Assessing Postoperative Benefits of a Nerve Block: Study Design is Critical [Letter]

Background: Genicular nerve ablation with radiofrequency (RF) has recently emerged as a promising treatment in the management of osteoarthritis related knee pain. To date, genicular nerve injections have been performed under fluoroscopic guidance. Objective: To evaluate the effect of ultrasound-guided genicular nerve pulsed RF treatment on chronic knee pain and function in patients with knee osteoarthritis. Study Design: Single-arm prospective study. Setting: University hospital and rehabilitation center in Turkey. Methods: A review was made of 29 patients with medial knee osteoarthritis who had undergone genicular nerve block in the previous 6 months. Patients with at least 50% reduction in the visual analog scale (VAS) score after genicular nerve block and with no on-going pain relief were selected for the study. Ultrasound-guided genicular nerve pulsed RF was applied to 15 knees of 9 patients. Pain and knee function were assessed with 100-mm VAS and Western Ontario and McMaster Universities (WOMAC) index throughout 3 months. Results: A significant reduction in VAS scores was detected over time after the pulsed RF procedure (f: 69.24, P < 0.01). There was a significant improvement in the WOMAC scores (f: 539.68 , P < 0.01). Limitations: The small number of participants, the lack of a control group, and short followup period were limitations of the study. Conclusions: Genicular nerve pulsed RF treatment has been found to be safe and beneficial in osteoarthritis related knee pain. Further studies with a larger population and randomized controlled study design are warranted to confirm the positive findings of this preliminary report. Key words: Knee pain, osteoarthritis, genicular nerve, ultrasonography, pulsed radiofrequency

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Lidocaine Versus Bupivacaine in the Treatment of Headache with Intranasal Sphenopalatine Nerve Block

January 2018 - Pain Physician ◽

10.36076/ppj.2020/23/423 ◽

2020 ◽

Vol 4;23 (7;4) ◽

pp. 423-427

Author(s):

Daniel L Kirkpatrick

Keyword(s):

Retrospective Study ◽

Nerve Block ◽

Study Design ◽

Treatment Options ◽

Treatment Success ◽

Tertiary Care ◽

Sphenopalatine Ganglion ◽

Pain Level ◽

Advantages And Disadvantages ◽

Significant Difference

Background: Intranasal sphenopalatine ganglion (SPG) block has been shown to be an effective treatment for headaches. Multiple therapeutic agents have been studied, although the wide availability and low cost of lidocaine and bupivacaine have made them attractive treatment options. To the authors knowledge, no study has yet demonstrated superiority of one anesthetic over the other. Objective: To determine the efficacy of lidocaine versus bupivacaine when performing intranasal sphenopalatine ganglion (SPG) block for the treatment of headaches. Study Design: Retrospective cohort study. Setting: A single tertiary care academic institution Methods: This retrospective study identified patients who underwent SPG block at a single institution from January 1, 2014 to December 20, 2017. Patients were included if they were treated with either lidocaine or bupivacaine and had both pre- and post-procedure pain scores recorded on a 0-10 scale. Patients were excluded if they were less than 18 years of age. Results: 386 total procedures were performed. 303 (78.5%) were lidocaine delivered via the SphenoCath device, and 83 (21.5%) were bupivacaine delivered via the Tx360 device. 90.2% of treatments (n = 348) decreased the patient’s pain level. Of the treatments performed with lidocaine, 89.1% (n = 270) resulted in improvement of the patient’s pain level with a mean decrease in pain level of 3.1 (SD ± 2.3). Of the treatments performed with bupivacaine, 94.0% (n = 78) resulted in improvement of the patient’s pain level, with a mean decrease in pain level of 3.0 (SD ± 1.9). No statistically significant difference was found between the 2 anesthetics. Limitations: The retrospective study design may introduce selection bias. Both lidocaine and bupivacaine were administered by different devices (Sphenocath and Tx360 respectively) which may account for differences in initial treatment success. There were differences in the size of the two groups, which may also introduce error. Conclusions: This study demonstrates similar efficacy of SPG block performed with lidocaine or bupivacaine. While no difference was found, the particular advantages and disadvantages of the intranasal delivery device may influence physician choice. Key words: Sphenopalatine ganglion nerve block, lidocaine, bupivacaine, sphenocath, Tx360, pain intervetnio, headache, miimally invasive therapy

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Vygotskian Theory and Case Study Design: A Fit of Theory and Methodology

Perspectives on Language Learning and Education ◽

10.1044/lle4.1.32 ◽

1997 ◽

Vol 4 (1) ◽

pp. 32-34

Author(s):

Anne van Kleeck

Keyword(s):

Study Design ◽

Case Study Design ◽

Vygotskian Theory

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Interferon beta-1b therapy in relapsing-remitting multiple sclerosis: Study design and preliminary results

Electroencephalography and Clinical Neurophysiology ◽

10.1016/s0013-4694(97)88414-7 ◽

1997 ◽

Vol 103 (1) ◽

pp. 99

Author(s):

G Salemi

Keyword(s):

Multiple Sclerosis ◽

Study Design ◽

Interferon Beta ◽

Preliminary Results ◽

Relapsing Remitting ◽

Remitting Multiple Sclerosis ◽

Relapsing Remitting Multiple Sclerosis

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Dark and Peculiar

Journal of Individual Differences ◽

10.1027/1614-0001/a000280 ◽

2019 ◽

Vol 40 (2) ◽

pp. 92-103 ◽

Cited By ~ 7

Author(s):

Janko Međedović ◽

Goran Knežević

Keyword(s):

Undergraduate Students ◽

Study Design ◽

Personal Characteristics ◽

Emotional Reaction ◽

Current Understanding ◽

Male Students ◽

Psychosis Proneness ◽

Negative Emotional Reaction ◽

Mind Set ◽

Psychopathic Tendencies

Abstract. Earlier research suggested that militant extremists could have certain aspects of psychopathic and psychotic characteristics. Relying on these studies, we investigated whether the Militant Extremist Mind-Set (MEM) could be explained by psychopathy, sadism, and Disintegration (psychosis proneness), as subclinical manifestations of amoral, antisocial, and psychotic-like traits. In Study 1 (306 undergraduate students), it was shown that sadistic and psychopathic tendencies were related to Proviolence (advocating violence as a means for achieving a goal); psychopathic and disintegrative tendencies were associated to the Vile World (belief in a world as a corrupted and vile place), while Disintegration was the best predictor of Divine Power (relying on supernatural forces as a rationale for extremist acts). In Study 2 (147 male convicts), these relations were largely replicated and broadened by including implicit emotional associations to violence in the study design. Thus, while Proviolence was found to be related to a weakened negative emotional reaction to violent pictures, Vile World was found to be associated with stronger negative emotions as a response to violence. Furthermore, Proviolence was the only MEM factor clearly differentiating the sample of convicts from male students who participated in Study 1. Results help extend current understanding about personal characteristics related to militant extremism.

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