The Journal of the American Osteopathic Association
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Methadone hydrochloride is an effective, inexpensive, and relatively safe opioid to use in the treatment of patients with chronic pain. It is especially effective in management of pain during the final stages of life, as it is the only long-acting analgesic available in liquid form. ⋯ Also, they should closely monitor patients during the titration phase and educate them with regard to basic pharmacologic properties and potential side effects. A plan to start at low doses and proceed slowly is applicable to methadone.
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Pain management in end-of-life care presents a unique set of opportunities for patients and physicians. Physicians will encounter patients at the end of life regardless of type of specialty practice. Symptom relief is the concern of all physicians. ⋯ Osteopathic principles and treatment philosophy complement quality pain management in end-of-life care. Physicians providing supportive care can assist patients and their families with comfort at the end of life. Good pain management at the end of life enhances the patient-physician relationship.
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J Am Osteopath Assoc · Feb 2005
Randomized Controlled Trial Comparative StudyIntramuscular ketorolac versus osteopathic manipulative treatment in the management of acute neck pain in the emergency department: a randomized clinical trial.
Ketorolac tromethamine injected intramuscularly (IM) has been shown to be an effective analgesic in treating patients with acute musculoskeletal pain in the emergency department (ED). The authors compare the efficacy of a single dose of IM ketorolac to osteopathic manipulative treatment (OMT) as delivered in the ED for the management of acute neck pain. A randomized clinical trial was conducted in three EDs. ⋯ When comparing pain relief at one hour posttreatment, there was no significant difference between the OMT and ketorolac study groups (P=.10). The authors found that, at one hour posttreatment, OMT is as efficacious as IM ketorolac in providing pain relief and significantly better in reducing pain intensity. The authors conclude that OMT is a reasonable alternative to parenteral nonsteroidal anti-inflammatory medication for patients with acute neck pain in the ED setting.
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J Am Osteopath Assoc · May 2004
Randomized Controlled Trial Clinical TrialA randomized controlled trial of osteopathic manipulative treatment following knee or hip arthroplasty.
Preliminary study results suggest that osteopathic manipulative treatment (OMT) may reduce pain, improve ambulation, and increase rehabilitation efficiency in patients undergoing knee or hip arthroplasty. ⋯ The OMT protocol used does not appear to be efficacious in this hospital rehabilitation population.