Role of Antidepressants in the Management of Pain

Waldman, Steven D.; Waldman, Corey W.

doi:10.1016/b978-1-4377-0721-2.00123-9

Cited by 16 publications

(22 citation statements)

References 20 publications

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“…The sites of injection points were selected based on Hilton’s law and chronic constitutional injury (CCI) injection points (Figure 1A) introduced previously 22. According to acupuncture sites depicted in Figures 1B and C for knee osteoarthritis, the trigger points are selected for injection of dextrose.…”

Section: Discussionmentioning

confidence: 99%

Periarticular dextrose prolotherapy instead of intra-articular injection for pain and functional improvement in knee osteoarthritis

Rezasoltani¹,

Taheri²,

Mofrad³

et al. 2017

JPR

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BackgroundOsteoarthritis (OA) is a degenerative disease that can lead to painful and dysfunctional joints. Prolotherapy involves using injections to produce functional restoration of the soft tissues of the joint. Intra-articular injections are controversial because of the introduction of needles into the articular capsule.ObjectivesTo compare the effect of periarticular versus intra-articular prolotherapy on pain and disability in patients with knee OA.Study designRandomized double-blind controlled clinical trial.SettingSingle center, university hospital (Imam Hossein Hospital, Tehran, Iran).MethodsA total of 104 patients with chronic knee OA were enrolled. In the intra-articular group, 8 mL of 10% dextrose and 2 mL of 2% lidocaine were injected. Injections were repeated at 1 and 2 weeks after the first injection. In the periarticular group, 5 mL of 20% dextrose and 5 mL of 1% lidocaine were injected subcutaneously at 4 points in the periarticular area. Pain and disability, as assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), were recorded at each follow-up visit at 1, 2, 3, 4, and 5 months post-injection.ResultsThe visual analog scale score was significantly lower in the periarticular compared with the intra-articular group at the 2-, 3-, 4-, and 5-month visits but not at 1 month. Morning stiffness and difficulty in rising from sitting were improved in both groups and were not signifi-cantly different in the peri- and intra-articular groups. Pain, joint locking, and limitation scores were all improved in both groups. Difficulty in walking on flat surfaces or climbing stairs, and sitting and standing pain, were all improved in both groups from 1 to 5 months after treatment.LimitationsWOMAC scores are subjective and could be a limitation of the study.ConclusionPeriarticular prolotherapy has comparable effects on pain and disability due to knee OA to intra-articular injections, while avoiding risks of complications.

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Section: Discussionmentioning

confidence: 99%

Periarticular dextrose prolotherapy instead of intra-articular injection for pain and functional improvement in knee osteoarthritis

Rezasoltani¹,

Taheri²,

Mofrad³

et al. 2017

JPR

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“…Pain is a subjective sense expressed by the patients and cannot be effortlessly measured by the clinicians (1). Available physiologic markers cannot reliably assess the pain severity, as well (2).…”

Section: Introductionmentioning

confidence: 99%

Does Changes in the Electrical Resistance of an Acupuncture Meridian Predict Pain Intensity Following Orthopedic Surgery?

et al. 2012

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BackgroundSeveral methods for assessment of severity of pain have been proposed but all of them are subjective.ObjectivesThis study evaluated the association concerning changes in electrical resistance (ER) between two acupuncture points and severity of postoperative pain in order to define an objective measurement of pain.Patients and MethodsIn a cross-sectional study, 50 patients undergoing lower extremity orthopedic surgery with postoperative moderate to severe pain (VAS > 4,) were consecutively enrolled. In the recovery room, the patients' pain scores were assessed and in patients with VAS > 4, the electrical resistance between Li4 and Li11 acupuncture points as well as pain scores was measured prior and following analgesic administration.ResultsFollowing meperidine use, the mean VAS significantly decreased and the ER between the two acupoints was significantly increased. However, Pearson correlation analysis did not reveal any association between the trends of pain intensity and ER (P > 0.05). The ER change in patients operated under epidural anesthesia was significantly less than those who experienced general or spinal anesthesia.ConclusionsThere is a coincidence of pain relief and change in the ER of acupuncture meridians without significant association. The diagnostic value of ER for pain, stress response or any other physiologic outcome needs to be investigated in clinical trials with a well-defined control group, with more accurate instruments and probably in different acupuncture meridians.

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“…Postganglionic axons may join the gray rami communicantes, which join the cervical nerve supply to cervical portion of the brachial plexus. 8 Stellate ganglion can be blocked with a local anesthetic to induce a sympatholytic effect in the ipsilateral upper extremity, thus, increased perfusion. PRF ablation of the stellate ganglion has been reported to be used for pain syndromes such as radiculopathies, complex regional pain syndrome, postherpetic neuralgia, and postmastectomy/sternotomy pain.…”

Section: Discussionmentioning

confidence: 99%

Radiofrequency Ablation of the Stellate Ganglion for Management of Acute Digital Ischemia: A Case Report

2018

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The authors present a report of a pulsed radiofrequency ablation of the stellate ganglion performed on a patient with microemboli to the hand from a thrombosed abandoned arteriovenous fistula. The patient was initially managed using vasodilators and anticoagulation. However, the patient’s skin mottling, pain, and decreased strength persisted. Ablation of the stellate ganglia increased perfusion to his hand and likely prevented amputation that has lasted for approximately 1 year. While radiofrequency ablation is more commonly used for pain syndromes, this is an example of its use in the treatment and potential treatment of acute ischemia.

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Role of Antidepressants in the Management of Pain

Cited by 16 publications

References 20 publications

Periarticular dextrose prolotherapy instead of intra-articular injection for pain and functional improvement in knee osteoarthritis

Periarticular dextrose prolotherapy instead of intra-articular injection for pain and functional improvement in knee osteoarthritis

Does Changes in the Electrical Resistance of an Acupuncture Meridian Predict Pain Intensity Following Orthopedic Surgery?

Radiofrequency Ablation of the Stellate Ganglion for Management of Acute Digital Ischemia: A Case Report

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