Nitrous oxide (N2O) is an odorless and colorless gas routinely used as an adjuvant of anesthesia and for short-duration analgesia in various clinical settings mostly in the form of an N2O/O2 50%-50% equimolar mixture (EMONO). Experimental studies have suggested that EMONO could also induce long-lasting analgesic effects related to the blockade of N-methyl-D-aspartate receptors. We designed the first international multicenter proof of concept randomized, placebo-controlled study to assess the efficacy and safety of a 1-hour administration of EMONO or placebo (medical air) on 3 consecutive days up to 1 month after the last administration in patients with chronic peripheral neuropathic pain.
View Article and Find Full Text PDFBackground: Recent studies have highlighted multicolumn spinal cord stimulation (SCS) efficacy, hypothesizing that optimized spatial neural targeting provided by new-generation SCS lead design or its multicolumn programming abilities could represent an opportunity to better address chronic back pain (BP).
Objective: To compare multicolumn vs. monocolumn programming on clinical outcomes of refractory postoperative chronic BP patients implanted with SCS using multicolumn surgical lead.
Chronic postsurgical neuropathic pain (CPSNP) is frequent. While prevalence varies considerably according to type of operation and means of evaluation, it can reach 37% following breast surgery. Identification of risk factors related to the procedure and to the patient and taking into account the development of new, minimally invasive surgical techniques is increasingly nerve-sparing and reduces the likelihood of injury.
View Article and Find Full Text PDF: To determine the mean number of procedural painful episodes per patient, and to retrieve information regarding diagnosis, therapeutic procedures and analgesic management, in patients visiting Emergency Departments (EDs) for minor trauma. : This observational, non-interventional, multicenter study in adult patients was performed in 35 French EDs. All patients entering the EDs for minor trauma on a specified day between noon and 10 pm were registered; consenting patients were included in the study.
View Article and Find Full Text PDFThe objective of the present systematic literature review was to provide an update on medical treatment of neuropathic pain in cancer patients. The number of cancer patients is steadily increasing. Pain is frequent in cancer patients.
View Article and Find Full Text PDFClinicoecon Outcomes Res
November 2018
Cancer pain is one of the most common, feared, debilitating, and often undertreated symptoms among cancer patients. It needs attention since it has a significant impact on the quality of life (QoL) of the patients. Also, since cancer has emerged as a major health problem in developing countries, there is a need to strengthen preventive strategies for effective cancer pain management and provide comfort to cancer patients.
View Article and Find Full Text PDFPurpose: This study aimed to estimate the prevalence of pain among French adults and assess the impact of pain on health-related quality of life (HRQoL), activity impairment, and health care resource use (HRU).
Patients And Methods: Respondents from the 2015 France National Health and Wellness Survey (N=19,173) were categorized by self-reported pain (experienced pain in the past 12 months vs no pain) and compared on HRQoL (36-Item Short Form Health Survey version 2: Mental Component Summary, Physical Component Summary, and Short Form-6 Dimensions health utilities), activity impairment (Work Productivity and Activity Impairment questionnaire), employment status, and HRU (health care provider visits, emergency room visits, and hospitalizations). Bivariate analyses examined differences between pain groups stratified by age, sex, income, and Charlson comorbidity index (CCI) scores.
Objective: To assess efficacy and safety of tapentadol prolonged release (PR) for moderate-to-severe chronic osteoarthritis knee pain.
Methods: Patients (n = 990) were randomized (1:1:1) to tapentadol PR, oxycodone controlled release (CR; reference compound for assay sensitivity), or placebo for a double-blind 3-week titration and 12-week maintenance period. Primary efficacy end-points were change from baseline in average pain intensity at week 12 of maintenance (US end-point) and over the entire maintenance period (non-US end-point) with "last observation carried forward" as imputation method for missing scores.
Migraine is a primary headache disorder (according to the latest International Headache Society criteria) affecting approximately 8% of African population. Women are more often affected than men and attacks usually occur before the age of 40 years Although some treatments, hygienic-dietary measures and other non-pharmacological methods can reduce the intensity and frequency of attacks, medicinal treatment of migraine attack is often necessary. Availability of treatments and access to care differ in Africa and led to the implementation of the first expert consensus recommendations for the management of the migraine in african adult patients.
View Article and Find Full Text PDFPain is a real issue of public health, quality and evolution of a system of health test: this is a major social problem. Pain management meets a humanistic, ethical purpose and dignity of man because of the physical and psychological implications. It induces a disability which excludes the patient of society gradually or suddenly.
View Article and Find Full Text PDFBackground: Many studies have demonstrated the efficacy of spinal cord stimulation (SCS) for chronic neuropathic radicular pain over recent decades, but despite global favourable outcomes in failed back surgery syndrome (FBSS) with leg pain, the back pain component remains poorly controlled by neurostimulation. Technological and scientific progress has led to the development of new SCS leads, comprising a multicolumn design and a greater number of contacts. The efficacy of multicolumn SCS lead configurations for the treatment of the back pain component of FBSS has recently been suggested by pilot studies.
View Article and Find Full Text PDFObjective: Evaluation of acute pain in patients with language barriers is often difficult during humanitarian missions. Algoplus, a behavioral scale validated for acute pain evaluation in Caucasians with verbal communication difficulties, was tested during a clinical mission in Cambodia in patients admitted to hospital for acute pain.
Methods: Patients (N = 33, 19 men and 14 women [38 ± 3 years old]) suffering from acute pain were admitted to Calmette Hospital, Phnom Penh, Cambodia during June 2010.
In 2007, the Plan for the improvement of the quality of life of people with chronic diseases stressed that support for pain was the first expectations of patient associations. And pain support is primarily the field of competence of the treating physician. It is in this context, that (HAS) recommendations were developed to promote the implementation of care tailored for people expressing a chronic pain.
View Article and Find Full Text PDFAn increasing number of obese patients are undergoing surgery, particularly bariatric and orthopaedic surgery. The physiological differences between obese and normal-weight subjects may modify not only anaesthetic requirements during surgery but also post-operative analgesic management, raising a number of challenges in a critical period. In this review, we analyse studies of post-operative pain management with opioids in obese subjects.
View Article and Find Full Text PDFJ Natl Compr Canc Netw
March 2013
As management of patients with cancer is evolving, an increased focus is being placed on individualized patient-centered care. Early integration of palliative care into the overall management of patients with cancer can help achieve this paradigm shift. Despite recommendations for earlier integration of palliative care by national and international societies, several barriers remain to achieving this goal.
View Article and Find Full Text PDFObjective: To evaluate the efficacy and safety of the paracetamol-tramadol combination (PTC) in treating moderate-to-severe pain, in patients aged 65 years and over within general practitioner (GP) practice centers.
Research Design And Methods: This was an observational, non-interventional, longitudinal, multicenter, open, non-comparative, prospective study. This intermediary analysis was of patients recruited before the French Health Authority confirmation (25th June, 2009) of the EMEA decision to withdraw all analgesics containing dextropropoxyphen.
We used functional magnetic resonance imaging (fMRI) to analyze changes in brain activity associated with stimulation of the cutaneous trigger zone in patients with classic trigeminal neuralgia (CTN). Fifteen consecutive patients with CTN in the second or third division of the nerve, were included in this study. The fMRI paradigm consisted of light tactile stimuli of the trigger zone and the homologous contralateral area.
View Article and Find Full Text PDFWe report the results of an investigation carried out on the activity of functional neurosurgery of the cranial nerves in the French-speaking countries, based on the analysis of a questionnaire addressed to all the members of the SNCLF. Eighteen centers responded to this questionnaire, which showed that activities and indications varied greatly from one unit to another. The results appear homogeneous and comparable with those reported in the literature.
View Article and Find Full Text PDFObjective: To study pain coping strategies in patients with hip and knee osteoarthritis (OA), and to assess the psychometric qualities of the French version of the Pain Coping Inventory (PCI).
Methods: We conducted a national, cross-sectional survey in a primary care setting in France. A total of 1,811 general practitioners included 5,324 patients with hip and knee OA who completed several questionnaires, including the PCI, which assesses ability to cope with pain.
Objective: To evaluate the effects of a short interactive training program for general practitioners (GP) on pain management in patients with osteoarthritis (OA).
Methods: A multicenter, parallel-group study. GP were randomized to receive training on relationships and communication, pain evaluation, prescription, and negotiation of a patient contract or to a control group receiving a presentation about obtaining consent in trials.