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Pain and Therapy

Joseph V Pergolizzi, Antonella Paladini, Giustino Varrassi, Robert B Raffa
Since 1986, the pharmacological management of pain was mainly based on the WHO "analgesic ladder", with very few drugs available. The huge development of the basic knowledge on pain and its therapy, especially in the past 15 years, has made the "guidelines" of WHO obsolete. That's why, during the presidency of EFIC of one of the authors (GV), an international advisory board was proposed to review the document, but mainly to ameliorate the approach to the pain patients.
October 14, 2016: Pain and Therapy
Elizabeth Marrett, Winghan Jacqueline Kwong, Feride Frech, Chunlin Qian
INTRODUCTION: Nausea and vomiting (NV) are common side effects of opioid use and limiting factors in pain management. This study sought to quantify the frequency of antiemetic prescribing and the impact of NV on health care resource utilization and costs in outpatients prescribed opioids for acute pain. The perspective was that of a commercial health plan. METHODS: Medical and pharmacy claims from IMS PharMetrics Plus were used to identify patients initiating opioid therapy with a prescription for an oxycodone-, hydrocodone- or codeine-containing immediate-release product for acute use (≤15-day supply) between October 1, 2013 and September 30, 2014...
October 4, 2016: Pain and Therapy
Cameron MacLachlan, Edward A Shipton, J Elisabeth Wells
INTRODUCTION: Presently, it is difficult to predict which patients are at increased risk of ongoing pain problems postoperatively. This study followed a group of patients from the week before their operation until 3 months after it, to identify potential risk variables. METHODS: Fifty-four patients undergoing moderate-major gynaecological surgery at Christchurch Women's Hospital were recruited and assessed preoperatively over an 11-week period. At this initial assessment, participants were subjected to a cold pressor test (CPT)...
September 20, 2016: Pain and Therapy
Tiago Sousa-Veloso
Pharmacovigilance is concerned with the detection, assessment, understanding, and prevention of adverse reactions to medicines. It is helpful to prevent undesired harm sustained by the patient due to inappropriate or unsafe use of medicinal agents. As the use of drugs and polypharmacy increase in prevalence, pharmacovigilance gains relevance and momentum. Practice-based research networks have the potential to enhance health research by promoting earlier detection of adverse events at a decreased level of cost...
August 22, 2016: Pain and Therapy
Farid A Gharehdaghi, Mansoureh Gorginzadeh, Saeid Safari
BACKGROUND: With the increase in the prevalence of cancer, cancer-related issues also deserve more attention especially in developing countries where there is already limited access to high-quality healthcare. Cancer-related pain, the most common and the most annoying one, is not only a symptom but also an important subspecialty and its management is still challenging. OBJECTIVES: To assess the level of pain and cancer pain knowledge in Iran in comparison with the whole world...
August 11, 2016: Pain and Therapy
Andreas Kimergård, Paolo Deluca, Peter Hindersson, Torben Breindahl
INTRODUCTION: Misuse of opioid analgesics, in combination with diversion, dependence, and fatal overdoses, presents a serious problem for public health, which affects many countries worldwide. Within this context, tampering with opioids has been associated with serious harm. The aim of the present study was to assess the tampering potential of codeine combination analgesics on the market (containing codeine/non-opioid analgesics) by the extraction of codeine. METHODS: Codeine was extracted from three combination formulations sold lawfully from licensed pharmacies without a medical prescription in Denmark and the UK...
June 13, 2016: Pain and Therapy
Massimo Mammucari, Enrica Maggiori, Marzia Lazzari, Silvia Natoli
Wide variations in the types of pain and response to analgesic pharmacotherapy mean that a variety of treatment strategies are needed. One approach is mesotherapy (intradermal therapy). This consists of microinjections into the skin and is ideally suited to the management of localized pain. Advantages include increasing the duration of drug activity, reduced risk of adverse events and interactions, and possible synergy with other therapies. Mesotherapy provides general practitioners with another tool for the treatment of local pain...
June 2016: Pain and Therapy
Gareth P Jones, Shiva S Tripathi
INTRODUCTION: Opioid analgesics are widely regarded to be highly effective but are equally known for their side effects on the bowel. A new combination of the opioid analgesic oxycodone and naloxone has been developed to combat opioid-induced bowel dysfunction (OIBD) whilst still being effective as an analgesic. The aim of this observational study was to assess the analgesic efficacy of this new combination and to analyze its effect on bowel function. METHODS: Twenty-six patients underwent a trial of this new combination, with 21 patients reaching week 8 and 18 reaching week 12...
June 2016: Pain and Therapy
Kurian P Thomas, Shaji Sainudeen, Suraj Jose, Mansour Y Nadhari, Philippe B Macaire
INTRODUCTION: Sternal fractures are a painful condition which can result in pulmonary morbidity if not treated promptly. The management of isolated fractures has changed from hospital to home-based treatment, provided other major injuries have been excluded. Pain management is the mainstay of treatment. In this case report, we describe how a parasternal block under ultrasound guidance for sternal fracture provided better analgesia thereby improving ventilation. CASE REPORT: A 26-year-old man was admitted to the emergency department following a road traffic accident...
June 2016: Pain and Therapy
Andrei Danilov, Julia Kurganova
Melatonin is a neurohormone secreted by epiphysis and extrapineal structures. It performs several functions including chronobiotic, antioxidant, oncostatic, immune modulating, normothermal, and anxiolytic functions. Melatonin affects the cardiovascular system and gastrointestinal tract, participates in reproduction and metabolism, and body mass regulation. Moreover, recent studies have demonstrated melatonin efficacy in relation to pain syndromes. The present paper reviews the studies on melatonin use in fibromyalgia, headaches, irritable bowel syndrome, chronic back pain, and rheumatoid arthritis...
June 2016: Pain and Therapy
Eleni G Hapidou, Emily Horst
INTRODUCTION: The objective of the present study was to gain insight into patients' experiences in a 4-week interdisciplinary chronic pain management program by determining major themes from patients' written comments on exit questionnaires. METHODS: Upon completion of the program at the Chronic Pain Management Unit (CPMU), patients fill out program satisfaction (Pain Program Satisfaction Questionnaire) and evaluation of goal accomplishment (Self-Evaluation Scale) forms, sections of which are open-ended...
June 2016: Pain and Therapy
Bruce C M Wang, Dongdong Liu, Wesley E Furnback, Fan Bifa, Peng Dong, Li Xie, Gregory F Guzauskas, Sali Zhang
INTRODUCTION: Postherpetic neuralgia (PHN), a type of peripheral neuropathic pain (pNeP), is the most common complication of herpes zoster. The objective of this analysis was to determine the cost-effectiveness of pregabalin compared with gabapentin in pNeP and PHN in China. METHODS: We developed a China-localized 12-week simulation model to determine the cost-effectiveness of pregabalin compared to gabapentin in 1000 patients with pNeP and PHN. We utilized a questionnaire of Chinese key opinion leaders to estimate the pre-treatment distribution of pain scores for pNeP and PHN...
June 2016: Pain and Therapy
Myriam Bellon, Alix Le Bot, Daphnée Michelet, Julie Hilly, Mathieu Maesani, Christopher Brasher, Souhayl Dahmani
INTRODUCTION: Dexmedetomidine (Dex) has sedative, analgesic, and anesthetic-sparing effects. This meta-analysis examines demonstrated intraoperative and postoperative effects of intraoperative Dex administration during pediatric surgery. METHODS: A search for randomized placebo-controlled trials was conducted to identify clinical trials examining intraoperative Dex use in children, infants, and neonates. Primary outcome was postoperative opioid consumption; secondary outcomes were: postoperative pain intensity and postoperative nausea and vomiting (PONV)...
June 2016: Pain and Therapy
Despoina G Sarridou, Georgia Chalmouki, Maria Braoudaki, Ioanna Siafaka, Chrisi Asmatzi, Athina Vadalouka
INTRODUCTION: Intravenous administration of parecoxib could provide significant pain relief in surgical operations that require additional forms of analgesia. However, very little is known about its effects on the anxiety levels of patients before a surgical procedure. The aim of this prospective study was to investigate whether intravenous parecoxib, pre-emptively administered, has an effect on anxiety levels experienced post-surgically after total knee arthroplasty (TKA) and if it influences the reported pain of the procedure itself...
June 2016: Pain and Therapy
Zalina Zahari, Chee Siong Lee, Muslih Abdulkarim Ibrahim, Nurfadhlina Musa, Mohd Azhar Mohd Yasin, Yeong Yeh Lee, Soo Choon Tan, Nasir Mohamad, Rusli Ismail
INTRODUCTION: Methadone is a full agonist of the opioid receptor mu 1 which is encoded by the OPRM1 gene. Sleep disorders were frequently reported by opioid-dependent patients during methadone maintenance therapy (MMT). It is possible, therefore, that genetic polymorphisms in OPRM1 influence sleep quality among patients on MMT. This study investigated the association of OPRM1 polymorphisms with sleep quality among opioid-dependent patients on MMT. METHODS: The sleep quality of 165 male opioid-dependent patients receiving MMT was evaluated using the Pittsburgh Sleep Quality Index (PSQI)...
June 2016: Pain and Therapy
David Castel, Michael Naveh, Arnon Aharon, Ofer Doron, Sigal Meilin
INTRODUCTION: Local anesthetic infusion techniques have been reported to reduce opiate requirements and pain scores following different kinds of surgery, including orthopedic surgery, inguinal hernia, and Cesarean surgery in women. METHODS: PRF-108 and PRF-110 formulations were applied to the wound space in an incisional model in pigs to test the hypothesis that these formulations have better and longer analgesic effects than the commercially available ropivacaine solution (Naropin(®), AstraZeneca)...
June 2016: Pain and Therapy
Christos Kontogiorgis, Evangelia Nena, Eleftherios Berberoglou, Kyriaki Moschoni, Spyros Polyzois, Athanasios Tselemponis, Theodoros C Constantinidis
INTRODUCTION: Non-prescription over-the-counter (OTC) drugs are widely used by patients to control aches, pain, and fever. One of the most frequently used OTC medications worldwide is paracetamol (acetaminophen). The aim of the present study was to fill the current knowledge gap regarding the beliefs and attitudes of people in Greece associated with the use of paracetamol during the years of financial crisis. METHODS: The present study employed a sample of individuals visiting community pharmacies in the second largest city of Greece, Thessaloniki...
June 2016: Pain and Therapy
Zalina Zahari, Chee Siong Lee, Muslih Abdulkarim Ibrahim, Nurfadhlina Musa, Mohd Azhar Mohd Yasin, Yeong Yeh Lee, Soo Choon Tan, Nasir Mohamad, Rusli Ismail
INTRODUCTION: We recently reported that a majority of opioid-dependent Malay males on methadone therapy are cold pain sensitive. It is postulated that common OPRM1 polymorphisms may be responsible. This study investigated the association between 118A>G (dbSNP rs1799971) and IVS2+691G>C (dbSNP rs2075572) variants on cold pain responses among opioid-dependent Malay males on methadone maintenance therapy. METHODS: Cold pain responses including pain threshold, pain tolerance, and pain intensity were measured using the cold pressor test...
December 2015: Pain and Therapy
Maurizio de Martino, Alberto Chiarugi
Paracetamol is a common analgesic and antipyretic drug for management of fever and mild-to-moderate pain in infants and children, and it is considered as first-line therapy for the treatment of both according to international guidelines and recommendations. The mechanism of action of paracetamol is complex and multifactorial, and several aspects of the pharmacology impact its clinical use, especially in the selection of the correct analgesic and antipyretic dose. A systematic literature search was performed by following procedures for transparent reporting of systematic reviews and meta-analyses...
December 2015: Pain and Therapy
Rosaria Del Giorno, Stephen Skaper, Antonella Paladini, Giustino Varrassi, Stefano Coaccioli
INTRODUCTION: Fibromyalgia syndrome (FM) is characterized by persistent pain which is often refractory to common analgesic therapies and is particularly disabling. The objective of this study was to evaluate the therapeutic efficacy of duloxetine (DLX) + pregabalin (PGB) in patients suffering from FM and the possible added benefit of the lipid signaling molecule, palmitoylethanolamide (PEA). PEA is well-documented to exert anti-inflammatory, analgesic, and pain-relieving effects at both the preclinical and clinical level...
December 2015: Pain and Therapy
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