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Novel multimodal analgesia regimen improves post-TACE pain in patients with hepatocellular carcinoma

Hepatobiliary & Pancreatic Diseases International 2018年第6期17卷 510-516页

作者： Jian-Guo Guo Lu-Ping Zhao Yue-Feng Rao Yin-Ping Gao Xue-Jiao Guo Tan-Yang Zhou Zhi-Ying Feng Jun-Hui Sun Xiao-Yang Lu Department of pain Medicine The First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China Key Laboratory of Precision Diagnosis and Treatment for Hepatobiliary and Pancreatic Tumor of Zhejiang Province Hangzhou 310003China Department of Pharmacy Dongyang People’s HospitalDongyang 322100China

Backgroud: Transarterial chemoembolization(TACE) is the primary palliative treatment for patients with unresectable hepatocellular carcinoma(HCC). However, it is often accompanied by postoperative pain which hinder patient recovery. This study was to examine whether preemptive parecoxib and sufentanilbased patient controlled analgesia(PCA) could improve the pain management in patients receiving TACE for inoperable HCC. Methods: From June to December 2016, 84 HCC patients undergoing TACE procedure were enrolled. Because of the willingness of the individuals, it is difficult to randomize the patients to different groups. We matched the patients’ age, gender and pain scores, and divided the patients into the multimodal group( n = 42) and control group( n = 42). Patients in the multimodal group received 40 mg of parecoxib, 30 min before TACE, followed by 48 h of sufentanil-based PCA. Patients in the control group received a routine analgesic regimen, i.e., 5 mg of dezocine during operation, and 100 mg of tramadol or equivalent intravenous opioid according to patient’s complaints and pain intensity. Postoperative pain intensity, percentage of patients as per the pain category, adverse reaction, duration of hospital stay, cost-effectiveness, and patient’s satisfaction were all taken into consideration when evaluated. Results: Compared to the control group, the visual analogue scale scores for pain intensity was significantly lower at 2, 4, 6, and 12 h(all P pain con

关键词： Multimodal analgesia Transarterial chemoembolization Parecoxib pain management

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Hirudotherapy attenuates arthritic pain in patients with various chronic pain syndromes: A retrospective analysis

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Journal of Integrative Medicine 2020年第5期18卷 425-433页

作者： Johannes Loeser Brigitte Layer Christopher Plata Klaus-Maria Perrar Tim Hucho Rebecca Kulbida Department of Anaesthesiology and Intensive Care Medicine University Clinic of CologneKoeln 50937Germany Department of Palliative Care University Clinic of CologneKoeln 50937Germany

Objective: Osteoarthritis is a degenerative disease that affects synovial joints. Micro-injuries of articular structures initiate inflammatory processes, leading to persistent pain. Due to various risk factors,osteoarthritis is often diagnosed in multimorbid patients. This makes pain management one of the key challenges, with a consistent need for new therapeutic strategies. Hence, complementary and integrative methods such as hirudotherapy have become increasingly important, even though their mechanisms of action are not entirely ***: We retrospectively analyzed the longitudinal effect of a single leech application on osteoarthritic joints in a heterogenic cohort of 24 cases with various chronic pain syndromes. We assessed articular pain intensity ratings and movability of the treated joint after one-time leeching for up to 12 *** further investigated the effect of hirudotherapy on the systemic pain status and multimodal treatment strategies of the ***: There was a significant reduction in pain intensity ratings at the joint of leech application for up to 12 months after treatment. The improvements in pain intensities were independent of the form of osteoarthritis treated. In addition, we saw a considerable enhancement in local movability of the treated joint. Hirudotherapy did not seem to influence the systemic pain status as well as the previously established individualized multimodal treatment model of the ***: Leeching as an adjuvant therapy has a great potential especially in terms of safety and longterm outcome.

关键词： Hirudotherapy Medicinal leeching Chronic pain syndromes pain management Osteoarthritis

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Phenol-based endoscopic ultrasound-guided celiac plexus neurolysis for East Asian alcohol-intolerant upper gastrointestinal cancer patients:A pilot study

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World Journal of Gastroenterology 2014年第30期20卷 10512-10517页

作者： Hirotoshi Ishiwatari Tsuyoshi Hayashi Makoto Yoshida Michihiro Ono Hiroyuki Masuko Tsutomu Sato Koji Miyanishi Yasushi Sato Rishu Takimoto Masayoshi Kobune Atsushi Miyamoto Tomoko Sonoda Junji Kato Department of Medical Oncology and Hematology Sapporo Medical University School of MedicineSapporo 0600061Japan Department of Hospital Pharmacy Sapporo Medical University School of MedicineSapporo 0600061Japan Department of Public Health Sapporo Medical University School of MedicineSapporo 0600061Japan

AIM: To investigate the effectiveness of phenol for the relief of cancer pain by endoscopic ultrasound-guided celiac plexus neurolysis (EUS-CPN).

关键词： Celiac plexus neurolysis Celiac plexus blockade Endoscopic ultrasound Phenol pain management Upper gastrointestinal cancer

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Dexmededomidine in pediatric unilateral internal inguinal ring ligation

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World Journal of Clinical Cases 2022年第21期10卷 7376-7385页

作者： Guang Liu Ling Zhang Hui-Se Wang Yi Lin Hong-Quan Jin Xiao-Dan Wang Wei-Na Qiao Ya-Tao Zhang Jiao-Qian Sun Zhi-Na Liu Department of Anesthesiology Baoding Children's HospitalBaoding 071000Hebei ProvinceChina

BACKGROUND Safe and effective analgesia strategy remains one of the priorities for pediatric inguinal hernia *** To explore safety and efficacy of dexmededomidine monotherapy for postoperative analgesia in children who received laparoscopic unilateral internal inguinal ring *** This randomized single-center controlled trial included 390 children(aged 1-3 years,ASA grade I-II),randomly divided into a dexmededomidine group(D group),a dexmededomidine+sufentanil group(DS group),and a sufentanil group(S group).The primary endpoint was percentage of children with the Face,Legs,Activity,Cry,and Consolability(FLACC)score≤3 points 2 h after *** The comparisons of the FLACC scores at 2,4,6,8,12,and 24 h were not significantly different among the three groups(P>0.05).The sedative effects in the D group were significantly better than those in the S group(P>0.05),but not significantly different from those in the DS *** incidence of nausea and vomiting was significantly lower in the D group than in the S group and DS group(P>0.05).CONCLUSION Analgesic effects of dexmededomidine monotherapy are comparable to those of sufentanil alone or in combination with dexmededomidine for children who underwent laparoscopic unilateral internal inguinal ring ligation,with better sedative effects and a lower incidence of adverse events.

关键词： Child Dexmededomidine Inguinal hernia pain management Laparoscopy Analgesics

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Cognition and Sociodemographic Determinants for Effective pain Control in Patients with Cancer pain: a Cross-sectional Survey in China

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Current Medical Science 2020年第2期40卷 249-256页

作者： Xiao-fang SHANGGUAN Zao-qin YU Lu JI Yang-yang CHEN Hong-yan WU Rui HUANG Cheng-liang ZHANG School of Pharmacy Tongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China Deparment of Pharmacy Tongji HospialTongji Medical CollegeHuazhong University of Science and TechmologyWuhan 430030China School of Medicine and Health management Tongji Medical CollegeHuazhong University of Science cand TechnologyWuhan 430030China Deparment of Oncology Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China Department of Nursing Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430022China

This cross-sectional study aimed to investigate cancer patients'cognitive level of pain control and to evaluate the patient-related factors or barriers to effective cancer pain management in *** seven tertiary hospitals across China,372 patients experiencing cancer pain were surveyed through a self-designed questionnaire to assess the factors associated with effective pain ***'demographic data and pain control-related factors were *** sampling and binary logistic regression models were used to investigate the association between predictive factors and effective pain *** survey showed that the majority of the patients were more than 45 years old(76.3%),and 64.4%had an average annual income of more than 20000 ***-third of the patients suffered from cancer pain for more than 3 months,and 75.1%received professional guidance during *** barriers to pain control for patients included preference to enduring pain and refusing analgesics(62.9%),negligence towards drug usage(28.5%),concerns about the addiction(48.2%)and adverse reaction(56.4%).The average annual family income,pro fessional guidance,knowledge of pain medication,adherence to analgesics,and concerns about addiction to analgesics were significantly correlated to the effect of patients'pain *** study presents major barriers to optimal pain control among patients with cancer in *** findings suggest that educational programs and medical insurance reimbursement support from the government are urgently needed to overcome the cognitive barriers toward effective pain management and to relieve the economic burden among patients with cancer pain in China.

关键词： cancer pain cognition sociodemographic determinants pain control pain management

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Accuracy study of a binocular-stereo-vision-based navigation robot for minimally invasive interventional procedures

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World Journal of Clinical Cases 2020年第16期8卷 3440-3449页

作者： Ran Wang Ying Han Min-Zhou Luo Nai-Kun Wang Wei-Wei Sun Shi-Chong Wang Hua-Dong Zhang Li-Juan Lu Department of pain management Nanjing Drum Tower Hospital The Affiliated Hospital of Nanjing University Medical SchoolNanjing 210008Jiangsu ProvinceChina Institute of Intelligent Manufacturing Technology Jiangsu Industrial Technology Research InstituteNanjing 210000Jiangsu ProvinceChina

BACKGROUND Medical robot is a promising surgical tool,but no specific one has been designed for interventional treatment of chronic *** developed a computed tomography-image based navigation robot using a new registration method with binocular *** kind of robot is appropriate for minimal invasive interventional procedures and easy to *** feasibility,accuracy and stability of this new robot need to be *** To assess quantitatively the feasibility,accuracy and stability of the binocularstereo-vision-based navigation robot for minimally invasive interventional *** A box model was designed for assessing the accuracy for targets at different ***(three sets)lead spheres were embedded in the model as puncture *** entry-to-target distances were set 50 mm(short-distance),100 mm(medium-distance)and 150 mm(long-distance).Puncture procedure was repeated three times for each *** Euclidian error of each puncture was calculated and statistically *** head phantoms were used to explore the clinical feasibility and *** independent operators conducted foramen ovale placement on head phantoms(both sides)by freehand or under the guidance of robot(18 punctures with each method).The operation time,adjustment time and one-time success rate were recorded,and the two guidancemethods were *** On the box model,the mean puncture errors of navigation robot were 1.7±0.9 mm for the short-distance target,2.4±1.0 mm for the moderate target and 4.4±1.4 mm for the long-distance *** the head phantom,no obvious differences in operation time and adjustment time were found among the three performers(P>0.05).The median adjustment time was significantly less under the guidance of the robot than under free *** one-time success rate was significantly higher with the robot(P0.05).CONCLUSION In the laboratory environment,

关键词： Navigation robot Binocular stereo vision Interventional procedure pain management Trigeminal neuralgia Needle placement

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Effectiveness of pulsed radiofrequency on the medial cervical branches for cervical facet joint pain

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World Journal of Clinical Cases 2022年第22期10卷 7720-7727页

作者： Min Cheol Chang Seoyon Yang Department of Physical Medicine and Rehabilitation College of MedicineYeungnam UniversityTaegu 42415South Korea Department of Rehabilitation Medicine School of MedicineEwha Woman's University Seoul HospitalSeoul 07804South Korea

BACKGROUND Cervical facet joint pain(CFP)is one of the most common causes of neck pain and *** CFP deteriorates the quality of life of patients and reduces their productivity at *** To investigate the effectiveness of pulsed radiofrequency(PRF)stimulation of cervical medial branches in patients with chronic *** We retrospectively included 21 consecutive patients(age=50.9±15.3 years,range 26-79 years;male:female=8:13;pain duration=7.7±5.0 mo)with chronic CFP,defined as≥4 on the numeric rating scale(NRS).We performed PRF stimulation on the cervical medial *** outcomes of the PRF procedure were evaluated by comparing the NRS scores for CFP before treatment and 1 and 3 mo after *** pain relief was defined as a≥50%reduction in the NRS score at 3 mo when compared with the pretreatment NRS *** No patient had immediate or late adverse effects following *** average NRS score for CFP decreased from 5.3±1.1 at pre-treatment to 2.4±0.6 at the 1 mo follow-up,and 3.1±1.1 at the 3 mo *** to the NRS scores before PRF stimulation,those at 1 and 3 mo after PRF stimulation had significantly *** of the 21 patients(52.4%)reported successful pain relief 3 mo after the PRF *** stimulation on cervical medial branches may be a useful therapeutic option to control chronic *** PRF stimulation of the cervical medial branches may be used as an alternative treatment method in patients with *** can effectively alleviate CFP,and is safe to perform.

关键词： Pulsed radiofrequency treatment Zygapophyseal joint Chronic pain pain Neck pain pain management

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Effectiveness of patient education focusing on circadian pain rhythms:A case report and review of literature

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World Journal of Clinical Cases 2021年第17期9卷 4441-4452页

作者： Yoichi Tanaka Gosuke Sato Ryota Imai Michihiro Osumi Hayato Shigetoh Ren Fujii Shu Morioka Graduate School of Health Sciences Kio UniversityKitakatsuragi-gun 635-0832NaraJapan Department of Rehabilitation Nara Prefecture General Rehabilitation CenterShiki Gun Tawaramoto Cho 636-0345NaraJapan Neuro Rehabilitation Research Center Kio UniversityKitakatsuragi-gun 635-0832NaraJapan Department of Rehabilitation Osaka Kawasaki Rehabilitation UniversityKaizuka Shi 597-0104OsakaJapan

BACKGROUND Neuropathic pain management should aim at improving quality of life and daily living activities of patients;therefore,emphasis should be placed on pain management including understanding the pain patterns during daily ***,lifestyle guidance should be based on a detailed understanding of pain;however,previous studies commonly evaluated pain intensity at a single point in *** report a case on patient education intervention based on the relationship between pain circadian rhythms and detailed physical activity during the *** SUMMARY A man in his 60s,who suffered a brachial plexus injury in a traffic accident,presented with neuropathic *** assessment of the importance of daily living activities to the patient,pain rhythmicity,and physical activity,was *** early assessments showed that the pain intensity was lower on days when more light-intensity physical activity(LIPA)was performed,than on days when less LIPA was ***,patient education focused on methods to decrease the pain intensity that tended to worsen in the afternoon,and encouraged behavioral changes by suggesting the patient to take walks,which could be used to maintain LIPA in the *** reassessment,the afternoon LIPA,which had been the focus of attention,had increased and a change was noted in the circadian rhythm of *** Patient education based on a composite assessment elicited positive results in relation to the pain circadian rhythm and physical activity.

关键词： Circadian rhythms Physical activity Neuropathic pain pain management Patient education Case report

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Lipid bound extended release buprenorphine(high and low doses)and sustained release buprenorphine effectively attenuate post-operative hypersensitivity in an incisional pain model in mice(Mus musculus)

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Animal Models and Experimental Medicine 2021年第2期4卷 129-137页

作者： Kaela Navarro Katechan Jampachaisri Monika Huss Cholawat Pacharinsak Department of Comparative Medicine Stanford UniversityStanfordCAUSA Department of Mathematics Naresuan UniversityPhitsanulokThailand

Background:Extended-release buprenorphine(XR)is indicated for pain management in rodents,but little is known about its use in *** study aimed to investigate whether high dose XR effectively attenuates post-operative hypersensitivity better than low dose XR in a mouse model of incisional ***:Mice(n 44)were randomly assigned to 1 of 4 treatment groups:(a)saline(1 ml/kg SC,once);(b)sustained release buprenorphine(Bup-SR,1 mg/kg SC,once);(c)low dose extended-release buprenorphine(XR-lo,3.25 mg/kg SC,once);(d)high dose extended-release buprenorphine(XR-hi,6.5 mg/kg SC,once).On days􀆴1,0(4 hours),1,2,and 3,mechanical and thermal hypersensitivities were evaluated,and plasma buprenorphine concentrations were ***:Mechanical(days 0-2)and thermal(days 0-1)hypersensitivities were ob-served in the saline ***-SR,XR-lo,and XR-hi attenuated mechanical hyper-sensitivity on days 0,1,and *** of the treatment groups,except XR-Lo on day 0,attenuated thermal hypersensitivity on days 0 or *** buprenorphine concen-tration peaked at 4 hours(day 0)in all treatment groups and remained greater than 1 ng/mL on days *** abnormal clinical observations or gross pathologic findings were seen in any ***:The results indicate XR-hi did not effectively attenuate post-operative hypersensitivity better than *** both 3.25 and 6.5 mg/kg XR are recom-mended for attenuating post-operative hypersensitivity for at least up to 48 hours in mice.

关键词： analgesia analgesics buprenorphine mouse pain management

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NATIONAL SURVEY ON PREVALENCE OF CANCER pain

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Chinese Medical Sciences Journal 2001年第3期16卷 175-178页

作者：刘志民连智周伟华穆悦吕宪祥赵苳蔡志基曹家琪任正洪 National Institute on Drug Dependence Peking University public Health School Peking University

Objective. To collect nationwide basic data about cancer related pain. Methods. Sixty cancer patients in each province were randomly selected to participate in this survey. The subjects represented all stages of cancer, tumor sites, and different demographic characteristics. Two self- designed structured questionnaires including reasons, types of pain and pain management were used by patients and physicians respectively. Subjects were asked to report whether he/she had experienced any type of cancer related pain and filled out the equivalent questionnaire. The severity of pain was assessed by using“ visual analogue scale” . Original data input and analysis were using EPI- INFO software package. Results. The result showed that 61.6％ (958/1555) of patients had different types of cancer related pain. Majority of pain (85.1％ ) were caused by advanced cancer. The major reasons (64.4％ ) for poor management or impedimental factors of pain care are due to patient including over- concern on opioid analgesic addiction, reluctance to report pain or refused to use opioid analgesic until at times when pain is intolerable; 26.8％ belonged to physician’s reasons including fear to cause addiction on opioid and lack of knowledge about cancer pain management; 16.2％ are due to lack of different kinds of opioid analgesic for use and 16.1％ belonged to drug regulation. Conclusions. The results showed that majority of patients (61.6％ ) had different types of cancer related pain. In most of patients, cancer pain was relieved when they were treated. The major reason for under- treatment or impeded factors for effective relief of cancer pain was fear of opioid addiction by both medical professionals and patients.

关键词： neoplasm epidemiology pain management

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