Pub Date : 2016-12-27DOI: 10.4172/2167-0846.1000279
K. Jm
Bimoclomol and arimoclomol are small new chemical entities which have been synthesized during the end of last century by a Hungarian pharmaceutical company, Biorex. Both compounds consistently increase Heat Shock Protein (HSP) expression and reduce functional as well as structural pathology in a series of animal models. The development of bimoclomol stagnated, most probably due the short half life time of the compound. Arimoclomol is currently in development for orphan disorders such as amyotrophic lateral sclerosis, the sphingolipidose Niemann- Pick type C and inclusion body myositis. Arimoclomol has high oral availability and good CNS penetration, without inducing troublesome CNS side effects. It might also be a promising compound for the treatment of diabetic neuropathy and neuropathic pain in (diabetic) neuropathy, due to its neuroprotective and analgesic properties.
{"title":"Bimoclomol and Arimoclomol: HSP-co-Inducers for the Treatment of ProteinMisfolding Disorders, Neuropathy and Neuropathic Pain","authors":"K. Jm","doi":"10.4172/2167-0846.1000279","DOIUrl":"https://doi.org/10.4172/2167-0846.1000279","url":null,"abstract":"Bimoclomol and arimoclomol are small new chemical entities which have been synthesized during the end of last \u0000 century by a Hungarian pharmaceutical company, Biorex. Both compounds consistently increase Heat Shock \u0000 Protein (HSP) expression and reduce functional as well as structural pathology in a series of animal models. The \u0000 development of bimoclomol stagnated, most probably due the short half life time of the compound. Arimoclomol is \u0000 currently in development for orphan disorders such as amyotrophic lateral sclerosis, the sphingolipidose Niemann- \u0000 Pick type C and inclusion body myositis. Arimoclomol has high oral availability and good CNS penetration, without \u0000 inducing troublesome CNS side effects. It might also be a promising compound for the treatment of diabetic neuropathy and neuropathic pain in (diabetic) neuropathy, due to its neuroprotective and analgesic properties.","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"84 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80499121","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 : 2016-12-26DOI: 10.4172/2167-0846.1000280
M. Stotland, Helen Rahimzad
In extreme cases Methadone has been used for severe pain in oncologic patients; frequently cancer patients have severe headaches in addition to their pain. This patient is a 50 year old Hispanic female with metastatic Burkitt’s Lymphoma and controlled HIV on triple therapy. Throughout her inpatient hospitalizations of chemotherapy with R-EPOCH and then salvage chemotherapy in addition to pancytopenia she experienced consistent pain of 9-10 out of 10 on the pain scale and headaches of 9-10 in severity out of 10. The patient underwent various methods of pain and headache control including PCA of hydromorphone, intravenous and oral hydromorphone, intravenous morphine, intravenous Tylenol, Fioricet and oral analgesics. The patient received moderate relief with oral Methadone of both her pain and headaches, bringing the pain and headache scale down to a 4-5 out of 10. This is the first case of intractable pain and headaches in an opiate naive patient with non-metastatic Burkitt’s Lymphoma and HIV that received with 50 percent reduction in symptoms from the addition of oral Methadone that has no prior use of opiate abuse or dependence.
{"title":"The Use of Methadone in Refractory Headache Pain in an Opiate Naive Patientwith Non Metastatic BurkittâÂÂs Lymphoma and HIV - A Case Report","authors":"M. Stotland, Helen Rahimzad","doi":"10.4172/2167-0846.1000280","DOIUrl":"https://doi.org/10.4172/2167-0846.1000280","url":null,"abstract":"In extreme cases Methadone has been used for severe pain in oncologic patients; frequently cancer patients \u0000 have severe headaches in addition to their pain. This patient is a 50 year old Hispanic female with metastatic \u0000 Burkitt’s Lymphoma and controlled HIV on triple therapy. Throughout her inpatient hospitalizations of chemotherapy \u0000 with R-EPOCH and then salvage chemotherapy in addition to pancytopenia she experienced consistent pain of 9-10 \u0000 out of 10 on the pain scale and headaches of 9-10 in severity out of 10. The patient underwent various methods of \u0000 pain and headache control including PCA of hydromorphone, intravenous and oral hydromorphone, intravenous \u0000 morphine, intravenous Tylenol, Fioricet and oral analgesics. The patient received moderate relief with oral \u0000 Methadone of both her pain and headaches, bringing the pain and headache scale down to a 4-5 out of 10. This is \u0000 the first case of intractable pain and headaches in an opiate naive patient with non-metastatic Burkitt’s Lymphoma \u0000 and HIV that received with 50 percent reduction in symptoms from the addition of oral Methadone that has no prior \u0000 use of opiate abuse or dependence.","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"74 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74567096","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 : 2016-12-21DOI: 10.4172/2167-0846.1000278
Mitchell Stotl
Alport Syndrome results in a genetic mutation in type IV collagen; one place of major significance is the glomerular basement membrane of nephrons. These patients are at high risk for glomerulonephritis and renal failure in addition to inner ear and eye pathology. This patient is a 25 year old Caucasian female with non-deaf Alport Syndrome who was hospitalized for intractable headaches with pain scale measuring 8-10 out of 10 of severity. This patient received a CT of the head, MRI, MRA and MRV of the brain that demonstrated no evidence of chronic or acute hemorrhage, acute intracranial process, chronic or acute infarction, vasculitis, brain lesions or emboli. This patient’s headaches were refractory to oral Fioricet, Aspirin, Tylenol and NSAIDS. The patient initially refused oral and intravenous analgesics including morphine, oxycodone due to the side effects of nausea, lethargy and drowsiness. The patient’s pain was moderately relieved by small doses of oral oxycodone and intravenous morphine. The patient experienced mild nausea and drowsiness from these medications; however her pain reduced over 60% in severity to a final rating of 3-4 out of 10 from an initial 8-10 out of 10 in severity. This patient was the first patient reported with Alport Syndrome and intractable headaches without evidence of acute or chronic brain lesions on brain MRV, MRI, MRA and CT imaging whose headache pain was reduced by over 60% in severity by oral and intravenous analgesics in the inpatient setting.
{"title":"Intractable Headaches in a Patient with Alport Syndrome with No Evidence of Brain Lesions-A Case Report","authors":"Mitchell Stotl","doi":"10.4172/2167-0846.1000278","DOIUrl":"https://doi.org/10.4172/2167-0846.1000278","url":null,"abstract":"Alport Syndrome results in a genetic mutation in type IV collagen; one place of major significance is the glomerular basement membrane of nephrons. These patients are at high risk for glomerulonephritis and renal failure in addition to inner ear and eye pathology. This patient is a 25 year old Caucasian female with non-deaf Alport Syndrome who was hospitalized for intractable headaches with pain scale measuring 8-10 out of 10 of severity. This patient received a CT of the head, MRI, MRA and MRV of the brain that demonstrated no evidence of chronic or acute hemorrhage, acute intracranial process, chronic or acute infarction, vasculitis, brain lesions or emboli. This patient’s headaches were refractory to oral Fioricet, Aspirin, Tylenol and NSAIDS. The patient initially refused oral and intravenous analgesics including morphine, oxycodone due to the side effects of nausea, lethargy and drowsiness. The patient’s pain was moderately relieved by small doses of oral oxycodone and intravenous morphine. The patient experienced mild nausea and drowsiness from these medications; however her pain reduced over 60% in severity to a final rating of 3-4 out of 10 from an initial 8-10 out of 10 in severity. This patient was the first patient reported with Alport Syndrome and intractable headaches without evidence of acute or chronic brain lesions on brain MRV, MRI, MRA and CT imaging whose headache pain was reduced by over 60% in severity by oral and intravenous analgesics in the inpatient setting.","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89571429","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 : 2016-12-13DOI: 10.4172/2167-0846.1000277
I. Wilderman
Objective: To describe and bring awareness for the Integral of Pain Relief (IPR), a novel multidimensional measure which can be used by practitioners in daily practice. Methods: The IPR incorporates both a patients’ percentage of pain relief since treatment, along with their duration of relief into a single, multidimensional value. This value can allow for practitioners to better understand optimal treatments for various patients, select between different treatment modalities, and visualize on a graph the efficacy of numerous treatment methods. Conclusion: With the implementation of the IPR in daily practice, a multidimensional perspective on an individual’s overall pain relief can provide promising hope for upcoming practice and treatment. Future research can focus on discovering optimal IPR ranges for various treatment modalities, as well as for determining weighted values for both variables of the IPR.
{"title":"Integral of Pain Relief as an Innovative Method of Pain Measurement","authors":"I. Wilderman","doi":"10.4172/2167-0846.1000277","DOIUrl":"https://doi.org/10.4172/2167-0846.1000277","url":null,"abstract":"Objective: To describe and bring awareness for the Integral of Pain Relief (IPR), a novel multidimensional measure which can be used by practitioners in daily practice. Methods: The IPR incorporates both a patients’ percentage of pain relief since treatment, along with their duration of relief into a single, multidimensional value. This value can allow for practitioners to better understand optimal treatments for various patients, select between different treatment modalities, and visualize on a graph the efficacy of numerous treatment methods. Conclusion: With the implementation of the IPR in daily practice, a multidimensional perspective on an individual’s overall pain relief can provide promising hope for upcoming practice and treatment. Future research can focus on discovering optimal IPR ranges for various treatment modalities, as well as for determining weighted values for both variables of the IPR.","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84805437","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 : 2016-11-28DOI: 10.4172/2167-0846.1000276
Wesley Lapommeray
Childbirth is an dynamic experience fraught with medical complications. The field of Anesthesiology has alleviated excruciating pain throughout modernity. The development of new medication and procedures have reduced adverse fatalities. Furthermore, epidural anesthesia have afforded rather painless childbirth. Before the advent of modern anesthesiology (epidural anesthesia), women were bereft of painless births. “Childbirth is painful, and we are in an era when most American women consider some chemical means of pain relief an accepted part of the delivery process” [1]. The advent of anesthesiology has remarkable reduced possible death of the fetus and the mother. However, complications arise not withstanding the fact of the proper implementation of standard protocol. Aspiration of vomitus in obstetric anesthesiology is ubiquitous in the hospital setting. A sizeable amount of pregnant, expectant mothers have vomited during or immediately after following inhalation of anesthesia. In addition, death from epidural anesthesia or spinal anesthesia may result from hypotension. A physiological response to the implementation of an epidural anesthesia is hypotension associated with sympathetic blockade. Effectively managing the blood pressure of an expectant, pregnant mother is an ongoing issue of the utmost importance. Diligent Anesthesiologists adequately resolve the factors leading to hypovolemic state of the patients. There are intrinsic psychosomatic factors that may exacerbate the precarious hypovolemic state blood in expectant, pregnant women.
{"title":"Audio-Analgesia a Complementary Pain Relief Application within the Confines of Epidural Anesthesia","authors":"Wesley Lapommeray","doi":"10.4172/2167-0846.1000276","DOIUrl":"https://doi.org/10.4172/2167-0846.1000276","url":null,"abstract":"Childbirth is an dynamic experience fraught with medical complications. The field of Anesthesiology has alleviated excruciating pain throughout modernity. The development of new medication and procedures have reduced adverse fatalities. Furthermore, epidural anesthesia have afforded rather painless childbirth. Before the advent of modern anesthesiology (epidural anesthesia), women were bereft of painless births. “Childbirth is painful, and we are in an era when most American women consider some chemical means of pain relief an accepted part of the delivery process” [1]. The advent of anesthesiology has remarkable reduced possible death of the fetus and the mother. However, complications arise not withstanding the fact of the proper implementation of standard protocol. Aspiration of vomitus in obstetric anesthesiology is ubiquitous in the hospital setting. A sizeable amount of pregnant, expectant mothers have vomited during or immediately after following inhalation of anesthesia. In addition, death from epidural anesthesia or spinal anesthesia may result from hypotension. A physiological response to the implementation of an epidural anesthesia is hypotension associated with sympathetic blockade. Effectively managing the blood pressure of an expectant, pregnant mother is an ongoing issue of the utmost importance. Diligent Anesthesiologists adequately resolve the factors leading to hypovolemic state of the patients. There are intrinsic psychosomatic factors that may exacerbate the precarious hypovolemic state blood in expectant, pregnant women.","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"931 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2016-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85595261","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 : 2016-11-18DOI: 10.4172/2167-0846.1000275
Arif Ahmed
The literature on application of prolonged PRF of genicular nerves of knee for osteoarthritis of knee is nil. This study will provide level IV evidence that prolonged PRF is a safe and effective in treating knee pain from osteoarthritis of knee joint not responding to conservative modalities of treatment and who wants to avoid surgery.
{"title":"Prolonged Pulsed Radiofrequency Ablation of Genicular Nerves of Knee for Intractable Pain from Knee Osteoarthritis: A Case Report","authors":"Arif Ahmed","doi":"10.4172/2167-0846.1000275","DOIUrl":"https://doi.org/10.4172/2167-0846.1000275","url":null,"abstract":"The literature on application of prolonged PRF of genicular nerves of knee for osteoarthritis of knee is nil. This study will provide level IV evidence that prolonged PRF is a safe and effective in treating knee pain from osteoarthritis of knee joint not responding to conservative modalities of treatment and who wants to avoid surgery.","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"64 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2016-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84017167","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 : 2016-11-11DOI: 10.4172/2167-0846.1000274
K. Jm
Topical analgesics are in need to be differentiated from transdermal formulations of analgesics. Topical analgesics are characterized by local analgesic effects in the absence of systemic effects, and do not require a transdermal delivery formulation. There are two key issues in the development of topical analgesics. 1. For optimal clinical effects specific characteristics for the vehicle (a cream base or gel base) are required, depending on the physicochemical characteristics of the pharmaceutical active ingredient in the carrier. 2. One cannot and should not skip well designed phase II dose-finding studies, and this unfortunately happens often, as we will discuss in this paper. In fact, we will demonstrate underdosing is one of the major hurdles to detect meaningful and statistically relevant clinical effects of topical analgesics. In the case of gels or creams containing ketamine, amitriptyline and baclofen, the dose-finding most probably needs to start at 10% for ketamine and amitriptyline and 2.5% for baclofen, while the doses tested were much lower: 4%, 2% and 1% respectively. Topical analgesics are promising inroads for the treatment of neuropathic pain, once sufficient attention is given to aspects such as formulation and concentration.
{"title":"Topical Analgesics: Critical Issues Related to Formulation and Concentration","authors":"K. Jm","doi":"10.4172/2167-0846.1000274","DOIUrl":"https://doi.org/10.4172/2167-0846.1000274","url":null,"abstract":"Topical analgesics are in need to be differentiated from transdermal formulations of analgesics. Topical analgesics are characterized by local analgesic effects in the absence of systemic effects, and do not require a transdermal delivery formulation. There are two key issues in the development of topical analgesics. 1. For optimal clinical effects specific characteristics for the vehicle (a cream base or gel base) are required, depending on the physicochemical characteristics of the pharmaceutical active ingredient in the carrier. 2. One cannot and should not skip well designed phase II dose-finding studies, and this unfortunately happens often, as we will discuss in this paper. In fact, we will demonstrate underdosing is one of the major hurdles to detect meaningful and statistically relevant clinical effects of topical analgesics. In the case of gels or creams containing ketamine, amitriptyline and baclofen, the dose-finding most probably needs to start at 10% for ketamine and amitriptyline and 2.5% for baclofen, while the doses tested were much lower: 4%, 2% and 1% respectively. Topical analgesics are promising inroads for the treatment of neuropathic pain, once sufficient attention is given to aspects such as formulation and concentration.","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"36 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2016-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89780257","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 : 2016-10-28DOI: 10.4172/2167-0846.C1.012
F. Dardmeh
A simple, precise, and accurate HPLC method has been developed and validated for assay of combined dosage form of Paracetamol and Thiocolchicoside in commercial pharmaceutical dosage form. Reversed-Phase liquid chromatographic analysis was performed on a BDS hypersil C18, 250mm × 4.6mm, 5µ(particle size), Thermo scientific column using Potassium Dihydrogen phosphate: Methanol (40:60, v/v) as eluent. The flow rate of the mobile phase was adjusted to 1.0 ml/min and the injection volume was 20 µl. Detection performed at 247nm. The retention time of Paracetamol and Thiocolchicoside were found to be 3.27 and 5.50 respectively. The method was validated for linearity, precision, accuracy, robustness. Response was a linear function of drug concentration in the range with 250-750 µg/ml for paracetamol and 1-3µg/ml for thiocolchicoside. Intraday and Interday precision were determined. Accuracy of Paracetamol and thiocolchicoside was found between 99-100%.All analytical validation parameters were determined by following the ICH guidelines and its limit. The developed method proclaimed to be precise and robust for the estimation of Paracetamol and
{"title":"The impact of chronic musculoskeletal pain on male reproductive hormones and sperm quality","authors":"F. Dardmeh","doi":"10.4172/2167-0846.C1.012","DOIUrl":"https://doi.org/10.4172/2167-0846.C1.012","url":null,"abstract":"A simple, precise, and accurate HPLC method has been developed and validated for assay of combined dosage form of Paracetamol and Thiocolchicoside in commercial pharmaceutical dosage form. Reversed-Phase liquid chromatographic analysis was performed on a BDS hypersil C18, 250mm × 4.6mm, 5µ(particle size), Thermo scientific column using Potassium Dihydrogen phosphate: Methanol (40:60, v/v) as eluent. The flow rate of the mobile phase was adjusted to 1.0 ml/min and the injection volume was 20 µl. Detection performed at 247nm. The retention time of Paracetamol and Thiocolchicoside were found to be 3.27 and 5.50 respectively. The method was validated for linearity, precision, accuracy, robustness. Response was a linear function of drug concentration in the range with 250-750 µg/ml for paracetamol and 1-3µg/ml for thiocolchicoside. Intraday and Interday precision were determined. Accuracy of Paracetamol and thiocolchicoside was found between 99-100%.All analytical validation parameters were determined by following the ICH guidelines and its limit. The developed method proclaimed to be precise and robust for the estimation of Paracetamol and","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87848804","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 : 2016-10-28DOI: 10.4172/2167-0846.C1.010
M. Romoli
{"title":"Posturology: A new discipline involving art, well-being, physiology, pain management and prevention of musculoskeletal disorders","authors":"M. Romoli","doi":"10.4172/2167-0846.C1.010","DOIUrl":"https://doi.org/10.4172/2167-0846.C1.010","url":null,"abstract":"","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"75 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81541066","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 : 2016-10-24DOI: 10.4172/2167-0846.1000273
T. Hirai, T. Yoshii, M. Enomoto, Tsuyoshi Yamada, Takashi Taniyama, H. Inose, Tsuyoshi Kato, and Atsushi Okawa
Therapeutic efficacy of pregabalin (PGL) for reducing neuropathic pain in patients who received a cervical operation is unclear. The purpose of this prospective pilot study was to compare the efficacy and adverse events between PGL and acetaminophen (ACM) for residual neuropathic pain. Thirty-four patients who received cervical spine surgery at our hospital from September 2011 to April 2013 and were diagnosed with residual neuropathic pain in the extremities were enrolled and were randomized to receive PGL (50 mg/day initially as an induction dose for 2 weeks) or ACM (1200 mg/day) for 8 weeks. PGL dosage was adjusted to 50-150 mg/day according to the severity of pain using a visual analog scale (VAS) after a 2-week time point. The Neck Disability Index (NDI) and VAS were used to evaluate subjective pain of the extremities and sleep condition. Short Form-36 (SF-36) and Japanese Orthopedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ) were used to evaluate neurologic function. Thirty-three patients (PGL 19 cases, ACM 14 cases) completed 8 weeks of follow-up. The average VAS for pain and numbness significantly improved in both groups at the final visit. The scale for sleep improved in the PGL group but was unchanged in the ACM group. The proportion of patients with satisfactory improvement in sleep was 31.6% and 0% in the PGL and ACM groups, respectively. There was a significant difference in VAS for sleep only. There were no significant improvements in the NDI and each domain of JOACMEQ in both groups. The number of patients who complained of somnolence tended to be greater in the PGL group. Thus, both PGL and ACM administration improved residual neuropathic pain in patients treated with cervical spine surgery for myelopathy. PGL was more effective in reducing sleep interference related to refractory neuropathic pain compared with ACM.
{"title":"Pregabalin Versus Acetaminophen for a Treatment of Chronic Neuropathic Painon Extremities after Cervical Surgery: A Prospective Randomized, Open-LabelPreliminary Study","authors":"T. Hirai, T. Yoshii, M. Enomoto, Tsuyoshi Yamada, Takashi Taniyama, H. Inose, Tsuyoshi Kato, and Atsushi Okawa","doi":"10.4172/2167-0846.1000273","DOIUrl":"https://doi.org/10.4172/2167-0846.1000273","url":null,"abstract":"Therapeutic efficacy of pregabalin (PGL) for reducing neuropathic pain in patients who received a cervical operation is unclear. The purpose of this prospective pilot study was to compare the efficacy and adverse events between PGL and acetaminophen (ACM) for residual neuropathic pain. Thirty-four patients who received cervical spine surgery at our hospital from September 2011 to April 2013 and were diagnosed with residual neuropathic pain in the extremities were enrolled and were randomized to receive PGL (50 mg/day initially as an induction dose for 2 weeks) or ACM (1200 mg/day) for 8 weeks. PGL dosage was adjusted to 50-150 mg/day according to the severity of pain using a visual analog scale (VAS) after a 2-week time point. The Neck Disability Index (NDI) and VAS were used to evaluate subjective pain of the extremities and sleep condition. Short Form-36 (SF-36) and Japanese Orthopedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ) were used to evaluate neurologic function. Thirty-three patients (PGL 19 cases, ACM 14 cases) completed 8 weeks of follow-up. The average VAS for pain and numbness significantly improved in both groups at the final visit. The scale for sleep improved in the PGL group but was unchanged in the ACM group. The proportion of patients with satisfactory improvement in sleep was 31.6% and 0% in the PGL and ACM groups, respectively. There was a significant difference in VAS for sleep only. There were no significant improvements in the NDI and each domain of JOACMEQ in both groups. The number of patients who complained of somnolence tended to be greater in the PGL group. Thus, both PGL and ACM administration improved residual neuropathic pain in patients treated with cervical spine surgery for myelopathy. PGL was more effective in reducing sleep interference related to refractory neuropathic pain compared with ACM.","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"356 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2016-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76496539","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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