Pain Reports最新文献

{"title":"Open-label placebo treatment for acute postoperative pain (OLP-POP study): a randomized controlled trial.","authors":"Dilan Sezer, Matthijs de Leeuw, Andrea H Meyer, Sarah Buergler, Cordula Netzer, Cosima Locher, Jens Gaab, Wilhelm Ruppen, Tobias Schneider","doi":"10.1097/PR9.0000000000001405","DOIUrl":"https://doi.org/10.1097/PR9.0000000000001405","url":null,"abstract":"<p><strong>Introduction: </strong>Treatment options for acute postoperative pain are often limited and associated with side effects and negative consequences. Therefore, effective, accessible, and safe alternatives are needed to extend existing multimodal analgesia concepts. Open-label placebos (OLPs) are discussed as a means to do so in various experimental and clinical conditions.</p><p><strong>Objective: </strong>With this randomized controlled trial, we aimed to investigate whether OLPs have the potential to reduce opioid consumption in patients suffering from postoperative pain after dorsal lumbar interbody fusion (dLIF) surgery.</p><p><strong>Methods: </strong>In this study, 65 patients with acute postoperative pain after dLIF were randomly assigned to 2 groups. One group received treatment as usual (TAU) including a patient-controlled morphine pump, whereas the other group additionally received 2 daily OLP injections during the first 2 postoperative days. As an indirect measure of pain and desire for pain relief, the primary outcome was defined as the cumulative amount of morphine consumed during the intervention period of 48 hours.</p><p><strong>Results: </strong>In our elderly study population, an analysis of covariance showed no significant differences in morphine consumption between the OLP and TAU group (estimate = -6.94, SE = 5.75, t[60] = -1.21, P = 0.880, d = -0.15).</p><p><strong>Conclusion: </strong>These findings suggest that transferring the effects of OLPs from experimental studies with younger participants to clinical studies might not be feasible. Further research should confirm these results and explore additional methodological factors such as administration mode and observation time frame.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":"11 2","pages":"e1405"},"PeriodicalIF":4.3,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186043","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}

{"title":"The accuracy and reliability of patient-reported opioid consumption following surgical fracture management.","authors":"James Bilbrough, Joseph Descallar, Sam Adie, Justine M Naylor, Ian A Harris, Deanne E Jenkin","doi":"10.1097/PR9.0000000000001399","DOIUrl":"10.1097/PR9.0000000000001399","url":null,"abstract":"<p><strong>Objective: </strong>Postoperative opioid use is commonly determined by patient-report; however, the accuracy of this measure is unclear. We aimed to determine the accuracy and reliability of patient-reported daily opioid consumption up to day 7 and over weeks 1, 2, and 3 after hospital discharge.</p><p><strong>Methods: </strong>This was a secondary analysis of a randomised trial which tested the comparative effectiveness of 2 opioid regimens. Participants' daily opioid consumption was recorded by patient self-report and the quantity of returned pills in blister packs during the treatment period. Intraclass correlation coefficient (ICC) and Bland-Altman plots for repeated measures were used to assess the agreement between each collection method.</p><p><strong>Results: </strong>Records with complete patient-reported daily opioid consumption and returned blister packs were included in the analysis (81 of 120). For day 1 postdischarge, the ICC between patient-reported opioid consumption and consumption determined by blister-pack countback was 0.730. From days 2 to 7, the ICC was consistently greater than 0.8, and the mean difference was consistently less than half a tablet. For week 1 overall, the ICC was 0.904, and the mean difference was -0.4 tablets. For weeks 2 and weeks 3, the ICC was 0.953 and 0.884, respectively.</p><p><strong>Conclusion: </strong>Patient-reported consumption was a reliable and accurate measure of opioid consumption after hospital discharge. Daily consumption demonstrated less reliability and accuracy during the first 24 hours (day 1) which improved overtime. Although patients tended to under-report use, this difference was not seen as clinically meaningful.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":"11 2","pages":"e1399"},"PeriodicalIF":4.3,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12915707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146229760","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}

{"title":"Dual-Target SPG-Mandibular Neuromodulation for Post-Radiation Painful Trigeminal Neuropathy: A 7-Year Follow-up.","authors":"Vadim Tashlykov, Ofir Morag, Gabriel Lichtenshtein, Itay Goor-Aryeh, Evgeni Brotfain","doi":"10.1097/PR9.0000000000001419","DOIUrl":"10.1097/PR9.0000000000001419","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic facial neuropathic pain following surgical or radiation-induced trigeminal nerve damage presents significant therapeutic challenges.</p><p><strong>Objectives: </strong>We aim to demonstrate the effectiveness of combined SPG and V3 neuromodulation as a potential therapiutic measure for trigeminal neuropathy.</p><p><strong>Methods: </strong>First, trial SPG neuromodulation was implanted. Based on significant decreaze in VAS score after trial period, the permanent SPG and, in addition, mandibular electrode (V3) were provided.</p><p><strong>Results: </strong>A 72-year-old male with diabetes mellitus and dyslipidemia presented to our pain clinic in 2017 with chronic facial pain. In 2008, he underwent left parotid gland tumor resection, chemotherapy and radiation therapy. Facial pain developed post-treatment and significantly worsened following left carotid artery stenting in 2015. Pain was localized to the left maxillary (V2) and mandibular (V3) divisions of the trigeminal nerve with constant burning pain (VAS 5/10) and superimposed electric shock-like attacks (VAS 8-9/10). After failure of multimodal pharmacological and interventional treatments, combined SPG and V3 peripheral nerve stimulation was performed. During interventional procedure, at first, permanent SPG neuromodulation and then, the mandibular electrode was introduced from the same incision. The patient achieved 90% pain reduction initially, with sustained benefit at 7-year follow-up despite some habituation.</p><p><strong>Conclusion: </strong>Combined sphenopalatine ganglion and V3 neuromodulation represents a viable therapeutic option for refractory facial neuropathic pain, particularly in cases with multiterritorial involvement.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":"11 2","pages":"e1419"},"PeriodicalIF":4.3,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12915720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146229771","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}

{"title":"Neuronal metabolism role in ketogenic diet improvements in bortezomib-induced painful peripheral neuropathy mouse model.","authors":"Lana L Heslop, Trent K Madden, Gentry Totta-Griese, Sarah J Crowards, Will Hauser, Janelle Ryals, Kyle M Baumbauer, Heather M Wilkins, Douglas E Wright","doi":"10.1097/PR9.0000000000001414","DOIUrl":"10.1097/PR9.0000000000001414","url":null,"abstract":"<p><strong>Introduction: </strong>A ketogenic diet (KD) can benefit a range of neurological conditions, including different types of peripheral neuropathy. Bortezomib (BTZ), a first-line chemotherapy for treating multiple myeloma, has neurotoxic effects and often induces chemotherapy-induced peripheral neuropathy.</p><p><strong>Objectives: </strong>Here, we tested whether a KD could prevent the onset of small fiber neuropathy and behavioral hypersensitivity associated with bortezomib-induced peripheral neuropathy (BIPN).</p><p><strong>Methods: </strong>Male C57BL/6 mice were fed either a standard chow diet or a KD for 10 days. During the first 5 days of KD administration, mice received daily intraperitoneal injections of BTZ or vehicle. Mice entered a BTZ washout period on day 6 while remaining on their specific diets. Hindpaw responses to mechanical (von Frey) and cold (acetone) stimuli were measured to determine how KD and BTZ treatment affected behavioral sensitivity. Footpads were harvested for analysis of intraepidermal nerve fiber density (IENFD), and lumbar dorsal root ganglia were collected for in vitro analysis of neurite outgrowth and cellular bioenergetics.</p><p><strong>Results: </strong>Bortezomib-treated, KD-fed mice exhibited decreased mechanical hypersensitivity, normalized cold hypersensitivity, preserved IENFD, and decreased extracellular acidification rate compared with BTZ-treated, chow-fed mice. In vitro analysis of ketones' ability to protect against BTZ-induced reductions in neurite growth revealed that cultured neurons pretreated with ketones were protected from BTZ-induced neurite degeneration.</p><p><strong>Conclusion: </strong>Findings suggest that KD protects against reductions in IENFD, behavioral hypersensitivity, and bioenergetic shifts induced by BIPN, and provides evidence that KD provides protection against BTZ and could be a potential therapeutic for BIPN.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":"11 2","pages":"e1414"},"PeriodicalIF":4.3,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12915722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146229777","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}

{"title":"Optimum electrical sinusoidal frequency stimulation to activate C-nociceptors.","authors":"Divya Dileep, Kiran Bali, Sabrina Soares, Martin Schmelz, Roman Rukwied","doi":"10.1097/PR9.0000000000001412","DOIUrl":"10.1097/PR9.0000000000001412","url":null,"abstract":"<p><strong>Introduction: </strong>Electrical sinusoidal stimulation has been shown to reliably activate C-fibers. Here, we explored the optimum sinusoidal frequency for C-nociceptor responses.</p><p><strong>Objectives: </strong>Identify the optimum sinusoidal frequency to activate single C-nociceptors in pigs and to provoke pain and axon reflex flare in humans.</p><p><strong>Methods: </strong>Single C-fibers (n = 60) were recorded from pig saphenous nerves in vivo in response to transcutaneous sinusoidal electrical stimulation delivered at frequencies of 3 to 100 Hz with increasing amplitudes. In 22 human subjects, 30 sinusoidal pulses were delivered with 3 to 20 Hz at 0.0125 to 0.4 mA amplitudes and perception thresholds, evoked pain (numeric rating scale, 0-10) and axon reflex flare (full-field laser perfusion imaging) were monitored in 4 seconds intervals.</p><p><strong>Results: </strong>Single C-nociceptors (36 \"polymodal\" [C-mechano-heat-sensitive], 15 \"very high threshold, and 9 \"silent\" [C-mechano-insensitive]) were activated more easily at frequencies below 8 Hz as compared with frequencies >10 Hz. In humans, pain and flare responses were also found to be frequency dependent. Pain threshold assessments were particularly sensitive at a frequency of 4 Hz. Highest pain ratings were recorded from 3 to 6 Hz at stimulation amplitudes of 0.2 mA. Significant axon reflex flare responses developed at low amplitudes of 0.05 and 0.1 mA at frequencies of 4 and 8 Hz only.</p><p><strong>Conclusion: </strong>Sinusoidal frequencies between 3 and 8 Hz are better suited to activate C-nociceptors than stimuli above 10 Hz and are expected to facilitate C-nociceptor recruitment for their functional assessment in volunteers and chronic pain patients.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":"11 2","pages":"e1412"},"PeriodicalIF":4.3,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12915732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146229809","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}

{"title":"A rare case of secondary paroxysmal hemicrania caused by a T1 nerve root schwannoma.","authors":"Rachel-Maria Zwergal, Filipp Filippopulos, Andreas Straube, Max Wuehr, Andreas Zwergal","doi":"10.1097/PR9.0000000000001404","DOIUrl":"10.1097/PR9.0000000000001404","url":null,"abstract":"<p><strong>Introduction: </strong>Paroxysmal hemicrania (PH) is a rare headache disorder of severe intensity, which is classified within the group of trigeminal autonomic cephalalgias and is renowned for its prompt response to indomethacin.</p><p><strong>Objectives: </strong>Since its first description in 1974, only few cases of secondary PH have been published and even fewer with distinct lesions and a clear pathophysiological association.</p><p><strong>Methods: </strong>We here present a unique case of long-standing secondary PH, which resolved permanently after resection of a schwannoma of the T1 nerve root, which carries sympathetic projections to the periorbital region.</p><p><strong>Results: </strong>The current case stresses the importance of sympathetic/parasympathetic dysregulation in the pathophysiological origination of PH, which is far beyond purely central mechanisms. It is the first case ever published, which shows a quite remote peripheral pathology causing a trigeminal autonomic headache disorder.</p><p><strong>Conclusion: </strong>This case has important implications on a better understanding of the pathophysiology and future diagnostic workup of PH, which should ideally include imaging not only of the brain but also of the spine down to the thoracic level.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":"11 2","pages":"e1404"},"PeriodicalIF":4.3,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12915705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146229766","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}

{"title":"Pain in multiple sclerosis: clinical phenotypes and therapeutic strategies - a narrative review.","authors":"Livia Sophie Lang, Maria Protopapa, Stefan Bittner, Frank Birklein","doi":"10.1097/PR9.0000000000001403","DOIUrl":"10.1097/PR9.0000000000001403","url":null,"abstract":"<p><strong>Introduction: </strong>Pain is a frequent and burdensome symptom in multiple sclerosis (MS), yet it remains underrecognized and undertreated.</p><p><strong>Objective: </strong>This review summarizes current knowledge on the prevalence, mechanisms, clinical phenotypes, and therapeutic strategies of MS-related pain, with an emphasis on implications for clinical management.</p><p><strong>Methods: </strong>We conducted a narrative review of the literature, integrating epidemiological, clinical, and mechanistic evidence on pain in MS.</p><p><strong>Results: </strong>Pain is reported by 29% to 86% of people with MS, and up to one-third describe it as their most distressing symptom. Multiple sclerosis-related pain can be classified mechanistically as nociceptive, neuropathic, nociplastic, or mixed. Common clinical syndromes include migraine, tension-type headache, optic neuritis-related pain, trigeminal neuralgia, painful spasticity, and Lhermitte sign. Nociplastic, fibromyalgia-like widespread pain has recently gained attention but remains poorly defined. Evidence for pharmacological interventions - such as anticonvulsants, tricyclic antidepressants, muscle relaxants, corticosteroids for acute optic neuritis, and nabiximols for spasticity - is limited, with few trials addressing specific pain subtypes. Among nonpharmacological strategies, structured exercise shows the most consistent benefits for MS-related pain, whereas evidence for other approaches, including physiotherapy, psychological interventions, and neuromodulation, remains limited. Nevertheless, multimodal strategies addressing co-occurring fatigue, depression, and sleep disturbance appear most effective.</p><p><strong>Conclusion: </strong>Pain is common and disabling across all MS phenotypes but is often insufficiently addressed in clinical practice. A mechanism-based classification combined with individualized, multimodal treatment offers the most promising framework to improve patient outcomes.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":"11 2","pages":"e1403"},"PeriodicalIF":4.3,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12915704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146229728","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}

{"title":"Influence of psychological and somatosensory characteristics on treatment outcomes in adolescent chronic postsurgical and primary pain.","authors":"Lisa M Einhorn, Andrew M Breglio, Thomas Wise, Morgan Rosser, Don Daniel Ocay, Nada Mohamed, Pablo Ingelmo","doi":"10.1097/PR9.0000000000001408","DOIUrl":"10.1097/PR9.0000000000001408","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic postsurgical pain (CPSP) affects 20% to 30% of pediatric patients at 12 months after surgery. We hypothesized that differences in biopsychosocial and somatosensory profiles exist between patients with CPSP and those with chronic primary pain (CPP) and that these differences affect treatment outcomes.</p><p><strong>Methods: </strong>This cohort included prospectively collected, retrospectively analyzed data from adolescents treated at the Edwards Family Interdisciplinary Center for Complex Pain between May 2016 and May 2022. During clinic intake, patients completed the Functional Disability Inventory, Revised Child Anxiety and Depression Scale, and Pittsburgh Sleep Quality Index to assess for disability, anxiety, depression, and sleep quality, respectively. Baseline quantitative sensory testing/conditioned pain modulation (QST/CPM) was performed to characterize somatosensory functioning. The primary outcome was a score of 6 (\"much better\") or 7 (\"very much better\") on the Patient Global Impression of Change (PGIC) measure at treatment end.</p><p><strong>Results: </strong>Of 99 patients (14.8 ± 2.0 years, 90% female), 46 had CPSP and 53 had CPP. Compared to CPP, patients with CPSP had less baseline functional disability, coexisting depression, and social phobia and better sleep quality. After adjusting for psychosocial differences, patients with CPSP were more likely to score ≥6 on PGIC than patients with CPP (odds ratio = 3.0 [95% confidential interval: 1.3-7.7], <i>P</i> = 0.01). Patients with dynamic mechanical allodynia and/or temporal summation were less likely to score ≥6 on PGIC compared to patients without (odds ratio = 0.33 [95% confidential interval: 0.13-0.82], <i>P</i> = 0.02).</p><p><strong>Conclusion: </strong>Differences in biopsychosocial factors, somatosensory profiles, and treatment outcomes exist between patients with CPSP and CPP. The presence of centrally driven pain hypersensitivity on baseline QST/CPM was associated with worse recovery prognosis.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":"11 2","pages":"e1408"},"PeriodicalIF":4.3,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12915702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146229733","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}

{"title":"Functional magnetic resonance imaging insights into nociceptive signal processing network in rat lumbar spinal cord.","authors":"Xuerong Zhang, Chaoqi Mu, Arabinda Mishra, Feng Wang, Pai-Feng Yang, Xinqiang Yan, Ming Lu, John C Gore, Li Min Chen","doi":"10.1097/PR9.0000000000001368","DOIUrl":"10.1097/PR9.0000000000001368","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>High-resolution functional magnetic resonance imaging (fMRI) allows the mapping of functional organization of intraspinal circuits. This study aimed to identify nociceptive heat processing regions within the gray matter of the lumbar spinal cords and delineate their functional organization using task and resting-state fMRI in rats under anesthesia.</p><p><strong>Methods: </strong>High-resolution fMRI BOLD data were acquired from L3-L5 spinal segments during noxious heat (47.5°C) stimulation of the left hind paw and at rest at 9.4T MRI.</p><p><strong>Results: </strong>Noxious heat-elicited BOLD signal increases were detected at deep layers of dorsal horns and intermediate zone within the rostral lumbar enlargement (L3) and deep layers of the ipsilateral dorsal horn in lumbar segment L4. Resting-state functional connectivity (rsFC) analysis revealed the strongest rsFC strengths between dorsal-dorsal and ventral-ventral horns within each lumbar segment. No significant rsFC was found between the horns in different segments.</p><p><strong>Conclusion: </strong>Our results demonstrate that lumbar enlargement (L3 and L4) was involved in processing heat nociceptive information and bilateral dorsal and ventral horns were strongly interconnected at rest. We hypothesize that the intermediate zone in the rostral subsegment of L3 serves as a modulation center for nociceptive processing within the lumbar cord.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":"11 2","pages":"e1368"},"PeriodicalIF":4.3,"publicationDate":"2026-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12900226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203809","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}

{"title":"Pregabalin naproxencarbil in acute post-bunionectomy pain: a randomized clinical trial.","authors":"Guang-Liang Jiang, J Richard Evanson, Daneshvari Solanki, Dominick D'Aunno, Emanuel DeNoia, Juan Carlos Rondon, Alina Beaton, Louise Taber","doi":"10.1097/PR9.0000000000001424","DOIUrl":"10.1097/PR9.0000000000001424","url":null,"abstract":"<p><strong>Introduction: </strong>Practice guidelines recommend multimodal approaches for better management of acute pain including the administration of two or more drugs that act by different analgesic mechanisms.</p><p><strong>Objective: </strong>The study aimed to assess pregabalin naproxencarbil (PNC), a new chemical entity targeting both nociceptive and neuropathic pain pathways, for the management of acute pain.</p><p><strong>Methods: </strong>This randomized, double-blind, placebo-controlled trial enrolled 450 participants scheduled for first metatarsal bunionectomy. Participants were randomized (1:1:1) to receive either 1250 mg or 750 mg of PNC or placebo. Study drug was administered 1 hour before surgery and thereafter every 12 hours for 72 hours. Participants reported numeric pain rating scale to calculate summed pain intensity (SPI). Rescue pain medication use and safety were monitored.</p><p><strong>Results: </strong>The least-squares mean (LSM) (SE) of SPI over 48 hours (SPI48) for the 1250 mg PNC group vs placebo as the primary efficacy end point was 132.6 (8.0) vs 286.0 (8.2) (<i>P</i> < 0.0001). For the 750 mg group vs placebo as the key secondary efficacy end point, the LSM (SE) of SPI48 was 157.9 (8.3) vs 289.5 (8.5) (<i>P</i> < 0.0001). Rescue medication was spared by 42.8%, 33.6%, and 2.7% participants in the 1250 mg, 750 mg, and placebo groups, respectively. Hazard ratios (95% confidence interval) for time to initiate rescue medication were 0.18 (0.14-0.25) for 1250 mg vs placebo and 0.24 (0.18-0.31) for 750 mg vs placebo. Tramadol consumption over 72 hours in the placebo was 4.1- or 3.0-fold higher than in the 1250 mg or 750 mg groups, and 3- or 2.5-fold higher with acetaminophen. Mild somnolence, dizziness, nausea, and constipation were more common in active groups.</p><p><strong>Conclusion: </strong>Pregabalin naproxencarbil dose-dependently reduced acute postoperative pain with acceptable safety profiles.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT06017999.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":"11 2","pages":"e1424"},"PeriodicalIF":4.3,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12928910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147286242","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}