Background: Irritable bowel syndrome (IBS) is a clinical disease mainly characterized as a syndrome of abdominal pain and discomfort, which frequently occurs in humans aged 20-50. Abdomen massage is of great medical significance for the health of the human body, including promoting intestinal peristalsis, relieving constipation, and facilitating weight loss. However, its potential benefits in alleviating IBS and the underlying mechanisms remain elusive.
Methods: In this study, we established an IBS model in rats to evaluate the effects of abdomen massage. Forty male Sprague Dawley (SD) rats were randomly assigned into 4 groups: the normal (control) group, IBS group, abdominal massage group, and abdominal massage + ketotifen treatment group (n = 10 rats in each group). Abdominal massage was performed once a day for 5 minutes for 14 days. On day 14, the rats were euthanized and the tissues were analyzed by transmission electron microscopy (TEM), immunohistochemistry or immunofluorescence staining, and laser confocal focus to visualize the micromorphology of the intestinal mucosa. The expression of TRPV1 and the release of trypase were determined by RT-qPCR and western blot.
Results: We found that compared with the control group, the mast cells in the IBS group were significantly increased and the increased MC was partially decreased by an abdominal massage with or without ketotifen treatment. We also found that TRPV1 was upregulated in the IBS group. Abdominal massage with or without ketotifen treatment could attenuate the upregulation of TRPV1 in IBS. Mechanically, results of IHC and western Blot suggested that abdominal massage reduces the sensitivity of IBS by regulating the trypase-PAR2-PKCε pathway.
Conclusion: Overall, our results suggested that abdominal massage produces a beneficial effect in improving the symptoms of IBS through reducing mast cell recruitment and attenuating the trypase-PAR2-PKCε pathway. Ketotifen could promote the effect of abdominal massage on IBS treatment, which can serve as a potential therapeutic strategy for IBS.
{"title":"Abdominal Massage Improves the Symptoms of Irritable Bowel Syndrome by Regulating Mast Cells via the Trypase-PAR2-PKC<i>ε</i> Pathway in Rats.","authors":"Huanan Li, Wei Zhang, Fei Ma, Xiaofan Zhang, Yuyan Wang, Jingui Wang","doi":"10.1155/2022/8331439","DOIUrl":"10.1155/2022/8331439","url":null,"abstract":"<p><strong>Background: </strong>Irritable bowel syndrome (IBS) is a clinical disease mainly characterized as a syndrome of abdominal pain and discomfort, which frequently occurs in humans aged 20-50. Abdomen massage is of great medical significance for the health of the human body, including promoting intestinal peristalsis, relieving constipation, and facilitating weight loss. However, its potential benefits in alleviating IBS and the underlying mechanisms remain elusive.</p><p><strong>Methods: </strong>In this study, we established an IBS model in rats to evaluate the effects of abdomen massage. Forty male Sprague Dawley (SD) rats were randomly assigned into 4 groups: the normal (control) group, IBS group, abdominal massage group, and abdominal massage + ketotifen treatment group (<i>n</i> = 10 rats in each group). Abdominal massage was performed once a day for 5 minutes for 14 days. On day 14, the rats were euthanized and the tissues were analyzed by transmission electron microscopy (TEM), immunohistochemistry or immunofluorescence staining, and laser confocal focus to visualize the micromorphology of the intestinal mucosa. The expression of TRPV1 and the release of trypase were determined by RT-qPCR and western blot.</p><p><strong>Results: </strong>We found that compared with the control group, the mast cells in the IBS group were significantly increased and the increased MC was partially decreased by an abdominal massage with or without ketotifen treatment. We also found that TRPV1 was upregulated in the IBS group. Abdominal massage with or without ketotifen treatment could attenuate the upregulation of TRPV1 in IBS. Mechanically, results of IHC and western Blot suggested that abdominal massage reduces the sensitivity of IBS by regulating the trypase-PAR2-PKC<i>ε</i> pathway.</p><p><strong>Conclusion: </strong>Overall, our results suggested that abdominal massage produces a beneficial effect in improving the symptoms of IBS through reducing mast cell recruitment and attenuating the trypase-PAR2-PKC<i>ε</i> pathway. Ketotifen could promote the effect of abdominal massage on IBS treatment, which can serve as a potential therapeutic strategy for IBS.</p>","PeriodicalId":19913,"journal":{"name":"Pain Research & Management","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2022-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9534680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33517217","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: Fibromyalgia (FM) is characterized by spontaneous chronic widespread pain in combination with hyperalgesia to pressure stimuli. Sound-induced flash illusions (SIFIs) reflect cross-modal interactions between senses allowing to assess a visual cortical hoerexcitability (VCH) by evaluating the fission and fusion illusions disruption. The aims of the present study were to explore whether SIFIs are perceived differently in patients with fibromyalgia as compared to healthy controls (HCs) and how migraine affects fission and fusion illusions in fibromyalgia.
Methods: A single flash (F) accompanied by 0 to 4 beeps (B) was presented to induce the fission illusion while multiple flash (i.e., 2 to 4) accompanied by 0 or 1 beep was presented to induce fusion illusion. The mean number of perceived flashes in fission and fusion illusion trials was compared between the groups (i.e., FM, FM with migraine, and HCs) using repeated-measures analysis of variance. Medication history was recorded along with the administration of Fibromyalgia Impact Questionnaire and Hospital Anxiety and Depression scales.
Results: Twenty-four patients with FM (mean age 51, 2 ± 10, 6 years; 22 females), seventeen patients with FM and migraine without aura (mean age 47.8 ± 11.4 years; 16 females; 13 chronic, 4 episodic migraine), and forty-one age- and sex-matched HCs (mean age 47.3 ± 6.9 years; 34 females) participated in the study. Fission and fusion illusory effects were detected in all the participants. However, in FM patients, the fission illusion was reduced and almost abolished as compared to HCs (1F1B, p = 0.02; 1F2B, p < 0.0001; 1F3B, p < 0.0001; 1F4B, p = 0.0001), while there were no differences between groups in fusion trials. Migraine did not affect the fission and the fusion illusions.
Conclusion: Results from this study confirm that patients with FM have a VCH suggesting that the pathological changes in cortical excitability might have important roles in the pathophysiology of FM. SIFI represents a noninvasive behavioral tool for the exploration of cross-sensory functional interplay.
目的:纤维肌痛(FM)的特点是自发性慢性广泛疼痛,并伴有对压力刺激的痛觉过敏。声音诱发的闪光幻觉(sifi)反映了感官之间的跨模态相互作用,通过评估裂变和融合幻觉的破坏来评估视觉皮层的超兴奋性(VCH)。本研究的目的是探讨纤维肌痛患者对sifi的感知是否与健康对照(hc)不同,以及偏头痛如何影响纤维肌痛患者的裂变和融合幻觉。方法:单次闪光(F)伴随0 ~ 4次哔哔声(B)诱导裂变错觉,多次闪光(即2 ~ 4次)伴随0 ~ 1次哔哔声诱导融合错觉。使用重复测量方差分析比较两组(即FM、FM伴偏头痛和hc)在裂变幻觉和融合幻觉试验中感知到的闪光的平均次数。记录用药史,同时填写纤维肌痛影响问卷和医院焦虑抑郁量表。结果:24例FM患者(平均年龄51岁,2±10.6岁;22例女性),17例FM合并无先兆偏头痛患者(平均年龄47.8±11.4岁;16雌性;慢性偏头痛13例,发作性偏头痛4例),年龄和性别匹配的hcc 41例(平均年龄47.3±6.9岁;34名女性)参与了这项研究。在所有参与者中都检测到裂变和聚变错觉效应。然而,与hc相比,FM患者的裂变错觉减少,几乎消失(1F1B, p = 0.02;1F2B, p < 0.0001;1F3B, p < 0.0001;1F4B, p = 0.0001),而融合试验各组间无差异。偏头痛对裂变幻觉和融合幻觉没有影响。结论:本研究结果证实FM患者存在VCH,提示皮质兴奋性的病理改变可能在FM的病理生理中起重要作用。SIFI是一种探索跨感觉功能相互作用的无创行为工具。
{"title":"Sound-Induced Flash Illusions Support Cortex Hyperexcitability in Fibromyalgia.","authors":"Vincenzo Di Stefano, Salvatore Iacono, Andrea Gagliardo, Bruna Maggio, Giuliana Guggino, Massimo Gangitano, Roberto Monastero, Vito Renato Maggio, Nadia Bolognini, Filippo Brighina","doi":"10.1155/2022/7355102","DOIUrl":"https://doi.org/10.1155/2022/7355102","url":null,"abstract":"<p><strong>Objectives: </strong>Fibromyalgia (FM) is characterized by spontaneous chronic widespread pain in combination with hyperalgesia to pressure stimuli. Sound-induced flash illusions (SIFIs) reflect cross-modal interactions between senses allowing to assess a visual cortical hoerexcitability (VCH) by evaluating the fission and fusion illusions disruption. The aims of the present study were to explore whether SIFIs are perceived differently in patients with fibromyalgia as compared to healthy controls (HCs) and how migraine affects fission and fusion illusions in fibromyalgia.</p><p><strong>Methods: </strong>A single flash (F) accompanied by 0 to 4 beeps (B) was presented to induce the fission illusion while multiple flash (i.e., 2 to 4) accompanied by 0 or 1 beep was presented to induce fusion illusion. The mean number of perceived flashes in fission and fusion illusion trials was compared between the groups (i.e., FM, FM with migraine, and HCs) using repeated-measures analysis of variance. Medication history was recorded along with the administration of Fibromyalgia Impact Questionnaire and Hospital Anxiety and Depression scales.</p><p><strong>Results: </strong>Twenty-four patients with FM (mean age 51, 2 ± 10, 6 years; 22 females), seventeen patients with FM and migraine without aura (mean age 47.8 ± 11.4 years; 16 females; 13 chronic, 4 episodic migraine), and forty-one age- and sex-matched HCs (mean age 47.3 ± 6.9 years; 34 females) participated in the study. Fission and fusion illusory effects were detected in all the participants. However, in FM patients, the fission illusion was reduced and almost abolished as compared to HCs (1F1B, <i>p</i> = 0.02; 1F2B, <i>p</i> < 0.0001; 1F3B, <i>p</i> < 0.0001; 1F4B, <i>p</i> = 0.0001), while there were no differences between groups in fusion trials. Migraine did not affect the fission and the fusion illusions.</p><p><strong>Conclusion: </strong>Results from this study confirm that patients with FM have a VCH suggesting that the pathological changes in cortical excitability might have important roles in the pathophysiology of FM. SIFI represents a noninvasive behavioral tool for the exploration of cross-sensory functional interplay.</p>","PeriodicalId":19913,"journal":{"name":"Pain Research & Management","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2022-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9527419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33489680","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}
Pub Date : 2022-09-22eCollection Date: 2022-01-01DOI: 10.1155/2022/1217717
H-C Aster, D Evdokimov, A Braun, N Üçeyler, C Sommer
There is no approved drug for fibromyalgia syndrome (FMS) in Europe. In the German S3 guideline, amitriptyline, duloxetine, and pregabalin are recommended for temporary use. The aim of this study was to cross-sectionally investigate the current practice of medication in FMS patients in Germany. We systematically interviewed 156 patients with FMS, while they were participating in a larger study. The patients had been stratified into subgroups with and without a decrease in intraepidermal nerve fiber density. The drugs most commonly used to treat FMS pain were nonsteroidal anti-inflammatory drugs (NSAIDs) (41.0% of all patients), metamizole (22.4%), and amitriptyline (12.8%). The most frequent analgesic treatment regimen was "on demand" (53.9%), during pain attacks, while 35.1% of the drugs were administered daily and the remaining in other regimens. Median pain relief as self-rated by the patients on a numerical rating scale (0-10) was 2 points for NSAIDS, 2 for metamizole, and 1 for amitriptyline. Drugs that were discontinued due to lack of efficacy rather than side effects were acetaminophen, flupirtine, and selective serotonin reuptake inhibitors. Reduction in pain severity was best achieved by NSAIDs and metamizole. Our hypothesis that a decrease in intraepidermal nerve fiber density might represent a neuropathic subtype of FMS, which would be associated with better effectiveness of drugs targeting neuropathic pain, could not be confirmed in this cohort. Many FMS patients take "on-demand" medication that is not in line with current guidelines. More randomized clinical trials are needed to assess drug effects in FMS subgroups.
{"title":"Analgesic Medication in Fibromyalgia Patients: A Cross-Sectional Study.","authors":"H-C Aster, D Evdokimov, A Braun, N Üçeyler, C Sommer","doi":"10.1155/2022/1217717","DOIUrl":"https://doi.org/10.1155/2022/1217717","url":null,"abstract":"<p><p>There is no approved drug for fibromyalgia syndrome (FMS) in Europe. In the German S3 guideline, amitriptyline, duloxetine, and pregabalin are recommended for temporary use. The aim of this study was to cross-sectionally investigate the current practice of medication in FMS patients in Germany. We systematically interviewed 156 patients with FMS, while they were participating in a larger study. The patients had been stratified into subgroups with and without a decrease in intraepidermal nerve fiber density. The drugs most commonly used to treat FMS pain were nonsteroidal anti-inflammatory drugs (NSAIDs) (41.0% of all patients), metamizole (22.4%), and amitriptyline (12.8%). The most frequent analgesic treatment regimen was \"on demand\" (53.9%), during pain attacks, while 35.1% of the drugs were administered daily and the remaining in other regimens. Median pain relief as self-rated by the patients on a numerical rating scale (0-10) was 2 points for NSAIDS, 2 for metamizole, and 1 for amitriptyline. Drugs that were discontinued due to lack of efficacy rather than side effects were acetaminophen, flupirtine, and selective serotonin reuptake inhibitors. Reduction in pain severity was best achieved by NSAIDs and metamizole. Our hypothesis that a decrease in intraepidermal nerve fiber density might represent a neuropathic subtype of FMS, which would be associated with better effectiveness of drugs targeting neuropathic pain, could not be confirmed in this cohort. Many FMS patients take \"on-demand\" medication that is not in line with current guidelines. More randomized clinical trials are needed to assess drug effects in FMS subgroups.</p>","PeriodicalId":19913,"journal":{"name":"Pain Research & Management","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2022-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9553668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33514720","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}
Pub Date : 2022-09-20eCollection Date: 2022-01-01DOI: 10.1155/2022/3903720
Haggai Sharon, Hila Greener, Uri Hochberg, Silviu Brill
Background: Chronic pain (CP) prevalence in different studies has been inconsistent, ranging from 12% in Spain to 42% in the UK.
Purpose: We conducted an internet-based survey in a representative cohort of Israeli adults assembled by a large professional survey company in order to probe the prevalence of CP in Israel.
Methods: 8,300 Israeli adults comprising a representative cohort of the Israeli population were asked whether they were suffering from pain lasting over 3 months. 1647 participants responded (19.8% response rate). Of these, 515 (31.3%) had CP. Participants with CP were then asked a series of follow-up questions regarding their chronic pain. Statistical weights were used to correct for the distribution of the Israeli population based on sociodemographic characteristics.
Results: CP patients were significantly older than respondents without pain. The average daily pain was 5.8/10 on a numerical rating scale. Common pain locations were axial skeleton and headaches. However, over half of patients reported pain in multiple body areas, and around a fifth had an undiagnosed chronic pain syndrome. Around 40% of pain patients reported to have visited a specialized pain clinic, and the same proportion has consulted several specialists. Despite this, a sizable proportion of high pain intensity patients were still left with no or inefficient treatment to alleviate their pain.
Conclusions: This is the first internet survey conducted in Israel to estimate the incidence of CP, and the high CP prevalence documented is in agreement with previous reports from Europe and the USA. It also reaffirms the widespread existence of multifocal or widespread pain in clinical chronic pain and the correlation between pain intensity, impact on patients' quality of life and disability, and pain intractability. These data reaffirm the similarly major health burden CP presents across different countries and cultures.
{"title":"The Prevalence of Chronic Pain in the Adult Population in Israel: An Internet-Based Survey.","authors":"Haggai Sharon, Hila Greener, Uri Hochberg, Silviu Brill","doi":"10.1155/2022/3903720","DOIUrl":"https://doi.org/10.1155/2022/3903720","url":null,"abstract":"<p><strong>Background: </strong>Chronic pain (CP) prevalence in different studies has been inconsistent, ranging from 12% in Spain to 42% in the UK.</p><p><strong>Purpose: </strong>We conducted an internet-based survey in a representative cohort of Israeli adults assembled by a large professional survey company in order to probe the prevalence of CP in Israel.</p><p><strong>Methods: </strong>8,300 Israeli adults comprising a representative cohort of the Israeli population were asked whether they were suffering from pain lasting over 3 months. 1647 participants responded (19.8% response rate). Of these, 515 (31.3%) had CP. Participants with CP were then asked a series of follow-up questions regarding their chronic pain. Statistical weights were used to correct for the distribution of the Israeli population based on sociodemographic characteristics.</p><p><strong>Results: </strong>CP patients were significantly older than respondents without pain. The average daily pain was 5.8/10 on a numerical rating scale. Common pain locations were axial skeleton and headaches. However, over half of patients reported pain in multiple body areas, and around a fifth had an undiagnosed chronic pain syndrome. Around 40% of pain patients reported to have visited a specialized pain clinic, and the same proportion has consulted several specialists. Despite this, a sizable proportion of high pain intensity patients were still left with no or inefficient treatment to alleviate their pain.</p><p><strong>Conclusions: </strong>This is the first internet survey conducted in Israel to estimate the incidence of CP, and the high CP prevalence documented is in agreement with previous reports from Europe and the USA. It also reaffirms the widespread existence of multifocal or widespread pain in clinical chronic pain and the correlation between pain intensity, impact on patients' quality of life and disability, and pain intractability. These data reaffirm the similarly major health burden CP presents across different countries and cultures.</p>","PeriodicalId":19913,"journal":{"name":"Pain Research & Management","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2022-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9553676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33543058","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}
Pub Date : 2022-09-19eCollection Date: 2022-01-01DOI: 10.1155/2022/9958668
Ghada Mohammad Abo Elfadl, Marwa Mahmoud AbdelRady, Hany M Osman, Mohamed Omar Gad, Nessren M Abd El-Rady, Wesam Nashat Ali
Background: The study evaluated the analgesic effects of levobupivacaine infiltration in the tonsil bed, and a combination of levobupivacaine and dexmedetomidine in patients undergoing tonsillectomy.
Methods: Ninety children (ages 3 to 7 years) who were scheduled for a tonsillectomy were allocated randomly into two groups. (L Group): peritonsillar infiltration with 0.25% levobupivacaine (2 ml + 0.5 ml saline 0.9% per tonsil). (LD Group): levobupivacaine 0.25% (2 ml) plus dexmedetomidine 1 μg/kg diluted in 1 ml saline 0.9% (0.5 ml in each tonsil), and administered by peritonsillar infiltration (2.5 ml per tonsil) following intubation 3-5 minutes before operation. To avoid bias, infiltrate a total volume of 2.5 ml in each tonsil. The first analgesic request time was the primary outcome, with postoperative pain score, total analgesic consumption, total oral intake, sedation, and side effects as secondary outcomes.
Results: The first rescue analgesia time in the LD group was longer (644.31 ± 112.89 min) than in the L group (551.51 ± 146.16 min, P-value <0.001). The number of patients who required >1 analgesic dose in the L group (n = 13) was higher than in the LD group (n = 5). The LD group consumes a lower total dose of IV paracetamol in the first 24 hours postoperatively (321.89 ± 93.25 mg) than the L group (394.89 ± 183.71 mg, P < 0.00-value < 0.050). On the first day postoperatively, patients in the LD group had a higher total oral intake (P < 0.001). Except for a slight increase in laryngospasm in the L group, there were no side effects.
Conclusions: The Children's peritonsillar infiltration of levobupivacaine and dexmedetomidine improved postoperative pain after adenotonsillectomy. The topically applied levobupivacaine and dexmedetomidine were concomitant with no systemic effects, greater total oral intake on the first day postoperative, and higher family satisfaction.
{"title":"Efficacy of Levobupivacaine Versus Levobupivacaine Plus Dexmedetomidine Infiltration for Post-Tonsillectomy Analgesia: A Randomized Controlled Trial.","authors":"Ghada Mohammad Abo Elfadl, Marwa Mahmoud AbdelRady, Hany M Osman, Mohamed Omar Gad, Nessren M Abd El-Rady, Wesam Nashat Ali","doi":"10.1155/2022/9958668","DOIUrl":"https://doi.org/10.1155/2022/9958668","url":null,"abstract":"<p><strong>Background: </strong>The study evaluated the analgesic effects of levobupivacaine infiltration in the tonsil bed, and a combination of levobupivacaine and dexmedetomidine in patients undergoing tonsillectomy.</p><p><strong>Methods: </strong>Ninety children (ages 3 to 7 years) who were scheduled for a tonsillectomy were allocated randomly into two groups. (L Group<b>)</b>: peritonsillar infiltration with 0.25% levobupivacaine (2 ml + 0.5 ml saline 0.9% per tonsil). (LD Group): levobupivacaine 0.25% (2 ml) plus dexmedetomidine 1 <i>μ</i>g/kg diluted in 1 ml saline 0.9% (0.5 ml in each tonsil), and administered by peritonsillar infiltration (2.5 ml per tonsil) following intubation 3-5 minutes before operation. To avoid bias, infiltrate a total volume of 2.5 ml in each tonsil. The first analgesic request time was the primary outcome, with postoperative pain score, total analgesic consumption, total oral intake, sedation, and side effects as secondary outcomes.</p><p><strong>Results: </strong>The first rescue analgesia time in the LD group was longer (644.31 ± 112.89 min) than in the <i>L</i> group (551.51 ± 146.16 min, <i>P</i>-value <0.001). The number of patients who required >1 analgesic dose in the <i>L</i> group (<i>n</i> = 13) was higher than in the LD group (<i>n</i> = 5). The LD group consumes a lower total dose of IV paracetamol in the first 24 hours postoperatively (321.89 ± 93.25 mg) than the <i>L</i> group (394.89 ± 183.71 mg, <i>P</i> < 0.00-value < 0.050). On the first day postoperatively, patients in the LD group had a higher total oral intake (<i>P</i> < 0.001). Except for a slight increase in laryngospasm in the <i>L</i> group, there were no side effects.</p><p><strong>Conclusions: </strong>The Children's peritonsillar infiltration of levobupivacaine and dexmedetomidine improved postoperative pain after adenotonsillectomy. The topically applied levobupivacaine and dexmedetomidine were concomitant with no systemic effects, greater total oral intake on the first day postoperative, and higher family satisfaction.</p>","PeriodicalId":19913,"journal":{"name":"Pain Research & Management","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2022-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9553655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33543057","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}
Pub Date : 2022-08-31eCollection Date: 2022-01-01DOI: 10.1155/2022/4206275
Onur Atalı, Elif Özçelik, Onur Gönül, Hasan Garip
Aim: Temporomandibular disorders (TMDs) are clinical situations that are characterized by pain, sound, and irregular movements of the temporomandibular joints. The most common method in the treatment of TMDs is arthrocentesis. This study aims to compare the effect of conventional extraoral auriculotemporal nerve block (ANB) and Gow-Gates (GG) mandibular anesthesia techniques on patient comfort in an arthrocentesis procedure.
Materials and methods: We performed this study on 40 patients who underwent TMJ arthrocentesis with ANB (n = 20) or GG (n = 20) mandibular anesthesia techniques at the Marmara University Faculty of Dentistry between 2016 and 2019. The predictor variable was the type of an anesthesia technique, and the outcome variables included were pain, maximum mouth opening (MMO), and protrusive movement (PM). They were compared at the preoperative period and 3rd and 6th month periods. Statistical analysis included means with standard deviations, a one-way ANOVA for continuous data, and the results were evaluated at the significance level of p < 0.05.
Results: No statistically significant difference was observed between the VAS values, MMO, and PM averages of preoperative, 3rd and 6th months of ANB and GG (p=0.142, p=0.209, and p=0.148).
Conclusion: Both anesthesia techniques have provided effective results in terms of pain and functional jaw movements in the postoperative period in arthrocentesis treatment.
{"title":"Evaluation of Patient Comfort and Impact of Different Anesthesia Techniques on the Temporomandibular Joint Arthrocentesis Applications by Comparing Gow-Gates Mandibular Block Anesthesia with Auriculotemporal Nerve Block.","authors":"Onur Atalı, Elif Özçelik, Onur Gönül, Hasan Garip","doi":"10.1155/2022/4206275","DOIUrl":"https://doi.org/10.1155/2022/4206275","url":null,"abstract":"<p><strong>Aim: </strong>Temporomandibular disorders (TMDs) are clinical situations that are characterized by pain, sound, and irregular movements of the temporomandibular joints. The most common method in the treatment of TMDs is arthrocentesis. This study aims to compare the effect of conventional extraoral auriculotemporal nerve block (ANB) and Gow-Gates (GG) mandibular anesthesia techniques on patient comfort in an arthrocentesis procedure.</p><p><strong>Materials and methods: </strong>We performed this study on 40 patients who underwent TMJ arthrocentesis with ANB (<i>n</i> = 20) or GG (<i>n</i> = 20) mandibular anesthesia techniques at the Marmara University Faculty of Dentistry between 2016 and 2019. The predictor variable was the type of an anesthesia technique, and the outcome variables included were pain, maximum mouth opening (MMO), and protrusive movement (PM). They were compared at the preoperative period and 3<sup>rd</sup> and 6<sup>th</sup> month periods. Statistical analysis included means with standard deviations, a one-way ANOVA for continuous data, and the results were evaluated at the significance level of <i>p</i> < 0.05.</p><p><strong>Results: </strong>No statistically significant difference was observed between the VAS values, MMO, and PM averages of preoperative, 3<sup>rd</sup> and 6<sup>th</sup> months of ANB and GG (<i>p</i>=0.142, <i>p</i>=0.209, and <i>p</i>=0.148).</p><p><strong>Conclusion: </strong>Both anesthesia techniques have provided effective results in terms of pain and functional jaw movements in the postoperative period in arthrocentesis treatment.</p>","PeriodicalId":19913,"journal":{"name":"Pain Research & Management","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2022-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9453085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33459430","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}
Pain sensitization and neuropathic pain-like symptoms are some of the common pain symptoms in patients with lower limbs, including hip and knee, osteoarthritis (HOA/KOA). Exercise therapy has been the first-line treatment; however, the effects differ for each patient. This prospective cohort study investigated the relationship between the effectiveness of exercise therapy and pretreatment characteristics (radiologic severity, pain sensitization, and neuropathic pain-like symptoms) of patients with HOA/KOA. We assessed the pain intensity using a numerical rating scale (NRS) before and after 12 weeks of exercise therapy in patients with HOA/KOA (n = 101). Before treatment, the Kellgren-Lawrence (K-L) grade; minimum joint space width (mJSW); pressure pain threshold (PPT) and temporal summation of pain (TSP) at the affected joint, tibia, and forearm; Central Sensitization Inventory-9; and painDETECT questionnaire (PDQ) were assessed. Cluster analysis was based on the pretreatment NRS and change in NRS with exercise therapy to identify the subgroups of pain reduction. The pretreatment characteristics of each cluster were compared. According to the results of the cluster analyses, patients in cluster 1 had severe pain that did not improve after exercise therapy, patients in cluster 2 had severe pain that improved, and those in cluster 3 had mild pain that improved. The patients in cluster 1 exhibited lower PPT at all measurement sites, higher TSP at the affected joint, and higher PDQ scores than those in other clusters. There was no difference in the K-L grade and mJSW among the clusters. The subgroup with severe pain and pain sensitization or neuropathic pain-like symptoms at pretreatment, even with mild joint deformity, may have difficulty in achieving improvement in pain after 12 weeks of exercise therapy. These findings could be useful for prognosis prediction and for planning exercise therapy and combining with other treatment.
{"title":"Pain Sensitization and Neuropathic Pain-like Symptoms Associated with Effectiveness of Exercise Therapy in Patients with Hip and Knee Osteoarthritis.","authors":"Takafumi Hattori, Kazuhiro Shimo, Yuto Niwa, Yuichi Katsura, Yuji Tokiwa, Satoshi Ohga, Takako Matsubara","doi":"10.1155/2022/4323045","DOIUrl":"https://doi.org/10.1155/2022/4323045","url":null,"abstract":"<p><p>Pain sensitization and neuropathic pain-like symptoms are some of the common pain symptoms in patients with lower limbs, including hip and knee, osteoarthritis (HOA/KOA). Exercise therapy has been the first-line treatment; however, the effects differ for each patient. This prospective cohort study investigated the relationship between the effectiveness of exercise therapy and pretreatment characteristics (radiologic severity, pain sensitization, and neuropathic pain-like symptoms) of patients with HOA/KOA. We assessed the pain intensity using a numerical rating scale (NRS) before and after 12 weeks of exercise therapy in patients with HOA/KOA (<i>n</i> = 101). Before treatment, the Kellgren-Lawrence (K-L) grade; minimum joint space width (mJSW); pressure pain threshold (PPT) and temporal summation of pain (TSP) at the affected joint, tibia, and forearm; Central Sensitization Inventory-9; and painDETECT questionnaire (PDQ) were assessed. Cluster analysis was based on the pretreatment NRS and change in NRS with exercise therapy to identify the subgroups of pain reduction. The pretreatment characteristics of each cluster were compared. According to the results of the cluster analyses, patients in cluster 1 had severe pain that did not improve after exercise therapy, patients in cluster 2 had severe pain that improved, and those in cluster 3 had mild pain that improved. The patients in cluster 1 exhibited lower PPT at all measurement sites, higher TSP at the affected joint, and higher PDQ scores than those in other clusters. There was no difference in the K-L grade and mJSW among the clusters. The subgroup with severe pain and pain sensitization or neuropathic pain-like symptoms at pretreatment, even with mild joint deformity, may have difficulty in achieving improvement in pain after 12 weeks of exercise therapy. These findings could be useful for prognosis prediction and for planning exercise therapy and combining with other treatment.</p>","PeriodicalId":19913,"journal":{"name":"Pain Research & Management","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2022-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9444422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33448061","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: The biopsychosocial mechanism by which exercise leads to improvement in chronic low back pain (CLBP) remains unstudied. This prospective cohort study was performed to examine the effectiveness of exercise on pain, disability, and psychological status for CLBP. We also tested path analytic models in which changes in these variables were included.
Methods: CLBP patients who visited the Interdisciplinary Pain Center of Keio University Hospital from July 2018 to April 2020 were included. The propensity score matching was performed between patients who underwent exercise (the exercise group) and those who did not (the control group). At the first visit and at the 3-month follow-up, pain (Numerical Rating Scale (NRS)), disability (Pain Disability Assessment Scale (PDAS)), and psychological status (Pain Self-Efficacy Questionnaire (PSEQ), and Pain Catastrophizing Scale (PCS)) were assessed. Changes in pain and disability at the follow-up were compared between the groups. The relationships between changes in pain, disability, and psychological variables were examined using Pearson's correlation and mediation analysis.
Results: A significantly larger decrease in the PDAS was observed in the exercise group (N = 49) than in the control (N = 49) (p < 0.05). Increased PSEQ scores were significantly correlated with decreased NRS scores in both groups. In the exercise group, decreased PDAS fully mediated the relationship between increased PSEQ and decreased NRS (P < 0.05).
Conclusion: Exercise improved disability, and the improved disability by exercise mediated the effect of increased self-efficacy on pain relief in CLBP patients.
{"title":"Improvement in Disability Mediates the Effect of Self-Efficacy on Pain Relief in Chronic Low Back Pain Patients with Exercise Therapy.","authors":"Yuta Shinohara, Kenta Wakaizumi, Aiko Ishikawa, Mari Ito, Reiko Hoshino, Chisato Tanaka, Saki Takaoka, Michiyuki Kawakami, Osahiko Tsuji, Daisuke Fujisawa, Toshiyuki Fujiwara, Tetsuya Tsuji, Hiroshi Morisaki, Shizuko Kosugi","doi":"10.1155/2022/4203138","DOIUrl":"https://doi.org/10.1155/2022/4203138","url":null,"abstract":"<p><strong>Background: </strong>The biopsychosocial mechanism by which exercise leads to improvement in chronic low back pain (CLBP) remains unstudied. This prospective cohort study was performed to examine the effectiveness of exercise on pain, disability, and psychological status for CLBP. We also tested path analytic models in which changes in these variables were included.</p><p><strong>Methods: </strong>CLBP patients who visited the Interdisciplinary Pain Center of Keio University Hospital from July 2018 to April 2020 were included. The propensity score matching was performed between patients who underwent exercise (the exercise group) and those who did not (the control group). At the first visit and at the 3-month follow-up, pain (Numerical Rating Scale (NRS)), disability (Pain Disability Assessment Scale (PDAS)), and psychological status (Pain Self-Efficacy Questionnaire (PSEQ), and Pain Catastrophizing Scale (PCS)) were assessed. Changes in pain and disability at the follow-up were compared between the groups. The relationships between changes in pain, disability, and psychological variables were examined using Pearson's correlation and mediation analysis.</p><p><strong>Results: </strong>A significantly larger decrease in the PDAS was observed in the exercise group (<i>N</i> = 49) than in the control (<i>N</i> = 49) (<i>p</i> < 0.05). Increased PSEQ scores were significantly correlated with decreased NRS scores in both groups. In the exercise group, decreased PDAS fully mediated the relationship between increased PSEQ and decreased NRS (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>Exercise improved disability, and the improved disability by exercise mediated the effect of increased self-efficacy on pain relief in CLBP patients.</p>","PeriodicalId":19913,"journal":{"name":"Pain Research & Management","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2022-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9444439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33448063","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}
Pub Date : 2022-08-22eCollection Date: 2022-01-01DOI: 10.1155/2022/3312589
David W Lee, Patrick Buchanan, Shashank Vodapally, Christopher James, Jack Diep
Sacroiliac (SI) joint arthropathy is the primary pain generator in approximately 15-25% of patients with axial low back pain and traditionally diagnosed with >50% pain reduction following an intra-articular injection localized to the inferior 1/3 of the SI joint. The conventional technique for accessing the SI joint encompasses a posterior approach with fluoroscopic guidance at 10-20⁰ contralateral oblique angulation, and minor adjustments to this approach have been implemented with varying degrees of success. The authors present a novel technique for SI joint injection, infiltrating the middle third of the joint through an alternative far-contralateral oblique (FCO) approach, angulation between 20-40⁰. This approach theoretically endows easier access to the SI joint and at the very least provides another option for interventionalists in the diagnosis and treatment of sacroiliac joint pain. It can also be utilized to determine if a patient is a candidate for posterior percutaneous SI joint fusion. The authors sought to document this approach to ensure that it was both reproducible and safe, while recognizing the need for future studies.
{"title":"Far-Contralateral Oblique (FCO) Sacroiliac Joint Injection: Description of a Novel Technique.","authors":"David W Lee, Patrick Buchanan, Shashank Vodapally, Christopher James, Jack Diep","doi":"10.1155/2022/3312589","DOIUrl":"https://doi.org/10.1155/2022/3312589","url":null,"abstract":"<p><p>Sacroiliac (SI) joint arthropathy is the primary pain generator in approximately 15-25% of patients with axial low back pain and traditionally diagnosed with >50% pain reduction following an intra-articular injection localized to the inferior 1/3 of the SI joint. The conventional technique for accessing the SI joint encompasses a posterior approach with fluoroscopic guidance at 10-20⁰ contralateral oblique angulation, and minor adjustments to this approach have been implemented with varying degrees of success. The authors present a novel technique for SI joint injection, infiltrating the middle third of the joint through an alternative far-contralateral oblique (FCO) approach, angulation between 20-40⁰. This approach theoretically endows easier access to the SI joint and at the very least provides another option for interventionalists in the diagnosis and treatment of sacroiliac joint pain. It can also be utilized to determine if a patient is a candidate for posterior percutaneous SI joint fusion. The authors sought to document this approach to ensure that it was both reproducible and safe, while recognizing the need for future studies.</p>","PeriodicalId":19913,"journal":{"name":"Pain Research & Management","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2022-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9423991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40334460","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}
Pub Date : 2022-08-16eCollection Date: 2022-01-01DOI: 10.1155/2022/6115782
Grzegorz Zieliński, Michał Baszczowski, Maria Rapa, Anna Matysik-Woźniak, Magdalena Zawadka, Jacek Szkutnik, Piotr Gawda, Robert Rejdak, Piotr Majcher, Michał Ginszt
Objective: The present study aimed to evaluate the correlation of eye length and bioelectric activity of temporalis, masseter, digastric, and sternocleidomastoid muscles in women with myopia compared to healthy women.
Methods: Based on the exclusion and inclusion criteria, 42 women aged 24 years (±2 years) were eligible for the study. Two equally sized groups with myopic (n = 21) and emmetropic healthy subjects (n = 21) were formed. An electromyographic study of the examined muscles was performed in four conditions: at rest, during maximal voluntary clenching in the intercuspal position, during maximal voluntary clenching on dental cotton rollers, and during maximal mouth opening using BioEMG III (BioResearch Associates, Inc. Milwaukee, WI, USA). The IOL Master 500 (Carl Zeiss Meditec, Jena, Germany) was used to examine the eyeball length. Statistical analysis showed significant positive correlations during mouth opening in both groups with open and closed eyes.
Results: A greater number of correlations between the analyzed variables was observed in emmetropic women. In almost all cases, the longer axial eye length was associated with an increase in the bioelectrical activity of the analyzed muscles. Significant correlations were most often observed within the masseter and digastric muscles during the maximum mouth opening and at rest.
Conclusion: There is a relationship between the bioelectrical activity of the masticatory muscles and the axial length of the eyeball on the same side.
{"title":"The Axial Length of the Eyeball and Bioelectrical Activity of Masticatory and Neck Muscles: A Preliminary Report.","authors":"Grzegorz Zieliński, Michał Baszczowski, Maria Rapa, Anna Matysik-Woźniak, Magdalena Zawadka, Jacek Szkutnik, Piotr Gawda, Robert Rejdak, Piotr Majcher, Michał Ginszt","doi":"10.1155/2022/6115782","DOIUrl":"https://doi.org/10.1155/2022/6115782","url":null,"abstract":"<p><strong>Objective: </strong>The present study aimed to evaluate the correlation of eye length and bioelectric activity of temporalis, masseter, digastric, and sternocleidomastoid muscles in women with myopia compared to healthy women.</p><p><strong>Methods: </strong>Based on the exclusion and inclusion criteria, 42 women aged 24 years (±2 years) were eligible for the study. Two equally sized groups with myopic (<i>n</i> = 21) and emmetropic healthy subjects (<i>n</i> = 21) were formed. An electromyographic study of the examined muscles was performed in four conditions: at rest, during maximal voluntary clenching in the intercuspal position, during maximal voluntary clenching on dental cotton rollers, and during maximal mouth opening using BioEMG III (BioResearch Associates, Inc. Milwaukee, WI, USA). The IOL Master 500 (Carl Zeiss Meditec, Jena, Germany) was used to examine the eyeball length. Statistical analysis showed significant positive correlations during mouth opening in both groups with open and closed eyes.</p><p><strong>Results: </strong>A greater number of correlations between the analyzed variables was observed in emmetropic women. In almost all cases, the longer axial eye length was associated with an increase in the bioelectrical activity of the analyzed muscles. Significant correlations were most often observed within the masseter and digastric muscles during the maximum mouth opening and at rest.</p><p><strong>Conclusion: </strong>There is a relationship between the bioelectrical activity of the masticatory muscles and the axial length of the eyeball on the same side.</p>","PeriodicalId":19913,"journal":{"name":"Pain Research & Management","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2022-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9398725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33438534","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}