The Clinical journal of pain
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Randomized Controlled Trial
Long-term Safety of Gastroretentive Gabapentin in Postherpetic Neuralgia Patients.
This study evaluated the long-term safety and tolerability of a gastroretentive formulation of gabapentin (G-GR) and its effect on weight gain in postherpetic neuralgia (PHN) patients participating in a 14-week, open-label extension to a 10-week double-blind study. ⋯ Long-term treatment (up to 24 wk) with G-GR of 1800 mg was well tolerated and associated with little weight gain (< 1 kg) in patients with PHN. No new safety issues emerged with G-GR long-term treatment.
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Randomized Controlled Trial Multicenter Study Comparative Study
Comparative study between 2 protocols for management of severe pain in patients with unresectable pancreatic cancer: one-year follow-up.
The efficacy of a celiac plexus block for the treatment of upper abdominal cancer-related pain has been documented. However, the effect of preprocedural pharmacological control of pain on its efficacy remains unknown. The researchers investigated the effect of first controlling severe pain with medications and then performing the celiac plexus block and compared the results with those obtained when the celiac block was performed first followed by pharmacotherapy for controlling severe pain; the impact on and duration of pain relief, effect on the quality of life, and analgesic requirements were analyzed. ⋯ Controlling severe pain with medication and then performing the celiac block seems to be more effective in controlling pain, reducing opioid consumption, and improving the quality of life of patients with pancreatic cancer compared with performing the celiac block at the beginning followed by pharmacotherapy for pain relief.
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Randomized Controlled Trial
Therapeutic touch is not therapeutic for procedural pain in very preterm neonates: a randomized trial.
Preterm neonates below 30 weeks' gestational age undergo numerous painful procedures. Many management approaches are not appropriate for this population. Therapeutic Touch, an alternative approach based on the theory of energy medicine, has been shown to promote physiological stability in preterm neonates and reduce pain in some adult studies. The objective was to determine whether Therapeutic Touch is efficacious in decreasing pain in preterm neonates. ⋯ Therapeutic Touch given immediately before and after heel lance has no comforting effect in preterm neonates. Other effective strategies involving actual touch should be considered.
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Randomized Controlled Trial
Combining Cognitive-Behavioral Therapy and Milnacipran for Fibromyalgia: A Feasibility Randomized-controlled Trial.
To evaluate the feasibility of a randomized-controlled trial and to obtain estimates of the effects of combined cognitive-behavioral therapy (CBT) and milnacipran for the treatment of fibromyalgia. ⋯ In this pilot study, a therapeutic approach that combines phone-based CBT and milnacipran was feasible and acceptable. Moreover, the preliminary data supports conducting a fully powered randomized-controlled trial.
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In specialized pain clinics there is an increasing number of patients with severe chronic noncancer pain (CNCP) despite long-term opioid medication. Few clinical studies show short-term pain relief after opioid withdrawal (OW). We have evaluated the relation between pain intensity after OW and long-term opioid nonuse. ⋯ In many patients with severe CNCP, despite opioid medication, sustainable pain relief can be achieved if OW is included in the rehabilitation program. Consequently, we recommend OW for opioid-resistant CNCP before any opioid escalation. Lower pain intensity shortly after OW may predict the long-term opioid nonuse probability.