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Latest & greatest articles for pain
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Increasing the pH of lidocaine reduces patients’ pain and discomfort on injection. Increasing the pH of lidocaine reduces patients’ pain and discomfort on injection. ADA Websites Access news, member benefits and ADA policy Attend ADA's premier event Access cutting-edge continuing education courses Find evidence to support your clinical decisions Access member-only practice content Investing in better oral health for all. Together. Take advantage of endorsed, discounted business products (...) Purchase ADA products Access oral-health information for the public and ADA Find-A-Dentist Partnerships and Commissions Learn about ADA CERP recognition, look up CERP recognized CE providers and find CE courses. Explore CODA's role and find accredited schools and programs Learn about the examinations used in licensing dentists and dental hygienists Learn about recognized dental specialties and certifying boards Evidence Education * Associated Topics Increasing the pH of lidocaine reduces patients’ pain
Patient positioning (mobilisation) and bracing for pain relief and spinal stability in metastatic spinal cord compression in adults. Many patients with metastatic spinal cord compression (MSCC) have spinal instability but are determined, by their clinician, to be unsuitable for surgical internal fixation due to their advanced disease. Mobilisation may be hazardous in the presence of spinal instability as further vertebral collapse can occur. Current guidance on positioning (or mobilisation (...) ) and spinal bracing is contradictory.To investigate the correct positioning (or mobilisation) and examine the effects of spinal bracing to relieve pain or to prevent further vertebral collapse in patients with MSCC.The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, CANCERLIT, NICE, SIGN, AMED, TRIP, National Guideline Clearinghouse and PEDro database were searched; the last search was run in February 2012.We selected randomised controlled trials (RCTs) of adults
Pain management for women in labour: an overview of systematic reviews. The pain that women experience during labour is affected by multiple physiological and psychosocial factors and its intensity can vary greatly. Most women in labour require pain relief. Pain management strategies include non-pharmacological interventions (that aim to help women cope with pain in labour) and pharmacological interventions (that aim to relieve the pain of labour).To summarise the evidence from Cochrane (...) systematic reviews on the efficacy and safety of non-pharmacological and pharmacological interventions to manage pain in labour. We considered findings from non-Cochrane systematic reviews if there was no relevant Cochrane review.We searched the Cochrane Database of Systematic Reviews (The Cochrane Library 2011, Issue 5), The Cochrane Database of Abstracts of Reviews of Effects (The Cochrane Library 2011, Issue 2 of 4), MEDLINE (1966 to 31 May 2011) and EMBASE (1974 to 31 May 2011) to identify all
Topical capsaicin may be of benefit for chronic neuropathic pain PEARLS Practical Evidence About Real Life Situations PEARLS are succinct summaries of Cochrane Systematic Reviews for primary care practitioners. They Topical capsaicin may be of benefit for chronic neuropathic pain Clinical question How effective is topical capsaicin for chronic neuropathic pain in adults? Bottom line Six studies compared regular application of low-dose (0.075%) capsaicin cream with placebo cream; the NNT (...) * for any pain relief over 6 to 8 weeks was 6.6 (4.1 to 17). Two studies compared a single application of high-dose (8%) capsaicin patch with placebo patch; the NNT for ³30% pain relief over 12 weeks was 12 (6.4 to 70). Local skin irritation, which is often mild and transient but may lead to withdrawal, is common. The NNH** for repeated low-dose application was 2.5 (2.1 to 3.1). Systemic adverse effects were rare. * NNT = number needed to treat to benefit 1 individual (95% confidence intervals) ** NNH
Lidocaine and Benzocaine are Equally Effective in Reducing Pain from Injection of Needles UTCAT2174, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title Lidocaine and Benzocaine are Equally Effective in Reducing Pain from Injection of Needles Clinical Question For a patient receiving an intraoral anesthetic injection, will topical benzocaine as compared with topical lidocaine decrease the pain score felt by the patient (...) during the injection process? Clinical Bottom Line In patients receiving intraoral needle injections, topical lidocaine is just as effective as topical benzocaine in reducing the amount of pain felt upon injection. This is supported by several randomized controlled trials in which no statistically or clinically significant differences were seen on comparison of the two agents in reducing injection pain. Both agents are significantly more effective than a placebo. Best Evidence (you may view more info
Diagnostic characteristics of S100A8/A9 in a multicenter study of patients with acute right lower quadrant abdominal pain Over the past decade, clinicians have become increasingly reliant on computed tomography (CT) for the evaluation of patients with suspected acute appendicitis. To limit the radiation risks and costs of CT, investigators have searched for biomarkers to aid in diagnostic decision-making. We evaluated one such biomarker, calprotectin or S100A8/A9, and determined the diagnostic (...) performance characteristics of a developmental biomarker assay in a multicenter investigation of patients presenting with acute right lower quadrant abdominal pain.This was a prospective, double-blinded, single-arm, multicenter investigation performed in 13 emergency departments (EDs) from August 2009 to April 2010 of patients presenting with acute right lower quadrant abdominal pain. Plasma samples were tested using the investigational S100A8/A9 assay. The primary outcome of acute appendicitis
A double-blind randomised controlled trial of 25% oral glucose for pain relief in 2-month old infants undergoing immunisation Infant immunisation is the most commonly performed health procedure in developed countries. Associated pain may be harmful because we do not know what painful experiences the infant has already had and whether it might contribute to a cumulative pain experience. Healthy infants undergo immunisation with minimal pain relief. However, immunisation pain can be managed using (...) oral sweet solutions.To determine the effectiveness of 25% oral glucose solution in reducing immunisation pain in 2-month old infants. TRIAL DESIGN AND METHODS: A double-blind, randomised controlled trial conducted in Jordan. A total of 120 healthy full-term infants who met the eligibility criteria and were attending immunisation clinics for routine 2-month immunisation were randomised to receive either 2 mL of 25% oral glucose solution immediately prior to their immunisation or 2 mL of oral
Post-treatment exercises effective for prevention of recurrences of low-back pain PEARLS Practical Evidence About Real Life Situations PEARLS are succinct summaries of Cochrane Systematic Reviews for primary care practitioners. They Post-treatment exercises effective for prevention of recurrences of low- back pain Clinical question How effective are exercises for prevention of recurrences of low-back pain? Bottom line There was moderate quality evidence post-treatment exercises (provided (...) to patients after their regular treatment for an episode of low-back pain had been finished) were more effective than no intervention for reducing the rate of recurrences at 1 year. There was moderate quality evidence from 2 studies that the number of recurrences was significantly reduced at 6 months to 2 years' follow-up. There was very low quality evidence the days on sick leave were reduced by post- treatment exercises at 6 months to 2 years' follow-up. There was conflicting evidence
Drugs for relief of pain in patients with sciatica: systematic review and meta-analysis Drugs for relief of pain in patients with sciatica: systematic review and meta-analysis Drugs for relief of pain in patients with sciatica: systematic review and meta-analysis Pinto RZ, Maher CG, Ferreira ML, Ferreira PH, Hancock M, Oliveira VC, McLachlan AJ, Koes B CRD summary The review concluded that the efficacy and tolerability of drugs commonly prescribed for the management of sciatica in primary care (...) was unclear. Despite some limitations to the review searching and selection processes, the authors' conclusions were suitably cautious in reflecting the limited evidence available and appear likely to be reliable. Authors' objectives To investigate the efficacy and tolerability of analgesic and adjuvant pain drugs typically administered in primary care for the management of patients with sciatica. Searching The following databases were searched to 15 March 2010: International Pharmaceutical Abstracts
Can pregabalin effectively diminish acute herpetic pain and reduce the incidence of post-herpetic neuralgia in patients who present with acute herpes zoster? BestBets: Can pregabalin effectively diminish acute herpetic pain and reduce the incidence of post-herpetic neuralgia in patients who present with acute herpes zoster? Can pregabalin effectively diminish acute herpetic pain and reduce the incidence of post-herpetic neuralgia in patients who present with acute herpes zoster? Report (...) By: Eliane Raymond-Dufresne - PGY-3, Emergency Medicine Search checked by Katharine Wylie - Senior Informatacist Institution: Laval University, Québec, Canada Date Submitted: 23rd November 2011 Date Completed: 13th February 2012 Last Modified: 20th February 2012 Status: Green (complete) Three Part Question In [patients with new onset of herpes zoster infection], can [pregabalin] be used to [decrease the incidence of post-herpetic neuralgia and to decrease the intensity of acute herpetic pain]? Clinical
Comparing the Pilates method with no exercise or lumbar stabilization for pain and functionality in patients with chronic low back pain: systematic review and meta-analysis To perform a systematic review with meta-analyses that evaluates the effectiveness of the Pilates method on the pain and functionality outcome in adults with non-specific chronic low back pain.The search was performed in the following databases: Medline, Embase, AMED, Cinahl, Lilacs, Scielo, SportDiscus, ProQuest, Web (...) of Science, PEDro, Academic Search Premier and the Cochrane Central Register of Controlled Trials from 1950 to 2011; the following keywords were used: 'Pilates', 'Pilates-based', 'back exercises', 'exercise therapy', 'low back pain', 'back pain' and 'backache'.The inclusion criteria were studies that assessed the effects of the Pilates method on patients with chronic low back pain.Five studies met the inclusion criteria. The total number of patients was 71 in the Pilates group and 68 in the control group
Procedural sedation with propofol for painful orthopaedic manipulation in the emergency department expedites patient management compared with a midazolam/ketamine regimen: a randomized prospective study The use of procedural sedation and analgesia to allow painful orthopaedic manipulations in the emergency department has become a standard practice over the last decade. Both propofol and midazolam/ketamine are attractive sedative regimens for routine use in the emergency department. We
Non-nutritive sucking and facilitated tucking relieve preterm infant pain during heel-stick procedures: A prospective, randomised controlled crossover trial Preterm infants' repeated exposure to painful procedures may contribute to negative consequences. Thus, improving preterm infants' neurodevelopmental outcomes requires prioritising their pain management.To compare the effectiveness of two non-pharmacological pain-relief strategies (non-nutritive sucking and facilitated tucking) with routine (...) care on preterm infants' pain, behavioural, and physiological responses before, during, and after heel-stick procedures.Prospective, randomised controlled crossover trial.Level III Neonatal Intensive Care Unit in Taipei.Thirty-four preterm infants (gestational age 29-37 weeks) needing three procedural heel sticks were recruited by convenience sampling and randomly assigned to a sequence of three treatments (two pain-relief interventions and the control condition): (1) routine care, non-nutritive
Drugs for relief of pain in patients with sciatica: systematic review and meta-analysis. To investigate the efficacy and tolerability of analgesic and adjuvant pain drugs typically administered in primary care for the management of patients with sciatica.Systematic review. Data source International Pharmaceutical Abstracts, PsycINFO, Medline, Embase, Cochrane Central Register of Clinical Trials (CENTRAL), CINAHL, and LILACS.Randomised controlled trials assessing the efficacy and tolerability (...) of drugs versus placebo or other treatment for sciatica.Two independent reviewers extracted data and assessed methodological quality using the PEDro scale. Pain and disability outcomes were converted to a common 0 to 100 scale. Data were pooled with a random effects model, and the GRADE approach was used in summary conclusions.Twenty three published reports met the inclusion criteria. The evidence to judge the efficacy of non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids, antidepressants
Mucosal Atomization Devices for the Administration of Pain Medications: Clinical Effectiveness, 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 (...) Devices for the Administration of Pain Medications: Clinical Effectiveness, Safety, and Guidelines DATE: 16 January 2012 RESEARCH QUESTIONS 1. What is the clinical effectiveness of mucosal atomization devices for the administration of pain medications? 2. What is the clinical evidence on the safety of mucosal atomization devices for the administration of pain medications? 3. What are the evidence-based guidelines and recommendations regarding mucosal atomization devices for the administration of pain
Upper cervical and upper thoracic thrust manipulation versus nonthrust mobilization in patients with mechanical neck pain: a multicenter randomized clinical trial Randomized clinical trial.To compare the short-term effects of upper cervical and upper thoracic high-velocity low-amplitude (HVLA) thrust manipulation to nonthrust mobilization in patients with neck pain.Although upper cervical and upper thoracic HVLA thrust manipulation and nonthrust mobilization are common interventions (...) for the management of neck pain, no studies have directly compared the effects of both upper cervical and upper thoracic HVLA thrust manipulation to nonthrust mobilization in patients with neck pain.Patients completed the Neck Disability Index, the numeric pain rating scale, the flexion-rotation test for measurement of C1-2 passive rotation range of motion, and the craniocervical flexion test for measurement of deep cervical flexor motor performance. Following the baseline evaluation, patients were randomized
Effects of yoga interventions on pain and pain-associated disability: a meta-analysis We searched databases for controlled clinical studies, and performed a meta-analysis on the effectiveness of yoga interventions on pain and associated disability. Five randomized studies reported single-blinding and had a higher methodological quality; 7 studies were randomized but not blinded and had moderate quality; and 4 nonrandomized studies had low quality. In 6 studies, yoga was used to treat patients (...) with back pain; in 2 studies to treat rheumatoid arthritis; in 2 studies to treat patients with headache/migraine; and 6 studies enrolled individuals for other indications. All studies reported positive effects in favor of the yoga interventions. With respect to pain, a random effect meta-analysis estimated the overall treatment effect at SMD = -.74 (CI: -.97; -.52, P < .0001), and an overall treatment effect at SMD = -.79 (CI: -1.02; -.56, P < .0001) for pain-related disability. Despite some
Short-term effects of local microwave hyperthermia on pain and function in patients with mild to moderate carpal tunnel syndrome: a double blind randomized sham-controlled trial To determine the short-term effects of local microwave hyperthermia on pain and function in patients with mild to moderate idiopathic carpal tunnel syndrome.Double-blind randomized sham-controlled trial.Outpatient clinic of the Department of Physical Medicine and Rehabilitation, University Hospital.Twenty-two patients (...) with idiopathic carpal tunnel syndrome, 12 of whom had bilateral involvement, for a total of 34 wrists, divided into two groups: a hyperthermia active treatment group (number of wrists = 17) and a sham-controlled group (number of wrists = 17).Six sessions, two per week, of either hyperthermia or sham treatment were provided over a period of three weeks.Visual analogue scale, Levine-Boston Self-Assessment Questionnaire (part I: evaluation of pain intensity; part II: evaluation of functional status