Interventional management of neuropathic pain: NeuPSIG recommendations.
Robert H. Dworkin,Alec B. O'Connor,Joel L. Kent,Sean Mackey,Srinivasa N. Raja,Brett R. Stacey,Robert M. Levy,Miroslav Backonja,Ralf Baron,Henning Harke,John D. Loeser,Rolf-Detlef Treede,Dennis C. Turk,Christopher D. Wells +13 more
TLDR
Based on the available data, it is recommended not to use sympathetic blocks for PHN nor radiofrequency lesions for radiculopathy, and four weak recommendations can be made due to the paucity of high‐quality clinical trials.Abstract:
Neuropathic pain (NP) is often refractory to pharmacologic and noninterventional treatment. On behalf of the International Association for the Study of Pain Neuropathic Pain Special Interest Group, the authors evaluated systematic reviews, clinical trials, and existing guidelines for the interventional management of NP. Evidence is summarized and presented for neural blockade, spinal cord stimulation (SCS), intrathecal medication, and neurosurgical interventions in patients with the following peripheral and central NP conditions: herpes zoster and postherpetic neuralgia (PHN); painful diabetic and other peripheral neuropathies; spinal cord injury NP; central poststroke pain; radiculopathy and failed back surgery syndrome (FBSS); complex regional pain syndrome (CRPS); and trigeminal neuralgia and neuropathy. Due to the paucity of high-quality clinical trials, no strong recommendations can be made. Four weak recommendations based on the amount and consistency of evidence, including degree of efficacy and safety, are: 1) epidural injections for herpes zoster; 2) steroid injections for radiculopathy; 3) SCS for FBSS; and 4) SCS for CRPS type 1. Based on the available data, we recommend not to use sympathetic blocks for PHN nor radiofrequency lesions for radiculopathy. No other conclusive recommendations can be made due to the poor quality of available data. Whenever possible, these interventions should either be part of randomized clinical trials or documented in pain registries. Priorities for future research include randomized clinical trials, long-term studies, and head-to-head comparisons among different interventional and noninterventional treatments.read more
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Pharmacotherapy for neuropathic pain in adults: a systematic review and meta-analysis.
Nanna B. Finnerup,Nadine Attal,Simon Haroutounian,Ewan D McNicol,Ralf Baron,Robert H. Dworkin,Ian Gilron,Maija Haanpää,Per Hansson,Per Hansson,Troels S. Jensen,Troels S. Jensen,Peter R. Kamerman,Karen Lund,Andrew Moore,Srinivasa N. Raja,Andrew S.C. Rice,Andrew S.C. Rice,Michael C. Rowbotham,Emily S. Sena,Emily S. Sena,Philip J. Siddall,Philip J. Siddall,Blair H. Smith,Mark S. Wallace +24 more
TL;DR: The results support a revision of the NeuPSIG recommendations for the pharmacotherapy of neuropathic pain and allow a strong recommendation for use and proposal as first-line treatment in neuropathicPain for tricyclic antidepressants, serotonin-noradrenaline reuptake inhibitors, pregabalin, and gabapentin.
Journal ArticleDOI
The Erector Spinae Plane Block: A Novel Analgesic Technique in Thoracic Neuropathic Pain.
TL;DR: The ESP block holds promise as a simple and safe technique for thoracic analgesia in both chronic neuropathic pain as well as acute postsurgical or posttraumatic pain.
Journal ArticleDOI
The IASP classification of chronic pain for ICD-11: chronic neuropathic pain.
Joachim Scholz,Nanna B. Finnerup,Nadine Attal,Qasim Aziz,Ralf Baron,Michael I. Bennett,Rafael Benoliel,Milton Cohen,Giorgio Cruccu,Karen D. Davis,Karen D. Davis,Stefan Evers,Michael B. First,Maria Adele Giamberardino,Per Hansson,Per Hansson,Stein Kaasa,Beatrice Korwisi,Beatrice Korwisi,Eva Kosek,Patricia Lavand'homme,Michael K. Nicholas,Turo Nurmikko,Serge Perrot,Srinivasa N. Raja,Andrew S.C. Rice,Michael C. Rowbotham,Stephan A. Schug,David M. Simpson,Blair H. Smith,Peter Svensson,Peter Svensson,Johan W.S. Vlaeyen,Johan W.S. Vlaeyen,Shuu Jiun Wang,Antonia Barke,Winfried Rief,Rolf-Detlef Treede +37 more
TL;DR: The most common conditions of peripheral neuropathic pain are trigeminal neuralgia, peripheral nerve injury, painful polyneuropathy, postherpetic neural gia, and painful radiculopathy.
Journal ArticleDOI
Management of cancer pain in adult patients: ESMO Clinical Practice Guidelines.
Marie Fallon,Raffaele Giusti,Federica Aielli,Peter Hoskin,Roman Rolke,M Sharma,Carla Ripamonti +6 more
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Pharmacological management of chronic neuropathic pain: Revised consensus statement from the Canadian Pain Society
Dwight E. Moulin,Aline Boulanger,Alexander J. Clark,Hance Clarke,Thuan Dao,G. A. Finley,Andrea D Furlan,Ian Gilron,Allan Gordon,Patricia Morley-Forster,Barry J. Sessle,P Squire,Jennifer Stinson,Paul Taenzer,Ana M. Velly,Mark A. Ware,EL Weinberg,Owen Douglas Williamson +17 more
TL;DR: This update to these guidelines for the treatment of neuropathic pain in the Canadian context incorporates new evidence published since the first guidelines were released in 2007.
References
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Core outcome domains for chronic pain clinical trials: IMMPACT recommendations.
Dennis C. Turk,Robert H. Dworkin,Robert R. Allen,Nicholas Bellamy,Nancy A. Brandenburg,Daniel B. Carr,Charles S. Cleeland,Raymond A. Dionne,John T. Farrar,Bradley S. Galer,David J. Hewitt,Alejandro R. Jadad,Nathaniel P. Katz,Lynn D. Kramer,Donald C. Manning,Cynthia McCormick,Michael P. McDermott,Patrick J. McGrath,Steve Quessy,Bob A. Rappaport,James P. Robinson,Mike A. Royal,Lee S. Simon,Joseph W. Stauffer,Wendy M. Stein,Jane Tollett,James Witter +26 more
TL;DR: In this article, the authors provide recommendations for the core outcome domains that should be considered by investigators conducting clinical trials of the efficacy and effectiveness of treatments for chronic pain, and develop a core set of outcome domains would facilitate comparison and pooling of d
Journal ArticleDOI
What is “quality of evidence” and why is it important to clinicians?
Gordon H. Guyatt,Andrew D Oxman,Regina Kunz,Gunn Elisabeth Vist,Yngve Falck-Ytter,Holger J. Schünemann +5 more
TL;DR: Guideline developers use a bewildering variety of systems to rate the quality of the evidence underlying their recommendations as mentioned in this paper, some are facile, some confused, and others sophisticated but complex.
Journal ArticleDOI
Topical Review and RecommendationsCore outcome measures for chronic pain clinical trials: IMMPACT recommendations
Robert H. Dworkin,Dennis C. Turk,John T. Farrar,Jennifer A. Haythornthwaite,Mark P. Jensen,Nathaniel P. Katz,Robert D. Kerns,Gerold Stucki,Robert R. Allen,Nicholas Bellamy,Daniel B. Carr,Julie Chandler,Penney Cowan,Raymond A. Dionne,Bradley S. Galer,Sharon Hertz,Alejandro R. Jadad,Lynn D. Kramer,James Witter +18 more
Journal ArticleDOI
Diagnosis and Treatment of Low Back Pain: A Joint Clinical Practice Guideline from the American College of Physicians and the American Pain Society
TL;DR: This guideline is to present the available evidence for evaluation and management of acute and chronic low back pain in primary care settings and grades its recommendations by using the ACP's clinical practice guidelines grading system.
Journal ArticleDOI
Neuropathic pain Redefinition and a grading system for clinical and research purposes
Rolf-Detlef Treede,Troels S. Jensen,James N. Campbell,Giorgio Cruccu,Jonathan O. Dostrovsky,J. W. Griffin,Per Hansson,Richard A. C. Hughes,Turo Nurmikko,Jordi Serra +9 more
TL;DR: A grading system of definite, probable, and possible neuropathic pain is proposed, which includes the grade possible, which can only be regarded as a working hypothesis, and the grades probable and definite, which require confirmatory evidence from a neurologic examination.
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