The Clinical journal of pain
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Comparative Study Clinical Trial
Patient compliance with SSRIs and gabapentin in painful diabetic neuropathy.
Anticonvulsants are widely used for treatment of painful diabetic neuropathy. Selective serotonin reuptake inhibitors (SSRIs) are not first-line drugs but are commonly prescribed medicines for chronic pain. The majority of patients are hesitant to use these drug groups, thus their compliance remains an issue. ⋯ The lack of negative effects on quality of life, the better compliance, and the comparable efficiency of SSRIs suggest that these drugs may be considered as alternative to gabapentin in painful diabetic neuropathy.
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Comparative Study
Use of tricyclic antidepressants in older patients with diabetic peripheral neuropathy.
To describe patterns of use of tricyclic antidepressants (TCAs) (eg, amitriptyline, nortriptyline) among older patients with diabetic peripheral neuropathy (DPN). ⋯ The high prevalence of contraindications, warnings, or precautions and the low level of TCA exposure suggest that many older patients with DPN who receive TCAs may be inappropriately treated.
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Randomized Controlled Trial Comparative Study Clinical Trial
A randomized, double-blind, placebo-controlled pilot study of IV morphine-6-glucuronide for postoperative pain relief after knee replacement surgery.
To determine the dose-response effect of intravenous morphine-6-glucuronide (M6G) on acute postoperative pain. ⋯ The analgesic effect of M6G in postoperative pain was demonstrated with 30 mg/70 kg M6G superior to placebo. At this dose, M6G has a long duration of action as determined by a reduction in the use of morphine PCA over 12 and 24 hours.
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Randomized Controlled Trial Comparative Study Clinical Trial
Preincisional subcutaneous infiltration of ketamine suppresses postoperative pain after circumcision surgery.
N-methyl-D-aspartate and other glutamate receptors have been shown to present on the peripheral axons of primary afferents, and peripheral injection of N-methyl-D-aspartate-receptor antagonists can suppress hyperalgesia and allodynia. Thus, this study examined postoperative analgesic and adverse effects of local ketamine administered postoperatively. ⋯ We conclude that preincisional subcutaneous ketamine infiltration can suppress postoperative pain after the circumcision surgery.
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Randomized Controlled Trial Comparative Study Clinical Trial
The effect of intra-articular injection of ultracain in the temporomandibular joint in patients with preauricular pain: a randomized prospective double-blind placebo-controlled crossover study.
To evaluate the distinguishing ability of intra-articular anesthesia from placebo in orofacial pain patients with pain located in the temporomandibular joint (TMJ) region, aiming at a validation of intra-articular anesthesia injection as a diagnostic test of pain in the TMJ region. ⋯ TMJ injection with local anesthesia leads to the decrease of pain in patients with preauricular pain. To establish the source of pain, injection of a local anesthetic in the TMJ may be used as a diagnostic tool. However, the results of diagnostic injections should still be interpreted cautiously.