Comparing the Efficacy of Dorsal Root Ganglion Stimulation With Conventional Medical Management in Patients With Chronic Postsurgical Inguinal Pain: Post Hoc Analyzed Results of the SMASHING Study.

Objectives: Approximately 10% of patients who undergo inguinal hernia repair or Pfannenstiel incision develop chronic (> three months) postsurgical inguinal pain (PSIP). If medication or peripheral nerve blocks fail, a neurectomy is the treatment of choice. However, some patients do not respond to this treatment.

Long-Term Effects of Dexmedetomidine versus Propofol During the Implantation of a Neurostimulator-A Post-Trial Follow-Up Analysis.

Objective: The success of neurostimulation depends partly on the amount of coverage of the neurostimulation-induced paresthesia of the painful area. This is often achieved by asking feedback from patients intraoperatively. If sedation analgesia is used, it is important that the patient is comfortable during sedation and easily arousable.

Ketamine therapy for chronic pain in The Netherlands: a nationwide survey.

Objectives: Ketamine is used to treat chronic refractory pain. However, there are no scientific guidelines for ketamine use in the Netherlands. The aim of this survey was to provide an overview of the use of ketamine for chronic pain in the Netherlands.

Effect of intravenous low-dose S-ketamine on pain in patients with Complex Regional Pain Syndrome: A retrospective cohort study.

Objective: The objective of this study was to assess the effectiveness of a low-dose intravenous S-ketamine treatment on refractory pain in patients with Complex Regional Pain Syndrome (CRPS).

Methods: In this retrospective study, patients with CRPS who received intravenous S-ketamine from March 2010 to April 2019 were included. According to our inpatient protocol, S-ketamine dose was increased until pain reduction was achieved or side effects were observed.

The Effect of Percutaneous Nucleoplasty vs Anterior Discectomy in Patients with Cervical Radicular Pain due to a Single-Level Contained Soft-Disc Herniation: A Randomized Controlled Trial.

Background: Cervical radicular pain (CRP) is a common problem in the adult population. When conservative treatment fails and the severe pain persist, surgical treatment is considered. However, surgery is associated with some serious risks.

The Relation Between Patients' Beliefs About Pain Medication, Medication Adherence, and Treatment Outcome in Chronic Pain Patients: A Prospective Study.

Objectives: Nonadherence to prescribed pain medication is common in chronic noncancer pain patients. Beliefs about pain medication have been reported to be associated with nonadherence behavior in cross-sectional studies. The aim of this study was to prospectively investigate the relationship between patients' beliefs about pain medication and their medication adherence and treatment outcome.

Survey on sedation-analgesia regimens, in particular the use of dexmedetomidine, among Dutch implanters of spinal cord neurostimulators.

Background And Aims: During implantation of most spinal cord neurostimulators, patients need to be cooperative to give feedback during lead placement, and also be comfortable. Sedation and analgesia can support these conditions. This survey aimed to provide an overview of the sedation-analgesia regimens currently used among Dutch pain specialists.

Dexmedetomidine vs propofol as sedation for implantation of neurostimulators: A single-center single-blinded randomized controlled trial.

Background: During the lead implantation of most spinal cord neurostimulators, the patient has to be comfortable and without pain. However, the patient is expected to provide feedback during electrical mapping. Titrating sedatives and analgesics for this double goal can be challenging.

Clinical Course and Impact of Complex Regional Pain Syndrome Confined to the Knee.

Objective: Although complex regional pain syndrome (CRPS) of the knee is comparable to CRPS of the ankle/foot at time of diagnosis, no reports are available concerning the course of knee CRPS. Therefore, this study investigated the clinical course in terms of the symptoms and signs, health-related quality of life (HR-QoL), and work status of patients diagnosed with CRPS of the knee.

Design: Observational, descriptive study.

Adding steroids to lidocaine in a therapeutic injection regimen for patients with abdominal pain due to anterior cutaneous nerve entrapment syndrome (ACNES): a single blinded randomized clinical trial.

Background and aims Anterior cutaneous nerve entrapment syndrome (ACNES) may result in chronic abdominal pain. Therapeutic options include local injection therapy. Data on the efficacy of adding corticosteroids to these injections is lacking.

Spinal Cord Stimulation in Patients With Complex Regional Pain Syndrome: A Possible Target for Immunomodulation?

Objective: Complex regional pain syndrome (CRPS) is characterized by continued pain disproportional to the inciting event, sensory abnormalities, vasomotor and sudomotor disturbances, and motor and trophic changes. Inflammatory involvement has been demonstrated in past CRPS studies resulting in pain, swelling, and warmth. Currently, it is unknown whether spinal cord stimulation (SCS) has immunomodulatory properties.

The design of a theory-based intervention to improve medication adherence in chronic pain patients.

Objective: Non-adherence to pain medication is common in chronic pain patients and may result in unfavorable treatment outcomes. Interventions to improve adherence behavior often fail to significantly change medication use. In this report, we describe the application of a theoretical psychological model of behavior change in order to design an intervention to improve medication adherence in chronic pain patients.

Dorsal Column Stimulation vs. Dorsal Root Ganglion Stimulation for Complex Regional Pain Syndrome Confined to the Knee: Patients' Preference Following the Trial Period.

Background And Objectives: Patients with complex regional pain syndrome (CRPS) confined to the knee are often therapy resistant. Neurostimulation is an accepted treatment for CRPS. Although results with dorsal column (DC) stimulation in patients with CRPS confined to the knee are often disappointing, the availability of dorsal root ganglion (DRG) stimulation may provide new opportunities for this complaint.

Phenotypic Variation in Complex Regional Pain Syndrome: Comparison Between Presentation in Knee Alone or in Ankle/Foot.

Objective: To compare the phenotypes of patients with complex regional pain syndrome (CRPS) of the knee to those with CRPS of the ankle/foot.

Setting: A retrospective study.

Subjects: Patients with CRPS of the knee and patients with CRPS of the ankle/foot.

Efficacy of Dexmedetomidine as a Sole Sedative Agent in Small Diagnostic and Therapeutic Procedures: A Systematic Review.

Dexmedetomidine is an upcoming agent with sedative, anxiolytic, and analgesic properties. This review summarizes empirical evidence for the efficacy of dexmedetomidine as a sole sedative agent, and its effectiveness for small diagnostic and therapeutic procedure, in comparison with other frequently used sedatives. All randomized controlled trials on the effect of dexmedetomidine were reviewed.

Inter-rater reliability of diagnostic criteria for sacroiliac joint-, disc- and facet joint pain.

Background/objective: Several diagnostic criteria sets are described in the literature to identify low back pain subtypes, but very little is known about the inter-rater reliability of these criteria. We conducted a study to determine the reliability of diagnostic tests that point towards SI joint-, disc- or facet joint pain.

Methods: Inter-rater reliability study alongside three randomized clinical trials.

Randomized Sham-controlled Double-Blind Multicenter Clinical Trial to Ascertain the Effect of Percutaneous Radiofrequency Treatment for Sacroiliac Joint Pain: Three-month Results.

Objectives: To investigate the effect of a percutaneous radiofrequency (RF) heat lesion compared with a sham procedure, applied to the lateral branches of L5, S1, S2, S3, and S4 nerve roots.

Materials And Methods: Sixty patients aged 18 years and above with a medical history and physical examination suggestive for sacroiliac joint pain and a reduction of 2 or more on a numerical rating scale (NRS, 0 to 10) after a sacroiliac joint test block were included in this study. Treatment group: percutaneous RF heat lesion at the lateral branches of S1, S2, S3, and S4 nerve roots and the posterior ramus dorsalis of L5; sham group: same procedure as the treatment group except for the RF heat lesion.

The Value of Medication-Specific Education on Medication Adherence and Treatment Outcome in Patients with Chronic Pain: A Randomized Clinical Trial.

Objective: Non-adherence to pain medication is common and may jeopardize the effect of prescribed therapy in chronic pain patients. We investigated the effect of medication-specific education on pain medication adherence.

Methods: One hundred eligible chronic pain patients were randomized into a control or intervention group.

Dexmedetomidine as a Sedative in the Awake Implantation of a Neuromodulative System.

Objective: During implantation of a neuromodulative system, high patient satisfaction is closely associated with the equilibrium between an effective analgesia and sedation regimen, and the possibility for the patient to be awake and cooperative during procedure. This study assessed the efficacy of the sedative dexmedetomidine to achieve this balance, with patient satisfaction as the primary outcome.

Methods: Ten patients undergoing implantation of a dorsal column and dorsal root ganglion stimulator received dexmedetomidine (1 mcg/kg over 10 minutes, followed by 0.

The prevalence of autoantibodies in complex regional pain syndrome type I.

Autoimmunity has been suggested as one of the pathophysiologic mechanisms that may underlie complex regional pain syndrome (CRPS). Screening for antinuclear antibodies (ANA) is one of the diagnostic tests, which is usually performed if a person is suspected to have a systemic autoimmune disease. Antineuronal antibodies are autoantibodies directed against antigens in the central and/or peripheral nervous system.

The tryptophan kynurenine pathway, neopterin and IL-6 during vulvectomy and abdominal hysterectomy.

Background: Surgery has wide ranging immunomodulatory properties of which the mechanism is poorly understood. In order to investigate how different types of surgery influence inflammation, we designed a longitudinal observational study investigating two inflammatory profiles of two separate patient groups undergoing gynaecological operations of differing severity. In addition to measuring the well known inflammatory markers neopterin and IL-6, we also determined the kynurenine/tryptophan ratio.

Successful treatment of intractable complex regional pain syndrome type I of the knee with dorsal root ganglion stimulation: a case report.

Objectives: To report on the efficacy of dorsal root ganglion stimulation in a patient with complex regional pain syndrome (CRPS) type I of the knee.

Materials And Methods: A 48-year-old woman with CRPS type I of the right knee, diagnosed according to the Budapest criteria set, received DRG stimulation for intractable CRPS type I of the knee.

Results: After a successful trial period with three DRG stimulation leads on spinal levels L2, L3, and L4 (covering 90% of the painful area of her knee), a definitive pulse generator was implanted.

Adherence to pharmacological pain therapy in patients with nonmalignant pain: the role of patients' knowledge of pain medication.

Background: Nonadherence to pharmacological therapy is a common and underexposed problem in patients with chronic nonmalignant pain. It may lead to treatment failure and increased healthcare costs.

Methods: In this prospective observational study we analyzed the association between knowledge and adherence in the chronic nonmalignant pain population.

Report of a preliminary discontinued double-blind, randomized, placebo-controlled trial of the anti-TNF-α chimeric monoclonal antibody infliximab in complex regional pain syndrome.

Objective: Inflammation appears to play a role in CRPS as, for example, cytokines (like TNF-α) are involved in the affected limb. The ongoing inflammation is probably responsible for the central sensitization that sometimes occurs in CRPS. Thus, early start of a TNF-α antagonist may counteract inflammation, thereby preventing rest damage and leading to recovery of the disease.