Pain Management

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Research outputs from the Pain Management team at the RD&E.

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    Mirror Therapy for the Management of Phantom Limb Pain: A Single- Center Experience
    (Elsevier, 2023-09-01) Chong, D. S. T.; Pople, M.; Hardy, T. J.; Cowan, A.; Birchley, D.; Guy, A.; McCarthy, R.; Welchman, S. A.
    BACKGROUND: Phantom limb pain (PLP) can have devastating consequences, affecting up to 90% of amputees. PLP is associated with analgesia dependence and impaired quality of life. Mirror therapy (MT) is a novel treatment that has been applied in other pain syndromes. We prospectively evaluated MT in the management of PLP. METHODS: A prospective study of patients recruited between 2008 and 2020 who underwent unilateral major limb amputation, with a healthy contralateral limb. Participants were invited to attend weekly MT sessions. Pain in the 7 days prior to each MT session was scored on a Visual Analog Scale (VAS: 0-10 mm) and the short form McGill pain questionnaire. RESULTS: Ninety eight patients (68 males and 30 females) aged 17-89 years were recruited over 12 years. Forty four percent of patients had amputations due to peripheral vascular disease. Over an average of 2.5 sessions, the final treatment score on the VAS scale was 2.6 (standard deviation ± 3.0) with a reduction of 4.5 points on VAS score. As a comparison using the short form McGill pain questionnaire scoring system, the average final treatment score was 3.2 (± 5.0) with 91% overall improvement. CONCLUSIONS: MT is a very powerful and effective intervention for PLP. It is an exciting addition to the armory of vascular surgeons in the management of this condition.
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    EEG Recordings as Biomarkers of Pain Perception: Where Do We Stand and Where to Go?
    (Springer, 2022-03-23) Zis, P.; Liampas, A.; Artemiadis, A.; Tsalamandris, G.; Neophytou, P.; Unwin, Z.; Kimiskidis, V. K.; Hadjigeorgiou, G. M.; Varrassi, G.; Zhao, Y.; Sarrigiannis, P. G.
    INTRODUCTION: The universality and complexity of pain, which is highly prevalent, yield its significance to both patients and researchers. Developing a non-invasive tool that can objectively measure pain is of the utmost importance for clinical and research purposes. Traditionally electroencephalography (EEG) has been mostly used in epilepsy; however, over the recent years EEG has become an important non-invasive clinical tool that has helped increase our understanding of brain network complexities and for the identification of areas of dysfunction. This review aimed to investigate the role of EEG recordings as potential biomarkers of pain perception. METHODS: A systematic search of the PubMed database led to the identification of 938 papers, of which 919 were excluded as a result of not meeting the eligibility criteria, and one article was identified through screening of the reference lists of the 19 eligible studies. Ultimately, 20 papers were included in this systematic review. RESULTS: Changes of the cortical activation have potential, though the described changes are not always consistent. The most consistent finding is the increase in the delta and gamma power activity. Only a limited number of studies have looked into brain networks encoding pain perception. CONCLUSION: Although no robust EEG biomarkers of pain perception have been identified yet, EEG has potential and future research should be attempted. Designing strong research protocols, controlling for potential risk of biases, as well as investigating brain networks rather than isolated cortical changes will be crucial in this attempt.
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    The Prescription and Administration of Analgesics in a Foundation Trust Hospital
    (2016-09) Murdoch, Julie; Price, Lucy; Cook, Laura; Wassall, Richard; Jackson, Mark
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    Pain Assessment and Management in the Cognitively Impaired
    (2016-09) Murdoch, Julie; Price, Lucy; Cook, Laura; Wassall, Richard; Jackson, Mark
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    10 Years of Improving Pain Assessment Documentation in a Foundation Trust Hospital
    (2016-09) Murdoch, Julie; Price, Lucy; Cook, Laura; Wassall, Richard; Jackson, Mark