In The News: 12/07
Pregabalin Reduces Pain, Improves Movement after Knee Repair
The anti-convulsant drug pregabalin, administered before and after knee replacement surgery, dramatically decreases pain while expediting mobility after surgery. A study presented at the September 2007 meeting of the American Society of Anesthesiologists involved 60 patients, divided into two groups, who had undergone total knee replacement. One group received 300 mg of pregabalin two hours before surgery and 150 mg twice a day for 14 days following surgery. Other patients were given a placebo during the same intervals. Researchers found a "significant decrease" in pain levels following surgery in the pregabalin group. Further, knee range of motion at hospital discharge was higher in the pregabalin group: 84 degrees vs. 76 degrees among the placebo patients—a level that typically takes a patient a full week to attain.
TNF-Inhibitors Cut RA Cancer, Cardiac Deaths but Infection Still Problematic
Though it is widely accepted that rheumatoid arthritis (RA) patients are at risk for heart disease, infection, and cancer, there has been some concern that TNF-inhibitors—also known as biologic response modifiers and used to reduce RA inflammation—might contribute to mortality from these risks. A study by a group of Spanish rheumatologists, however, has uncovered evidence that death from these causes is 30 to 50 percent lower in TNF-treated patients and that mortality from heart disease, particularly in women, is significantly reduced. Infection rates were higher in the TNF-treated patients, especially among those over age 60, but death from infection was lower than in the non-TNF-treated patients. The findings, based on a study of 4,459 patients treated with TNF-inhibitors and 789 patients who were not, appeared in the March 2007 issue of Annals of Rheumatic Diseases.
Lack of Vitamin D May Increase Chronic Pain
Approximately one in every four patients who suffer from chronic pain lack adequate levels of vitamin D, which could contribute to their continuing pain. A study presented at the September 2007 meeting of the American Society of Anesthesiologists examined the vitamin D levels of 267 patients being treated for chronic pain. Of those observed, 26 percent were deficient in vitamin D and, among those patients, the dosage of pain medication (morphine) was nearly twice that of the group with adequate levels of vitamin D. Further, the group with low levels of vitamin D used pain medication for 71 months vs. 44 months for the vitamin D-adequacy group. Researchers concluded that although vitamin D inadequacy is not the principal cause of pain, it could be a contributing factor, and suggest that such deficiency could be easily treated with a prescription supplement.
Acupuncture Alleviates Post-Op Pain
Nearly 80 percent of patients experience pain following surgery. If acupuncture is performed after surgery, researchers at Duke University have found, pain is effectively reduced, and without serious side effects. Fifteen research studies involving 1,166 patients revealed not only a significant reduction in pain among patients receiving acupuncture, but the patients required less pain medication, and thus reported fewer medication-related side effects. The findings were reported in a September 2007 report by the American Society of Anesthesiologists.
New Treatment for Calcified Shoulder Soreness
Calcific tendinitis, inflammation of a shoulder tendon triggered by calcium depostis, can effectively be treated by injections of lidocaine or saline. Spanish researchers conducted a study of 67 patients whose shoulders were treated with sonographically guided injections of the solutions. One year after treatment, 91 percent of patient shoulders had considerably or completely improved, 64 percent had normal motion, and shoulder calcifications had resolved completely or nearly completely in 89 percent of the patients. The study appeared in the September 2007 issue of the American Journal of Roentgenology