Latest & greatest articles for pain

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Top results for pain

4101. Optimal Pharmaceutical Pain Management Following Tonsillectomy or Adenoidectomy for Pediatric Patients: Clinical Evidence and Guidelines

Optimal Pharmaceutical Pain Management Following Tonsillectomy or Adenoidectomy for Pediatric Patients: Clinical Evidence and Guidelines Disclaimer: The Rapid Response Service is an information service for those involved in planning and providing health care in Canada. Rapid responses are based on a limited literature search and are not comprehensive, systematic reviews. The intent is to provide a list of sources of the best evidence on the topic that CADTH could identify using all reasonable (...) . TITLE: Optimal Pharmaceutical Pain Management Following Tonsillectomy or Adenoidectomy for Pediatric Patients: Clinical Evidence and Guidelines DATE: 06 December 2012 RESEARCH QUESTIONS 1. What is the clinical evidence regarding optimal pharmaceutical pain management options for pediatric patients following tonsillectomy, adenoidectomy, or both? 2. What are the evidence-based guidelines regarding pain management for pediatric patients following tonsillectomy, adenoidectomy, or both? KEY MESSAGE Two

2013 Canadian Agency for Drugs and Technologies in Health - Rapid Review

4102. A randomized, double-blind, placebo-controlled trial of low-dose oral prednisolone for treating painful hand osteoarthritis Full Text available with Trip Pro

A randomized, double-blind, placebo-controlled trial of low-dose oral prednisolone for treating painful hand osteoarthritis Anti-inflammatory therapies are effective analgesics for OA. This study determined whether low-dose oral prednisolone (PNL) was an effective analgesic for hand OA.This was a randomized, double-blind, placebo-controlled trial of people with ACR criteria hand OA and baseline hand pain visual analogue scale (VAS) of >40/100 mm. Participants received 5 mg PNL or placebo daily (...) for 4 weeks. Pain VAS, disease activity VAS, Australian/Canadian Hand Osteoarthritis Index and joint counts were performed at baseline, 4 and 12 weeks. Primary outcome was the change in hand pain VAS at 4 weeks. Analysis of covariance was used for analysis, controlling for baseline values. To explore potential mechanism of action of PNL, non-contrast 0.2 Tesla MRI was performed on the most painful hand at baseline and 4 weeks.A total of 70 participants were recruited (57 women, mean age 61 years

2013 EvidenceUpdates Controlled trial quality: predicted high

4103. Does Exercise Reduce Pain and Improve Physical Function Before Hip or Knee Replacement Surgery? A Systematic Review and Meta-Analysis of Randomized Controlled Trials (Abstract)

Does Exercise Reduce Pain and Improve Physical Function Before Hip or Knee Replacement Surgery? A Systematic Review and Meta-Analysis of Randomized Controlled Trials To investigate the preoperative effects of exercise-based interventions on pain and physical function for people awaiting joint replacement surgery of the hip or knee.Four computer databases (CINAHL, MEDLINE, Embase, and Cochrane Library) were searched until July 4, 2012. Search terms included knee, hip, joint replacement (...) , arthroplasty, physiotherapy, physical therapy, exercise, hydrotherapy, rehabilitation, and preoperative. Reference lists of retrieved articles were also screened.Randomized or quasi-randomized studies comparing an exercise-based intervention with a no-intervention group for people awaiting hip or knee joint replacement surgery were included. Outcomes were pain and physical function including self-reported function, walking speed, and muscle strength. One of 2 reviewers determined that 18 studies met

2013 EvidenceUpdates

4104. Cost-effectiveness of tapentadol in severe chronic pain in Spain: a cost analysis of data from RCTs

Cost-effectiveness of tapentadol in severe chronic pain in Spain: a cost analysis of data from RCTs Cost-effectiveness of tapentadol in severe chronic pain in Spain: a cost analysis of data from RCTs Cost-effectiveness of tapentadol in severe chronic pain in Spain: a cost analysis of data from RCTs Obradovic M, Ikenberg R, Hertel N, Antonanzas F, Galvez R, Liedgens H Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each (...) abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. CRD summary This study examined the cost-effectiveness of tapentadol, compared with opioids that were commonly used, as a first treatment for severe, chronic, non-malignant pain. The authors concluded that tapentadol was likely to be the best initial treatment for severe chronic non-malignant pain, in Spain. All the model

2013 NHS Economic Evaluation Database.

4105. Effect of vitamin D supplementation on progression of knee pain and cartilage volume loss in patients with symptomatic osteoarthritis: a randomized controlled trial. Full Text available with Trip Pro

Effect of vitamin D supplementation on progression of knee pain and cartilage volume loss in patients with symptomatic osteoarthritis: a randomized controlled trial. Knee osteoarthritis (OA), a disorder of cartilage and periarticular bone, is a public health problem without effective medical treatments. Some studies have suggested that vitamin D may protect against structural progression.To determine whether vitamin D supplementation reduces symptom and structural progression of knee OA.A 2 (...) -year randomized, placebo-controlled, double-blind, clinical trial involving 146 participants with symptomatic knee OA (mean age, 62.4 years [SD, 8.5]; 57 women [61%], 115 white race [79%]). Patients were enrolled at Tufts Medical Center in Boston between March 2006 and June 2009.Participants were randomized to receive either placebo or oral cholecalciferol, 2000 IU/d, with dose escalation to elevate serum levels to more than 36 ng/mL.Primary outcomes were knee pain severity (Western Ontario

2013 JAMA Controlled trial quality: predicted high

4106. Assessment and Management of Pain (Third Edition)

Assessment and Management of Pain (Third Edition) Clinical Best Practice Guidelines DECEMBER 2013 Assessment and Management of Pain Third EditionDisclaimer These guidelines are not binding on nurses or the organizations that employ them. The use of these guidelines should be flexible, and based on individual needs and local circumstances. They neither constitute a liability nor discharge from liability. While every effort has been made to ensure the accuracy of the contents at the time (...) and published in its entirety, without modification, in any form, including in electronic form, for educational or non-commercial purposes. Should any adaptation of the material be required for any reason, written permission must be obtained from the Registered Nurses’ Association of Ontario. Appropriate credit or citation must appear on all copied materials as follows: Registered Nurses’ Association of Ontario (2013). Assessment and Management of Pain (3 rd ed.). T oronto, ON: Registered Nurses

2013 Registered Nurses' Association of Ontario

4107. Review: Application of heat or hot water reduces pain from jellyfish stings. (Abstract)

Review: Application of heat or hot water reduces pain from jellyfish stings. 23247961 2013 04 12 2012 12 18 1539-3704 157 12 2012 Dec 18 Annals of internal medicine Ann. Intern. Med. ACP Journal Club. Review: application of heat or hot water reduces pain from jellyfish stings. JC6-12 10.7326/0003-4819-157-12-201212180-02012 Buckley Nicholas A NA University of New South Wales, Sydney, New South Wales, Australia. Isbister Geoffrey K GK eng Comment Journal Article United States Ann Intern Med

2012 Annals of Internal Medicine

4108. Pain over speed bumps in diagnosis of acute appendicitis: diagnostic accuracy study. Full Text available with Trip Pro

Pain over speed bumps in diagnosis of acute appendicitis: diagnostic accuracy study. To assess the diagnostic accuracy of pain on travelling over speed bumps for the diagnosis of acute appendicitis.Prospective questionnaire based diagnostic accuracy study.Secondary care surgical assessment unit at a district general hospital in the UK.101 patients aged 17-76 years referred to the on-call surgical team for assessment of possible appendicitis.Sensitivity, specificity, positive and negative (...) predictive values, and positive and negative likelihood ratios for pain over speed bumps in diagnosing appendicitis, with histological diagnosis of appendicitis as the reference standard.The analysis included 64 participants who had travelled over speed bumps on their journey to hospital. Of these, 34 had a confirmed histological diagnosis of appendicitis, 33 of whom reported increased pain over speed bumps. The sensitivity was 97% (95% confidence interval 85% to 100%), and the specificity was 30% (15

2012 BMJ

4109. A single preoperative dose of gabapentin does not improve postcesarean delivery pain management: a randomized, double-blind, placebo-controlled dose-finding trial Full Text available with Trip Pro

A single preoperative dose of gabapentin does not improve postcesarean delivery pain management: a randomized, double-blind, placebo-controlled dose-finding trial A single preoperative dose of 600 mg gabapentin, combined with multimodal analgesia, has previously been shown to reduce postcesarean pain and improve maternal satisfaction but was associated with increased maternal sedation. We hypothesized that a lower dose of gabapentin may be effective with less sedation.We conducted a doubleblind (...) diclofenac and acetaminophen, and systemic morphine as required. Pain assessments at rest and on movement (visual analog scale 0 to 100 mm) were conducted at 6, 12, 24, and 48 hours after surgical incision. The primary outcome was pain on movement at 24 hours. Secondary outcomes included satisfaction with analgesia, supplemental opioid consumption, lactation difficulties, neonatal outcomes, maternal sedation, and other adverse effects. Three months after delivery, patients were contacted for assessment

2012 EvidenceUpdates Controlled trial quality: predicted high

4110. Comparison of application times for ice packs used to relieve perineal pain after normal birth: a randomised clinical trial (Abstract)

Comparison of application times for ice packs used to relieve perineal pain after normal birth: a randomised clinical trial To compare the effect of an ice pack applied for 10, 15 and 20 minutes to relieve perineal pain after birth.Perineal pain after vaginal birth, with or without vaginal trauma, is one of the most common morbidities reported for postnatal women. Cryotherapy has been used in postpartum period to relieve perineal pain and investigated in several studies. However, cryotherapy (...) trial). Participants' perineal pain magnitude was evaluated through a numerical scale (0-10), at four different points: before the cryotherapy; immediately after and at 20 and 40 minutes after cryotherapy.After application of the ice pack, there was no statistical difference when comparing the perineal pain among groups in the second, third and fourth evaluations. Most of the postnatal women reported pain relief, with 72.8% reporting a decrease in pain >50%; 21.9% reported a decrease between 30-50

2012 EvidenceUpdates Controlled trial quality: uncertain

4111. Intrathecal Bupivacaine via Infusion Pump for the Management of Pain: Clinical Evidence, Safety, and Guidelines

Intrathecal Bupivacaine via Infusion Pump for the Management of Pain: Clinical Evidence, Safety, and Guidelines Disclaimer: The Rapid Response Service is an information service for those involved in planning and providing health care in Canada. Rapid responses are based on a limited literature search and are not comprehensive, systematic reviews. The intent is to provide a list of sources of the best evidence on the topic that CADTH could identify using all reasonable efforts within the time (...) Bupivacaine via Infusion Pump for the Management of Pain: Clinical Evidence, Safety, and Guidelines DATE: 21 November 2012 RESEARCH QUESTIONS 1. What is the clinical-effectiveness of bupivacaine when administered as an intrathecal infusion via an infusion pump for patients requiring enhanced pain control? 2. What is the clinical evidence regarding the safety of bupivacaine when administered as an intrathecal infusion via an infusion pump for patients requiring enhanced pain control? 3. What

2012 Canadian Agency for Drugs and Technologies in Health - Rapid Review

4112. Evaluation of a single preoperative dose of etoricoxib for postoperative pain relief in therapeutic knee arthroscopy Full Text available with Trip Pro

Evaluation of a single preoperative dose of etoricoxib for postoperative pain relief in therapeutic knee arthroscopy BACKGROUND AND PURPOSE Analgesics can have undesirable effects. We assessed whether a single preoperative dose of 120 mg etoricoxib reduces the need for additional opioids after therapeutic arthroscopic knee surgery. METHODS A double-blind, placebo-controlled study was performed at a single center. 66 patients scheduled to undergo elective therapeutic knee arthroscopy were (...) included. They were randomly selected to be given either 120 mg of etoricoxib (n = 33) or placebo (n = 33) 1 hour before induction of general anesthesia. A patient-controlled analgesia device was used postoperatively. We recorded total postoperative morphine consumption over 24 h, degree of pain as assessed with a visual analog scale, degree of satisfaction, and occurrence of adverse effects. RESULTS Mean total morphine consumption during the first 24 h was 24 (9-60) mg in the placebo group and 9 (0-34

2012 EvidenceUpdates Controlled trial quality: predicted high

4113. A meta-analysis and systematic review of computed tomography angiography as a diagnostic triage tool for patients with chest pain presenting to the emergency department

A meta-analysis and systematic review of computed tomography angiography as a diagnostic triage tool for patients with chest pain presenting to the emergency department Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.

2012 DARE.

4114. The Efficacy of Intra-Articular Injections for Pain Control Following the Closed Reduction and Percutaneous Pinning of Pediatric Supracondylar Humeral Fractures: A Randomized Controlled Trial Full Text available with Trip Pro

The Efficacy of Intra-Articular Injections for Pain Control Following the Closed Reduction and Percutaneous Pinning of Pediatric Supracondylar Humeral Fractures: A Randomized Controlled Trial The purpose of this single-blinded, randomized, controlled trial was to compare the analgesic efficacy of intra-articular injections of bupivacaine or ropivacaine with that of no injection for postoperative pain control after the operative treatment of supracondylar humeral fractures in a pediatric (...) population.Subjects (n=124) were randomized to treatment with 0.25% bupivacaine (Group B) (n=42), 0.20% ropivacaine (Group R) (n=39), or no injection (Group C) (n=43). The opioid doses and the times of administration as well as child-reported pain severity (Faces Pain Scale-Revised) and parent-reported pain severity (Total Quality Pain Management survey) were recorded.The proportion of subjects who required morphine and/or fentanyl injections was significantly (p=0.004) lower in Group B (10%) as compared

2012 EvidenceUpdates Controlled trial quality: predicted high

4115. Failure of Prospective Validation and Derivation of a Refined Clinical Decision Rule for Chest Radiography in Emergency Department Patients With Chest Pain and Possible Acute Coronary Syndrome Full Text available with Trip Pro

Failure of Prospective Validation and Derivation of a Refined Clinical Decision Rule for Chest Radiography in Emergency Department Patients With Chest Pain and Possible Acute Coronary Syndrome The authors previously derived a clinical decision rule (CDR) for chest radiography in patients with chest pain and possible acute coronary syndrome (ACS) consisting of the absence of three predictors: history of congestive heart failure, history of smoking, and abnormalities on lung auscultation. The aim (...) of the investigation was to prospectively validate and refine the CDR for chest radiography in an independent patient population.Patients over 24 years of age with a primary complaint of chest pain and possible ACS were prospectively enrolled from September 2008 to January 2010 at an academic emergency department (ED) with 73,000 annual patient visits. Physicians completed standardized data collection forms before ordering chest radiographs. Two investigators, blinded to the data collection forms, independently

2012 EvidenceUpdates

4116. Physical therapy interventions for knee pain secondary to osteoarthritis: a systematic review

Physical therapy interventions for knee pain secondary to osteoarthritis: a systematic review Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.

2012 DARE.

4117. Nonpharmacological approaches to the management of chronic pain in community-dwelling older adults: a review of empirical evidence

Nonpharmacological approaches to the management of chronic pain in community-dwelling older adults: a review of empirical evidence Nonpharmacological approaches to the management of chronic pain in community-dwelling older adults: a review of empirical evidence Nonpharmacological approaches to the management of chronic pain in community-dwelling older adults: a review of empirical evidence Park J, Hughes AK CRD summary This review concluded that some non-pharmacological interventions relieved (...) chronic pain in older adults, but the most appropriate intervention was unknown. Further research was necessary. These conclusions should be treated with some caution given limitations in the conduct of the review. Authors' objectives To investigate the efficacy of non-pharmacological interventions for the management of chronic pain in community-dwelling older adults Searching MEDLINE (from 1965), CINAHL (from 1937) and PsycINFO (from 1965) were searched for articles published in English in peer

2012 DARE.

4118. Effect of perioperative systemic alpha-2 agonists on postoperative morphine consumption and pain intensity: systematic review and meta-analysis of randomized controlled trials

Effect of perioperative systemic alpha-2 agonists on postoperative morphine consumption and pain intensity: systematic review and meta-analysis of randomized controlled trials Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.

2012 DARE.

4119. Effect of abiraterone acetate and prednisone compared with placebo and prednisone on pain control and skeletal-related events in patients with metastatic castration-resistant prostate cancer: exploratory analysis of data from the COU-AA-301 randomised tri (Abstract)

Effect of abiraterone acetate and prednisone compared with placebo and prednisone on pain control and skeletal-related events in patients with metastatic castration-resistant prostate cancer: exploratory analysis of data from the COU-AA-301 randomised tri Bone metastases are a major cause of morbidity in metastatic castration-resistant prostate cancer. Abiraterone acetate potently disrupts intracrine androgen receptor signalling pathways implicated in the progression of the disease, including (...) bone metastases. We assessed data for pain control and skeletal-related events prospectively collected as part of the randomised, phase 3 COU-AA-301 trial of abiraterone acetate plus prednisone versus placebo plus prednisone in patients with metastatic castration-resistant prostate cancer after docetaxel chemotherapy.The COU-AA-301 trial enrolled patients with metastatic castration-resistant prostate cancer in whom one or two lines of chemotherapy (one docetaxel based) had been unsuccessful and who

2012 EvidenceUpdates Controlled trial quality: predicted high

4120. The prognosis of acute and persistent low-back pain: a meta-analysis Full Text available with Trip Pro

The prognosis of acute and persistent low-back pain: a meta-analysis Although low-back pain is a highly prevalent condition, its clinical course remains uncertain. Our main objective was to systematically review the literature on the clinical course of pain and disability in patients with acute and persistent low-back pain. Our secondary objective was to investigate whether pain and disability have similar courses.We performed a meta-analysis of inception cohort studies. We identified eligible (...) studies by searching MEDLINE, Embase and CINAHL. We included prospective studies that enrolled an episode-inception cohort of patients with acute or persistent low-back pain and that measured pain, disability or recovery. Two independent reviewers extracted data and assessed methodologic quality. We used mixed models to determine pooled estimates of pain and disability over time.Data from 33 discrete cohorts (11 166 participants) were included in the review. The variance-weighted mean pain score (out

2012 EvidenceUpdates