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Pain management

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By Stan Marchuk Nurse Practitioner, working in area of Nephrology in a large urban teaching center
Boaz Gedaliahu Samolsky Dekel, Gabriele Donati, Alessio Vasarri, Anna Laura Croci Chiocchini, Alberto Gori, Giuseppe Cavallari, Gianfranco Di Nino, Laura Mercolini, Michele Protti, Roberto Mandrioli, Rita Maria Melotti, Gaetano La Manna
OBJECTIVES: Opioids are the preferred analgesic drugs to treat severe chronic pain conditions among dialysis patients; however, knowledge about their dialyzability features is limited. Oxycodone is increasingly used for the treatment of chronic pain conditions as oral controlled release (CR) tablets; however, evidence about this drug and its metabolites' dialyzability is lacking. METHODS: We assessed, during 4-hour dialysis sessions, the effect of standard hemodialysis (HD) and online hemodiafiltration (HDF) methods on the plasma concentration of oxycodone and its metabolites in n = 20 chronic pain patients with end-stage renal disease who were stably treated with oral CR oxycodone...
September 2, 2016: Pain Practice: the Official Journal of World Institute of Pain
Joel Katz, Aliza Weinrib, Samantha R Fashler, Rita Katznelzon, Bansi R Shah, Salima Sj Ladak, Jiao Jiang, Qing Li, Kayla McMillan, Daniel Santa Mina, Kirsten Wentlandt, Karen McRae, Diana Tamir, Sheldon Lyn, Marc de Perrot, Vivek Rao, David Grant, Graham Roche-Nagle, Sean P Cleary, Stefan Op Hofer, Ralph Gilbert, Duminda Wijeysundera, Paul Ritvo, Tahir Janmohamed, Gerald O'Leary, Hance Clarke
Chronic postsurgical pain (CPSP), an often unanticipated result of necessary and even life-saving procedures, develops in 5-10% of patients one-year after major surgery. Substantial advances have been made in identifying patients at elevated risk of developing CPSP based on perioperative pain, opioid use, and negative affect, including depression, anxiety, pain catastrophizing, and posttraumatic stress disorder-like symptoms. The Transitional Pain Service (TPS) at Toronto General Hospital (TGH) is the first to comprehensively address the problem of CPSP at three stages: 1) preoperatively, 2) postoperatively in hospital, and 3) postoperatively in an outpatient setting for up to 6 months after surgery...
2015: Journal of Pain Research
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