Evidence-Based Medicine, Systematic Reviews,
and Guidelines in Interventional Pain
Management: Part 4: Observational Studies

Manchikanti, Laxmaiah; Singh, Sanjiv; Hs, Smith; Ja, Hirsch

doi:10.36076/ppj.2009/12/73

Cited by 67 publications

(12 citation statements)

References 297 publications

(282 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There are severalcritical appraisal tools for assessment of RCTs; however ,there is a paucity of literature on methodological quality assessment of observational studies. [ 42 43 ] Certain Grading of Recommendations, Assessment, Development and Evaluations (GRADE) criteria specified for observational studies could not be applied in the studies selected in the current review due to the cross-sectional nature of the studies. The CASP tool was found suitable for the said study types, and was hence applied.…”

Section: Discussionmentioning

confidence: 99%

Point-of-Care Ultrasound (POCUS) for the assessment of volume status and fluid management in patients with severe pre-eclampsia: A systematic review and meta-analysis

Bajwa¹,

Kurdi²,

Sutagatti³

et al. 2021

Indian J Anaesth

View full text Add to dashboard Cite

Background and Aims: Appropriate volume assessment and fluid management can prevent maternal deaths in the severely pre-eclamptic (SPE) parturients. We planned a systematic review and meta-analysis (MA) to evaluate the role and ability of point-of-care ultrasound (POCUS) in the assessment of volume status and early detection of lung oedema in an SPE parturient. Methods: An e-literature search was done from several databases. Data were extracted under five domains including POCUS-derived parameters like echo comet score (ECS), lung ultrasound (LUS) scores, B-patterns, optic nerve sheath diameter (ONSD), E/e' ratio, presence of pleural effusion, pulmonary interstitial syndrome and pulmonary congestion. The risk of bias was assessed. Extracted data were analysed using MetaXL and Revman 5.3. Heterogeneity in the studies was evaluated using the Cochrane Q test and I 2 statistics. Funnel plots were used for the assessment of publication bias. Results: Seven prospective studies including 574 parturients (including 396 pre-eclamptics) were selected. POCUS included lung, optic nerve, cardiac and thoracic US. In two studies, the ECS and LUS scores pre-delivery were higher in pre-eclamptics. Two studies found a mean ONSD of 5–5.84 mm before delivery. MA revealed a significantly lower mean ECS score at post-delivery than pre-delivery, and the summary prevalence of B-pattern and pleural effusion among SPE parturients was found to be 0.28 (0.03–0.84) and 0.1 (0–0.2), respectively. A good correlation was observed between B-line patterns and diastolic dysfunction (increased E/e' ratio), LUS score and thoracic fluid content, ONSD and ECS in individual studies. Conclusion: POCUS parameters can be useful as early markers of fluid status and serve as useful tools in the precise clinical management of pre-eclampsia.

show abstract

Section: Discussionmentioning

confidence: 99%

Point-of-Care Ultrasound (POCUS) for the assessment of volume status and fluid management in patients with severe pre-eclampsia: A systematic review and meta-analysis

Bajwa¹,

Kurdi²,

Sutagatti³

et al. 2021

Indian J Anaesth

View full text Add to dashboard Cite

show abstract

“…Multiple outcome measures will be utilized including the NRS (0 -10 scale), the ODI on a 0 -50 scale, employment status, and opioid intake in terms of daily intake of morphine equivalents, with assessment at 3, 6, 12, 18, and 24 months post treatment. The value and validity of the NRS and ODI have been reported (141)(142)(143)(144)(145). Thresholds for the minimum clinically important difference for the ODI varied from a 4 to 15 point change from a total score of 50.…”

Section: Discussionmentioning

confidence: 99%

Protocol for Evaluation of the Comparative Effectiveness of Percutaneous Adhesiolysis and Caudal Epidural Steroid Injections in Low Back and/or Lower Extremity Pain without Post Surgery Syndrome or Spinal Stenosis

Manchikanti

Pampati²,

Cash³

2010

Pain Phys

Self Cite

View full text Add to dashboard Cite

Background: Treatment of chronic low back pain with or without lower extremity pain continues to be a challenge. Epidural steroids are commonly utilized in patients after the failure of conservative treatment. The results of epidural steroid injections have been variable based on the pathophysiology, the route of administration, injected drugs, and utilization of fluoroscopy. In patients resistant to fluoroscopically directed epidural injections, percutaneous epidural adhesiolysis and percutaneous targeted delivery of injections with or without adhesiolysis has been recommended. Percutaneous adhesiolysis has been studied in chronic pain syndromes related to post laminectomy syndrome and spinal stenosis with encouraging results. There is a paucity of literature regarding the effectiveness of the targeted delivery of medications with or without epidural adhesiolysis in patients recalcitrant to epidural steroid injections without a history of surgery and spinal stenosis. Study Design: A randomized, equivalence trial of percutaneous lumbar adhesiolysis and caudal epidural steroid injections in patients with low back and/or lower extremity pain without post surgery syndrome or spinal stenosis. Setting: An interventional pain management practice setting in the United States. Objective: The study is designed to evaluate the effectiveness of percutaneous epidural adhesiolysis in managing chronic low back and/or lower extremity pain in patients without post lumbar surgery syndrome or spinal stenosis and compare it with fluoroscopically directed caudal epidural steroid injections Methods: The study design includes 120 patients randomly assigned into 2 groups. Group I (60 patients), the control group, will receive caudal epidural injections with catheterization up to S3 with local anesthetic, steroids, and 0.9% sodium chloride solution; Group II (60 patients), the intervention group, will receive percutaneous adhesiolysis with target delivery of lidocaine, 10% hypertonic sodium chloride solution, and non-participate betamethasone. Randomization will be performed by computer-generated random allocation sequence by simple randomization. Outcome Measures: Multiple outcome measures will be utilized including numeric rating scale (NRS), the Oswestry Disability Index 2.0 (ODI), employment status, and opioid intake with assessment at 3, 6, 12, 18 and 24 months post treatment. Significant pain relief is considered as 50% or more, whereas significant improvement in the disability score is defined as a reduction of 40% or more. Results: The results will be analyzed to show significant relief as well as improvement in functional status. Limitations: This study is limited by potentially inadequate double blinding and the lack of a placebo group.Conclusion: This protocol describes a comparative effectiveness evaluation of percutaneous adhesiolysis and epidural steroid injections in managing chronic low back and lower extremity pain in patients without post surgery syndrome or spinal stenosis utilizing a randomized, equivalence trial design. Clinical Trial Registration: NCT01053273 Key words: Chronic low back pain, disc herniation, post lumbar surgery syndrome, spinal stenosis, epidural steroid injections, percutaneous adhesiolysis, randomized trial, comparative effectiveness

show abstract

“…The methodology utilized in this systematic review followed the review process derived from evidence-based systematic reviews and metaanalysis of randomized trials and observational studies [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30].…”

Section: Methodsmentioning

confidence: 99%

Peripheral Nerve Stimulation for Chronic Pain: A Systematic Review of Effectiveness and Safety

et al. 2021

View full text Add to dashboard Cite

show abstract

Evidence-Based Medicine, Systematic Reviews, and Guidelines in Interventional Pain Management: Part 4: Observational Studies

Cited by 67 publications

References 297 publications

Point-of-Care Ultrasound (POCUS) for the assessment of volume status and fluid management in patients with severe pre-eclampsia: A systematic review and meta-analysis

Point-of-Care Ultrasound (POCUS) for the assessment of volume status and fluid management in patients with severe pre-eclampsia: A systematic review and meta-analysis

Protocol for Evaluation of the Comparative Effectiveness of Percutaneous Adhesiolysis and Caudal Epidural Steroid Injections in Low Back and/or Lower Extremity Pain without Post Surgery Syndrome or Spinal Stenosis

Peripheral Nerve Stimulation for Chronic Pain: A Systematic Review of Effectiveness and Safety

Contact Info

Product

Resources

About