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Latest & greatest articles for pain
The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on pain or other clinical topics then use Trip today.
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Subacromial corticosteroid injection on poststroke hemiplegic shoulder pain: a randomized, triple-blind, placebo-controlled trial To evaluate the effect of subacromial corticosteroid injection on hemiplegic shoulder pain (HSP).Multicenter, randomized, triple-blind, placebo-controlled trial.Three primary and 1 university-affiliated tertiary-care hospitals.Poststroke HSP patients (N=58) with evidence of rotator cuff disorder.Participants were randomly assigned to receive ultrasound-guided (...) subacromial injection with triamcinolone 40mg (treatment group, n=29), or lidocaine (placebo group, n=29). After a single injection, participants were followed up for 8 weeks.Visual analog scale (VAS) of the average shoulder pain level at day and night (VAS-day/night, the primary outcome measures), Modified Barthel Index, Shoulder Disability Questionnaire (SDQ), and angles of shoulder active range of motion (flexion, abduction, external rotation, and internal rotation) at pretreatment and weeks 2, 4
Cervical lidocaine for IUD insertional pain: a randomized controlled trial Anticipated pain with intrauterine device (IUD) insertion may be a barrier to widespread use. Our objective was to evaluate the efficacy of intracervical 2% lidocaine gel for pain relief with IUD insertion.We performed a double-blind, randomized controlled trial of women undergoing IUD insertion. Participants were randomly assigned to 2% lidocaine or placebo gel. Study gel (3 mL) was placed 3 minutes prior to IUD (...) insertion. Pain scores were measured at various time points using a 10-point visual analog scale.Of the 200 participants randomized, 199 completed the study. Pain scores among lidocaine and placebo arms were similar at tenaculum placement (lidocaine and placebo: median, 4; range, 0-10; P = .15) and with insertion (lidocaine: median, 5; range, 1-10; placebo: median, 6; range, 0-10; P = .16). These results did not differ by parity.Topical or intracervical 2% lidocaine gel prior to IUD insertion does
Ketamine as an adjuvant to opioids for cancer pain. This is an update of the original review published in Issue 1, 2003. Ketamine is a commonly used anaesthetic agent, and in subanaesthetic doses is also given as an adjuvant to opioids for the treatment of cancer pain, particularly when opioids alone prove to be ineffective. Ketamine is known to have psychotomimetic (including hallucinogenic), urological and hepatic adverse effects.To determine the effectiveness and adverse effects of ketamine (...) as an adjuvant to opioids in the treatment of cancer pain.Studies were originally identified from MEDLINE (1966 to 2002), EMBASE (1980 to 2002), CancerLit (1966 to 2002), The Cochrane Library (Issue 1, 2001); by handsearching reference lists from review articles, trials, and chapters from standard textbooks on pain and palliative care. The manufacturer of ketamine (Pfizer Parke-Davis) provided search results from their in-house database, PARDLARS.An improved and updated search of the following was performed
Case records of the Massachusetts General Hospital: Case 34-2012: a 27-year-old woman in ethiopia with severe pain, bleeding, and shock during labor. A 27-year-old woman was admitted to a hospital in Ethiopia because of severe abdominal pain during labor, with cessation of contractions. She had been in labor at home, pushing for 24 hours. On arrival at the hospital 3 hours later, she was in shock. A procedure was performed.
Hydrocodone-acetaminophen for pain control in first-trimester surgical abortion: a randomized controlled trial Although hydrocodone-acetaminophen is commonly used for pain control in first-trimester abortion, the efficacy of oral opioids for decreasing pain has not been established. Our objective was to estimate the effect of hydrocodone-acetaminophen on patient pain perception during first-trimester surgical abortion.We conducted a randomized, double-blinded, placebo-controlled trial. Patients (...) (before 11 weeks of gestation) received standard premedication (ibuprofen and lorazepam) and a paracervical block with the addition of 10 mg hydrocodone and 650 mg acetaminophen or placebo 45-90 minutes before surgical abortion. A sample size of 120 was calculated to provide 80% power to show a 15-mm difference (α=0.05) in the primary outcome of pain with uterine aspiration (100-mm visual analog scale). Secondary outcomes were pain at additional time points, satisfaction, side effects, adverse events
A web-based intervention to improve and prevent low back pain among office workers: a randomized controlled trial Randomized controlled trial.To test the feasibility, safety, and efficacy of a web-based multidisciplinary intervention for office workers with subacute, nonspecific low back pain.Low back pain is one of the most frequent ailments seen in primary care consultations.The trial included 100 office workers with subacute low back pain. The intervention group had access to both the study (...) by the Roland-Morris Disability Questionnaire, and health-related quality of life, as measured by the European Quality of Life-5 Dimensions-3 Levels. Secondary outcomes were the number of episodes of low back pain and trunk muscle endurance. Outcomes were measured before and after the 9-month intervention period.Over the 9-month study, the score on the Roland-Morris Disability Questionnaire for the participants in the web-based intervention group improved by a mean of -7.36 points (95% confidence interval
Hip Posterolateral Musculature Strengthening in Sedentary Women With Patellofemoral Pain Syndrome: A Randomized Controlled Clinical Trial With 1-Year Follow-up Randomized controlled trial.To determine if adding hip-strengthening exercises to a conventional knee exercise program produces better long-term outcomes than conventional knee exercises alone in women with patellofemoral pain syndrome (PFPS).Recent studies have shown that a hip-strengthening program reduces pain and improves function (...) group (n = 28; mean age, 22 years) performed the same exercises as those in the KE group, as well as strengthening exercises for the hip abductors, lateral rotators, and extensors. An 11-point numeric pain rating scale, the Lower Extremity Functional Scale, the Anterior Knee Pain Scale, and a single-hop test were used as outcome measures at baseline (pretreatment) and 3, 6, and 12 months posttreatment.At baseline, demographic, pain, and functional assessment data were similar between groups. Those
Brief report: lumbar plexus blockade reduces pain after hip arthroscopy: a prospective randomized controlled trial Hip arthroscopy causes moderate to severe postoperative pain. We hypothesized that performance of a lumbar plexus block (LPB) would reduce postoperative pain in the postanesthesia care unit (PACU) for patients discharged home on the day of surgery.Patients received a combined spinal epidural with IV sedation, ondansetron, and ketorolac. Half of the patients (n = 42) also underwent (...) a single-injection bupivacaine LPB. Postoperative analgesia (PACU and after discharge) was provided with oral hydrocodone/acetaminophen (5/500 mg) and an oral nonsteroidal antiinflammatory drug. IV hydromorphone was given as needed in the PACU.The LPB reduced pain at rest in the PACU (GEE: β estimate of the mean on a 0 to 10 scale = -0.9; 95% confidence interval = -1.7 to -0.1; P = 0.037). Mean PACU pain scores at rest were reduced by the LPB from 4.2 to 3.3 (P = 0.048, 95% confidence interval
Short-term effects of 890-nanometer radiation on pain, physical activity, and postural stability in patients with knee osteoarthritis: a double-blind, randomized, placebo-controlled study To investigate the effects of short-term light therapy with 890-nm radiation on pain, physical activity, and postural stability in patients with knee osteoarthritis (OA).A double-blind, randomized, placebo-controlled study.Rehabilitation clinic.Women (n=62) and men (n=10) with a mean age of 61.2 years (range (...) assessed weekly over 4 weeks using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for pain, stiffness, and physical function. Physical activity (timed stair climbing, 10-m fast-speed walking, and chair-rising time) and postural stability (using the postural stability evaluation system) were also assessed. The pain score on WOMAC was the primary outcome variable. Data were analyzed by repeated-measures analysis of covariance.Compared with baseline, no significant improvement
Efficacy of 10 % Sucralfate Ointment in the Reduction of Acute Postoperative Pain After Open Hemorrhoidectomy: A Prospective, Double-Blind, Randomized, Placebo-Controlled Trial The aim of the present study was to evaluate the efficacy of 10 % sucralfate ointment in the reduction of acute postoperative pain after open hemorrhoidectomy.A total of 48 patients (24 men and 24 women) between 20 and 70 years of age who underwent open hemorrhoidectomy were included in this prospective, double-blind (...) , randomized, controlled trial and were randomly divided into two groups (24 in each group), receiving either sucralfate ointment or placebo immediately after surgery and then every 12 h for 14 days. The primary outcome measure was pain intensity measured by a visual analogue scale at different time points after hemorrhoidectomy.The sucralfate group had significantly less pain than the placebo group at 24th h and the 48th h after hemorrhoidectomy (4 ± 1.14 vs 5.08 ± 0.97; P = 0.001 and 3 ± 0.72 vs 4.41
Validation of the Vancouver Chest Pain Rule: a prospective cohort study The objective was to validate the Vancouver Chest Pain Rule in an emergency department (ED) setting to identify very-low-risk patients with acute chest pain.A prospective cohort study was conducted on consecutive patients 25 years of age and older presenting to the ED with a chief complaint of acute chest pain during January 2009 to July 2009. According to the Vancouver Chest Pain Rule, cardiac history, chest pain (...) , specificity, positive predictive value, and negative predictive value were calculated.Of 593 patients who were eligible for evaluation, 39 (6.6%) developed MI and 43 (7.3%) developed unstable angina. Among all patients, 292 (49.2%) patients could have been assigned to the very-low-risk group and discharged after a brief ED assessment according to the Vancouver Chest Pain Rule. Among these patients, four (1.4%) developed ACS within 30 days. Sensitivity of the rule was 95.1% (95% confidence interval [CI
Clinical effects of a nine-month web-based intervention in subacute non-specific low back pain patients: a randomized controlled trial To test the clinical effect of a web-based lower back pain intervention on quality of life and selected lower back pain outcomes.A prospective single-blinded randomized intervention.Occupational preventive service.One hundred office workers with non-specific subacute lower back pain.The 50 intervention group subjects were educated daily about sitting correctly (...) improvement). Logistic regression analysis revealed positive changes in EuroQol questionnaire, increasing the likelihood of observing positive changes in StarT Back Screening Tool (OR = 15.5) and Oswestry Disability Index (OR = 4.5).The intervention showed clinical improvements in quality of life and selected lower back pain outcomes in the experimental group compared to the control group.
The 2012 Chitranjan Ranawat Award: Intraarticular Analgesia After TKA Reduces Pain: A Randomized, Double-blinded, Placebo-controlled, Prospective Study Postoperative pain after total knee arthroplasty remains one of the most important challenges facing patients undergoing this surgery. Providing a balance of adequate analgesia while limiting the functional impact of regional anesthesia and minimizing opioid side effects is critical to minimize adverse events and improve patient satisfaction.We (...) asked whether bupivacaine delivered through an elastomeric device decreases the (1) patients' perception of pain after TKA; (2) narcotic consumption; and (3) narcotic-related side effects as compared with a placebo.In this prospective, double-blind, placebo-controlled study, all patients received standardized regional anesthesia, a preemptive and multimodal analgesic protocol, and a continuous intraarticular infusion at 5 mL/hour through an elastomeric infusion pump. The patients were randomized
Paracetamol effective for perineal pain in the early postpartum period PEARLS Practical Evidence About Real Life Situations PEARLS are succinct summaries of Cochrane Systematic Reviews for primary care practitioners. They are funded by the New Zealand Guidelines Group. PEARLS provide guidance on whether a treatment is effective or ineffective. PEARLS are prepared as an educational resource and do not replace clinician judgement in the management of individual cases. View PEARLS online (...) at: www.cochraneprimarycare.org Paracetamol effective for perineal pain in the early postpartum period Clinical question How effective is a single administration of paracetamol for the relief of acute postpartum perineal pain? Bottom line More women experienced pain relief with paracetamol compared with placebo (most pain was caused by episiotomies). In addition, there were significantly fewer women having additional pain relief with paracetamol compared with placebo. Both the 500mg to 650mg and 1000mg doses were effective
Optimal Post-Tonsillectomy Pain Management 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 efforts within the time allowed. Rapid (...) of research or private study only. It may not be copied, posted on a web site, redistributed by email or stored on an electronic system without the prior written permission of CADTH or applicable copyright owner. Links: This report may contain links to other information available on the websites of third parties on the Internet. CADTH does not have control over the content of such sites. Use of third party sites is governed by the owners’ own terms and conditions. TITLE: Optimal Post-Tonsillectomy Pain
Tapentadol (Palexia) for chronic intense pain. Prolonged release opioid of unknown therapeutic value 2012. DAR No 6. Tapentadol (Palexia®) for chronic intense pain - navarra.es Castellano | Euskara | Français | English Use the search tool! Search engine : : : : : : DAR No 6. Tapentadol (Palexia®) for chronic intense pain DAR No 6. Tapentadol (Palexia®) for chronic intense pain Content tools Share it Prolonged release opioid of unknown therapeutic value Tapentadol has proved more effective than (...) placebo in arthrosis, lumbalgia and pain related to diabetic neuropathy. However, the results should be interpreted with caution as there are important limitations. No direct comparisons have been made with other opioids. There is only one analysis in which tapentadol did not show any differences when compared to oxycodone. No studies are available on its use for pain in cancer patients. This drug has the same adverse effect profile as other opioid analgesics. The most frequent are nausea
Does evidence support physiotherapy management of adult female chronic pelvic pain? A systematic review Does evidence support physiotherapy management of adult female chronic pelvic pain? A systematic review Does evidence support physiotherapy management of adult female chronic pelvic pain? A systematic review Loving S, Nordling J, Jaszczak P, Thomsen T CRD summary The review concluded that there seemed to be some limited evidence to support an effect of multidisciplinary intervention (...) and Mensendieck somatocognitive therapy on female chronic pelvic pain, but further research was warranted. The evidence base had a number of limitations. The authors noted these drawbacks and appropriately urged a need for further research before definitive conclusions can be made. Authors' objectives To critically evaluate the evidence for an effect of physiotherapy on pain, physical activity and quality of life in the treatment of female chronic pelvic pain. Searching EMBASE, MEDLINE, CINAHL, PsycINFO
Systematic review of efficacy and safety of buprenorphine versus fentanyl or morphine in patients with chronic moderate to severe pain 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.
Accuracy of single progesterone test to predict early pregnancy outcome in women with pain or bleeding: meta-analysis of cohort studies. To determine the accuracy with which a single progesterone measurement in early pregnancy discriminates between viable and non-viable pregnancy.Systematic review and meta-analysis of diagnostic accuracy studies.Medline, Embase, CINAHL, Web of Science, ProQuest, Conference Proceedings Citation Index, and the Cochrane Library from inception until April 2012 (...) % to 98.5%), positive likelihood ratio of 18 (7.2 to 45), and negative likelihood ratio of 0.35 (0.24 to 0.50). The probability of a non-viable pregnancy was raised from 62.9% to 96.8%.A single progesterone measurement for women in early pregnancy presenting with bleeding or pain and inconclusive ultrasound assessments can rule out a viable pregnancy.
The role of regional anaesthesia techniques in the management of acute pain The role of regional anaesthesia techniques in the management of acute pain The role of regional anaesthesia techniques in the management of acute pain Cowlishaw PJ, Scott DM, Barrington MJ CRD summary The review concluded that regional anaesthesia/analgesia was superior to conventional therapy for management of postoperative pain following a range of surgical types. Variation in characteristics of the included studies (...) and potential for bias in the review process mean that the authors' conclusions should be considered tentative. Authors' objectives To assess the efficacy of regional anaesthesia and analgesia for the management of acute pain following surgery. Searching MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials (CENTRAL) were searched for relevant studies published between March 2009 and March 2011. There were no language restrictions. Search terms were reported. Study selection Randomised