Meta‐analyses of gabapentinoids for pain management after knee arthroplasty ‐ a caveat emptor? A narrative review

2021 ◽  
Author(s):  
Girish P. Joshi ◽  
Henrik Kehlet
Keyword(s):  
Pain Management ◽  
Knee Arthroplasty ◽  
Narrative Review ◽  
Caveat Emptor ◽  
Meta Analyses

scholarly journals Methods for Pain Assessment in Calves and Their Use for the Evaluation of Pain during Different Procedures—A Review

Animals ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 1235
Author(s):  
Theresa Tschoner
Keyword(s):  
Pain Management ◽  
Pain Assessment ◽  
Research Data ◽  
Narrative Review ◽  
Literature Research ◽  
Field Practice ◽  
Definition Of ◽  
Evaluation And Assessment

The evaluation and assessment of the level of pain calves are experiencing is important, as the experience of pain (e.g., due to routine husbandry procedures) severely affects the welfare of calves. Studies about the recognition of pain in calves, and especially pain management during and after common procedures, such as castration, dehorning, and disbudding, have been published. This narrative review discusses and summarizes the existing literature about methods for pain assessment in calves. First, it deals with the definition of pain and the challenges associated with the recognition of pain in calves. Then it proceeds to outline the different options and methods for subjective and objective pain assessment in calves, as described in the literature. Research data show that there are several tools suitable for the assessment of pain in calves, at least for research purposes. Finally, it concludes that for research purposes, various variables for the assessment of pain in calves are used in combination. However, there is no variable which can be used solely for the exclusive assessment of pain in calves. Also, further research is needed to describe biomarkers or variables which are easily accessible in the field practice.

scholarly journals Topical Treatments and Their Molecular/Cellular Mechanisms in Patients with Peripheral Neuropathic Pain—Narrative Review

Pharmaceutics ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 450
Author(s):  
Magdalena Kocot-Kępska ◽  
Renata Zajączkowska ◽  
Joanna Mika ◽  
David J. Kopsky ◽  
Jerzy Wordliczek ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Pain Management ◽  
Clinical Studies ◽  
Neuronal Cells ◽  
Case Series ◽  
Narrative Review ◽  
Peripheral Sensitization ◽  
Cellular Mechanisms ◽  
Peripheral Neuropathic Pain ◽  
Topical Treatments

Neuropathic pain in humans results from an injury or disease of the somatosensory nervous system at the peripheral or central level. Despite the considerable progress in pain management methods made to date, peripheral neuropathic pain significantly impacts patients’ quality of life, as pharmacological and non-pharmacological methods often fail or induce side effects. Topical treatments are gaining popularity in the management of peripheral neuropathic pain, due to excellent safety profiles and preferences. Moreover, topical treatments applied locally may target the underlying mechanisms of peripheral sensitization and pain. Recent studies showed that peripheral sensitization results from interactions between neuronal and non-neuronal cells, with numerous signaling molecules and molecular/cellular targets involved. This narrative review discusses the molecular/cellular mechanisms of drugs available in topical formulations utilized in clinical practice and their effectiveness in clinical studies in patients with peripheral neuropathic pain. We searched PubMed for papers published from 1 January 1995 to 30 November 2020. The key search phrases for identifying potentially relevant articles were “topical AND pain”, “topical AND neuropathic”, “topical AND treatment”, “topical AND mechanism”, “peripheral neuropathic”, and “mechanism”. The result of our search was 23 randomized controlled trials (RCT), 9 open-label studies, 16 retrospective studies, 20 case (series) reports, 8 systematic reviews, 66 narrative reviews, and 140 experimental studies. The data from preclinical studies revealed that active compounds of topical treatments exert multiple mechanisms of action, directly or indirectly modulating ion channels, receptors, proteins, and enzymes expressed by neuronal and non-neuronal cells, and thus contributing to antinociception. However, which mechanisms and the extent to which the mechanisms contribute to pain relief observed in humans remain unclear. The evidence from RCTs and reviews supports 5% lidocaine patches, 8% capsaicin patches, and botulinum toxin A injections as effective treatments in patients with peripheral neuropathic pain. In turn, single RCTs support evidence of doxepin, funapide, diclofenac, baclofen, clonidine, loperamide, and cannabidiol in neuropathic pain states. Topical administration of phenytoin, ambroxol, and prazosin is supported by observational clinical studies. For topical amitriptyline, menthol, and gabapentin, evidence comes from case reports and case series. For topical ketamine and baclofen, data supporting their effectiveness are provided by both single RCTs and case series. The discussed data from clinical studies and observations support the usefulness of topical treatments in neuropathic pain management. This review may help clinicians in making decisions regarding whether and which topical treatment may be a beneficial option, particularly in frail patients not tolerating systemic pharmacotherapy.

scholarly journals Commonly Used Agent for Acute Pain Management of Sickle Cell Anemia in Saudi Emergency Department: a Narrative Review

2021 ◽  
Author(s):  
Reem A. Hejazi ◽  
Nameer A. Mandourah ◽  
Aryaf S. Alsulami ◽  
Hussain T. Bakhsh ◽  
Reem M. Diri ◽  
...  
Keyword(s):  
Emergency Department ◽  
Pain Management ◽  
Sickle Cell ◽  
Sickle Cell Anemia ◽  
Acute Pain ◽  
Narrative Review ◽  
Acute Pain Management

Rehabilitation and Pain Management Modalities in Total Knee Arthroplasty

2016 ◽  
Vol 29 (03) ◽  
pp. 179-179 ◽  
Author(s):  
Morad Chughtai ◽  
Randa Elmallah ◽  
Jeffrey Cherian ◽  
Jaydev Mistry ◽  
Steven Harwin ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Pain Management ◽  
Knee Arthroplasty ◽  
Total Knee

scholarly journals Anxiety as a risk factor for cardiovascular disease independent of depression: A narrative review of current status and conflicting findings

2021 ◽  
Vol 8 (1) ◽  
pp. 205510292098746
Author(s):  
Håvard R Karlsen ◽  
Florian Matejschek ◽  
Ingvild Saksvik-Lehouillier ◽  
Eva Langvik
Keyword(s):  
Cardiovascular Disease ◽  
Risk Factor ◽  
Study Design ◽  
Empirical Support ◽  
Narrative Review ◽  
Current Status ◽  
Depression And Anxiety ◽  
Evidential Support ◽  
Meta Analyses

The aim of this paper is to summarise and evaluate the empirical support for the association between anxiety and cardiovascular disease (CVD) and to address challenges related to method and study design. We review results from meta-analyses and more recent findings on the association of anxiety and the risk of CVD. Depression and anxiety are often listed as psychosocial risk markers of CVD, but the role of anxiety as a risk factor for CVD has not received the same evidential support as the effects of depression. Through a narrative review we identified six meta-analyses as well as 15 recent large studies of anxiety and CVD that we summarise. Some of the conflicting findings may be artefacts of study design or population the sample is drawn from. Researchers should take care to be population specific, measurement specific and outcome specific, and to control for comorbid depression.

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