Pub Date : 2024-06-14DOI: 10.1177/20494637241262516
F. Abdelfatah, M. Elhadad
The pericapsular nerve group (PENG) block offers effective postoperative pain relief following hip fracture surgery. This research investigated three doses of bupivacaine, all administered in the same total volume, for performing ultrasound-guided PENG blocks during hip fracture procedures. This randomized, double-blinded clinical trial was conducted on 135 patients aged between 18 and 70 years of both sexes who underwent hip fracture surgeries. Participants were randomized into three groups ( n = 45). Ultrasound-guided PENG block was applied, the groups received 20 mL of local anesthetics. The first group received 0.5% bupivacaine, the second group received 0.375% bupivacaine, and the third group received 0.25% bupivacaine. The following parameters were recorded: onset of sensory block, resting NRS after passively raising the limb by 15° half an hour post-procedure, quality of recovery score (QoR-15) at 24 h postoperative. The 0.25% bupivacaine group exhibited a longer sensory block onset than the other groups ( p ≤ .05). Significant differences were demonstrated between the groups regarding the time to 1st analgesia ( p = .033) and total morphine consumption ( p = .025). NRS at baseline and T30 post-block did not show significant differences between the studied groups. No significant differences were detected postoperatively in rest and dynamic NRS ( p ≤ .05). Patient satisfaction, QoR-15 score, and ease of spinal positioning did not differ between the groups. Compared to 0.25% bupivacaine, PENG block with 0.5% and 0.375% bupivacaine provided a rapid onset sensory block, delayed first analgesic requirements, and reduced total morphine consumption after hip surgeries. The trial was registered at the clinicaltrials.gov with study number (Trial ID: NCT05788458).
{"title":"Effect of bupivacaine concentration on ultrasound-guided pericapsular group nerve block efficacy in hip surgery patients: comparative, randomized, double-blinded clinical trial","authors":"F. Abdelfatah, M. Elhadad","doi":"10.1177/20494637241262516","DOIUrl":"https://doi.org/10.1177/20494637241262516","url":null,"abstract":"The pericapsular nerve group (PENG) block offers effective postoperative pain relief following hip fracture surgery. This research investigated three doses of bupivacaine, all administered in the same total volume, for performing ultrasound-guided PENG blocks during hip fracture procedures. This randomized, double-blinded clinical trial was conducted on 135 patients aged between 18 and 70 years of both sexes who underwent hip fracture surgeries. Participants were randomized into three groups ( n = 45). Ultrasound-guided PENG block was applied, the groups received 20 mL of local anesthetics. The first group received 0.5% bupivacaine, the second group received 0.375% bupivacaine, and the third group received 0.25% bupivacaine. The following parameters were recorded: onset of sensory block, resting NRS after passively raising the limb by 15° half an hour post-procedure, quality of recovery score (QoR-15) at 24 h postoperative. The 0.25% bupivacaine group exhibited a longer sensory block onset than the other groups ( p ≤ .05). Significant differences were demonstrated between the groups regarding the time to 1st analgesia ( p = .033) and total morphine consumption ( p = .025). NRS at baseline and T30 post-block did not show significant differences between the studied groups. No significant differences were detected postoperatively in rest and dynamic NRS ( p ≤ .05). Patient satisfaction, QoR-15 score, and ease of spinal positioning did not differ between the groups. Compared to 0.25% bupivacaine, PENG block with 0.5% and 0.375% bupivacaine provided a rapid onset sensory block, delayed first analgesic requirements, and reduced total morphine consumption after hip surgeries. The trial was registered at the clinicaltrials.gov with study number (Trial ID: NCT05788458).","PeriodicalId":503228,"journal":{"name":"British Journal of Pain","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141340228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-09DOI: 10.1177/20494637241254191
Kaísa Menezes Oliveira, Eduardo Silva Reis Barreto, Vinicius Borges Alencar, Liliane Elze Falcão Lins-Kusterer, Liana Maria Torres de Araujo Azi, D. Kraychete
Neuropathic pain (NP) is characterised as a lesion or disease directly affecting the somatosensory system. This study aims to analyse the efficacy of botulinum toxin type A (BT-A) in the treatment of neuropathic pain. This systematic literature review, guided by PRISMA, applied the PICO strategy with the following criteria: (P = patients with neuropathic pain, I = botulinum toxin, C = placebo or active drug, and O = pain relief). Fourteen articles, all randomised controlled trials with a placebo control, were included in the review. A total of 645 patients were randomised, with 353 patients receiving treatment with botulinum toxin type A in doses ranging from 25U to 400U. The evaluated studies addressed trigeminal neuralgia, diabetic polyneuropathy, post-herpetic neuralgia, spinal cord injury, phantom limb pain, and peripheral neuropathic pain after trauma or surgery. BT-A has emerged as a promising treatment for various origins of neuropathic pain. Therefore, future studies should adopt stricter criteria regarding dosage and routes of administration to ensure effective and consistent BT-A application.
{"title":"The efficacy of botulinum toxin in neuropathic pain: a systematic review","authors":"Kaísa Menezes Oliveira, Eduardo Silva Reis Barreto, Vinicius Borges Alencar, Liliane Elze Falcão Lins-Kusterer, Liana Maria Torres de Araujo Azi, D. Kraychete","doi":"10.1177/20494637241254191","DOIUrl":"https://doi.org/10.1177/20494637241254191","url":null,"abstract":"Neuropathic pain (NP) is characterised as a lesion or disease directly affecting the somatosensory system. This study aims to analyse the efficacy of botulinum toxin type A (BT-A) in the treatment of neuropathic pain. This systematic literature review, guided by PRISMA, applied the PICO strategy with the following criteria: (P = patients with neuropathic pain, I = botulinum toxin, C = placebo or active drug, and O = pain relief). Fourteen articles, all randomised controlled trials with a placebo control, were included in the review. A total of 645 patients were randomised, with 353 patients receiving treatment with botulinum toxin type A in doses ranging from 25U to 400U. The evaluated studies addressed trigeminal neuralgia, diabetic polyneuropathy, post-herpetic neuralgia, spinal cord injury, phantom limb pain, and peripheral neuropathic pain after trauma or surgery. BT-A has emerged as a promising treatment for various origins of neuropathic pain. Therefore, future studies should adopt stricter criteria regarding dosage and routes of administration to ensure effective and consistent BT-A application.","PeriodicalId":503228,"journal":{"name":"British Journal of Pain","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140997909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-07DOI: 10.1177/20494637241250271
C. Macgregor, David N Blane, Emmanuelle Tulle, Claire L Campbell, Ruth J Barber, Clementine Hill O’Connor, Christopher Seenan
Chronic pain is a highly prevalent long-term condition, experienced unequally, impacting both the individual living with pain, and wider society. ‘Acceptance’ of chronic pain is relevant to improved consultations in pain care, and navigating an approach towards evidence-based, long-term management and associated improvements in health. However, the concept proves difficult to measure, and primary qualitative studies of lived experiences show complexity related to our socio-cultural-political worlds, healthcare experiences, and difficulties with language and meaning. We framed acceptance of chronic pain as socially constructed and aimed to conceptualise the lived experiences of acceptance of chronic pain in adults. We conducted a systematic search and screening process, followed by qualitative, interpretive, literature synthesis using Meta-ethnography. We included qualitative studies using chronic pain as the primary condition, where the study included an aim to research the acceptance concept. We conducted each stage of the synthesis with co-researchers of differing disciplinary backgrounds, and with lived experiences of chronic pain. We included 10 qualitative studies from Canada, Sweden, The Netherlands, Ireland, UK, Australia and New Zealand. Our ‘lines of argument’ include a fluid and continuous journey with fluctuating states of acceptance; language and meaning of acceptance and chronic pain, a challenge to identity in a capitalist, ableist society and the limits to individualism; a caring, supportive and coherent system. The conceptual framework of the meta-ethnography is represented by a rosebush with interconnected branches, holding both roses and thorns, such is the nature of accepting life with chronic pain. Our findings broaden conceptualisation of ‘acceptance of chronic pain’ beyond an individual factor, to a fluid and continuous journey, interconnected with our socio-cultural-political worlds; an ecosystem.
{"title":"An ecosystem of accepting life with chronic pain: A meta-ethnography","authors":"C. Macgregor, David N Blane, Emmanuelle Tulle, Claire L Campbell, Ruth J Barber, Clementine Hill O’Connor, Christopher Seenan","doi":"10.1177/20494637241250271","DOIUrl":"https://doi.org/10.1177/20494637241250271","url":null,"abstract":"Chronic pain is a highly prevalent long-term condition, experienced unequally, impacting both the individual living with pain, and wider society. ‘Acceptance’ of chronic pain is relevant to improved consultations in pain care, and navigating an approach towards evidence-based, long-term management and associated improvements in health. However, the concept proves difficult to measure, and primary qualitative studies of lived experiences show complexity related to our socio-cultural-political worlds, healthcare experiences, and difficulties with language and meaning. We framed acceptance of chronic pain as socially constructed and aimed to conceptualise the lived experiences of acceptance of chronic pain in adults. We conducted a systematic search and screening process, followed by qualitative, interpretive, literature synthesis using Meta-ethnography. We included qualitative studies using chronic pain as the primary condition, where the study included an aim to research the acceptance concept. We conducted each stage of the synthesis with co-researchers of differing disciplinary backgrounds, and with lived experiences of chronic pain. We included 10 qualitative studies from Canada, Sweden, The Netherlands, Ireland, UK, Australia and New Zealand. Our ‘lines of argument’ include a fluid and continuous journey with fluctuating states of acceptance; language and meaning of acceptance and chronic pain, a challenge to identity in a capitalist, ableist society and the limits to individualism; a caring, supportive and coherent system. The conceptual framework of the meta-ethnography is represented by a rosebush with interconnected branches, holding both roses and thorns, such is the nature of accepting life with chronic pain. Our findings broaden conceptualisation of ‘acceptance of chronic pain’ beyond an individual factor, to a fluid and continuous journey, interconnected with our socio-cultural-political worlds; an ecosystem.","PeriodicalId":503228,"journal":{"name":"British Journal of Pain","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141002378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-25DOI: 10.1177/20494637241230204
C. Liossi
{"title":"Stepping into the future: A commitment to excellence in pain research for our journal","authors":"C. Liossi","doi":"10.1177/20494637241230204","DOIUrl":"https://doi.org/10.1177/20494637241230204","url":null,"abstract":"","PeriodicalId":503228,"journal":{"name":"British Journal of Pain","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139598713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-24DOI: 10.1177/20494637241229970
Michael Mansfield, Gianluca Roviello, Mick Thacker, Matthew Willett, Kirsty Bannister, Toby O Smith
Chronic spinal pain has negative effects on physical and mental well-being. Psychological factors can influence pain tolerance. However, whether these factors influence descending modulatory control mechanisms measured by conditioned pain modulation (CPM) in people with chronic spinal pain is unclear. This systematic review investigated the association between CPM response and psychological factors in people with chronic spinal pain. Published and unpublished literature databases were searched from inception to 23rd October 2023 included MEDLINE, EMBASE, CINAHL, and PubMed. Studies assessing the association between CPM response and psychological factors in people with chronic spinal pain were eligible. Data were pooled through meta-analysis. Methodological quality was assessed using the AXIS tool and the certainty of evidence measured through GRADE. From 2172 records, seven studies ( n = 598) were eligible. Quality of included studies was moderate. There was very low certainty of evidence that depression ( r = 0.01 [95% CI −0.10 to 0.12], I2 = 0%), and anxiety ( r = −0.20 [95% CI −0.56 to 0.16], I2 = 84%), fear avoidance ( r = −0.10 [95% CI −0.30 to 0.10], I2 = 70%) had no statistical associations with CPM responder status. Higher pain catastrophising was associated with CPM non-responder status (r = −0.19; 95% CI: −0.37 to −0.02; n = 545; I2: 76%) based on a very low certainty of evidence measured by GRADE. There is currently limited available evidence demonstrating an association between CPM response and psychological factors for people with chronic pain. Managing an individual’s chronic pain symptoms irrespective of comorbid psychological distress, should continue until evidence offer insights that more targeted interventions are needed.
慢性脊柱疼痛会对身心健康产生负面影响。心理因素会影响疼痛耐受性。然而，这些因素是否会影响慢性脊柱痛患者通过条件性疼痛调节（CPM）测量的降序调节控制机制尚不清楚。本系统综述调查了慢性脊柱痛患者的 CPM 反应与心理因素之间的关系。检索了从开始到 2023 年 10 月 23 日已发表和未发表的文献数据库，包括 MEDLINE、EMBASE、CINAHL 和 PubMed。符合条件的研究均评估了慢性脊柱疼痛患者的 CPM 反应与心理因素之间的关系。通过荟萃分析对数据进行汇总。采用 AXIS 工具对方法学质量进行评估，并通过 GRADE 对证据的确定性进行衡量。在 2172 条记录中，有 7 项研究（n = 598）符合条件。纳入研究的质量为中等。抑郁（r = 0.01 [95% CI -0.10 to 0.12]，I2 = 0%）、焦虑（r = -0.20 [95% CI -0.56 to 0.16]，I2 = 84%）、恐惧回避（r = -0.10 [95% CI -0.30 to 0.10]，I2 = 70%）与 CPM 反应状态无统计学关联，证据确定性极低。根据 GRADE 测量的极低证据确定性，较高的疼痛灾难化与 CPM 非应答状态相关（r = -0.19; 95% CI: -0.37 to -0.02; n = 545; I2: 76%）。目前，证明慢性疼痛患者 CPM 反应与心理因素之间存在关联的可用证据非常有限。在有证据表明需要更有针对性的干预措施之前，无论是否合并心理困扰，都应继续对个人的慢性疼痛症状进行管理。
{"title":"The association between conditioned pain modulation and psychological factors in people with chronic spinal pain: A systematic review","authors":"Michael Mansfield, Gianluca Roviello, Mick Thacker, Matthew Willett, Kirsty Bannister, Toby O Smith","doi":"10.1177/20494637241229970","DOIUrl":"https://doi.org/10.1177/20494637241229970","url":null,"abstract":"Chronic spinal pain has negative effects on physical and mental well-being. Psychological factors can influence pain tolerance. However, whether these factors influence descending modulatory control mechanisms measured by conditioned pain modulation (CPM) in people with chronic spinal pain is unclear. This systematic review investigated the association between CPM response and psychological factors in people with chronic spinal pain. Published and unpublished literature databases were searched from inception to 23rd October 2023 included MEDLINE, EMBASE, CINAHL, and PubMed. Studies assessing the association between CPM response and psychological factors in people with chronic spinal pain were eligible. Data were pooled through meta-analysis. Methodological quality was assessed using the AXIS tool and the certainty of evidence measured through GRADE. From 2172 records, seven studies ( n = 598) were eligible. Quality of included studies was moderate. There was very low certainty of evidence that depression ( r = 0.01 [95% CI −0.10 to 0.12], I2 = 0%), and anxiety ( r = −0.20 [95% CI −0.56 to 0.16], I2 = 84%), fear avoidance ( r = −0.10 [95% CI −0.30 to 0.10], I2 = 70%) had no statistical associations with CPM responder status. Higher pain catastrophising was associated with CPM non-responder status (r = −0.19; 95% CI: −0.37 to −0.02; n = 545; I2: 76%) based on a very low certainty of evidence measured by GRADE. There is currently limited available evidence demonstrating an association between CPM response and psychological factors for people with chronic pain. Managing an individual’s chronic pain symptoms irrespective of comorbid psychological distress, should continue until evidence offer insights that more targeted interventions are needed.","PeriodicalId":503228,"journal":{"name":"British Journal of Pain","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139600443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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