Canadian Journal of Pain-Revue Canadienne de la Douleur最新文献

英文中文

Adherence to Clinical Guidelines for Fibromyalgia: Help or Hindrance? 坚持纤维肌痛临床指南:帮助还是阻碍?

Q3 CLINICAL NEUROLOGY

Canadian Journal of Pain-Revue Canadienne de la Douleur

Pub Date : 2023-11-10 DOI: 10.1080/24740527.2023.2255070

Winfried Häuser, Mary-Ann Fitzcharles

引用次数: 0

Post Viral Pain, Fatigue, and Sleep Disturbance Syndromes: Current knowledge and Future Directions 病毒后疼痛，疲劳和睡眠障碍综合征:目前的知识和未来的方向

Q3 CLINICAL NEUROLOGY

Canadian Journal of Pain-Revue Canadienne de la Douleur

Pub Date : 2023-11-03 DOI: 10.1080/24740527.2023.2272999

Caleb Tackey, P. Maxwell Slepian, Hance Clarke, Nimish Mittal

Post-viral pain syndrome, also known as post-viral syndrome (PVS), is a complex condition characterized by persistent pain, fatigue, musculoskeletal pain, neuropathic pain, neurocognitive difficulties, and sleep disturbances1,2 that can occur after an individual has recovered from a viral infection. Much remains unknown regarding the pathophysiology of post-viral syndromes and few studies have provided a comprehensive summary of the condition, agents that cause it, and successful treatment modalities. With the COVID-19 pandemic continuing to affect millions of people worldwide, the need for understanding the etiology of post-viral illness and how to help individuals cope with the sequalae is paramount.2 This narrative review provides a summary of the sequelae of post-viral syndromes, viral agents that cause it, the pathophysiology, treatment, and future considerations for research and targeted therapies.

病毒后疼痛综合征，也称为病毒后综合征(PVS)，是一种复杂的疾病，其特征是个体从病毒感染恢复后出现持续疼痛、疲劳、肌肉骨骼疼痛、神经性疼痛、神经认知困难和睡眠障碍1,2。关于病毒后综合征的病理生理学仍有许多未知之处，很少有研究对病毒后综合征、引起病毒后综合征的药物和成功的治疗方式进行了全面的总结。随着COVID-19大流行继续影响全球数百万人，了解病毒后疾病的病因以及如何帮助个人应对后遗症的必要性至关重要本文综述了病毒后综合征的后遗症、引起后遗症的病毒因子、病理生理学、治疗以及未来研究和靶向治疗的考虑。

引用次数: 1

The impact of preoperative patient education on postoperative pain, opioid use, and psychological outcomes: A narrative review 术前患者教育对术后疼痛、阿片类药物使用和心理结果的影响:一篇叙述性综述

Q3 CLINICAL NEUROLOGY

Canadian Journal of Pain-Revue Canadienne de la Douleur

Pub Date : 2023-10-06 DOI: 10.1080/24740527.2023.2266751

Rasheeda Darville-Beneby, Anna M. Lomanowska, Hai Chuan Yu, Parker Jobin, Brittany N. Rosenbloom, Gretchen Gabriel, Helena Daudt, Michael Negraeff, Tania Di Renna, Maria Hudspith, Hance Clarke

Background Recent studies show preoperative education can positively impact postoperative recovery, improving postoperative pain management and patient satisfaction. Gaps in preoperative education regarding postoperative pain and opioid use may lead to increased patient anxiety and persistent postoperative opioid use.

最近的研究表明，术前教育可以积极影响术后恢复，改善术后疼痛管理和患者满意度。术前关于术后疼痛和阿片类药物使用的教育差距可能导致患者焦虑增加和术后持续使用阿片类药物。

引用次数: 1

The contribution of insomnia and obstructive sleep apnea on the transition from acute to chronic painful temporomandibular disorders, and its persistence: a prospective 3-month cohort study 失眠和阻塞性睡眠呼吸暂停对从急性到慢性疼痛性颞下颌疾病的转变及其持续性的贡献:一项为期3个月的前瞻性队列研究

Q3 CLINICAL NEUROLOGY

Canadian Journal of Pain-Revue Canadienne de la Douleur

Pub Date : 2023-10-06 DOI: 10.1080/24740527.2023.2266738

Sherif M. Elsaraj, Mervyn Gornitsky, Richard Hovey, Firoozeh Samim, Zovinar Der Khatchadourian, Ana Velly

Insomnia and excessive daytime sleepiness, a surrogate marker of obstructive sleep apnea, are common sleep-related conditions among painful temporomandibular disorders (TMD) subjects. Obstructive sleep apnea was found to increase the risk of chronic painful TMD. This prospective cohort study aims to determine the contribution of insomnia and excessive daytime sleepiness (ESS/OSA) on acute to chronic painful TMD transition as well as its persistence when chronic pain is defined by: (i) duration (> 3 months), and (ii) dysfunction (Graded Chronic Pain Scale [GCPS II-IV]). From 456 subjects recruited between 2015 to 2021, through four locations in Canada, 378 completed the follow-up. A diagnosis was obtained using the Research Diagnostic Criteria or the Diagnostic Criteria for Temporomandibular Disorders. Insomnia was assessed with the Insomnia Severity Scale (ISS), and excessive daytime sleepiness was measured using the Epworth Sleepiness Scale (ESS/OSA), both at baseline. Subjects completed the GCPS form at baseline and 3-month follow-up. Borderline associations were found between ESS/OSA and the transition or persistence of chronic painful TMD when chronic pain was defined by pain duration (RR adjusted_duration = 1.11, P = 0.07) and dysfunction (RRadjusted_dysfunction =1.40, P = 0.051). Furthermore, ESS/OSA was specifically associated with persistent painful TMD when chronic pain was defined by pain duration (RR = 1.13, 95%CI: 1.00-1.26, P = 0.04). Insomnia was not related to the study outcomes (RRadjusted_duration = 0.94, P = 0.27, RRadjusted_dysfunction =1.00, P = 0.99). Results indicate that ESS/OSA contrary to insomnia predicted the persistence of chronic painful TMD at a 3-month follow-up.

失眠和白天过度嗜睡是阻塞性睡眠呼吸暂停的替代标志，是疼痛性颞下颌疾病(TMD)患者中常见的睡眠相关疾病。发现阻塞性睡眠呼吸暂停会增加慢性疼痛性TMD的风险。这项前瞻性队列研究旨在确定失眠和白天过度嗜睡(ESS/OSA)对急性到慢性疼痛性TMD转变的贡献，以及慢性疼痛的持久性，慢性疼痛的定义是:(i)持续时间(> 3个月)，(ii)功能障碍(分级慢性疼痛量表[GCPS ii - iv])。2015年至2021年间，在加拿大的四个地点招募了456名受试者，其中378人完成了随访。使用研究诊断标准或颞下颌疾病诊断标准进行诊断。采用失眠严重程度量表(ISS)评估失眠症，使用Epworth嗜睡量表(ESS/OSA)测量白天过度嗜睡，两者均为基线。受试者在基线和3个月随访时完成GCPS表格。当慢性疼痛被定义为疼痛持续时间(RR adjusted_duration = 1.11, P = 0.07)和功能障碍(RRadjusted_dysfunction =1.40, P = 0.051)时，发现ESS/OSA与慢性疼痛性TMD的转变或持续存在边缘性关联。此外，当以疼痛持续时间定义慢性疼痛时，ESS/OSA与持续性疼痛性TMD特异性相关(RR = 1.13, 95%CI: 1.00-1.26, P = 0.04)。失眠与研究结果无关(RRadjusted_duration = 0.94, P = 0.27, RRadjusted_dysfunction =1.00, P = 0.99)。结果表明，在3个月的随访中，ESS/OSA与失眠相反，可预测慢性疼痛性TMD的持续存在。

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引用次数: 1

Cannabinoid CB1 receptor expression and localization in the dorsal horn of male and female rat and human spinal cord 大麻素CB1受体在雌雄大鼠背角和人脊髓中的表达和定位

Q3 CLINICAL NEUROLOGY

Canadian Journal of Pain-Revue Canadienne de la Douleur

Pub Date : 2023-09-29 DOI: 10.1080/24740527.2023.2264895

Jessica Parnell, Newton Martin, Annemarie Dedek, Christopher Rudyk, Jeffrey Landrigan, Justin Bellavance, Simon Vanderloo, Eve C. Tsai, Michael E. Hildebrand

Background Preclinical and clinical evidence suggests that cannabis has potential analgesic properties. However, cannabinoid receptor expression and localization within spinal cord pain processing circuits remains to be characterized across sex and species.

临床前和临床证据表明大麻具有潜在的镇痛作用。然而，大麻素受体在脊髓疼痛处理回路中的表达和定位仍然是跨性别和物种的特征。

引用次数: 0

Experiences and perceptions of medical cannabis among people living with chronic pain and community pharmacists: a qualitative study in Canada 慢性疼痛患者和社区药剂师对医用大麻的经验和看法:加拿大的一项定性研究

Q3 CLINICAL NEUROLOGY

Canadian Journal of Pain-Revue Canadienne de la Douleur

Pub Date : 2023-09-13 DOI: 10.1080/24740527.2023.2258537

Lise Dassieu, Emilie Paul-Savoie, Élise Develay, Ana Cecilia Villela Guilhon, Line Guénette, Kadija Perreault, Hélène Beaudry, Laurent Dupuis, Claudie Audet, Anaïs Lacasse

Background The use of cannabis to treat chronic pain is under debate despite high expectations from patients. Qualitative data exploring both patients’ and health professionals’ perspectives are scarce.Aims This study aimed to understand the experiences and perceptions of people living with chronic pain and community pharmacists regarding the role of cannabis in chronic pain treatment, in the Canadian context where both medical and recreational cannabis are legal.Methods We conducted 12 online focus groups (July 2020-Februrary 2021), with 26 patients and 19 community pharmacists using semi-structured discussion guides. All discussions were audio-recorded and transcribed verbatim were analyzed using a reflexive thematic approach.Results We developed three themes related to patients’ perspectives and three themes related to pharmacists’ perspectives. Patients’ perspectives: (1) Cannabis as an alternative to other pain medications; (2) A new treatment with potential health-related risks; (3) A therapy rather than a recreational drug. Pharmacists’ perspectives: (1) Challenges in monitoring drug interactions with cannabis in the context of scarce research data; (2) Informing and treating patients self-medicating with cannabis amid its growing popularity; (3) Financial costs and legal constraints for patients.Conclusions This study highlights patients’ and pharmacists’ urgent need for reliable information regarding the benefits and risks of cannabis. Training tailored to pharmacists’ needs and evidence-based information for patients should be developed to support pharmacists’ practice, improve patients’ experience and promote safe cannabis use.

尽管患者对使用大麻治疗慢性疼痛抱有很高的期望，但仍存在争议。探索患者和卫生专业人员观点的定性数据很少。本研究旨在了解慢性疼痛患者的经验和看法，以及社区药剂师对大麻在慢性疼痛治疗中的作用，在加拿大的背景下，医疗和娱乐大麻都是合法的。方法采用半结构化讨论指南，对26名患者和19名社区药师进行了12个在线焦点小组(2020年7月- 2021年2月)。所有的讨论都进行了录音和逐字记录，并使用反身性专题方法进行分析。结果我们开发了三个与患者视角相关的主题和三个与药师视角相关的主题。患者的观点:(1)大麻作为其他止痛药的替代品;(2)有潜在健康风险的新疗法;一种治疗药物，而非娱乐性药物。药剂师的观点:(1)在缺乏研究数据的背景下监测药物与大麻相互作用的挑战;(2)在大麻日益普及的情况下，告知和治疗患者使用大麻进行自我治疗;(3)患者的经济成本和法律约束。本研究强调了患者和药剂师迫切需要关于大麻的益处和风险的可靠信息。应开发适合药剂师需求的培训，并为患者提供循证信息，以支持药剂师的做法，改善患者的体验，促进安全使用大麻。

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引用次数: 0

Ultrasound-Guided Percutaneous Peripheral Nerve Stimulation of the Musculocutaneous Nerve for Refractory Antecubital ElbowPain-Brief Technical Report and Illustrative Case Report. 超声引导下经皮外周神经刺激肌皮神经治疗顽固性肘前关节疼痛技术报告及病例说明。

IF 2.4 Q3 CLINICAL NEUROLOGY

Canadian Journal of Pain-Revue Canadienne de la Douleur

Pub Date : 2023-08-22 eCollection Date: 2023-01-01 DOI: 10.1080/24740527.2023.2249054

Quinn Tate, Guilherme Ferreira-Dos-Santos, Darrell Vydra, Nuno Ferreira-Silva, Sahil Gupta, Mark Friedrich B Hurdle

Chronic pain following distal biceps rupture (DBR) is often nonspecific in that it may arise due to the injury, subsequent surgical repair, or a combination of factors, making the painful symptoms challenging to treat. Peripheral nerve injury in the setting of DBR most commonly affects the musculocutaneous nerve or one of its terminal branches and may lead to chronic neuropathic pain involving the elbow and lateral/radial aspect of the forearm. In this brief technical report, we describe an ultrasound-guided (USG) technique for percutaneous implantation of a peripheral nerve stimulator (PNS) targeting the musculocutaneous nerve, along with an illustrative case report of successful treatment of chronic refractory pain following DBR utilizing this technique. Six months postimplantation, the patient reported a greater than 60% baseline pain intensity reduction, and no complications were noted.

二头肌远端断裂（DBR）后的慢性疼痛通常是非特异性的，因为它可能是由损伤、随后的手术修复或多种因素的组合引起的，使疼痛症状难以治疗。DBR环境中的外周神经损伤最常见地影响肌肉皮神经或其末端分支之一，并可能导致涉及肘部和前臂外侧/径向的慢性神经性疼痛。在这份简短的技术报告中，我们描述了一种超声引导（USG）技术，用于经皮植入针对肌肉皮神经的外周神经刺激器（PNS），以及一份利用该技术成功治疗DBR后慢性顽固性疼痛的说明性病例报告。植入后6个月，患者报告基线疼痛强度减轻60%以上，未发现并发症。

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引用次数: 0

Caregiver Perspectives on Pain Sensitivity and Pain Experience in Rett Syndrome. 照顾者对Rett综合征疼痛敏感性和疼痛体验的看法。

IF 2.4 Q3 CLINICAL NEUROLOGY

Canadian Journal of Pain-Revue Canadienne de la Douleur

Pub Date : 2023-07-28 eCollection Date: 2023-01-01 DOI: 10.1080/24740527.2023.2229400

B J Byiers, A M Merbler, A Raiter, C C Burkitt, F J Symons

ABSTRACT Background Although delayed or decreased responses to pain are commonly reported among caregivers of individuals with Rett syndrome (RTT), previous studies in relatively small samples have documented that caregivers are concerned about pain, particularly due to gastrointestinal and musculoskeletal conditions. Aims The purpose of the current study was to investigate in detail caregivers’ perceptions of pain sensitivity, as well as the types, severity, and effect of pain experienced by individuals with RTT in a larger sample than previous studies. Methods A total of 51 caregivers (mostly mothers) participated in the study, which involved standardized questionnaires and interviews. The individuals with RTT ranged in age from 2 to 52 years of age, and most (n = 46; 90%) met criteria for classic RTT. Results Across the sample, 84% of caregivers reported that they believed that their child was less sensitive to pain compared to her typically developing peers. Despite this perception, 63% of caregivers reported that their child had experienced at least one form of pain in the previous 7 days, and 57% reported their child experienced at least one form of chronic pain. On average, caregivers reported that their child’s pain was of moderate severity and interfered with at least one activity of daily living. Conclusions The results suggest that pain is a substantial concern among caregivers of individuals with RTT and indicate that additional research is needed to understand the apparent paradox of frequently reported pain experiences despite widespread perceptions of decreased pain sensitivity.

背景:虽然Rett综合征(RTT)患者的护理人员对疼痛的反应延迟或减弱的报道很普遍，但之前在相对小样本的研究中已经证明，护理人员对疼痛很关注，特别是由于胃肠道和肌肉骨骼疾病。目的:当前研究的目的是在比以往研究更大的样本中详细调查护理人员对疼痛敏感性的感知，以及RTT患者所经历的疼痛的类型、严重程度和影响。方法:采用标准化问卷调查和访谈法对51名照顾者(多为母亲)进行调查。RTT患者年龄在2 ~ 52岁之间，大多数(n = 46;90%)符合经典RTT标准。结果:在整个样本中，84%的看护人报告说，他们认为他们的孩子比正常发育的同龄人对疼痛不那么敏感。尽管如此，63%的护理人员报告说他们的孩子在过去7天内至少经历过一种形式的疼痛，57%的人报告他们的孩子至少经历过一种形式的慢性疼痛。平均而言，照顾者报告他们孩子的疼痛是中等严重程度，并干扰了至少一项日常生活活动。结论:研究结果表明，疼痛是RTT患者的护理人员非常关心的问题，并表明需要进一步的研究来理解尽管普遍认为疼痛敏感性降低，但经常报告疼痛经历的明显矛盾。

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引用次数: 1

Understanding the Experience and Impacts of Brain Fog in Chronic Pain: A Scoping Review. 理解慢性疼痛中的脑雾体验和影响:一项范围综述。

IF 2 Q3 CLINICAL NEUROLOGY

Canadian Journal of Pain-Revue Canadienne de la Douleur

Pub Date : 2023-07-10 eCollection Date: 2023-01-01 DOI: 10.1080/24740527.2023.2217865

Ronessa Dass, Mohini Kalia, Jocelyn Harris, Tara Packham

Introduction: Approximately 15% to 40% of persons with chronic pain as a primary disorder experience brain fog. Prior research has investigated the etiology of "brain fog" in conditions in which pain presents as a key feature (e.g., fibromyalgia). However, it remains understudied in the context of chronic 10 musculoskeletal pain. Following current scoping review guidelines, we obtained stakeholder input from patient and health care professionals (HCPs) to define this phenomenon. Specific aims of this review were to (1) identify factors contributing to brain fog, (2) identify the functional correlates of brain fog and assessments used to measure them, and (3) establish a definition of brain fog that can be employed by researchers and HCPs to advance research and care.

Methods: A scoping review was conducted using recommendations of the Joanna Briggs Institute methodology of scoping reviews and the Levac et al methodology. Embase, Cinahl, PsycINFO, and Medline was searched to identify relevant sources. Findings were verified with patient and healthcare professionals.

Results: We identified four 15 key features of brain fog: perceived variability, subjective cognitive dysfunction, participation limitations, and changes in functional activities. We developed a model of brain fog illustrating the overlapping categories of contributors to brain fog in chronic musculoskeletal pain: (1) neuroanatomical and neurophysiological, (2) mental health/emotional, and (3) environmental/lifestyle.

Conclusion: The results of this scoping review conclude that the inconsistency in research regarding brain fog in 20 chronic musculoskeletal pain is obstructing a clear understanding of the phenomenon and therefore may be impeding persons with chronic pain and brain fog from receiving optimal care.

简介:大约15%至40%的慢性疼痛为原发性疾病的人经历脑雾。先前的研究已经调查了以疼痛为主要特征(如纤维肌痛)的情况下“脑雾”的病因。然而，它在慢性肌肉骨骼疼痛的背景下仍未得到充分研究。根据当前的范围审查指南，我们从患者和卫生保健专业人员(HCPs)那里获得了利益相关者的意见，以定义这一现象。本综述的具体目的是:(1)确定导致脑雾的因素，(2)确定脑雾的功能相关性和用于测量脑雾的评估，以及(3)建立脑雾的定义，供研究人员和HCPs使用，以推进研究和护理。方法:采用乔安娜布里格斯研究所的范围审查方法和Levac等人的方法进行范围审查。检索Embase, Cinahl, PsycINFO和Medline以确定相关来源。结果与患者和医疗保健专业人员进行了验证。结果:我们确定了脑雾的4个15个关键特征:感知变异性、主观认知功能障碍、参与限制和功能活动的变化。我们开发了一个脑雾模型，说明慢性肌肉骨骼疼痛中脑雾的重叠类别:(1)神经解剖学和神经生理学，(2)心理健康/情绪，(3)环境/生活方式。结论:本综述的结果表明，关于20例慢性肌肉骨骼疼痛的脑雾研究的不一致性阻碍了对这一现象的清晰理解，因此可能阻碍了慢性疼痛和脑雾患者获得最佳护理。

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引用次数: 0

Promoting inclusion, diversity, and equity in pain science. 促进疼痛科学的包容性、多样性和公平性。

IF 2 Q3 CLINICAL NEUROLOGY

Canadian Journal of Pain-Revue Canadienne de la Douleur

Pub Date : 2023-02-22 eCollection Date: 2023-01-01 DOI: 10.1080/24740527.2022.2161272

Tonya M Palermo, Karen Deborah Davis, Didier Bouhassira, Robert W Hurley, Joel D Katz, Francis J Keefe, Michael Schatman, Dennis C Turk, David Yarnitsky

引用次数: 0

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