The present study observed the effects of repeated electroacupuncture of Zusanli (ST36) and Yanglingquan (GB34) on expression of hippocampal acetylcholinesterase, vesicular acetylcholine transporter, and muscarini...The present study observed the effects of repeated electroacupuncture of Zusanli (ST36) and Yanglingquan (GB34) on expression of hippocampal acetylcholinesterase, vesicular acetylcholine transporter, and muscarinic M1 receptor mRNA in chronic constrictive injury (neuropathic pain) and/or ovariotomy rats. Results demonstrated increased expression of hippocampal acetylcholinesterase, vesicular acetylcholine transporter, and muscarinic M1 receptor mRNA, as well as decreased pain threshold, in a rat model of chronic neuropathic pain after electroacupuncture. The effects of electroacupuncture increased with prolonged time, but the above-mentioned effects decreased in memory-deficient animals. Results indicated that repeated electroacupuncture has a cumulative analgesic effect, which is closely associated with upregulation of acetylcholinesterase and vesicular acetylcholine transporter activity, as well as M1 receptor mRNA expression and memory.展开更多
Low-level laser therapy(LLLT) may have an effect on the pain associated with orthodontic treatment. The aim of this study was to evaluate the effect of LLLT on pain and somatosensory sensitization induced by orthodont...Low-level laser therapy(LLLT) may have an effect on the pain associated with orthodontic treatment. The aim of this study was to evaluate the effect of LLLT on pain and somatosensory sensitization induced by orthodontic treatment. Forty individuals(12–33 years old; mean ± standard deviations: 20.8 ± 5.9 years) scheduled to receive orthodontic treatment were randomly divided into a laser group(LG) or a placebo group(PG)(1:1). The LG received LLLT(810-nm gallium-aluminium-arsenic diode laser in continuous mode with the power set at 400 mW, 2 J·cm–2) at 0 h, 2 h, 24 h, 4 d, and 7 d after treatment, and the PG received inactive treatment at the same time points. In both groups, the non-treated side served as a control. A numerical rating scale(NRS) of pain, pressure pain thresholds(PPTs), cold detection thresholds(CDTs), warmth detection thresholds(WDTs), cold pain thresholds(CPTs), and heat pain thresholds(HPTs) were tested on both sides at the gingiva and canine tooth and on the hand. The data were analysed by a repeated measures analysis of variance(ANOVA). The NRS pain scores were significantly lower in the LG group(P = 0.01). The CDTs,CPTs, WDTs, HPTs, and PPTs at the gingiva and the PPTs at the canine tooth were significantly less sensitive on the treatment side of the LG compared with that of the PG(P < 0.033). The parameters tested also showed significantly less sensitivity on the nontreatment side of the LG compared to that of the PG(P < 0.043). There were no differences between the groups for any quantitative sensory testing(QST) measures of the hand. The application of LLLT appears to reduce the pain and sensitivity of the tooth and gingiva associated with orthodontic treatment and may have contralateral effects within the trigeminal system but no generalized QST effects. Thus, the present study indicated a significant analgesia effect of LLLT application during orthodontic treatment.Further clinical applications are suggested.展开更多
Objective The aim of the study was to investigate the efficacy and adverse effects of olanzapine in the treatment of moderate to severe refractory neuropathic pain.Methods Forty patients with digestive system cancer w...Objective The aim of the study was to investigate the efficacy and adverse effects of olanzapine in the treatment of moderate to severe refractory neuropathic pain.Methods Forty patients with digestive system cancer were enrolled,who had moderate to severe refractory neuropathic pain;the patients were treated with olanzapine for 2 weeks at a daily dosage of 5 mg to 10 mg per night according to patients’response and tolerability,combined with conventional analgesic therapy.Pain intensity was evaluated by using a Numeral Rating Scale(NRS)at baseline,3 days,and 2 weeks after therapy.The Pittsburg Sleep Quality Index(PSQI)was evaluated at baseline and 2 weeks after therapy.Data on adverse events were recorded.The dosage of conventional analgesics was adjusted over time based on the severity of pain.Results The mean pain score decreased by 2.575±1.318(P<0.000)at 3 days and by 3.400±1.614(P<0.000)at 2 weeks;30%of the patients experienced significant pain relief at 3 days and 50%at 2 weeks.The PSQI decreased by 4.725±2.828(P<0.000)at 2 weeks.The adverse events induced by olanzapine included sleepiness,weight gain,dizziness,fatigue,dry mouth,and constipation;all the side effects were mild.Conclusion When combined with conventional analgesic therapy,olanzapine was effective in relieving pain and sleep disturbance,and was well-tolerated among patients with refractory neuropathic pain.展开更多
<b>Background & Aims:</b> The multimodal analgesia provides superior pain relief and reduces opioid consumption and its side effects. Gabapentin has been used successfully in multi-modal analgesia in d...<b>Background & Aims:</b> The multimodal analgesia provides superior pain relief and reduces opioid consumption and its side effects. Gabapentin has been used successfully in multi-modal analgesia in different doses. We designed a double-blind randomized control trial to find the minimal effective dose of gabapentin in multimodal analgesia for postoperative pain following total abdominal hysterectomy. <b>Material & Methods:</b> After informed consent, total of 87 patients were randomly assigned to A, B & C groups to receive gabapentin orally 300 mg, 600 mg, and 900 mg respectively one to two hours before surgery. Postoperatively pain was managed by patient-controlled analgesia (PCA) using pethidine. Pain score, opioid consumption, and side effects of gabapentin were monitored. Rescue analgesia was given and monitored. <b>Results:</b> There was no statistically significant difference among the groups with respect to age, weight, height, pethidine consumption, and rescue analgesia. Mean pain scores were statistically insignificant at baseline, 8, 12, and 24 hours postoperatively. Only at 4 hours, the highest pain score (mean) was found in group A, which is statistically significant. The side effects of gabapentin like nausea, vomiting, somnolence, and dizziness were also statistically insignificant. <b>Conclusion:</b> A single preoperative oral gabapentin 300 mg was found to be minimal effective dose in multimodal analgesic regimen for reducing post-operative pain and analgesic requirement following total abdominal hysterectomy.展开更多
BACKGROUND: The clinical treatment of neuropathic pain is very troublesome, and the physical method of radiofrequency thermocoagulation is a good choice for its treatment. OBJECTIVE: To observe the curative effect of ...BACKGROUND: The clinical treatment of neuropathic pain is very troublesome, and the physical method of radiofrequency thermocoagulation is a good choice for its treatment. OBJECTIVE: To observe the curative effect of percutaneous radiofrequency thermocoagulation on neuropathic neuralgia. DESIGN: A case follow-up analysis. SETTING: Minimally Invasive Surgery Room, Department of Neurosurgery, Urumqi General Hospital of Lanzhou Military Area Command of Chinese PLA. PARTICIPANTS: Totally 131 patients were selected from the Department of Neurosurgery, Urumqi General Hospital of Lanzhou Military Area Command of Chinese PLA from December 2000 to June 2006, including 73 males and 58 females, aging 37-72 years old, AND the disease course was 2-15 years. ① Drug treatment failed to alleviate the pain or induced obvious side effects; ② With the same pathological changes as pain and effective in the nerve block test; Had signed the informed consents before treatment. Distribution of the neuropathic pain: ① Trigeminal neuralgia, which were lighting attack, located at V2 in 28 cases, V3 in 46 cases, V1+V2 in 3 cases, V2+V3 in 28 cases, and V1+V2+V3 in 1 case; ② Migraine located at (except the frontal branch of trigeminal nerve) greater and lesser occipital nerves in 6 cases, auriculotemporal nerve in 3 cases, temporal and zygomatic nerves in 3 cases; ③ Unilateral neuralgia of C2 and C3 following herpes zoster in 1 case, and chest intercostals neuralgia in 2 cases; ④ Lasting burning pain in the operative area after thoracotomy was in 1 case of lung cancer. METHODS: ① All the enrolled patients were treated with percutaneous puncture at trigeminal ganglion or peripheral nerve, then nerve block was performed firstly for anesthesia, and the pain disappeared immediately at this moment, there was hypoesthesia or numbness in the area of innervation, which manifested the puncture apposition was correct, then electrostimulation of 50 Hz with the current of 0.1-0.5 V was given for further functional localization. ② The RFG-3C radiofrequency therapeutic instrument (Radionics, USA) was used, the tip of the radiofrequency electrode was exposed for 5 mm, the temperature was kept at 80-85 ℃, 30-60 for each time, and treated for 3 or 4 times. The neuralgia following herpes zoster could also be treated by thermocoagulation at several points. ③ Evaluation standards for the therapeutic efficacy: Excellent meant the pain disappeared completely without taking any anodyne. Good referred to the pain was alleviated as compared with the preoperative one, and it could be effectively controlled by anodyne at relapse, but radiofrequency therapy was unnecessary. MAIN OUTCOME MEASURES: Therapeutic efficacy of neuropathic neuralgia of different types after treatment of percutaneous radiofrequency thermocoagulation. RESULTS: All the 131 patients were involved in the final analysis of results, no one missed. ① Therapeutic efficacy: In the 24-month follow-up, the therapeutic efficacy was excellent in 106 cases (80.9%), good in 21 cases (16.0 %) and had no change in 4 cases (3.1%). For 13 of the patients with trigeminal neuralgia, the pain relapsed after the lesion of peripheral branches, and it disappeared after the second treatment. The treatment was invalid for 1 patient with lung cancer suffering from pain in the operative area after thoracotomy, and the pain was alleviated by spinal cord stimulation. The pain disappeared after treated for 3 times in the patients with cervical neuralgia following herpes zoster. ② The pain relapsed in 28 cases (21.4%) at 12 months of the follow-up. ③ Adverse events and side effects: Except the hypoesthesia of different severity at the site of pain, there was no other complication after treatment. CONCLUSION:The follow-up results showed that percutaneous radiofrequency thermocoagulation is one of the effective methods for treating neuropathic neuralgias of various types.展开更多
Objective:To evaluate the efficacy and safety of the treatment of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Methods- The randomized controlled trials (RCTs) about the treatment for CP/CPPS all o...Objective:To evaluate the efficacy and safety of the treatment of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Methods- The randomized controlled trials (RCTs) about the treatment for CP/CPPS all over the world were searched. MEDLINE (January 1966 to June 2007), EMBASE (January 1988 to June 2007), and 4 Chinese databases were electronically searched. The studies included in the refer- ences of eligible studies were additionally searched. Two reviewers independently screened the studies for eli- gibility, evaluated the quality and extracted the data from the eligible studies, with confirmation by cross- checking. Divergences of opinion were settled by discussion or consulted by the experts. Meta-analysis was performed by using RevMan 4.2 software. Results: Twelve original studies involving 1 003 participants met inclusion criteria. Compared with placebo, alpha-blockers could improve the symptoms of CP/CPPS obvious- ly with WMD of NIH-CPSI, total score and pain score were -4.10 (95%CI: -6. 92 to -1.28) and -1.68 (95 %CI: -2.54 to -0. 82). Antibiotics could not improve the symptoms obviously with WMD of NIH-CP- SI; total score and pain score were -2.71 (95%CI: -4. 78 to -0. 64) and -0.86 (95%CI: -2.07 to 0.36). Flavoxate could not improve the NIH-CPSI total score obviously, but could relieve the pain, with WMD of NIH-CPSI total score and pain score being -2.96 (95%CI: -5.17 to -0. 74) and --2.31 (95%CI.. -4.05 to 0.03). Prostat could improve the NIH-CPSI total score obviously, but could not relieve the pain, with WMD of NIH-CPSI total score and pain score being --7. 60 (95%CI.. -9. 97 to -5.23) and -2. 02 (95%CI: -4.07 to 0. 04). Conclusion: Drug intervention could improve total symptoms of CP/CPPS in some degree, but no universally effective treatment is available that can prove significant lasting benefit for all the symptoms of CP/CPPS. Future RCT must use an appropriate sample size and optimal duration and fol- low-up of participants. It is important to improve the quality of internal original studies.展开更多
AIM To identify unique clusters of patients based on their concerns in using analgesia for cancer pain and predictors of the cluster membership.METHODS This was a 3-mo prospective observational study(n = 207).Patients...AIM To identify unique clusters of patients based on their concerns in using analgesia for cancer pain and predictors of the cluster membership.METHODS This was a 3-mo prospective observational study(n = 207).Patients were included if they were adults(≥ 18 years), diagnosed with solid tumors or multiple myelomas, and had at least one prescription of around the clock pain medication for cancer or cancer-treatment-related pain.Patients were recruited from two outpatient medical oncology clinics within a large health system in Philadelphia.A choice-based conjoint(CBC) analysis experiment was used to elicit analgesic treatment preferences(utilities).Patients employed trade-offs based on five analgesic attributes(percent relief from analgesics, type of analgesic, type of sideeffects, severity of side-effects, out of pocket cost).Patients were clustered based on CBC utilities using novel adaptive statistical methods.Multiple logistic regression was used to identify predictors of cluster membership.RESULTS The analyses found 4 unique clusters: Most patients made trade-offs based on the expectation of pain relief(cluster 1, 41%).For a subset, the main underlying concern was type of analgesic prescribed, i.e., opioid vs non-opioid(cluster 2, 11%) and type of analgesic side effects(cluster 4, 21%), respectively.About one in four made trade-offs based on multiple concerns simultaneously including pain relief, type of side effects, and severity of side effects(cluster 3, 27.5%).In multivariable analysis, to identify predictors of cluster membership, clinical and socioeconomic factors(education, health literacy, income, social support) rather than analgesic attitudes and beliefs were found important; only the belief, i.e., pain medications can mask changes in health or keep you from knowing what is going on in your body was found significant in predicting two of the four clusters [cluster 1(-); cluster 4(+)].CONCLUSION Most patients appear to be driven by a single salient concern in using analgesia for cancer pain.Addressing these concerns, perhaps through real time clinical assessments, may improve patients' analgesic adherence patterns and cancer pain outcomes.展开更多
In the present study, we examined the analgesic effect of repeated electroacupuncture at bilateral Zusanfi (ST36) and Yanglingquan (GB34) once a day for 14 consecutive days in a rat model of chronic sciatic nerve ...In the present study, we examined the analgesic effect of repeated electroacupuncture at bilateral Zusanfi (ST36) and Yanglingquan (GB34) once a day for 14 consecutive days in a rat model of chronic sciatic nerve constriction injury-induced neuropathic pain. In addition, concomitant changes in calcium/calmodulin-dependent protein kinase II expression and synaptic ultrastructure of neurons in the hippocampal CA3 region were examined. The thermal pain threshold (paw withdrawal latency) was increased significantly in both groups at 2 weeks after electroacupuncture intervention compared with 2 days of electroacupuncture. In ovariectomized rats with chronic constriction injury, the analgesic effect was significantly reduced. Electroacupuncture for 2 weeks significantly diminished the injury-induced increase in synaptJc cleft width and thinning of the postsynaptJc density, and it significantly suppressed the down-regulation of intracellular calcium/ calmodulin-dependent protein kinase II expression in the hippocampal CA3 region. Repeated electroacupuncture intervention had a cumulative analgesic effect on injury-induced neuropathic pain reactions, and it led to synaptic remodeling of hippocampal neurons and upregulated calcium/calmodulin-dependent protein kJnase II expression in the hippocampal CA3 region.展开更多
The purpose of the study was to analyse on pain following traumatic spinal cord injury, its prevalence, the types of pain present, the common treatments used and their perceived effectiveness in the management of thes...The purpose of the study was to analyse on pain following traumatic spinal cord injury, its prevalence, the types of pain present, the common treatments used and their perceived effectiveness in the management of these reported pain types. A cross sectional study was carried out at St Giles Rehabilitation Centre and from members of the Spinal Injuries Association of Zimbabwe (SIAZ). A researcher-administered questionnaire was used to collect data from 24 participants with traumatic spinal cord injury. The questionnaire elicited information on demographic data, pain characteristics and the perceived effectiveness of the common treatments used. Among the 24 participants in the study, 17 were males (70.8%) and 7 were females (29.2%). Pain prevalence was 79.2% among the study participants and approximately a fifth (21.03%) of all participants rated their pain as severe. Eight (33.3%) of the participants had neuropathic pain while 11 (45.8%) had both nociceptive and neuropathic pain types. However, no association was found between sex, age, time post injury when tested against the presence of pain (p > 0.05). Weather changes aggravated almost every type of pain reported. Both pharmacological and non-pharmacological methods were used to manage the pain but their perceived effectiveness was rated as low. The majority of the traumatic spinal cord injured people experienced some pain and this pain was severe in a fifth of all participants. Pain significantly affected their quality of life. Physiotherapists and other medical professionals need to be aware of this and should employ pain reducing modalities and empathy when dealing with these patients.展开更多
In the present study, a rat model of chronic neuropathic pain was established by ligation of the sciatic nerve and a model of learning and memory impairment was established by ovariectomy to investigate the analgesic ...In the present study, a rat model of chronic neuropathic pain was established by ligation of the sciatic nerve and a model of learning and memory impairment was established by ovariectomy to investigate the analgesic effect of repeated electroacupuncture stimulation at bilateral Zusanfi (ST36) and Yanglingquan (GB34). In addition, associated synaptic changes in neurons in the paraventricular nucleus of the hypothalamus were examined. Results indicate that the thermal pain threshold (paw withdrawal latency) was significantly increased in rats subjected to 2-week electroacupuncture intervention compared with 2-day electroacupuncture, but the analgesic effect was weakened remarkably in ovariectomized rats with chronic constrictive injury. 2-week electroacupuncture intervention substantially reversed the chronic constrictive injury-induced increase in the synaptic cleft width and thinning of the postsynaptic density. These findings indicate that repeated electroacupuncture at bilateral Zusanfi and Yanglingquan has a cumulative analgesic effect and can effectively relieve chronic neuropathic pain by remodeling the synaptic structure of the hypothalamic paraventricular nucleus.展开更多
Objective: To explore the effect of aroma oil acupressure combined with music therapy in pain intervention for tumor patients. Methods: 60 patients with malignant tumors accompanied by cancer pain who were hospitalize...Objective: To explore the effect of aroma oil acupressure combined with music therapy in pain intervention for tumor patients. Methods: 60 patients with malignant tumors accompanied by cancer pain who were hospitalized in the oncology department of a tertiary-level hospital in Jingzhou City, Hubei Province, from January 2022 to December 2022 were selected as the study subjects, and were divided into 30 cases in the control group and 30 cases in the intervention group according to the stratified sampling method. The control group was divided into 30 cases of control group and 30 cases of intervention group according to the stratified sampling method. The control group was given medicine according to the conventional step analgesia, and the intervention group was given medicine according to the conventional step analgesia with the addition of aromatic oil acupressure combined with music therapy, and the effect of the intervention was valued by the NRS, the SAS and the SDS. Results: The NRS, SAS and SDS of patients in the intervention group were lower than those in the control group (p Conclusion: Aromatic oil acupressure combined with music therapy can effectively improve the pain symptoms of tumor patients, relieve anxiety and improve the quality of sleep of patients. Combined with pharmacological methods of pain relief, it can reduce the dose of pain medication and the frequency of administration of medication, and find a safe, low-cost, non-pharmacological pain complementary alternative therapy for tumor patients with cancer pain.展开更多
基金supported by the National Natural Science Foundation of China, No. 30472241, key project: 90709031the Ministry of Science and Technology of China ("973" Project), No. 2007CB512505
文摘The present study observed the effects of repeated electroacupuncture of Zusanli (ST36) and Yanglingquan (GB34) on expression of hippocampal acetylcholinesterase, vesicular acetylcholine transporter, and muscarinic M1 receptor mRNA in chronic constrictive injury (neuropathic pain) and/or ovariotomy rats. Results demonstrated increased expression of hippocampal acetylcholinesterase, vesicular acetylcholine transporter, and muscarinic M1 receptor mRNA, as well as decreased pain threshold, in a rat model of chronic neuropathic pain after electroacupuncture. The effects of electroacupuncture increased with prolonged time, but the above-mentioned effects decreased in memory-deficient animals. Results indicated that repeated electroacupuncture has a cumulative analgesic effect, which is closely associated with upregulation of acetylcholinesterase and vesicular acetylcholine transporter activity, as well as M1 receptor mRNA expression and memory.
基金funded by the Priority Academic Program Development of Jiangsu Higher Education Institution(Grant No.2014-37)the Jiangsu Provincial Health and Family Planning Commission(No.H201535)Orofacial Pain and TMD Research Unit,Institute of Stomatology,Affiliated Hospital of Stomatology,Nanjing Medical University,for their support
文摘Low-level laser therapy(LLLT) may have an effect on the pain associated with orthodontic treatment. The aim of this study was to evaluate the effect of LLLT on pain and somatosensory sensitization induced by orthodontic treatment. Forty individuals(12–33 years old; mean ± standard deviations: 20.8 ± 5.9 years) scheduled to receive orthodontic treatment were randomly divided into a laser group(LG) or a placebo group(PG)(1:1). The LG received LLLT(810-nm gallium-aluminium-arsenic diode laser in continuous mode with the power set at 400 mW, 2 J·cm–2) at 0 h, 2 h, 24 h, 4 d, and 7 d after treatment, and the PG received inactive treatment at the same time points. In both groups, the non-treated side served as a control. A numerical rating scale(NRS) of pain, pressure pain thresholds(PPTs), cold detection thresholds(CDTs), warmth detection thresholds(WDTs), cold pain thresholds(CPTs), and heat pain thresholds(HPTs) were tested on both sides at the gingiva and canine tooth and on the hand. The data were analysed by a repeated measures analysis of variance(ANOVA). The NRS pain scores were significantly lower in the LG group(P = 0.01). The CDTs,CPTs, WDTs, HPTs, and PPTs at the gingiva and the PPTs at the canine tooth were significantly less sensitive on the treatment side of the LG compared with that of the PG(P < 0.033). The parameters tested also showed significantly less sensitivity on the nontreatment side of the LG compared to that of the PG(P < 0.043). There were no differences between the groups for any quantitative sensory testing(QST) measures of the hand. The application of LLLT appears to reduce the pain and sensitivity of the tooth and gingiva associated with orthodontic treatment and may have contralateral effects within the trigeminal system but no generalized QST effects. Thus, the present study indicated a significant analgesia effect of LLLT application during orthodontic treatment.Further clinical applications are suggested.
基金grants from double top independent innovation physician funded projects of Huazhong University of Science and Technology(No.3011540024,5001540074,5001540095)Wuhan young and middle-age medical backbone training project(No.2016whzqnyxggrcl).
文摘Objective The aim of the study was to investigate the efficacy and adverse effects of olanzapine in the treatment of moderate to severe refractory neuropathic pain.Methods Forty patients with digestive system cancer were enrolled,who had moderate to severe refractory neuropathic pain;the patients were treated with olanzapine for 2 weeks at a daily dosage of 5 mg to 10 mg per night according to patients’response and tolerability,combined with conventional analgesic therapy.Pain intensity was evaluated by using a Numeral Rating Scale(NRS)at baseline,3 days,and 2 weeks after therapy.The Pittsburg Sleep Quality Index(PSQI)was evaluated at baseline and 2 weeks after therapy.Data on adverse events were recorded.The dosage of conventional analgesics was adjusted over time based on the severity of pain.Results The mean pain score decreased by 2.575±1.318(P<0.000)at 3 days and by 3.400±1.614(P<0.000)at 2 weeks;30%of the patients experienced significant pain relief at 3 days and 50%at 2 weeks.The PSQI decreased by 4.725±2.828(P<0.000)at 2 weeks.The adverse events induced by olanzapine included sleepiness,weight gain,dizziness,fatigue,dry mouth,and constipation;all the side effects were mild.Conclusion When combined with conventional analgesic therapy,olanzapine was effective in relieving pain and sleep disturbance,and was well-tolerated among patients with refractory neuropathic pain.
文摘<b>Background & Aims:</b> The multimodal analgesia provides superior pain relief and reduces opioid consumption and its side effects. Gabapentin has been used successfully in multi-modal analgesia in different doses. We designed a double-blind randomized control trial to find the minimal effective dose of gabapentin in multimodal analgesia for postoperative pain following total abdominal hysterectomy. <b>Material & Methods:</b> After informed consent, total of 87 patients were randomly assigned to A, B & C groups to receive gabapentin orally 300 mg, 600 mg, and 900 mg respectively one to two hours before surgery. Postoperatively pain was managed by patient-controlled analgesia (PCA) using pethidine. Pain score, opioid consumption, and side effects of gabapentin were monitored. Rescue analgesia was given and monitored. <b>Results:</b> There was no statistically significant difference among the groups with respect to age, weight, height, pethidine consumption, and rescue analgesia. Mean pain scores were statistically insignificant at baseline, 8, 12, and 24 hours postoperatively. Only at 4 hours, the highest pain score (mean) was found in group A, which is statistically significant. The side effects of gabapentin like nausea, vomiting, somnolence, and dizziness were also statistically insignificant. <b>Conclusion:</b> A single preoperative oral gabapentin 300 mg was found to be minimal effective dose in multimodal analgesic regimen for reducing post-operative pain and analgesic requirement following total abdominal hysterectomy.
文摘BACKGROUND: The clinical treatment of neuropathic pain is very troublesome, and the physical method of radiofrequency thermocoagulation is a good choice for its treatment. OBJECTIVE: To observe the curative effect of percutaneous radiofrequency thermocoagulation on neuropathic neuralgia. DESIGN: A case follow-up analysis. SETTING: Minimally Invasive Surgery Room, Department of Neurosurgery, Urumqi General Hospital of Lanzhou Military Area Command of Chinese PLA. PARTICIPANTS: Totally 131 patients were selected from the Department of Neurosurgery, Urumqi General Hospital of Lanzhou Military Area Command of Chinese PLA from December 2000 to June 2006, including 73 males and 58 females, aging 37-72 years old, AND the disease course was 2-15 years. ① Drug treatment failed to alleviate the pain or induced obvious side effects; ② With the same pathological changes as pain and effective in the nerve block test; Had signed the informed consents before treatment. Distribution of the neuropathic pain: ① Trigeminal neuralgia, which were lighting attack, located at V2 in 28 cases, V3 in 46 cases, V1+V2 in 3 cases, V2+V3 in 28 cases, and V1+V2+V3 in 1 case; ② Migraine located at (except the frontal branch of trigeminal nerve) greater and lesser occipital nerves in 6 cases, auriculotemporal nerve in 3 cases, temporal and zygomatic nerves in 3 cases; ③ Unilateral neuralgia of C2 and C3 following herpes zoster in 1 case, and chest intercostals neuralgia in 2 cases; ④ Lasting burning pain in the operative area after thoracotomy was in 1 case of lung cancer. METHODS: ① All the enrolled patients were treated with percutaneous puncture at trigeminal ganglion or peripheral nerve, then nerve block was performed firstly for anesthesia, and the pain disappeared immediately at this moment, there was hypoesthesia or numbness in the area of innervation, which manifested the puncture apposition was correct, then electrostimulation of 50 Hz with the current of 0.1-0.5 V was given for further functional localization. ② The RFG-3C radiofrequency therapeutic instrument (Radionics, USA) was used, the tip of the radiofrequency electrode was exposed for 5 mm, the temperature was kept at 80-85 ℃, 30-60 for each time, and treated for 3 or 4 times. The neuralgia following herpes zoster could also be treated by thermocoagulation at several points. ③ Evaluation standards for the therapeutic efficacy: Excellent meant the pain disappeared completely without taking any anodyne. Good referred to the pain was alleviated as compared with the preoperative one, and it could be effectively controlled by anodyne at relapse, but radiofrequency therapy was unnecessary. MAIN OUTCOME MEASURES: Therapeutic efficacy of neuropathic neuralgia of different types after treatment of percutaneous radiofrequency thermocoagulation. RESULTS: All the 131 patients were involved in the final analysis of results, no one missed. ① Therapeutic efficacy: In the 24-month follow-up, the therapeutic efficacy was excellent in 106 cases (80.9%), good in 21 cases (16.0 %) and had no change in 4 cases (3.1%). For 13 of the patients with trigeminal neuralgia, the pain relapsed after the lesion of peripheral branches, and it disappeared after the second treatment. The treatment was invalid for 1 patient with lung cancer suffering from pain in the operative area after thoracotomy, and the pain was alleviated by spinal cord stimulation. The pain disappeared after treated for 3 times in the patients with cervical neuralgia following herpes zoster. ② The pain relapsed in 28 cases (21.4%) at 12 months of the follow-up. ③ Adverse events and side effects: Except the hypoesthesia of different severity at the site of pain, there was no other complication after treatment. CONCLUSION:The follow-up results showed that percutaneous radiofrequency thermocoagulation is one of the effective methods for treating neuropathic neuralgias of various types.
文摘Objective:To evaluate the efficacy and safety of the treatment of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Methods- The randomized controlled trials (RCTs) about the treatment for CP/CPPS all over the world were searched. MEDLINE (January 1966 to June 2007), EMBASE (January 1988 to June 2007), and 4 Chinese databases were electronically searched. The studies included in the refer- ences of eligible studies were additionally searched. Two reviewers independently screened the studies for eli- gibility, evaluated the quality and extracted the data from the eligible studies, with confirmation by cross- checking. Divergences of opinion were settled by discussion or consulted by the experts. Meta-analysis was performed by using RevMan 4.2 software. Results: Twelve original studies involving 1 003 participants met inclusion criteria. Compared with placebo, alpha-blockers could improve the symptoms of CP/CPPS obvious- ly with WMD of NIH-CPSI, total score and pain score were -4.10 (95%CI: -6. 92 to -1.28) and -1.68 (95 %CI: -2.54 to -0. 82). Antibiotics could not improve the symptoms obviously with WMD of NIH-CP- SI; total score and pain score were -2.71 (95%CI: -4. 78 to -0. 64) and -0.86 (95%CI: -2.07 to 0.36). Flavoxate could not improve the NIH-CPSI total score obviously, but could relieve the pain, with WMD of NIH-CPSI total score and pain score being -2.96 (95%CI: -5.17 to -0. 74) and --2.31 (95%CI.. -4.05 to 0.03). Prostat could improve the NIH-CPSI total score obviously, but could not relieve the pain, with WMD of NIH-CPSI total score and pain score being --7. 60 (95%CI.. -9. 97 to -5.23) and -2. 02 (95%CI: -4.07 to 0. 04). Conclusion: Drug intervention could improve total symptoms of CP/CPPS in some degree, but no universally effective treatment is available that can prove significant lasting benefit for all the symptoms of CP/CPPS. Future RCT must use an appropriate sample size and optimal duration and fol- low-up of participants. It is important to improve the quality of internal original studies.
基金National Institutes of Health/National Institute of Nursing Research,No.NIH/NINR RC1-NR011591
文摘AIM To identify unique clusters of patients based on their concerns in using analgesia for cancer pain and predictors of the cluster membership.METHODS This was a 3-mo prospective observational study(n = 207).Patients were included if they were adults(≥ 18 years), diagnosed with solid tumors or multiple myelomas, and had at least one prescription of around the clock pain medication for cancer or cancer-treatment-related pain.Patients were recruited from two outpatient medical oncology clinics within a large health system in Philadelphia.A choice-based conjoint(CBC) analysis experiment was used to elicit analgesic treatment preferences(utilities).Patients employed trade-offs based on five analgesic attributes(percent relief from analgesics, type of analgesic, type of sideeffects, severity of side-effects, out of pocket cost).Patients were clustered based on CBC utilities using novel adaptive statistical methods.Multiple logistic regression was used to identify predictors of cluster membership.RESULTS The analyses found 4 unique clusters: Most patients made trade-offs based on the expectation of pain relief(cluster 1, 41%).For a subset, the main underlying concern was type of analgesic prescribed, i.e., opioid vs non-opioid(cluster 2, 11%) and type of analgesic side effects(cluster 4, 21%), respectively.About one in four made trade-offs based on multiple concerns simultaneously including pain relief, type of side effects, and severity of side effects(cluster 3, 27.5%).In multivariable analysis, to identify predictors of cluster membership, clinical and socioeconomic factors(education, health literacy, income, social support) rather than analgesic attitudes and beliefs were found important; only the belief, i.e., pain medications can mask changes in health or keep you from knowing what is going on in your body was found significant in predicting two of the four clusters [cluster 1(-); cluster 4(+)].CONCLUSION Most patients appear to be driven by a single salient concern in using analgesia for cancer pain.Addressing these concerns, perhaps through real time clinical assessments, may improve patients' analgesic adherence patterns and cancer pain outcomes.
基金supported by the National Natural Science Foundation of China,No.30472241,90709031 and 30973796the Ministry of Science and Technology of China("973"Project),No.2007CB512505+1 种基金provided by the Foundation of Hainan Province,No.310054the Health Department of Hainan Province,Qiong-Wei-45
文摘In the present study, we examined the analgesic effect of repeated electroacupuncture at bilateral Zusanfi (ST36) and Yanglingquan (GB34) once a day for 14 consecutive days in a rat model of chronic sciatic nerve constriction injury-induced neuropathic pain. In addition, concomitant changes in calcium/calmodulin-dependent protein kinase II expression and synaptic ultrastructure of neurons in the hippocampal CA3 region were examined. The thermal pain threshold (paw withdrawal latency) was increased significantly in both groups at 2 weeks after electroacupuncture intervention compared with 2 days of electroacupuncture. In ovariectomized rats with chronic constriction injury, the analgesic effect was significantly reduced. Electroacupuncture for 2 weeks significantly diminished the injury-induced increase in synaptJc cleft width and thinning of the postsynaptJc density, and it significantly suppressed the down-regulation of intracellular calcium/ calmodulin-dependent protein kinase II expression in the hippocampal CA3 region. Repeated electroacupuncture intervention had a cumulative analgesic effect on injury-induced neuropathic pain reactions, and it led to synaptic remodeling of hippocampal neurons and upregulated calcium/calmodulin-dependent protein kJnase II expression in the hippocampal CA3 region.
文摘The purpose of the study was to analyse on pain following traumatic spinal cord injury, its prevalence, the types of pain present, the common treatments used and their perceived effectiveness in the management of these reported pain types. A cross sectional study was carried out at St Giles Rehabilitation Centre and from members of the Spinal Injuries Association of Zimbabwe (SIAZ). A researcher-administered questionnaire was used to collect data from 24 participants with traumatic spinal cord injury. The questionnaire elicited information on demographic data, pain characteristics and the perceived effectiveness of the common treatments used. Among the 24 participants in the study, 17 were males (70.8%) and 7 were females (29.2%). Pain prevalence was 79.2% among the study participants and approximately a fifth (21.03%) of all participants rated their pain as severe. Eight (33.3%) of the participants had neuropathic pain while 11 (45.8%) had both nociceptive and neuropathic pain types. However, no association was found between sex, age, time post injury when tested against the presence of pain (p > 0.05). Weather changes aggravated almost every type of pain reported. Both pharmacological and non-pharmacological methods were used to manage the pain but their perceived effectiveness was rated as low. The majority of the traumatic spinal cord injured people experienced some pain and this pain was severe in a fifth of all participants. Pain significantly affected their quality of life. Physiotherapists and other medical professionals need to be aware of this and should employ pain reducing modalities and empathy when dealing with these patients.
基金supported by the National Natural Science Foundation of China,No.30472241,90709031 and 30973796the National Basic Research Program of China for Traditional Chinese Medicine Theory("973" Program),No.2007CB512505+1 种基金the Natural Foundation of Hainan Province(No.310054)a grant from the Health Department of Hainan Province(QiongWei 2010-45)
文摘In the present study, a rat model of chronic neuropathic pain was established by ligation of the sciatic nerve and a model of learning and memory impairment was established by ovariectomy to investigate the analgesic effect of repeated electroacupuncture stimulation at bilateral Zusanfi (ST36) and Yanglingquan (GB34). In addition, associated synaptic changes in neurons in the paraventricular nucleus of the hypothalamus were examined. Results indicate that the thermal pain threshold (paw withdrawal latency) was significantly increased in rats subjected to 2-week electroacupuncture intervention compared with 2-day electroacupuncture, but the analgesic effect was weakened remarkably in ovariectomized rats with chronic constrictive injury. 2-week electroacupuncture intervention substantially reversed the chronic constrictive injury-induced increase in the synaptic cleft width and thinning of the postsynaptic density. These findings indicate that repeated electroacupuncture at bilateral Zusanfi and Yanglingquan has a cumulative analgesic effect and can effectively relieve chronic neuropathic pain by remodeling the synaptic structure of the hypothalamic paraventricular nucleus.
文摘Objective: To explore the effect of aroma oil acupressure combined with music therapy in pain intervention for tumor patients. Methods: 60 patients with malignant tumors accompanied by cancer pain who were hospitalized in the oncology department of a tertiary-level hospital in Jingzhou City, Hubei Province, from January 2022 to December 2022 were selected as the study subjects, and were divided into 30 cases in the control group and 30 cases in the intervention group according to the stratified sampling method. The control group was divided into 30 cases of control group and 30 cases of intervention group according to the stratified sampling method. The control group was given medicine according to the conventional step analgesia, and the intervention group was given medicine according to the conventional step analgesia with the addition of aromatic oil acupressure combined with music therapy, and the effect of the intervention was valued by the NRS, the SAS and the SDS. Results: The NRS, SAS and SDS of patients in the intervention group were lower than those in the control group (p Conclusion: Aromatic oil acupressure combined with music therapy can effectively improve the pain symptoms of tumor patients, relieve anxiety and improve the quality of sleep of patients. Combined with pharmacological methods of pain relief, it can reduce the dose of pain medication and the frequency of administration of medication, and find a safe, low-cost, non-pharmacological pain complementary alternative therapy for tumor patients with cancer pain.