The Clinical journal of pain
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Randomized Controlled Trial
Adjuvant therapy with intrathecal clonidine improves postoperative pain in patients undergoing coronary artery bypass graft.
Alpha2 adrenergic agonists have long been employed as analgesics and to sedate patients undergoing surgical procedures. In addition, their therapeutic response synergizes that elicited by opioids. Although this response is well known, the role of alpha2 agonists, such as clonidine, during various painful surgical procedures remains to be elucidated. The goal of our study was to evaluate the effects of the intrathecal administration of clonidine on postoperative pain control and time to extubation in patients undergoing coronary artery bypass grafting. ⋯ Addition of clonidine to neuraxial opioids improves the quality of analgesia postoperatively and expedites the process of weaning from mechanical ventilation. There were no serious adverse events in the cohort of the patients studied. However, the safety profile of this medication remains to be examined with a larger group of patients.
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Randomized Controlled Trial
Oral glucose and parental holding preferable to opioid in pain management in preterm infants.
The purpose of this study was to compare the effectiveness of "facilitated tucking by parents" (FTP) in which a parent holds by her hands the infant in a side-lying flexed position offering support and skin contact, oral glucose, opioid (oxycodone), and placebo (oral water) in the context of heel stick and pharyngeal suctioning in very preterm infants. We hypothesized that nonpharmacologic methods equal the pharmacologic method and are superior to placebo in pain management. ⋯ Our study demonstrated that FTP is not just equal, but preferable to other pain management methods when both efficacy and safety are considered.
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Randomized Controlled Trial
8% Lidocaine pump spray relieves pain associated with peripheral blood flow disorders.
It is often difficult to reduce pain associated with peripheral blood flow disorders (PBFD) using standard analgesics. We assessed the analgesic effects of a metered-dose 8% lidocaine in patients with PBFD. ⋯ A metered-dose 8% lidocaine pump spray produced prompt analgesia in patients with PBFD-related pain without severe side effects.
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Randomized Controlled Trial
The pain quality response profile of oxymorphone extended release in the treatment of low back pain.
In controlled trials of analgesics, the primary outcome variable is most often a measure of global pain intensity. However, because pain is associated with a variety of pain sensations, the effects of analgesic treatments on different sensations could go undetected if specific pain qualities are not assessed. This study sought to evaluate the utility of assessing the multiple components of non-neuropathic pain in an analgesic clinical trial. ⋯ The results indicate that oxymorphone ER has different effects on different pain qualities of low back pain. The responsivity of the PQAS items and scales to the results of treatment with an effective and generally well-tolerated dose of an analgesic, and the ability of the PQAS items and scales to discriminate between an active analgesic and placebo, support their validity as outcome measures. The findings support the utility of using pain descriptor measures for (1) identifying the effects of pain treatments on different pain qualities and (2) targeting pain treatments to those patients who experience certain types of pain.