Pub Date : 2019-03-20DOI: 10.4172/2167-0846.1000343
N. Hochhausen, M. Ritter, Andreas Follmann, Henriette Dohmeier, R. Rossaint, M. Czaplik
Objective: Postoperative pain management requires a well-directed pain therapy. Generally, the assessment of pain intensity depends on a self-evaluated numeric rating scale (NRS, 0 to 10). Recently, a pain monitor using a socalled “ANI” (analgesia nociception index; 100 to 0) was introduced. The higher the ANI, the lower the pain intensity is considered. The aim of this study was to investigate if the use of ANI improves acute pain therapy in the post anesthesia care unit (PACU) by means of the experienced pain intensity (mean NRS) as the primary outcome parameter.Methods: After admission to PACU, patients were randomly assigned to the “supported by technique” (TC) or the control group (CO). In both groups, self-assessment of pain intensity was requested every 15 minutes and pain therapy was provided according to internal clinical standards when the self-reported NRS by the patient exceeded 4. In the TC group, NRS pain score was additionally assessed when ANI fell below 50.Results: Out of 91 collectively included patients, 46 were assigned to the TC group. The mean NRS did not differ between the groups (p=0.192) at discharge. However, suitability of the ANI monitor was strongly dependent from the individual patient. In some patients, a strong negative correlation was obtained, in other patients no correlation or, curiously, a strong positive correlation was observed.Conclusion: Although objective pain intensity assessment would be beneficial for postoperative care, its measurement remains challenging.
{"title":"Support of Acute Pain Therapy by Analgesia Nociception Index in Post Anesthesia Care Unit: A Randomized Controlled Trial","authors":"N. Hochhausen, M. Ritter, Andreas Follmann, Henriette Dohmeier, R. Rossaint, M. Czaplik","doi":"10.4172/2167-0846.1000343","DOIUrl":"https://doi.org/10.4172/2167-0846.1000343","url":null,"abstract":"Objective: Postoperative pain management requires a well-directed pain therapy. Generally, the assessment of pain intensity depends on a self-evaluated numeric rating scale (NRS, 0 to 10). Recently, a pain monitor using a socalled “ANI” (analgesia nociception index; 100 to 0) was introduced. The higher the ANI, the lower the pain intensity is considered. The aim of this study was to investigate if the use of ANI improves acute pain therapy in the post anesthesia care unit (PACU) by means of the experienced pain intensity (mean NRS) as the primary outcome parameter.Methods: After admission to PACU, patients were randomly assigned to the “supported by technique” (TC) or the control group (CO). In both groups, self-assessment of pain intensity was requested every 15 minutes and pain therapy was provided according to internal clinical standards when the self-reported NRS by the patient exceeded 4. In the TC group, NRS pain score was additionally assessed when ANI fell below 50.Results: Out of 91 collectively included patients, 46 were assigned to the TC group. The mean NRS did not differ between the groups (p=0.192) at discharge. However, suitability of the ANI monitor was strongly dependent from the individual patient. In some patients, a strong negative correlation was obtained, in other patients no correlation or, curiously, a strong positive correlation was observed.Conclusion: Although objective pain intensity assessment would be beneficial for postoperative care, its measurement remains challenging.","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"144 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73449734","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}
Pub Date : 2018-11-26DOI: 10.4172/2167-0846-C1-020
pMatthias Seidelp
{"title":"Neurogenic information in autoimmune diseases and chronic pain syndromes","authors":"pMatthias Seidelp","doi":"10.4172/2167-0846-C1-020","DOIUrl":"https://doi.org/10.4172/2167-0846-C1-020","url":null,"abstract":"","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"20 3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81730628","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}
Pub Date : 2018-05-28DOI: 10.4172/2167-0846.1000321
C. Tilburg, J. G. Groeneweg, D. Stronks, F. Huygen
Purpose: The aim of this observational study alongside our inter-rater reliability trial (ISRCTN 43417727) is to investigate the accuracy of lumbar X-ray images and MRIs as diagnostic tools of low back pain (LBP) subtypes (sacroiliac joint, disc and facet joint).Patients and methods: Included were patients aged 18 or more with medical history and physical examination suggestive of a chronic LBP subtype, followed by a diagnostic test block. Numbers of spinal imaging tests, and whether or not pathology was present was evaluated in patients with positive- as well as negative diagnostic test blocks. The sensitivity, specificity, positive and negative predictive value of the lumbar X-ray images and MRIs discriminating between the three LBP subtypes are presented.Results: One hundred patients were included. Facet joint pain was a general working diagnosis in 40 patients, disc pain in 8 patients and SI joint pain in 35 patients. The positive predictive value of X-ray was 82.6% for facet joint pain, 66.7% for disc pain and 60% for SI joint pain; the negative predictive value of X-ray was 50% for facet joint pain, 66.7% for disc pain and 7.7% for SI joint pain. The positive predictive value of MRI was 81.8% for facet joint pain, 50% for disc pain and 0% for SI joint pain; the negative predictive value of MRI was 55.6% for facet joint pain, 0% for disc pain and 13% for SI joint pain.Conclusion: The predictive validity of lumbar X-ray images and MRIs to distinguish between low back pain subtypes in patients with chronic LBP is questionable.
{"title":"Predictive Validity of Lumbar X-ray Images and MRIs for Chronic Low Back Pain Subtypes","authors":"C. Tilburg, J. G. Groeneweg, D. Stronks, F. Huygen","doi":"10.4172/2167-0846.1000321","DOIUrl":"https://doi.org/10.4172/2167-0846.1000321","url":null,"abstract":"Purpose: The aim of this observational study alongside our inter-rater reliability trial (ISRCTN 43417727) is to investigate the accuracy of lumbar X-ray images and MRIs as diagnostic tools of low back pain (LBP) subtypes (sacroiliac joint, disc and facet joint).Patients and methods: Included were patients aged 18 or more with medical history and physical examination suggestive of a chronic LBP subtype, followed by a diagnostic test block. Numbers of spinal imaging tests, and whether or not pathology was present was evaluated in patients with positive- as well as negative diagnostic test blocks. The sensitivity, specificity, positive and negative predictive value of the lumbar X-ray images and MRIs discriminating between the three LBP subtypes are presented.Results: One hundred patients were included. Facet joint pain was a general working diagnosis in 40 patients, disc pain in 8 patients and SI joint pain in 35 patients. The positive predictive value of X-ray was 82.6% for facet joint pain, 66.7% for disc pain and 60% for SI joint pain; the negative predictive value of X-ray was 50% for facet joint pain, 66.7% for disc pain and 7.7% for SI joint pain. The positive predictive value of MRI was 81.8% for facet joint pain, 50% for disc pain and 0% for SI joint pain; the negative predictive value of MRI was 55.6% for facet joint pain, 0% for disc pain and 13% for SI joint pain.Conclusion: The predictive validity of lumbar X-ray images and MRIs to distinguish between low back pain subtypes in patients with chronic LBP is questionable.","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"29 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2018-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90581909","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}
Pub Date : 2018-05-22DOI: 10.4172/2167-0846.1000320
M. Imanishi, H. Asato, Kohei Umekawa, S. Sasaki, Tetsuji Terashima
Background: Several studies have investigated the efficacy of transplanting adipose-derived mesenchymal stem cells (ADMSC) in the treatment of neuropathic pain in animals. However, these studies evaluated the effects of transplantation by measuring stimulus-induced pain but not spontaneous pain. Evaluation of spontaneous pain is essential for assessing neuropathic pain in clinical practice, using such measures as the visual analogue scale (VAS). Therefore, spontaneous pain should be evaluated even at the animal experiments stage to verify the efficacy of ADMSC transplantation for treating neuropathic pain. Here, we verify whether ADMSC transplantation improves spontaneous pain in a rat model of neuropathic pain induced by chronic constriction injury of the sciatic nerve. Methods: ADMSC were isolated from rat adipose tissue and propagated in culture. One week after CCI model rats were generated, ADMSC were transplanted into the epineurium of the area of nerve damage. The effects of transplantation were evaluated by automatically measuring the number of spontaneous pain-related behaviors and quantifying the degree of mechanical allodynia using the von-Frey filament test. A total of 20 F344 rats were used in these experiments. Results: ADMSC transplantation significantly reduced the number of spontaneous pain-related behaviors and significantly alleviated mechanical allodynia from 21 and 7 days after transplantation, respectively. No animals died during the experiments, and all animals gained weight over the course of the study. Conclusion: ADMSC transplantation improved not only stimulus-induced pain but also spontaneous pain. ADMSC transplantation may be an effective treatment for neuropathic pain in clinical practice.
{"title":"Adipose-derived Mesenchymal Stem Cells Improve Spontaneous Pain in a Rat Model of Neuropathic Pain","authors":"M. Imanishi, H. Asato, Kohei Umekawa, S. Sasaki, Tetsuji Terashima","doi":"10.4172/2167-0846.1000320","DOIUrl":"https://doi.org/10.4172/2167-0846.1000320","url":null,"abstract":"Background: Several studies have investigated the efficacy of transplanting adipose-derived mesenchymal stem cells (ADMSC) in the treatment of neuropathic pain in animals. However, these studies evaluated the effects of transplantation by measuring stimulus-induced pain but not spontaneous pain. Evaluation of spontaneous pain is essential for assessing neuropathic pain in clinical practice, using such measures as the visual analogue scale (VAS). Therefore, spontaneous pain should be evaluated even at the animal experiments stage to verify the efficacy of ADMSC transplantation for treating neuropathic pain. Here, we verify whether ADMSC transplantation improves spontaneous pain in a rat model of neuropathic pain induced by chronic constriction injury of the sciatic nerve. \u0000Methods: ADMSC were isolated from rat adipose tissue and propagated in culture. One week after CCI model rats were generated, ADMSC were transplanted into the epineurium of the area of nerve damage. The effects of transplantation were evaluated by automatically measuring the number of spontaneous pain-related behaviors and quantifying the degree of mechanical allodynia using the von-Frey filament test. A total of 20 F344 rats were used in these experiments. \u0000Results: ADMSC transplantation significantly reduced the number of spontaneous pain-related behaviors and significantly alleviated mechanical allodynia from 21 and 7 days after transplantation, respectively. No animals died during the experiments, and all animals gained weight over the course of the study. \u0000Conclusion: ADMSC transplantation improved not only stimulus-induced pain but also spontaneous pain. ADMSC transplantation may be an effective treatment for neuropathic pain in clinical practice.","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"2 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2018-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81063592","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}
Pub Date : 2018-05-09DOI: 10.4172/2167-0846.1000319
R. R. Matias, C. Leochico, G. Nilo
Background: Studies abroad demonstrate the effectiveness and safety of dexketoprofen in various therapeutic indications. However, there has been no related study on our local population. Objectives: To evaluate the effectiveness and safety of oral dexketoprofen among Filipino adults in the treatment of mild to moderate acute pain due to musculoskeletal causes (such as osteoarthritis and low back pain), postoperative pain, headache, or dysmenorrhea in primary health care setting in the Philippines. Methods: This was a prospective observational study. Drug prescription by attending physicians was based on the drug’s Summary of Product Characteristics, which included its indications, contraindications, and precautions. Dosage prescriptions varied, depending on the nature and severity of pain on initial consultation, and physicians’ clinical judgment. Effectiveness was evaluated using Wong-Baker faces pain rating scale, clinical global impressions scale, and efficacy index; while safety was evaluated according to incidence and severity of adverse events. Results: Osteoarthritis and low back pain were the most common conditions seen by the physicians during the study period. Majority received the recommended dosage and duration of the medicine, which was 51-75 milligrams of dexketoprofen a day (56.2%) for at least 1 week (57.5%). On follow-up, there was statistically significant improvement (p<0.0001) in pain scores among patients, regardless of medical condition and dexketoprofen dosage and duration. There was low (2.8%) incidence of adverse events in the study population. Majority of side effects did not significantly interfere with daily functioning of patients. Conclusion: This study demonstrated the effectiveness and safety of oral dexketoprofen in various therapeutic indications. Majority experienced moderate or marked therapeutic effect with no to minimal side effect. No serious adverse event from intake of non-steroidal anti-inflammatory drug, particularly related to gastrointestinal and nervous system disorders was noted.
{"title":"Effectiveness and Safety of Oral Dexketoprofen for Mild to Moderate Pain among Filipino Adults: A Post-marketing Surveillance Study","authors":"R. R. Matias, C. Leochico, G. Nilo","doi":"10.4172/2167-0846.1000319","DOIUrl":"https://doi.org/10.4172/2167-0846.1000319","url":null,"abstract":"Background: Studies abroad demonstrate the effectiveness and safety of dexketoprofen in various therapeutic indications. However, there has been no related study on our local population. \u0000Objectives: To evaluate the effectiveness and safety of oral dexketoprofen among Filipino adults in the treatment of mild to moderate acute pain due to musculoskeletal causes (such as osteoarthritis and low back pain), postoperative pain, headache, or dysmenorrhea in primary health care setting in the Philippines. \u0000Methods: This was a prospective observational study. Drug prescription by attending physicians was based on the drug’s Summary of Product Characteristics, which included its indications, contraindications, and precautions. Dosage prescriptions varied, depending on the nature and severity of pain on initial consultation, and physicians’ clinical judgment. Effectiveness was evaluated using Wong-Baker faces pain rating scale, clinical global impressions scale, and efficacy index; while safety was evaluated according to incidence and severity of adverse events. \u0000Results: Osteoarthritis and low back pain were the most common conditions seen by the physicians during the study period. Majority received the recommended dosage and duration of the medicine, which was 51-75 milligrams of dexketoprofen a day (56.2%) for at least 1 week (57.5%). On follow-up, there was statistically significant improvement (p<0.0001) in pain scores among patients, regardless of medical condition and dexketoprofen dosage and duration. There was low (2.8%) incidence of adverse events in the study population. Majority of side effects did not significantly interfere with daily functioning of patients. \u0000Conclusion: This study demonstrated the effectiveness and safety of oral dexketoprofen in various therapeutic indications. Majority experienced moderate or marked therapeutic effect with no to minimal side effect. No serious adverse event from intake of non-steroidal anti-inflammatory drug, particularly related to gastrointestinal and nervous system disorders was noted.","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"7 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2018-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86881000","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}
Pub Date : 2018-05-07DOI: 10.4172/2167-0846.1000317
M. Bakry, Hisham Mohamed Mohamed Salem
Purpose: Paravertebral block (PVB) is a simple and safe technique that can be more efficacious than epidural block (EPB) in controlling postoperative pain. We aimed to confirm this by comparing the two methods in patients after thoracotomy. Methods: Patients were randomly divided into two groups, PVB or EPB (n=30 in each). Vital signs and the visual analog scale (VAS) were evaluated before giving the block then 30 minutes and 3, 6, 9 and 12 hours after thoracotomy. Complications and need for additional analgesic agents were also scrutinized. Results: The most significant finding was better preservation of pulmonary function tests at most time points in the PVB group (<0.05). VAS scores trended to be better in the PVB group, but the difference was significant only at 30 minutes after giving the block. There were no significant differences between the groups in the incidence of complications or the need for additional analgesic agents. Conclusion: Paravertebral and epidural blocks are effective in a similar degree in controlling post-operative pain but paravertebral block is safer and more tolerable for the patients.
{"title":"Is Paravertebral Block More Effective in Thoracotomy Patients Compared to Thoracic Epidural Block","authors":"M. Bakry, Hisham Mohamed Mohamed Salem","doi":"10.4172/2167-0846.1000317","DOIUrl":"https://doi.org/10.4172/2167-0846.1000317","url":null,"abstract":"Purpose: Paravertebral block (PVB) is a simple and safe technique that can be more efficacious than epidural block (EPB) in controlling postoperative pain. We aimed to confirm this by comparing the two methods in patients after thoracotomy. \u0000Methods: Patients were randomly divided into two groups, PVB or EPB (n=30 in each). Vital signs and the visual analog scale (VAS) were evaluated before giving the block then 30 minutes and 3, 6, 9 and 12 hours after thoracotomy. Complications and need for additional analgesic agents were also scrutinized. \u0000Results: The most significant finding was better preservation of pulmonary function tests at most time points in the PVB group (<0.05). VAS scores trended to be better in the PVB group, but the difference was significant only at 30 minutes after giving the block. There were no significant differences between the groups in the incidence of complications or the need for additional analgesic agents. \u0000Conclusion: Paravertebral and epidural blocks are effective in a similar degree in controlling post-operative pain but paravertebral block is safer and more tolerable for the patients.","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"405 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2018-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79759789","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}
Pub Date : 2018-04-04DOI: 10.4172/2167-0846.1000315
C. Antunes, Tiago Jesus, Sara Ferreira, A. Coutinho, J. Magalhães
Post-dural puncture headache (PDPH) is a relatively common complication associated with neuraxial anesthesia and unintentional dural puncture. Epidural blood-patch (EBP) is the gold standard treatment when conservative therapy fails, but has significant risks associated. Recently, bilateral sphenopalatine ganglion block (SPGB) has emerged as an alternative and safe technique in patients with PDPH. Although, there are still few cases reported in the literature. The authors describe two cases of PDPH with resolution after performance of bilateral SPGB. Case 1: Male, submitted to knee arthroplasty under a combined neuraxial anesthesia, with accidental dural puncture with a Tuohy needle. On the third postoperative day, the patient reported frontal headache, exacerbated by orthostatism. The authors performed a bilateral transnasal SPGB and the patient reported clinical improvement, being discharged the next day without any symptoms. Case 2: Pregnant in labor. Epidural space approach with accidental dural puncture. On the second day postpartum, she started with PDPH symptoms, being decided conservative treatment. Two days later, the authors opt to perform a bilateral SPGB. After that, the puerpera has complete relief, being discharged 24 hours later. SPGB, although widely described in the control of headache in the context of chronic pain, has gained increasing interest for the treatment of PDPH because it is a safe and effective technique. In the literature, however, there are few reports of its use in the treatment of PDPH. The two cases described suggest a simple, minimally invasive use and with great potential in the treatment of PDPH.
{"title":"Sphenopalatine Ganglion Block for Postdural Puncture Headache","authors":"C. Antunes, Tiago Jesus, Sara Ferreira, A. Coutinho, J. Magalhães","doi":"10.4172/2167-0846.1000315","DOIUrl":"https://doi.org/10.4172/2167-0846.1000315","url":null,"abstract":"Post-dural puncture headache (PDPH) is a relatively common complication associated with neuraxial anesthesia and unintentional dural puncture. Epidural blood-patch (EBP) is the gold standard treatment when conservative therapy fails, but has significant risks associated. Recently, bilateral sphenopalatine ganglion block (SPGB) has emerged as an alternative and safe technique in patients with PDPH. Although, there are still few cases reported in the literature. The authors describe two cases of PDPH with resolution after performance of bilateral SPGB. Case 1: Male, submitted to knee arthroplasty under a combined neuraxial anesthesia, with accidental dural puncture with a Tuohy needle. On the third postoperative day, the patient reported frontal headache, exacerbated by orthostatism. The authors performed a bilateral transnasal SPGB and the patient reported clinical improvement, being discharged the next day without any symptoms. Case 2: Pregnant in labor. Epidural space approach with accidental dural puncture. On the second day postpartum, she started with PDPH symptoms, being decided conservative treatment. Two days later, the authors opt to perform a bilateral SPGB. After that, the puerpera has complete relief, being discharged 24 hours later. SPGB, although widely described in the control of headache in the context of chronic pain, has gained increasing interest for the treatment of PDPH because it is a safe and effective technique. In the literature, however, there are few reports of its use in the treatment of PDPH. The two cases described suggest a simple, minimally invasive use and with great potential in the treatment of PDPH.","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"249 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2018-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82540632","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}
Pub Date : 2018-03-22DOI: 10.4172/2167-0846.1000311
V. Pota, M. Passavanti, P. Sansone, M. Barbarisi, M. Pace, C. Aurilio
Chemotherapy-induced peripheral neuropathy (CIPN) is a disabling adverse event of most of commonly used antineoplastic agents. Previous studies have focused on several chemotherapeutic agents and reported that CIPN incidence varies from 19% to >85%. The mechanisms underlying CIPN are currently unknown. However, different theories have been proposed including microtubules dysfunction, mitochondrial dysfunction and mitochondrial toxicity, Glial pathway, substance P pathway, adenosine receptor pathway. CIPN is not simply to treat, and most randomized controlled trials failed to identify an effective therapy. Recent evidence supports the efficacy of serotonin (5-HT) and norepinephrine (NE) dual reuptake inhibitors (SNRI) in the treatment of neuropathy-related pain. Based on current evidence, we can speculate that duloxetine and topical menthol would improve CIPN pain as symptomatic treatment while, based on preclinical data, pifithrin-μ could be considered in future for the prevention of CIPN.
{"title":"Taxane-Induced Neuropathic Pain: Current Evidence and Treating Strategies","authors":"V. Pota, M. Passavanti, P. Sansone, M. Barbarisi, M. Pace, C. Aurilio","doi":"10.4172/2167-0846.1000311","DOIUrl":"https://doi.org/10.4172/2167-0846.1000311","url":null,"abstract":"Chemotherapy-induced peripheral neuropathy (CIPN) is a disabling adverse event of most of commonly used antineoplastic agents. Previous studies have focused on several chemotherapeutic agents and reported that CIPN incidence varies from 19% to >85%. The mechanisms underlying CIPN are currently unknown. However, different theories have been proposed including microtubules dysfunction, mitochondrial dysfunction and mitochondrial toxicity, Glial pathway, substance P pathway, adenosine receptor pathway. CIPN is not simply to treat, and most randomized controlled trials failed to identify an effective therapy. Recent evidence supports the efficacy of serotonin (5-HT) and norepinephrine (NE) dual reuptake inhibitors (SNRI) in the treatment of neuropathy-related pain. Based on current evidence, we can speculate that duloxetine and topical menthol would improve CIPN pain as symptomatic treatment while, based on preclinical data, pifithrin-μ could be considered in future for the prevention of CIPN.","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"9 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2018-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81067941","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}
Pub Date : 2018-03-04DOI: 10.4172/2167-0846.1000310
M. Boules
Background: Epidural analgesia offers superior pain relief and early mobilization, especially when a local anesthetic [LA] dose is combined with an adjuvant vs. an LA alone. Objective: The current study compares the analgesic and anesthetic efficiency of dexmedetomidine (1 and 2 μgkg-1) and levobupivacaine, as well as their respective side effects. Materials and methods: This study was conducted on a total of 60 ASA I-II patients aged between 20 and 70 years, who underwent elective lower limb operations. The patients that received 1 μgkg-1 dexmedetomidine plus levobupivacaine were assigned to Group 1 (n=30) and those that received 2 μgkg-1 dexmedetomidine plus levobupivacaine to Group 2 (n=30). Results: Group 2 showed a significantly shortened onset time of sensory block, time needed for maximum sensory level and prolonged duration of anesthesia. Postoperatively, the total dose of levobupivacaine used was significantly lower, patients experienced a higher level of sedation and postoperative analgesia. However, Bradycardia and hypotension were more pronounced in Group 2 patients. Conclusion: Dexmedetomedine 2 μgkg-1 as an adjuvant to epidural analgesia significantly prolonged the duration of anesthesia and provided excellent sedation and postoperative analgesia. Therefore, higher doses of epidural dexmedetomedine are recommended in long surgical operations to avoid delayed motor recovery, bradycardia and hypotension.
{"title":"Dexmedetomedine-As an Adjuvant to Epidural Analgesia: Comparison Between Different Doses","authors":"M. Boules","doi":"10.4172/2167-0846.1000310","DOIUrl":"https://doi.org/10.4172/2167-0846.1000310","url":null,"abstract":"Background: Epidural analgesia offers superior pain relief and early mobilization, especially when a local anesthetic [LA] dose is combined with an adjuvant vs. an LA alone. \u0000Objective: The current study compares the analgesic and anesthetic efficiency of dexmedetomidine (1 and 2 μgkg-1) and levobupivacaine, as well as their respective side effects. \u0000Materials and methods: This study was conducted on a total of 60 ASA I-II patients aged between 20 and 70 years, who underwent elective lower limb operations. The patients that received 1 μgkg-1 dexmedetomidine plus levobupivacaine were assigned to Group 1 (n=30) and those that received 2 μgkg-1 dexmedetomidine plus levobupivacaine to Group 2 (n=30). \u0000Results: Group 2 showed a significantly shortened onset time of sensory block, time needed for maximum sensory level and prolonged duration of anesthesia. Postoperatively, the total dose of levobupivacaine used was significantly lower, patients experienced a higher level of sedation and postoperative analgesia. However, Bradycardia and hypotension were more pronounced in Group 2 patients. \u0000Conclusion: Dexmedetomedine 2 μgkg-1 as an adjuvant to epidural analgesia significantly prolonged the duration of anesthesia and provided excellent sedation and postoperative analgesia. Therefore, higher doses of epidural dexmedetomedine are recommended in long surgical operations to avoid delayed motor recovery, bradycardia and hypotension.","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"1 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2018-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90037306","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}
Pub Date : 2018-01-01DOI: 10.4172/2167-0846.1000328
U. Hariharan, J. Doval
{"title":"Acupuncture and Auriculotherapy for Severe Pain Following Total Hip Replacement","authors":"U. Hariharan, J. Doval","doi":"10.4172/2167-0846.1000328","DOIUrl":"https://doi.org/10.4172/2167-0846.1000328","url":null,"abstract":"","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"60 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79882062","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}
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