuralgia: A Retrospective Study.","authors":"Wei Zhang, Bin Yu, Zipu Jia, Chunmei Zhao, Fang Luo","doi":"10.1097/AJP.0000000000001202","DOIUrl":"10.1097/AJP.0000000000001202","url":null,"abstract":"<p><strong>Objectives: </strong>This retrospective study aimed to investigate the effectiveness and safety of early combined therapy with CT-guided paravertebral nerve (PVN), pulsed radiofrequency (PRF), and subcutaneous block on acute/subacute herpes zoster (HZ).</p><p><strong>Methods: </strong>A total of 98 medical records were analyzed. All patients underwent CT-guided PRF on PVN immediately followed by a single subcutaneous block with lidocaine and dexamethasone in acute/subacute phase. The therapy efficacy was evaluated by pain numeric rating scale (NRS) and effective rate, which was defined as a percent of cases with a reduction in pain NRS>50% at day 1, week 2, 4, 12, and 24 after the procedure. The incidences of medication reduction and postherpetic neuralgia (PHN) were also retrieved. Further comparison was conducted between acute group (disease duration<30 days from HZ onset) and subacute group (30 day<duration<90 days from HZ onset).</p><p><strong>Results: </strong>Early combined therapy indicated an immediate and sustained improvement in pain NRS as compared with before treatment ( P <0.0001), with effective rates of 74%, 79%, 80%, 76%, and 79% at day 1, week 2, 4, 12, and 24 after procedure, respectively. At the end of follow-up, the proportion of patients with a reduction of >50% in prior medications amounted to 83% and the incidence of clinically meaningful PHN decreased to 23%. The clinical efficacy was more profound in acute group than in subacute group at every time points ( P <0.05). No severe complications occurred.</p><p><strong>Discussion: </strong>Our data revealed surprising levels of pain relief by combination therapies of PRF and subcutaneous block targeting different sites of pain pathway, thus suggesting a valuable treatment option for acute/subacute herpetic neuralgia.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":"299-305"},"PeriodicalIF":2.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139693508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Momentary Emotion Regulation Strategies and Pain Experience Among Adults With Chronic Pain: An Ecological Momentary Assessment Study. 成人慢性疼痛患者的瞬间情绪调节策略与疼痛体验:一项生态学瞬间评估研究。
IF 2.6 3区 医学
Clinical Journal of Pain Pub Date : 2024-05-01 DOI: 10.1097/AJP.0000000000001206
Andrew H Rogers, Tanya Smit, Jafar Bakhshaie, Michael J Zvolensky
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