Published by De Gruyter

Volume 16 Issue 1

Issue of Scandinavian Journal of Pain

Contents
Journal Overview

Page range: 213-220

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Abstract

Background Only two out of the five existing randomized studies have reported better results from fusion surgery for chronic low back pain (CLBP) compared to conservative treatment. In these studies the back symptoms of the patients were described simply as “chronic low back pain”. One possible reason for the modest results of surgery is the lack of a description of specified symptoms that might be related to a painful segment/disc, and patient selection may therefore be more or less a matter of chance. Previous prospective studies including facet joint injections and discography and eventually MRI have failed to identify patients with a painful segment/disc that will benefit from fusion surgery. Purpose Our purpose was to analyse in detail the pre-operative symptoms and signs presented by patients who showed substantial relief from their back pain following spinal fusion surgery with the aim of possibly finding a pain pattern indicating segmental, discogenic pain. Methods We analysed 40 consecutive patients, mean age 41 years, with a history of disabling low back pain for a mean of 7.7 years. Before surgery the patients completed a detailed questionnaire concerning various aspects of their back pain, and findings at clinical examination were thoroughly noted. Monosegmental posterior lumbar interbody fusion without internal fixation was performed using microsurgical technique. Outcome was assessed at 1, 2 and 4 years after surgery and finally at 18 years, using selfreporting measures and assessment by an independent examiner. Assessment at 18 years applied the Balanced Inventory for Spinal Disorders Questionnaire and the Roland-Morris Disability Questionnaire. Results According to the independent observer’s assessment at two years 27 of the 40 patients were much improved. Analysis of the pre-operative depiction of the back symptoms of this group revealed a rather uniform pattern, the most important being: dominating back pain originating in the midline of the spine, with a dull, aching character and stabbing pain in the same area provoked by sudden movements. Most patients in this group also had diffuse pain radiation of various extension down one or both legs and often bladder dysfunction with frequency. At clinical examination, localized interspinal tenderness was observed within the spinal area in question and the patient’s back pain was provoked by pressure in that area and by tapping a neighbouring spinous process. At 18 years after surgery 19 patients assessed themselves as much improved. At that time 5 of them had pension due to age, 7 early pension, one worked full time and six patients part time. Eleven patients were re-operated due to defect bony healing. Conclusions The results may suggest that the use of a detailed symptom analysis and clinical examination may make it possible to select a subgroup of patients within the CLBP group likely to have better outcome following fusion surgery. Implications The next step would be to execute prospective studies and if our findings concerning back pain details and signs among CLPB patients can be confirmed this can provide for more accurate selection of patients suitable for fusion surgery.

Editorial comment

July 1, 2017

Local anaesthesia methods for analgesia after total hip replacement: Problems of anatomy, methodology and interpretation?

Johan Ræder

Page range: 221-222

Clinical pain research

July 1, 2017

Local infiltration analgesia or femoral nerve block for postoperative pain management in patients undergoing total hip arthroplasty. A randomized, double-blind study

Ján Kuchálik, Anders Magnuson, Anders Lundin, Anil Gupta

Page range: 223-230

Abstract

Background and aims Several methods for pain management following total hip arthroplasty (THA) have been described but the best postoperative pain management technique remains uncertain. We compared surgeon applied local infiltration analgesia (LIA) with anaesthesiologist performed femoral nerve block (FNB) using ultrasound. The primary aim was to assess pain intensity 24 h after THA. Methods In this randomized, double-blind study, 56 patients (ASA I-III) undergoing THA consented to participate. In Group FNB, patients received an ultrasound-guided femoral nerve block using 30 ml of ropivacaine 7.5 mg/ml (225 mg) while Group LIA received a similar volume of saline. Spinal anaesthesia was then performed and bupivacaine heavy, 3–3.5 ml injected depending on patient characteristics. During surgery, patients in Group LIA received a mixture of 300 mg (150 ml) ropivacaine, ketorolac 30 mg (1 ml) and adrenaline 0.5 mg (0.5 ml) (total volume 151.5 ml) peri-articularly and subcutaneously while Group FNB received 151.5 ml of saline peri-articularly in a systematic way by the surgeon. A multi-hole catheter was placed with the tip placed intra-articularly at the end of surgery in both groups. After 23 h, the LIA mixture consisting of 20 ml ropivacaine (7.5 mg/ml), ketorolac 30 mg (1 ml), adrenaline 0.1 mg (1 ml) (total volume 22 ml) was injected in Group LIA and the same volume of saline in Group FNB. Postoperative pain, analgesic consumption (postoperative and post-discharge), side effects, home discharge, quality of life and hip function were recorded, the latter up to 6 months after surgery. Results Postoperative pain intensity was significantly lower in Group LIA compared to Group FNB during mobilization at 24 h (primary endpoint), mean difference 1.8 NRS units (95% CI 0.7–2.9) ( P = 0.006), at rest after 4 h ( P = 0.029) and on standing after 24 ( P = 0.0003) and 48 h ( P = 0.043). Rescue morphine consumption was also significantly lower in Group LIA during 0–24, mean difference 13.5 mg (95% CI, 6.1–20.9) ( P = 0.002) postoperatively. Motor block was greater at 6 h ( P = 0.029) postoperatively in Group FNB. Two patients (one in each group) had persistent post-surgical pain (NRS > 3) at 3 months (3.6%) but none at 6 month. No other differences were found between the groups. Conclusion Local infiltration analgesia significantly reduces pain intensity on standing and mobilization, and rescue analgesic consumption compared to femoral nerve block without causing significant side effects. The superior analgesia in the LIA group may result from the secondary injection at 23 h postoperatively and needs to be furtherevaluated in future studies. No differences were found in home discharge, quality of life and hip dysfunction between the groups. Implication Local infiltration analgesia is the preferred method for postoperative pain management following THA compared to single-shot femoral nerve block. © 2017 Scandinavian Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

Editorial

July 1, 2017

Scientific presentations at the 2017 annual meeting of the Scandinavian Association for the Study of Pain (SASP)

Letter to the Editor

July 1, 2017

Unjustified extrapolation

Georg Supp, Richard Rosedale, Mark Werneke

Page range: 189-190

Letter to the Editor

July 1, 2017

Response to: “Letter to the Editor entitled: Unjustified extrapolation” [by authors: Supp G., Rosedale R., Werneke M.]

Martin Rabey, Anne Smith, Darren Beales, Helen Slater, Peter O’Sullivan

Page range: 191-191

About this journal

SJPAIN will become an Open Access Journal from 2024

Scandinavian Journal of Pain will become an Open Access journal from 2024 onwards. Any new submissions made to the journal after the 10th of　December 2023 will be published Open Access under a CC-BY License and will be subject to an Article Processing charge, if they are accepted for publication. Further information can be found on the　submit tab.

For any queries relating to the change to Open Access, please contact the SJPAIN editorial office

Objective
The Scandinavian countries have a long and distinguished tradition of excellent scientific and medical contributions to pain research. Following this tradition, the Scandinavian Journal of Pain (SJPAIN) has been publishing internationally relevant articles on all aspects of pain since 2010. The journal is the official organ of the Scandinavian Association for the Study of Pain and serves as a comprehensive forum for original research on the nature of pain, pain mechanisms, and pain management. In order to bring pain-researchers and pain-clinicians up-to-date on important issues, the journal also encourages submissions of topical reviews.

Topics

Clinical Sciences: Acute Pain
Clinical Sciences: Cancer-related pain
Clinical Sciences: Chronic Pain
Clinical Sciences: Neuropathic Pain
Epidemiology, Omics and Economics of Pain
Experimental Pain
Methods, Measurements and Biostatistics
Neurobiology, Pharmacology and Basic Science
Nursing and Pain Management
Psychology of Pain and Pain Management

Article formats
Original articles (basic and clinical research), comprehensive systematic and topical reviews, hypothesis-generating case-reports and observational studies, short communications, letters to the Editor

Volume 16 Issue 1

Issue of Scandinavian Journal of Pain

Scandinavian Journal of Pain

Glucocorticoids – Efficient analgesics against postherpetic neuralgia?

Effect of intrathecal glucocorticoids on the central glucocorticoid receptor in a rat nerve ligation model

Abstract

Important new insight in pain and pain treatment induced changes in functional connectivity between the Pain Matrix and the Salience, Central Executive, and Sensorimotor networks

Salience, central executive, and sensorimotor network functional connectivity alterations in failed back surgery syndrome

Abstract

Education and support strategies improve assessment and management of pain by nurses

Using education and support strategies to improve the way nurses assess regular and transient pain – A quality improvement study of three hospitals

Abstract

The interference of pain with task performance: Increasing ecological validity in research

The disruptive effects of pain on multitasking in a virtual errands task

Abstract

Analyzing transition from acute back pain to chronic pain with linear mixed models reveals a continuous chronification of acute back pain

From acute to chronic back pain: Using linear mixed models to explore changes in pain intensity, disability, and depression

Abstract

NSAIDs relieve osteoarthritis (OA) pain, but cardiovascular safety in question even for diclofenac, ibuprofen, naproxen, and celecoxib: what are the alternatives?

Efficacy and safety of diclofenac in osteoarthritis: Results of a network meta-analysis of unpublished legacy studies

Abstract

Editorial comment on Nina Kreddig’s and Monika Hasenbring’s study on pain anxiety and fear of (re) injury in patients with chronic back pain: Sex as a moderator

Pain anxiety and fear of (re) injury in patients with chronic back pain: Sex as a moderator

Abstract

Intraoral QST – Mission impossible or not?

Multifactorial assessment of measurement errors affecting intraoral quantitative sensory testing reliability

Abstract

Objective measurement of subjective pain-experience: Real nociceptive stimuli versus pain expectation

Cerebral oxygenation for pain monitoring in adults is ineffective: A sequence-randomized, sham controlled study in volunteers

Abstract

Association between adolescent and parental use of analgesics

The association between adolescent and parental use of non-prescription analgesics for headache and other somatic pain – A cross-sectional study

Abstract

Cancer-pain intractable to high-doses systemic opioids can be relieved by intraspinal local anaesthetic plus an opioid and an alfa2-adrenoceptor agonist

Spinal analgesia for severe cancer pain: A retrospective analysis of 60 patients

Abstract

Specific symptoms and signs of unstable back segments and curative surgery?

Symptoms and signs possibly indicating segmental, discogenic pain. A fusion study with 18 years of follow-up

Abstract

Local anaesthesia methods for analgesia after total hip replacement: Problems of anatomy, methodology and interpretation?

Local infiltration analgesia or femoral nerve block for postoperative pain management in patients undergoing total hip arthroplasty. A randomized, double-blind study

Abstract

Scientific presentations at the 2017 annual meeting of the Scandinavian Association for the Study of Pain (SASP)

Correlation between quality of pain and depression: A post-operative assessment of pain after caesarian section among women in Ghana

Abstract

Dynamic and static mechanical pain sensitivity is associated in women with migraine

Abstract

The number of active trigger points is associated with sensory and emotional aspects of health-related quality of life in tension type headache

Abstract

Chronic neuropathic pain following oxaliplatin and docetaxel: A 5-year follow-up questionnaire study

Abstract

Expression of α1 adrenergic receptor subtypes by afferent fibers that innervate rat masseter muscle

Abstract

Buprenorphine alleviation of pain does not compromise the rat monoarthritic pain model

Abstract

Association between pain, disability, widespread pressure pain hypersensitivity and trigger points in subjects with neck pain

Abstract

Association between widespread pressure pain hypersensitivity, health history, and trigger points in subjects with neck pain

Abstract

Neuromas in patients with peripheral nerve injury and amputation - An ongoing study

Abstract

The link between chronic musculoskeletal pain and sperm quality in overweight orthopedic patients

Abstract

Several days of muscle hyperalgesia facilitates cortical somatosensory excitability

Abstract

Social stress, epigenetic changes and pain

Abstract

Characterization of released exosomes from satellite glial cells under normal and inflammatory conditions

Abstract

Cell-based platform for studying trigeminal satellite glial cells under normal and inflammatory conditions

Abstract

Tramadol in postoperative pain – 1 mg/ml IV gave no pain reduction but more side effects in third molar surgery

Abstract

Tempo-spatial discrimination to non-noxious stimuli is better than for noxious stimuli

Abstract

The encoding of the thermal grill illusion in the human spinal cord

Abstract

Effect of cocoa on endorphin levels and craniofacial muscle sensitivity in healthy individuals

Abstract

The impact of naloxegol treatment on gastrointestinal transit and colonic volume

Cancer-pain intractable to high-doses systemic opioids can be relieved by intraspinal local anaesthetic plus an opioid and an alfa₂-adrenoceptor agonist

Expression of α₁ adrenergic receptor subtypes by afferent fibers that innervate rat masseter muscle