Pub Date : 2022-11-23eCollection Date: 2022-01-01DOI: 10.1155/2022/3562191
Wang Shen, Ning Liu, Zhonghua Ji, Hongwei Fang, Feng Liu, Wei Zhang, Xiuqin Yu, Mingxia Wang, Jinyuan Zhang, Xiangrui Wang
Objective: To examine the efficacy and safety of ozonated autohemotherapy (O3-AHT) combined with pharmacological therapy for comorbid insomnia and myofascial pain syndrome (MPS).
Materials and methods: One hundred and eighteen patients were randomly divided into two groups: the control group (N = 50) and the O3-AHT group (N = 53). Patients in both groups were given the same pharmacological management for three weeks. Patients in the O3-AHT group were treated with ozonated autohemotherapy (the concentration of ozone was 20 µg/ml in the first week, 30 µg/ml in the second week, and 40 µg/ml in the third week) combined with pharmacological therapy. Primary (the insomnia severity index (ISI) and visual analogue scale (VAS)) and secondary outcomes (the Epworth sleepiness scale (ESS), polysomnography data, the anxiety and preoccupation about sleep questionnaire (APSQ), the beck depression index (BDI), and the multidimensional fatigue inventory (MFI)) were examined at pretreatment, posttreatment, 1 month, and 6 months.
Results: Fifty patients in the control group and fifty-three patients in the O3-AHT group completed the study. In both groups, insomnia and pain symptoms were relieved significantly compared with pretreatment. Compared with the control group, the O3-AHT group had significantly improved sleep quality, pain, and negative mood at different time points. No adverse complications were observed in either group.
Conclusion: Compared with pharmacological therapy alone, ozonated autohemotherapy combined with pharmacological therapy can ameliorate insomnia, reduce pain intensity, improve negative mood, and alleviate fatigue more effectively without serious adverse complications.
{"title":"Combining Ozonated Autohemotherapy with Pharmacological Therapy for Comorbid Insomnia and Myofascial Pain Syndrome: A Prospective Randomized Controlled Study.","authors":"Wang Shen, Ning Liu, Zhonghua Ji, Hongwei Fang, Feng Liu, Wei Zhang, Xiuqin Yu, Mingxia Wang, Jinyuan Zhang, Xiangrui Wang","doi":"10.1155/2022/3562191","DOIUrl":"10.1155/2022/3562191","url":null,"abstract":"<p><strong>Objective: </strong>To examine the efficacy and safety of ozonated autohemotherapy (O3-AHT) combined with pharmacological therapy for comorbid insomnia and myofascial pain syndrome (MPS).</p><p><strong>Materials and methods: </strong>One hundred and eighteen patients were randomly divided into two groups: the control group (<i>N</i> = 50) and the O<sub>3</sub>-AHT group (<i>N</i> = 53). Patients in both groups were given the same pharmacological management for three weeks. Patients in the O<sub>3</sub>-AHT group were treated with ozonated autohemotherapy (the concentration of ozone was 20 <i>µ</i>g/ml in the first week, 30 <i>µ</i>g/ml in the second week, and 40 <i>µ</i>g/ml in the third week) combined with pharmacological therapy. Primary (the insomnia severity index (ISI) and visual analogue scale (VAS)) and secondary outcomes (the Epworth sleepiness scale (ESS), polysomnography data, the anxiety and preoccupation about sleep questionnaire (APSQ), the beck depression index (BDI), and the multidimensional fatigue inventory (MFI)) were examined at pretreatment, posttreatment, 1 month, and 6 months.</p><p><strong>Results: </strong>Fifty patients in the control group and fifty-three patients in the O<sub>3</sub>-AHT group completed the study. In both groups, insomnia and pain symptoms were relieved significantly compared with pretreatment. Compared with the control group, the O<sub>3</sub>-AHT group had significantly improved sleep quality, pain, and negative mood at different time points. No adverse complications were observed in either group.</p><p><strong>Conclusion: </strong>Compared with pharmacological therapy alone, ozonated autohemotherapy combined with pharmacological therapy can ameliorate insomnia, reduce pain intensity, improve negative mood, and alleviate fatigue more effectively without serious adverse complications.</p>","PeriodicalId":19913,"journal":{"name":"Pain Research & Management","volume":"2022 ","pages":"3562191"},"PeriodicalIF":2.9,"publicationDate":"2022-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10195166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9936159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: In patients with postherpetic neuralgia (PHN), the effectiveness of epidural block and the benefits of adjuvant hypertonic saline (HS) have not been fully determined. Therefore, we investigated these issues in this study.
Methods: At a tertiary medical center's single pain clinic in Seoul, Republic of Korea, patients complaining of PHN even after 4 months of herpes zoster onset were enrolled and randomly assigned to either the HS or normal saline (NS) group. After epidural block with adjuvant HS or NS administration according to each protocol, outcomes were assessed at baseline and one and three months after the intervention. The primary outcome was pain intensity on the numerical rating scale (NRS). The secondary outcomes were the insomnia severity index (ISI), the medication quantification scale (MQS), and the global perceived effect of satisfaction (GPES).
Results: Thirty-six patients (NS: 17, HS: 19) were included in the intention-to-treat analysis. The estimated pain intensity decreased in both groups at one and three months after the procedure (P < 0.001), without a significant group difference. The estimated ISI and MQS were not significantly different at 1 month compared with baseline but significantly decreased at 3 months in each group (P < 0.001 and P < 0.001, respectively), without group differences. In addition, there was no difference between the groups on the GPES scale at one and three months after the procedure.
Conclusions: Epidural steroid injection may have the advantages of short-term pain relief, improved sleep quality, and decreased medication usage in patients with PHN. In addition, adjuvant HS administration with epidural steroid injection did not show beneficial effects in patients with PHN. Further studies are needed to clarify the potential effectiveness of HS in treating neuropathic pain such as PHN. This trial is registered with KCT0002845.
{"title":"Comparison of Adjuvant Hypertonic Saline and Normal Saline for Epidural Block in Patients with Postherpetic Neuralgia: A Double-Blind, Randomized Trial.","authors":"Hyun-Jung Kwon, Doo-Hwan Kim, Seong-Sik Cho, Bokyoung Jeon, Myong-Hwan Karm, Seong-Soo Choi","doi":"10.1155/2022/8081443","DOIUrl":"10.1155/2022/8081443","url":null,"abstract":"<p><strong>Background: </strong>In patients with postherpetic neuralgia (PHN), the effectiveness of epidural block and the benefits of adjuvant hypertonic saline (HS) have not been fully determined. Therefore, we investigated these issues in this study.</p><p><strong>Methods: </strong>At a tertiary medical center's single pain clinic in Seoul, Republic of Korea, patients complaining of PHN even after 4 months of herpes zoster onset were enrolled and randomly assigned to either the HS or normal saline (NS) group. After epidural block with adjuvant HS or NS administration according to each protocol, outcomes were assessed at baseline and one and three months after the intervention. The primary outcome was pain intensity on the numerical rating scale (NRS). The secondary outcomes were the insomnia severity index (ISI), the medication quantification scale (MQS), and the global perceived effect of satisfaction (GPES).</p><p><strong>Results: </strong>Thirty-six patients (NS: 17, HS: 19) were included in the intention-to-treat analysis. The estimated pain intensity decreased in both groups at one and three months after the procedure (<i>P</i> < 0.001), without a significant group difference. The estimated ISI and MQS were not significantly different at 1 month compared with baseline but significantly decreased at 3 months in each group (<i>P</i> < 0.001 and <i>P</i> < 0.001, respectively), without group differences. In addition, there was no difference between the groups on the GPES scale at one and three months after the procedure.</p><p><strong>Conclusions: </strong>Epidural steroid injection may have the advantages of short-term pain relief, improved sleep quality, and decreased medication usage in patients with PHN. In addition, adjuvant HS administration with epidural steroid injection did not show beneficial effects in patients with PHN. Further studies are needed to clarify the potential effectiveness of HS in treating neuropathic pain such as PHN. This trial is registered with KCT0002845.</p>","PeriodicalId":19913,"journal":{"name":"Pain Research & Management","volume":"2022 ","pages":"8081443"},"PeriodicalIF":2.5,"publicationDate":"2022-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9705113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10491178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objectives. Acupuncture is used worldwide to relieve both acute and chronic pain. Patient-controlled analgesia (PCA) is also frequently used for postoperative pain relief. However, there are few meta-analyses of the efficacy of acupuncture with PCA in reducing acute postoperative pain. This meta-analysis aimed to assess the effectiveness of acupuncture with PCA in relieving acute pain after back surgery. Methods. We searched seven databases (Cochrane Library, Web of Science, PubMed, China National Knowledge Infrastructure (CNKI), Wanfang database, Chongqing VIP (VIP), and Chinese BioMedical Literature Database (CBM)-from 1949 until now) without language restrictions for randomized controlled trials, including patients undergoing back surgery and receiving PCA alone or treated with acupuncture/sham acupuncture + PCA for pain relief. This meta-analysis assessed pain intensity, with visual analogue scale (VAS) score and postoperative opioid dosage as primary outcomes. Results. A total of 12 randomized controlled trials (n = 904) met the inclusion criteria. Compared with the control group (standard mean difference (SMD) = ‒0.42, 95% CI = ‒0.60 to ‒0.25, P < 0.01 ) or sham acupuncture + PCA (SMD = ‒0.7, 95% CI = ‒0.94 to ‒0.46, P < 0.01 ), acupuncture + PCA treatment reduced the VAS score in patients after back surgery. Acupuncture + PCA decreased the use of opioids after surgery compared to sham acupuncture + PCA (SMD = −0.35, 95% CI = ‒0.63 to ‒0.07, P = 0.01 ) or control group (SMD = ‒0.82, 95% CI = ‒1.03 to ‒0.61, P < 0.01 ). Furthermore, the use of acupuncture with PCA reduced the incidence of postoperative PCA-related total complications (odds ratio = 0.44, 95% CI = 0.23 to 0.85, P = 0.01 ), but may not reduce the incidence of postoperative nausea and vomiting (odds ratio =0.82 , 95% CI =0.49 to 1.36, P = 0.44 ). Conclusion. This systematic review found that acupuncture with PCA relieved acute pain after back surgery more effectively than PCA alone and could reduce opioid use and the incidence of postoperative PCA-related total complications
目标。针灸在世界范围内被用于缓解急性和慢性疼痛。患者自控镇痛(PCA)也常用于术后疼痛缓解。然而，很少有关于针灸配合PCA减轻术后急性疼痛的meta分析。本荟萃分析旨在评估针刺配合PCA缓解背部手术后急性疼痛的有效性。方法。我们检索了七个数据库(Cochrane Library, Web of Science, PubMed，中国知网(CNKI)，万方数据库，重庆VIP (VIP)和中国生物医学文献数据库(CBM)-从1949年至今)，没有语言限制，用于随机对照试验，包括接受背部手术并单独接受PCA或针灸/假针灸+ PCA治疗的疼痛缓解患者。该荟萃分析评估疼痛强度，以视觉模拟评分(VAS)评分和术后阿片类药物剂量作为主要结果。结果。共有12项随机对照试验(n = 904)符合纳入标准。与对照组(SMD = -0.42, 95% CI = -0.60 ~ -0.25, P < 0.01)或假针+ PCA组(SMD = -0.7, 95% CI = -0.94 ~ -0.46, P < 0.01)相比，针刺+ PCA治疗降低了背部手术后患者的VAS评分。与假针+ PCA组(SMD = - 0.35, 95% CI = -0.63 ~ -0.07, P = 0.01)或对照组(SMD = -0.82, 95% CI = -1.03 ~ -0.61, P < 0.01)相比，针刺+ PCA组术后阿片类药物使用减少。此外，针刺合并PCA降低了术后PCA相关总并发症的发生率(优势比= 0.44,95% CI = 0.23 ~ 0.85, P = 0.01)，但可能不会降低术后恶心和呕吐的发生率(优势比=0.82,95% CI =0.49 ~ 1.36, P = 0.44)。结论。本系统综述发现，针灸联合PCA比单独PCA更有效地缓解背部手术后急性疼痛，并可减少阿片类药物的使用和术后PCA相关总并发症的发生率
{"title":"Efficacy of Acupuncture Combined with Patient-Controlled Analgesia in the Treatment of Acute Pain after Back Surgery: A Meta-Analysis","authors":"Dalin Deng, Feng Xu, Ya-Fei Wang, Lulin Ma, Tianhao Zhang, Wenjing Zhao, Xiangdong Chen","doi":"10.1155/2022/2551591","DOIUrl":"https://doi.org/10.1155/2022/2551591","url":null,"abstract":"Objectives. Acupuncture is used worldwide to relieve both acute and chronic pain. Patient-controlled analgesia (PCA) is also frequently used for postoperative pain relief. However, there are few meta-analyses of the efficacy of acupuncture with PCA in reducing acute postoperative pain. This meta-analysis aimed to assess the effectiveness of acupuncture with PCA in relieving acute pain after back surgery. Methods. We searched seven databases (Cochrane Library, Web of Science, PubMed, China National Knowledge Infrastructure (CNKI), Wanfang database, Chongqing VIP (VIP), and Chinese BioMedical Literature Database (CBM)-from 1949 until now) without language restrictions for randomized controlled trials, including patients undergoing back surgery and receiving PCA alone or treated with acupuncture/sham acupuncture + PCA for pain relief. This meta-analysis assessed pain intensity, with visual analogue scale (VAS) score and postoperative opioid dosage as primary outcomes. Results. A total of 12 randomized controlled trials (n = 904) met the inclusion criteria. Compared with the control group (standard mean difference (SMD) = ‒0.42, 95% CI = ‒0.60 to ‒0.25, \u0000 \u0000 P\u0000 <\u0000 0.01\u0000 \u0000 ) or sham acupuncture + PCA (SMD = ‒0.7, 95% CI = ‒0.94 to ‒0.46, \u0000 \u0000 P\u0000 <\u0000 0.01\u0000 \u0000 ), acupuncture + PCA treatment reduced the VAS score in patients after back surgery. Acupuncture + PCA decreased the use of opioids after surgery compared to sham acupuncture + PCA (SMD = −0.35, 95% CI = ‒0.63 to ‒0.07, \u0000 \u0000 P\u0000 =\u0000 0.01\u0000 \u0000 ) or control group (SMD = ‒0.82, 95% CI = ‒1.03 to ‒0.61, \u0000 \u0000 P\u0000 <\u0000 0.01\u0000 \u0000 ). Furthermore, the use of acupuncture with PCA reduced the incidence of postoperative PCA-related total complications (odds ratio = 0.44, 95% CI = 0.23 to 0.85, \u0000 \u0000 P\u0000 =\u0000 0.01\u0000 \u0000 ), but may not reduce the incidence of postoperative nausea and vomiting (odds ratio =0.82 , 95% CI =0.49 to 1.36, \u0000 \u0000 P\u0000 =\u0000 0.44\u0000 \u0000 ). Conclusion. This systematic review found that acupuncture with PCA relieved acute pain after back surgery more effectively than PCA alone and could reduce opioid use and the incidence of postoperative PCA-related total complications","PeriodicalId":19913,"journal":{"name":"Pain Research & Management","volume":"1 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2022-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47956910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background The enhanced recovery after surgery (ERAS) program is aimed to shorten patients' recovery process and improve clinical outcomes. This study aimed to compare the outcomes between the ERAS program and the traditional pathway among patients with ankle fracture and distal radius fracture. Methods This is a multicenter prospective clinical controlled study consisting of 323 consecutive adults with ankle fracture from 12 centers and 323 consecutive adults with distal radial fracture from 13 centers scheduled for open reduction and internal fixation between January 2017 and December 2018. According to the perioperative protocol, patients were divided into two groups: the ERAS group and the traditional group. The primary outcome was the patients' satisfaction of the whole treatment on discharge and at 6 months postoperatively. The secondary outcomes include delapsed time between admission and surgery, length of hospital stay, postoperative complications, functional score, and the MOS item short form health survey-36. Results Data describing 772 patients with ankle fracture and 658 patients with distal radius fracture were collected, of which 323 patients with ankle fracture and 323 patients with distal radial fracture were included for analysis. The patients in the ERAS group showed higher satisfaction levels on discharge and at 6 months postoperatively than in the traditional group (P < 0.001). In the subgroup analysis, patients with distal radial fracture in the ERAS group were more satisfied with the treatment (P=0.001). Furthermore, patients with ankle fracture had less time in bed (P < 0.001) and shorter hospital stay (P < 0.001) and patients with distal radial fracture received surgery quickly after being admitted into the ward in the ERAS group than in the traditional group (P=0.001). Conclusions Perioperative protocol based on the ERAS program was associated with high satisfaction levels, less time in bed, and short hospital stay without increased complication rate and decreased functional outcomes.
{"title":"Perioperative Protocol of Ankle Fracture and Distal Radius Fracture Based on Enhanced Recovery after Surgery Program: A Multicenter Prospective Clinical Controlled study","authors":"Ting Li, Zhiwen Sun, Yan Zhou, Weitong Sun, P. Wang, Xinyu Cai, Junbo Liang, Jing-ming Dong, Da-Peng Zhou, Kai Yu, Ming-Xin Wu, Jiu-sheng He, Liangyuan Wen, Bao-Qing Yu, Jian Wang, Jun Yang, Fengfei Lin, Bing-Zuan Li, Zongxin Shi, Baoping Wang, Ai-Guo Wang, Gui-ling Peng, Xu Sun, Hong-Hao Xiao, Meng Mi, Xia Zhao, Chang-Run Li, Gang Liu, Shao-liang Li, Hang-yu Gu, Yuanyuan Zhou, Zhelun Tan, Xin-Bao Wu","doi":"10.1155/2022/3458056","DOIUrl":"https://doi.org/10.1155/2022/3458056","url":null,"abstract":"Background The enhanced recovery after surgery (ERAS) program is aimed to shorten patients' recovery process and improve clinical outcomes. This study aimed to compare the outcomes between the ERAS program and the traditional pathway among patients with ankle fracture and distal radius fracture. Methods This is a multicenter prospective clinical controlled study consisting of 323 consecutive adults with ankle fracture from 12 centers and 323 consecutive adults with distal radial fracture from 13 centers scheduled for open reduction and internal fixation between January 2017 and December 2018. According to the perioperative protocol, patients were divided into two groups: the ERAS group and the traditional group. The primary outcome was the patients' satisfaction of the whole treatment on discharge and at 6 months postoperatively. The secondary outcomes include delapsed time between admission and surgery, length of hospital stay, postoperative complications, functional score, and the MOS item short form health survey-36. Results Data describing 772 patients with ankle fracture and 658 patients with distal radius fracture were collected, of which 323 patients with ankle fracture and 323 patients with distal radial fracture were included for analysis. The patients in the ERAS group showed higher satisfaction levels on discharge and at 6 months postoperatively than in the traditional group (P < 0.001). In the subgroup analysis, patients with distal radial fracture in the ERAS group were more satisfied with the treatment (P=0.001). Furthermore, patients with ankle fracture had less time in bed (P < 0.001) and shorter hospital stay (P < 0.001) and patients with distal radial fracture received surgery quickly after being admitted into the ward in the ERAS group than in the traditional group (P=0.001). Conclusions Perioperative protocol based on the ERAS program was associated with high satisfaction levels, less time in bed, and short hospital stay without increased complication rate and decreased functional outcomes.","PeriodicalId":19913,"journal":{"name":"Pain Research & Management","volume":"38 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2022-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87710860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background The study was to assess the efficacy and safety of nalbuphine combined with dexmedetomidine for preventive analgesia in endoscopic sinus surgery. Methods 110 patients with deviation of the nasal septum were randomized into the nalbuphine group (group N), dexmedetomidine combined with nalbuphine group (group DN), and saline group (group C). Fifteen minutes before the induction of anesthesia, patients in group N were injected nalbuphine 0.2 mg/kg intravenously; patients in group DN received intravenous infusion of dexmedetomidine 0.5 μg/kg and injection of nalbuphine 0.2 mg/kg; patients in group C received 0.9% saline. Mean arterial pressure (MAP), heart rate (HR), numerical rating scale (NRS) scores, quality of recovery-40 (QoR-40) scores, the need for remedial analgesia, the consumption of remifentanil and propofol, and the incidence of adverse reactions were recorded. Results MAP, HR, and NRS scores of the DN group were significantly lower and the QoR-40 scores were higher than those of groups N and C (P < 0.001). The need for remedial analgesia, the consumption of remifentanil and propofol, and the incidence of nausea in the DN group were the lowest among the three groups (P < 0.001). Conclusion Preventive analgesia with nalbuphine and dexmedetomidine in endoscopic sinus surgery can not only maintain hemodynamic stability but also reduce intraoperative anesthetic dosage, postoperative pain, and improve the quality of postoperative recovery without affecting the revival and extubation time.
{"title":"Effect of Preventive Analgesia with Nalbuphine and Dexmedetomidine in Endoscopic Sinus Surgery","authors":"P. Yu, Jie Zhang, Yan Zou, Jun Wang","doi":"10.1155/2022/2344733","DOIUrl":"https://doi.org/10.1155/2022/2344733","url":null,"abstract":"Background The study was to assess the efficacy and safety of nalbuphine combined with dexmedetomidine for preventive analgesia in endoscopic sinus surgery. Methods 110 patients with deviation of the nasal septum were randomized into the nalbuphine group (group N), dexmedetomidine combined with nalbuphine group (group DN), and saline group (group C). Fifteen minutes before the induction of anesthesia, patients in group N were injected nalbuphine 0.2 mg/kg intravenously; patients in group DN received intravenous infusion of dexmedetomidine 0.5 μg/kg and injection of nalbuphine 0.2 mg/kg; patients in group C received 0.9% saline. Mean arterial pressure (MAP), heart rate (HR), numerical rating scale (NRS) scores, quality of recovery-40 (QoR-40) scores, the need for remedial analgesia, the consumption of remifentanil and propofol, and the incidence of adverse reactions were recorded. Results MAP, HR, and NRS scores of the DN group were significantly lower and the QoR-40 scores were higher than those of groups N and C (P < 0.001). The need for remedial analgesia, the consumption of remifentanil and propofol, and the incidence of nausea in the DN group were the lowest among the three groups (P < 0.001). Conclusion Preventive analgesia with nalbuphine and dexmedetomidine in endoscopic sinus surgery can not only maintain hemodynamic stability but also reduce intraoperative anesthetic dosage, postoperative pain, and improve the quality of postoperative recovery without affecting the revival and extubation time.","PeriodicalId":19913,"journal":{"name":"Pain Research & Management","volume":"72 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2022-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79590892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xiangyu Li, Ruoyu Zhao, S. Rudd, W. Ding, Sidong Yang
Objectives To investigate the correlation between tamoxifen (TAM) and lumbar intervertebral disc (IVD) degeneration (IVDD). Methods The patients who visited the department of spine surgery from January 2015 to December 2020 were retrospectively reviewed. Those with a history of breast cancer surgery were identified and their data were collected. These data included patients' age, body mass index (BMI), menstrual history, postoperative history, drug treatment plan, and imaging data. The participants were divided into the TAM group and the non-TAM group. Lumbar IVDD was assessed by lumbar lordosis (LL), vertebral CT density, lumbar disc height index (DHI), Modic changes, and modified Pfirrmann grading score. SPSS 20 was used for statistical analysis. Results A total of 75 patients were included in this study, 46 patients in the TAM group and 29 patients in the non-TAM group. No significant differences were present in age, BMI, postoperative history, LL, and vertebral CT density between the two groups. The DHI of L1/2 and L2/3 in the TAM group was lower compared to the non-TAM group (P=0.038 and P=0.034, respectively), while comparisons regarding the DHI of L3/4, L4/5, and L5/S1, and the average DHI between TAM and non-TAM groups were not significant. The modified Pfirrmann grading scores of the L1/2 and L2/3 IVDs in the TAM group were higher than those in the non-TAM group (P=0.004 and P=0.025, respectively). Comparisons of L3/4, L4/5, and L5/S1 between the two groups were not significant. The comparisons regarding the occurrence of Modic changes did not show a significant difference between the TAM and non-TAM groups. Conclusions This study indicates that there might be some positive correlation between TAM use and lumbar IVDD. In particular, the degeneration of L1/2 and L2/3 has shown a correlation with TAM use.
{"title":"Correlation Analysis between Tamoxifen and Lumbar Intervertebral Disc Degeneration: A Retrospective Case-Control Study","authors":"Xiangyu Li, Ruoyu Zhao, S. Rudd, W. Ding, Sidong Yang","doi":"10.1155/2022/3330260","DOIUrl":"https://doi.org/10.1155/2022/3330260","url":null,"abstract":"Objectives To investigate the correlation between tamoxifen (TAM) and lumbar intervertebral disc (IVD) degeneration (IVDD). Methods The patients who visited the department of spine surgery from January 2015 to December 2020 were retrospectively reviewed. Those with a history of breast cancer surgery were identified and their data were collected. These data included patients' age, body mass index (BMI), menstrual history, postoperative history, drug treatment plan, and imaging data. The participants were divided into the TAM group and the non-TAM group. Lumbar IVDD was assessed by lumbar lordosis (LL), vertebral CT density, lumbar disc height index (DHI), Modic changes, and modified Pfirrmann grading score. SPSS 20 was used for statistical analysis. Results A total of 75 patients were included in this study, 46 patients in the TAM group and 29 patients in the non-TAM group. No significant differences were present in age, BMI, postoperative history, LL, and vertebral CT density between the two groups. The DHI of L1/2 and L2/3 in the TAM group was lower compared to the non-TAM group (P=0.038 and P=0.034, respectively), while comparisons regarding the DHI of L3/4, L4/5, and L5/S1, and the average DHI between TAM and non-TAM groups were not significant. The modified Pfirrmann grading scores of the L1/2 and L2/3 IVDs in the TAM group were higher than those in the non-TAM group (P=0.004 and P=0.025, respectively). Comparisons of L3/4, L4/5, and L5/S1 between the two groups were not significant. The comparisons regarding the occurrence of Modic changes did not show a significant difference between the TAM and non-TAM groups. Conclusions This study indicates that there might be some positive correlation between TAM use and lumbar IVDD. In particular, the degeneration of L1/2 and L2/3 has shown a correlation with TAM use.","PeriodicalId":19913,"journal":{"name":"Pain Research & Management","volume":"101 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2022-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79379653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Pain can alter muscle activity, although it is not clear how pain intensity and site location affect muscle activity. This study aimed to reveal the complex associations among the pain site, pain intensity/quality, muscle activity, and muscle activity distribution. Methods Electromyographic signals were recorded from above a bilateral lumbar erector spinae muscle with a four-channel electrode in 23 patients with chronic low back pain while they performed a lumbar bending and returning task. We calculated the average value of muscle activity during the extension phase (agonist activity) and the centroid of muscle activity, as well as the distance between the centroid of muscle activity and pain site. We also assessed the pain site and pain intensity/quality by the interview and questionnaire method. A generalized linear mixed model analysis was performed to determine the relationships among pain intensity/quality, pain site, and muscle activity. Results The results showed that muscle activity during the extension phase was significantly negatively associated with neuropathic pain and “pain caused by light touch.” In addition, the distance between the centroid of muscle activity and pain site during the extension phase was significantly positively associated with intermittent pain, “throbbing pain,” “splitting pain,” “punishing-cruel,” and “pain caused by light touch.” Conclusions Our findings suggest the existence of a motor adaptation that suppresses muscle activity near the painful area as the pain intensity increases. Furthermore, the present study indicates that the presence or absence of this motor adaptation depended on the pain quality.
{"title":"The Pain Intensity/Quality and Pain Site Association with Muscle Activity and Muscle Activity Distribution in Patients with Chronic Low Back Pain: Using a Generalized Linear Mixed Model Analysis","authors":"H. Shigetoh, Y. Nishi, M. Osumi, S. Morioka","doi":"10.1155/2022/5751204","DOIUrl":"https://doi.org/10.1155/2022/5751204","url":null,"abstract":"Background Pain can alter muscle activity, although it is not clear how pain intensity and site location affect muscle activity. This study aimed to reveal the complex associations among the pain site, pain intensity/quality, muscle activity, and muscle activity distribution. Methods Electromyographic signals were recorded from above a bilateral lumbar erector spinae muscle with a four-channel electrode in 23 patients with chronic low back pain while they performed a lumbar bending and returning task. We calculated the average value of muscle activity during the extension phase (agonist activity) and the centroid of muscle activity, as well as the distance between the centroid of muscle activity and pain site. We also assessed the pain site and pain intensity/quality by the interview and questionnaire method. A generalized linear mixed model analysis was performed to determine the relationships among pain intensity/quality, pain site, and muscle activity. Results The results showed that muscle activity during the extension phase was significantly negatively associated with neuropathic pain and “pain caused by light touch.” In addition, the distance between the centroid of muscle activity and pain site during the extension phase was significantly positively associated with intermittent pain, “throbbing pain,” “splitting pain,” “punishing-cruel,” and “pain caused by light touch.” Conclusions Our findings suggest the existence of a motor adaptation that suppresses muscle activity near the painful area as the pain intensity increases. Furthermore, the present study indicates that the presence or absence of this motor adaptation depended on the pain quality.","PeriodicalId":19913,"journal":{"name":"Pain Research & Management","volume":"10 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2022-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87688166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Siming Jia, Chuan Ren, Xiaoying Shi, Tailong Shi, Dacheng Sun, Yuqin Zhang, Kai Ding, Hao Du, Yanbin Zhu, Wei Chen
Objective This cross-sectional study aimed to examine the incidence and associated factors of complex regional pain syndrome type I (CRPS I) in patients who underwent open reduction and internal fixation (ORIF) for radial head fractures. Methods The study enrolled 601 radial head fracture patients treated with ORIF, 523 of which completed the 1-year follow-up. The incidence of CRPS I in those patients was assessed using the Budapest criteria. Patients were then divided into 2 groups: patients with CRPS I (n = 28) and patients without CRPS I (n = 495). The patients' demographic and clinical data before the operation were prospectively collected by our team. Independent t-tests and χ2 tests were used as univariate analyses to compare the demographic and clinical data between the two groups. Meanwhile, multivariate regression analysis was conducted to identify the associated risk factors for CRPS I. Results The incidence of CRPS I in patients with radial head fractures treated with ORIF was 5.5% during the first year following surgery. Significant differences were observed in age, gender, type of trauma, modified Mason Classification, and depressive personality disorders. The logistic regression analysis revealed that the female gender, modified Mason type III fractures, and depressive patients were significantly more likely to develop CRPS I (p=0.021, 0.023, and 0.025, respectively). Conclusions The incidence of CRPS I among radial head fracture patients undergoing ORIF was 5.5%. In addition, early detection of CRPS I and providing adequate intervention will likely result in greater benefits for those patients.
{"title":"Relative Prevalence and Associated Factors of Complex Regional Pain Syndrome Type I in Patients with Radial Head Fractures Treated with Open Reduction and Internal Fixation: A Cross-Sectional Study","authors":"Siming Jia, Chuan Ren, Xiaoying Shi, Tailong Shi, Dacheng Sun, Yuqin Zhang, Kai Ding, Hao Du, Yanbin Zhu, Wei Chen","doi":"10.1155/2022/9214404","DOIUrl":"https://doi.org/10.1155/2022/9214404","url":null,"abstract":"Objective This cross-sectional study aimed to examine the incidence and associated factors of complex regional pain syndrome type I (CRPS I) in patients who underwent open reduction and internal fixation (ORIF) for radial head fractures. Methods The study enrolled 601 radial head fracture patients treated with ORIF, 523 of which completed the 1-year follow-up. The incidence of CRPS I in those patients was assessed using the Budapest criteria. Patients were then divided into 2 groups: patients with CRPS I (n = 28) and patients without CRPS I (n = 495). The patients' demographic and clinical data before the operation were prospectively collected by our team. Independent t-tests and χ2 tests were used as univariate analyses to compare the demographic and clinical data between the two groups. Meanwhile, multivariate regression analysis was conducted to identify the associated risk factors for CRPS I. Results The incidence of CRPS I in patients with radial head fractures treated with ORIF was 5.5% during the first year following surgery. Significant differences were observed in age, gender, type of trauma, modified Mason Classification, and depressive personality disorders. The logistic regression analysis revealed that the female gender, modified Mason type III fractures, and depressive patients were significantly more likely to develop CRPS I (p=0.021, 0.023, and 0.025, respectively). Conclusions The incidence of CRPS I among radial head fracture patients undergoing ORIF was 5.5%. In addition, early detection of CRPS I and providing adequate intervention will likely result in greater benefits for those patients.","PeriodicalId":19913,"journal":{"name":"Pain Research & Management","volume":"120 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2022-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79427268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Huiying Huang, Xiaohui Bai, Kun Zhang, Jin Guo, Shaoyong Wu, Handong Ouyang
Background Pentazocine produces a wide variety of actions in the treatment of perioperative analgesia. Neostigmine is a cholinesterase inhibitor used to antagonize the residual effects of muscle relaxants and also produces an analgesic effect. Objectives To investigate the analgesic effects of intrathecally injected pentazocine and neostigmine and their interaction. Methods Sprague–Dawley rats were used to test the analgesic effect of pentazocine and neostigmine using the paw formalin pain model and the incision mechanical allodynia model. Pentazocine (3, 10, 30, and 100 μg), neostigmine (0.3, 1, 3, and 10 μg) or a pentazocine-neostigmine mixture were separately injected to evaluate their antinociceptive effects alone on the treatment groups. The corresponding control group received an intrathecal injection containing the same volume of saline. The formalin pain test, or the plantar incision pain behavior test were performed 30 minutes later. Isobolographic analysis was used to evaluate the interaction between pentazocine and neostigmine. Intrathecally administered selective mu-opioid receptor antagonist CTAP, selective kappa-opioid receptor antagonist nor-Binaltorphimine (nor-BNI), nonselective opioid receptor antagonist naloxone, and muscarinic acetylcholine receptor antagonist atropine were also used to test the possible interaction mechanism. These antagonists were used 30 minutes before the pentazocine and neostigmine mixtures which were intrathecally injected. Results Intrathecally administered pentazocine (3, 10, 30, and 100 μg) and neostigmine (0.3, 1, 3, and 10 μg) alone had a marked dose-related impact on suppressing the biphasic responses in the formalin test. Pentazocine (3, 10, 30, and 100 μg) and neostigmine (0.3, 1, 3, and 10 μg) alone attenuated the mechanical allodynia in a plantar incision model in a dose-dependent manner. Isobolographic analysis revealed that the mixture of intrathecal pentazocine and neostigmine synergistically decreased both phase I and II activity in the formalin test and mechanical allodynia in the plantar incision model. Pretreatment of intrathecally administered nor-BNI, naloxone, atropine, but not CTAP, antagonized the analgesic effect of the pentazocine-neostigmine mixture. Conclusions All of these results suggest that the combined application of pentazocine and neostigmine is an effective way to relieve pain from formalin and acute incision mechanical allodynia. The synergistic effect between pentazocine and neostigmine is mostly attributed to the kappa-opioid receptor and the cholinergic receptor in the spinal cord.
{"title":"Antinociceptive Effects and Interaction Mechanisms of Intrathecal Pentazocine and Neostigmine in Two Different Pain Models in Rats","authors":"Huiying Huang, Xiaohui Bai, Kun Zhang, Jin Guo, Shaoyong Wu, Handong Ouyang","doi":"10.1155/2022/4819910","DOIUrl":"https://doi.org/10.1155/2022/4819910","url":null,"abstract":"Background Pentazocine produces a wide variety of actions in the treatment of perioperative analgesia. Neostigmine is a cholinesterase inhibitor used to antagonize the residual effects of muscle relaxants and also produces an analgesic effect. Objectives To investigate the analgesic effects of intrathecally injected pentazocine and neostigmine and their interaction. Methods Sprague–Dawley rats were used to test the analgesic effect of pentazocine and neostigmine using the paw formalin pain model and the incision mechanical allodynia model. Pentazocine (3, 10, 30, and 100 μg), neostigmine (0.3, 1, 3, and 10 μg) or a pentazocine-neostigmine mixture were separately injected to evaluate their antinociceptive effects alone on the treatment groups. The corresponding control group received an intrathecal injection containing the same volume of saline. The formalin pain test, or the plantar incision pain behavior test were performed 30 minutes later. Isobolographic analysis was used to evaluate the interaction between pentazocine and neostigmine. Intrathecally administered selective mu-opioid receptor antagonist CTAP, selective kappa-opioid receptor antagonist nor-Binaltorphimine (nor-BNI), nonselective opioid receptor antagonist naloxone, and muscarinic acetylcholine receptor antagonist atropine were also used to test the possible interaction mechanism. These antagonists were used 30 minutes before the pentazocine and neostigmine mixtures which were intrathecally injected. Results Intrathecally administered pentazocine (3, 10, 30, and 100 μg) and neostigmine (0.3, 1, 3, and 10 μg) alone had a marked dose-related impact on suppressing the biphasic responses in the formalin test. Pentazocine (3, 10, 30, and 100 μg) and neostigmine (0.3, 1, 3, and 10 μg) alone attenuated the mechanical allodynia in a plantar incision model in a dose-dependent manner. Isobolographic analysis revealed that the mixture of intrathecal pentazocine and neostigmine synergistically decreased both phase I and II activity in the formalin test and mechanical allodynia in the plantar incision model. Pretreatment of intrathecally administered nor-BNI, naloxone, atropine, but not CTAP, antagonized the analgesic effect of the pentazocine-neostigmine mixture. Conclusions All of these results suggest that the combined application of pentazocine and neostigmine is an effective way to relieve pain from formalin and acute incision mechanical allodynia. The synergistic effect between pentazocine and neostigmine is mostly attributed to the kappa-opioid receptor and the cholinergic receptor in the spinal cord.","PeriodicalId":19913,"journal":{"name":"Pain Research & Management","volume":"43 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2022-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91061776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Changming Xu, Zhiwei Fu, Juan Wang, Bao Wu, Xueqiang Wang
Background Chronic low back pain (CLBP) is a clinically common and expensive disease. Patients frequently take sick leaves because of pain and dysfunction, and their unpleasant life and work experiences cause psychological depression and anxiety and affect their quality of life. Sleep disturbance is a common problem among patients with low back pain (LBP) with more than 50% complaining about poor sleep quality. This study aimed to explore the correlations between anxiety, sleep quality, and pressure-pain threshold (PPT) and their differences between patients with CLBP and asymptomatic people. Methods Forty patients with CLBP and 40 asymptomatic people were recruited. Relevant data, including State-Trait Anxiety Inventory, Pittsburgh Sleep Quality Index, and PPT, were individually and independently collected by blinded physiotherapists with a practicing certificate and then statistically analyzed. An independent sample t-test was used to determine the intergroup differences between patients with CLBP and asymptomatic populations. Pearson correlation coefficient was employed for correlation analysis. Results The CLBP group had significantly higher anxiety scores (41.64 ± 9.88 vs. 36.69 ± 8.31; t = −2.496, p=0.015) than the asymptomatic group. A significant difference was found in the total score of the Pittsburgh Sleep Quality Index (6.41 ± 2.43 vs. 5.09 ± 2.18; t = −2.628, p=0.010) but not in the trait anxiety (44.00 ± 7.83 vs. 42.67 ± 9.51; t = −0.695, p=0.489) of the two groups. State−Trait Anxiety Inventory showed a low to moderate negative correlation with PPT. No remarkable correlation was observed between Pittsburgh Sleep Quality Index and PPT. Conclusions Patients with CLBP showed considerably worse state anxiety and sleep quality than asymptomatic people; however, no substantial difference in PPT was found between the two groups. The results suggest that in clinical practice, the focus should include pain and related social and psychological factors. CLBP treatment could be considered from multiple perspectives and disciplines.This trial is registered with Chinese Clinical Trial Registry (Trial registration: ChiCTR-TRC-13003701).
{"title":"Differences and Correlations of Anxiety, Sleep Quality, and Pressure-Pain Threshold between Patients with Chronic Low Back Pain and Asymptomatic People","authors":"Changming Xu, Zhiwei Fu, Juan Wang, Bao Wu, Xueqiang Wang","doi":"10.1155/2022/8648584","DOIUrl":"https://doi.org/10.1155/2022/8648584","url":null,"abstract":"Background Chronic low back pain (CLBP) is a clinically common and expensive disease. Patients frequently take sick leaves because of pain and dysfunction, and their unpleasant life and work experiences cause psychological depression and anxiety and affect their quality of life. Sleep disturbance is a common problem among patients with low back pain (LBP) with more than 50% complaining about poor sleep quality. This study aimed to explore the correlations between anxiety, sleep quality, and pressure-pain threshold (PPT) and their differences between patients with CLBP and asymptomatic people. Methods Forty patients with CLBP and 40 asymptomatic people were recruited. Relevant data, including State-Trait Anxiety Inventory, Pittsburgh Sleep Quality Index, and PPT, were individually and independently collected by blinded physiotherapists with a practicing certificate and then statistically analyzed. An independent sample t-test was used to determine the intergroup differences between patients with CLBP and asymptomatic populations. Pearson correlation coefficient was employed for correlation analysis. Results The CLBP group had significantly higher anxiety scores (41.64 ± 9.88 vs. 36.69 ± 8.31; t = −2.496, p=0.015) than the asymptomatic group. A significant difference was found in the total score of the Pittsburgh Sleep Quality Index (6.41 ± 2.43 vs. 5.09 ± 2.18; t = −2.628, p=0.010) but not in the trait anxiety (44.00 ± 7.83 vs. 42.67 ± 9.51; t = −0.695, p=0.489) of the two groups. State−Trait Anxiety Inventory showed a low to moderate negative correlation with PPT. No remarkable correlation was observed between Pittsburgh Sleep Quality Index and PPT. Conclusions Patients with CLBP showed considerably worse state anxiety and sleep quality than asymptomatic people; however, no substantial difference in PPT was found between the two groups. The results suggest that in clinical practice, the focus should include pain and related social and psychological factors. CLBP treatment could be considered from multiple perspectives and disciplines.This trial is registered with Chinese Clinical Trial Registry (Trial registration: ChiCTR-TRC-13003701).","PeriodicalId":19913,"journal":{"name":"Pain Research & Management","volume":"6 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2022-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78840782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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