[Intervention study on subacute and chronic pain in primary care: an approach to the effectiveness of neural therapy]. / Estudio de intervención sobre el dolor subagudo y crónico en atención primaria: una aproximación a la efectividad de la terapia neural.

OBJECTIVE: To evaluate the effectiveness of NT in reducing pain and minimising use of analgesics in patients. DESIGN: Before and after intervention study. SETTING: Llefià Primary Health Care centre in Badalona (Barcelona). PARTICIPANTS: Eighty-two patients between the ages of 25 and 85 years old, who suffered pain that did not disappear after a month. MAIN MEASUREMENTS: Data was collected to evaluate any change in pain and the use of analgesics in patients before intervention and then afterwards, at 2 weeks, 3 months and 6 months. This was conducted by means of interviews and use of the Visual Analogue Pain Scale (VAS). RESULTS: Mean VAS pre-treatment: 7.94 (SD: 1.68), mean VAS after two weeks 4.63 (SD: 2.79), after 3 months 3.73 (SD: 3.17), and after 6 months 3.48 (SD: 3,27) (P<.001 in the 3 comparisons, using the Wilcoxon-test for matched data). As regards analgesic use after treatment, 74.4% of patients reduced it after 2 weeks, 76.8% after 3 months and 80% after 6 months. CONCLUSIONS: Neural therapy can be effective in reducing pain, as well as the use of analgesics. Further clinical trials would be needed to confirm this assertion.

Effects on hemodynamic variables and echocardiographic parameters after a stellate ganglion block in 15 healthy volunteers.

BACKGROUND: The sympathetic nervous system has an important role in generating pain. Various pathomechanisms are involved that respond well to the application of local anesthetics (LA), for example to the stellate ganglion block (SGB). OBJECTIVES: We wanted to know more about the effects of SGB on cardiovascular parameters. METHODS: We included 15 healthy volunteers; another 15 healthy volunteers as a control group (sham injection of LA). In order to produce a more precise SGB, we employed only a small volume of LA (3mL), a LA with a lower permeability (procaine 1%), and a modified injection technique. Systolic and diastolic blood pressure (SBP, DBP), heart rate (HR), and echocardiographic parameters were recorded before and after SGB. We also investigated whether there are side differences (left and right SBG). RESULTS: At baseline all parameters were within the normal range. After performing right and left SGB DBP significantly increased (on the right side from 68.73±8.61 to 73.53±11.10, p=0.015; on the left side from 70.66±13.01 to 77.93±10.40, p=0.003). In the control group no increase in DBP was observed. No side-specific differences were found, except a significant reduction in the maximum velocity of myocardial contraction during the systole with left-sided SGB. CONCLUSIONS: Even with our methods we could not prevent the simultaneous occurrence of a partial parasympatholytic effect. For this reason, the SGB has only minor hemodynamic effects, which is desirable as it enhances the safety of the SGB.

Estudio de intervención sobre el dolor subagudo y crónico en atención primaria: una aproximación a la efectividad de la terapia neural / Intervention study on subacute and chronic pain in Primary Care: an approach to the effectiveness of neural therapy

ObjetivoEvaluar la efectividad de la TN para disminuir el dolor y el consumo de fármacos.DiseñoEstudio de intervención antes-después.EmplazamientoCAP de Llefià en Badalona (Barcelona).Participantes82 pacientes con edades entre 25 y 85 años que presentaban dolor que no remitió después de al menos un mes de evolución.Mediciones principalesSe recogieron datos para la valoración de las variaciones del dolor y sobre el consumo de fármacos antes de la intervención y después a las 2 semanas, 3 meses y 6 meses mediante entrevista personal y para el dolor mediante la escala visual analógica (EVA).ResultadosEVA media preintervención: 7,94 (DE: 1,68), EVA media a las 2 semanas 4,63 (DE: 2,79), a los 3 meses 3,74 (DE: 3,17) y a los 6 meses 3,48 (DE: 3,27) (p<0,001 en las 3 comparaciones, mediante test de Wilcoxon). En cuanto al consumo de fármacos después de la intervención, un 74,4% de los pacientes lo redujeron a las 2 semanas, un 76,8% lo redujeron a los 3 meses y un 80% a los 6 meses.ConclusionesLa TN puede ser eficaz en disminuir el dolor así como el consumo de fármacos. Faltarían ensayos clínicos que lo confirmaran(AU)

ObjectiveTo evaluate the effectiveness of NT in reducing pain and minimising use of analgesics in patients.DesignBefore and after intervention study.SettingLlefià Primary Health Care centre in Badalona (Barcelona).ParticipantsEighty-two patients between the ages of 25 and 85 years old, who suffered pain that did not disappear after a month.Main measurementsData was collected to evaluate any change in pain and the use of analgesics in patients before intervention and then afterwards, at 2 weeks, 3 months and 6 months. This was conducted by means of interviews and use of the Visual Analogue Pain Scale (VAS).ResultsMean VAS pre-treatment: 7.94 (SD: 1.68), mean VAS after two weeks 4.63 (SD: 2.79), after 3 months 3.73 (SD: 3.17), and after 6 months 3.48 (SD: 3,27) (P<.001 in the 3 comparisons, using the Wilcoxon-test for matched data). As regards analgesic use after treatment, 74.4% of patients reduced it after 2 weeks, 76.8% after 3 months and 80% after 6 months.ConclusionsNeural therapy can be effective in reducing pain, as well as the use of analgesics. Further clinical trials would be needed to confirm this assertion(AU)