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      Journal of Pain Research (submit here)

      This international, peer-reviewed Open Access journal by Dove Medical Press focuses on reporting of high-quality laboratory and clinical findings in all fields of pain research and the prevention and management of pain. Sign up for email alerts here.

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      Treatment of complex regional pain syndrome using free-flap surgery: a case report

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          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Complex regional pain syndrome is a chronic progressive illness with sensory, autonomic, trophic, and motor abnormalities. Treatment is difficult and controversial. We report the results of free-flap and vein wrapping of the superficial peroneal nerve surgery to treat complex regional pain syndrome.

          Most cited references9

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          Randomised controlled trial of gabapentin in Complex Regional Pain Syndrome type 1 [ISRCTN84121379]

          Background Complex Regional Pain Syndrome type one (CRPS I) or formerly Reflex Sympathetic Dystrophy (RSD) is a disabling syndrome, in which a painful limb is accompanied by varying symptoms. Neuropathic pain is a prominent feature of CRPS I, and is often refractory to treatment. Since gabapentin is an anticonvulsant with a proven analgesic effect in various neuropathic pain syndromes, we sought to study the efficacy of the anticonvulsant gabapentin as treatment for pain in patients with CRPS I. Methods We did a randomized double blind placebo controlled crossover study with two three-weeks treatment periods with gabapentin and placebo separated by a two-weeks washout period. Patients started at random with gabapentin or placebo, which was administered in identical capsules three times daily. We included 58 patients with CRPS type 1. Results Patients reported significant pain relief in favor of gabapentin in the first period. Therapy effect in the second period was less; finally resulting in no significant effect combining results of both periods. The CRPS patients had sensory deficits at baseline. We found that this sensory deficit was significantly reversed in gabapentin users in comparison to placebo users. Conclusions Gabapentin had a mild effect on pain in CRPS I. It significantly reduced the sensory deficit in the affected limb. A subpopulation of CRPS patients may benefit from gabapentin.
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            Antidepressants and anticonvulsants for diabetic neuropathy and postherpetic neuralgia: a quantitative systematic review.

            To determine the relative efficacy and adverse effects of antidepressants and anticonvulsants in the treatment of diabetic neuroapathy and postherpetic neuralgia, published reports were identified from a variety of electronic databases, including Medline, EMBASE, the Cochrane Library and the Oxford Pain Relief Database, and from two previously published reviews. Additional studies were identified from the reference lists of retrieved reports. The relative benefit (RB) and number-needed-to-treat (NNT) for one patient to achieve at least 50 % pain relief was calculated from available dichotomous data, as was the relative risk (RR) and number-needed-to-harm (NH) for minor adverse effects and drug related study withdrawal. In diabetic neuropathy, 16 reports compared antidepressants with placebo (491 patient episodes) and three compared anticonvulsants with placebo (321). The NNT for at least 50 % pain relief with antidepressants was 3.4 (95 % confidence interval 2.6-4. 7) and with anticonvulsants 2. 7 (2. 2-3. 8). In postherpetic neuralgia, three reports compared antidepressants with placebo (145 patient episodes) and one compared anticonvulsants with placebo (225), giving an NNT with antidepressants of 2.1 (1. 7-3) and with anticonvulsants 3.2 (2.4-5). There was little difference in the incidence of minor adverse effects with either antidepressants or anticonvulsants compared with placebo, with 1VH (minor) values of about 3. For drug-related study withdrawal, antidepressants had an NNH (major) of 17 (11-43) compared with placebo, whereas with anticonvulsants there was no significant difference from placebo. Antidepressants and anticonvulsants had the same efficacy and incidence of minor adverse effects in these tzoo neuropathic pain conditions. There was no evidence that selective serotonin reuptake inhibitors (SSRIs) were better than older antidepressants, and no evidence that gabapentin was better than older anticonvulsants. In these trials patients were more likely to stop taking antidepressants than anticonvulsants because of adverse effects.
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              Postoperative complications of posterior ankle and hindfoot arthroscopy.

              Posterior ankle and hindfoot arthroscopy, performed with use of posteromedial and posterolateral portals with the patient in the prone position, has been utilized for the treatment of various disorders. However, there is limited literature addressing the postoperative complications of this procedure. In this study, the postoperative complications in patients treated with posterior ankle and hindfoot arthroscopy were analyzed to determine the type, rate, and severity of complications.
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                Author and article information

                Journal
                J Pain Res
                J Pain Res
                Journal of Pain Research
                Journal of Pain Research
                Dove Medical Press
                1178-7090
                2017
                24 November 2017
                : 10
                : 2699-2702
                Affiliations
                [1 ]Department of Orthopedic Surgery, GangNeung Asan Hospital, College of Medicine, University of Ulsan, GangNeung-si, South Korea
                [2 ]Department of Orthopedic Surgery
                [3 ]Department of Plastic Surgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, South Korea
                [4 ]Department of Orthopedic Surgery, Cheil Orthopedic Hospital, Gangnam-gu, Seoul, South Korea
                [5 ]Department of Anesthesia, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, South Korea
                Author notes
                Correspondence: Ho-Seong Lee, Department of Orthopedic Surgery, Asan Medical Center, College of Medicine, University of Ulsan, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea, Tel +82 2 3010 3521, Fax +82 2 4887 877, Email hosng1902@ 123456gmail.com
                Article
                jpr-10-2699
                10.2147/JPR.S149379
                5703149
                9620b33e-a9ff-4c67-acaf-63cc4382dcab
                © 2017 Seo et al. This work is published and licensed by Dove Medical Press Limited

                The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

                History
                Categories
                Case Report

                Anesthesiology & Pain management
                foot,ankle,superficial peroneal nerve,vein wrapping
                Anesthesiology & Pain management
                foot, ankle, superficial peroneal nerve, vein wrapping

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