The Clinical journal of pain
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Randomized Controlled Trial
Somatosensory sensitivity in patients with persistent idiopathic orofacial pain is associated with pain relief from hypnosis and relaxation.
In a recent study hypnosis has been found to relieve persistent idiopathic orofacial pain. Quantitative sensory testing (QST) is widely used to evaluate somatosensory sensitivity, which has been suggested as a possible predictor of management outcome. The objectives of this study were to examine: (1) possible associations between clinical pain relief and baseline somatosensory sensitivity and (2) the effect of hypnosis management on QST parameters. ⋯ High pain sensitivity at baseline may predict poor pain management outcome. In addition, despite clear clinical pain relief, hypnosis did not significantly or specifically influence somatosensory sensitivity. Future studies should further explore QST measures as possible predictors of different management response in orofacial pain conditions.
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Randomized Controlled Trial
Evaluation of multiday analgesia with etoricoxib in a double-blind, randomized controlled trial using the postoperative third-molar extraction dental pain model.
To evaluate the analgesic effects of etoricoxib and comparator agents on the second and third days after oral surgery. ⋯ Pain control was most favorable for the etoricoxib doses and ibuprofen. Global Assessments of Study Medication continued to differentiate the treatments and demonstrated greater efficacy for etoricoxib on Days 2 and 3 compared with placebo and A/C (NCT00694369).
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Multicenter Study
Cost savings associated with early initiation of pregabalin in the management of peripheral neuropathic pain.
Peripheral neuropathic pain (PNP) is associated with significant economic burden. Guidelines recommend the early adoption of appropriate pharmacological interventions. The aim of this study was to explore whether early initiation of pregabalin was associated with lower economic burden, than later initiation, in the management of refractory chronic PNP. ⋯ Early initiation of pregabalin treatment after diagnosis in patients with refractory chronic PNP may result in substantial cost savings from a societal perspective in daily practice in Spain.
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To the best of our knowledge, there have been no reports on the pharmacokinetics and pharmacodynamics during the conversion from continuous intravenous infusion (CII) to transdermal fentanyl administration. The primary objective of the present study was to clarify the pharmacokinetic characteristics during this conversion. A secondary objective was to identify an association between serum albumin and the absorption of fentanyl from the transdermal patch. ⋯ Our study demonstrated that the dose-adjusted serum fentanyl concentrations remained relatively stable, and pain intensity and the number of rescue events remained stable during conversion. Hypoalbuminemia was strongly associated with poor absorption of transdermally administered fentanyl.
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Chronic neuropathic pain (NP) is a well-known phenomenon, whereas acute neuropathic pain is increasingly recognized. Both are potentially difficult for a nonspecialist to diagnose. The Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) and DN4 scales are screening tools developed to identify chronic NP. We aimed to evaluate and compare their performance in 2 different populations: outpatients with chronic pain, and inpatients with acute postoperative pain. ⋯ Although the LANSS performed better than the DN4 in the chronic population, both tools performed less well than published literature, demonstrating the importance of evaluating screening tools in the proposed patient population. There may be potential for using these questionnaires to identify acute NP.