The Clinical journal of pain
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Randomized Controlled Trial Multicenter Study
Do Resting Plasma Beta-Endorphin Levels Predict Responses to Opioid Analgesics?
Clinically feasible predictors of opioid analgesic responses for use in precision pain medicine protocols are needed. This study evaluated whether resting plasma β-endorphin (BE) levels predicted responses to an opioid analgesic, and whether chronic pain status or sex moderated these effects. ⋯ BE was a predictor of morphine analgesia for only 3 out of 9 outcomes examined, with these effects moderated by chronic pain status but not sex. On the whole, results do not suggest that resting plasma BE levels are likely to be a clinically useful predictor of opioid analgesic responses.
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Review Meta Analysis
Meta-Analysis: Postoperative Pain Management in Colorectal Surgical Patients and the Effects on Length of Stay in an ERAS Setting.
Enhanced Recovery After Surgery (ERAS) aims to minimize the length of a negative physiological response to surgical intervention. There are a number of aspects involved in ERAS protocols, one of which is postoperative pain relief. This meta-analysis investigates the current evidence for postoperative pain relief and its effect on patient pain and the length of stay after colorectal surgery. ⋯ In an ERAS setting with regard to a colorectal patient population, the choice of modality for postoperative pain relief does not impact the length of hospital stay, pain, the time to the first bowel motion, or nausea.
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Clinical Trial
Prediction of Acute Postoperative Pain Following Breast Cancer Surgery Using the Pain Sensitivity Questionnaire: A Cohort Study.
Previous studies have indicated that preoperative pain sensitivity correlates with postoperative pain intensity, and thus may be used to predict severe postoperative pain. Self-rating of pain sensitivity using the "Pain Sensitivity Questionnaire (PSQ)" may be an adjunct to these measures. ⋯ Results need to be validated in a larger cohort and for other types of surgery, but use of the simple PSQ may help to identify patients at risk of intense acute postoperative pain.
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This study compared persistent breast pain among women who received breast-conserving surgery for breast cancer and women without a history of breast cancer. ⋯ Results indicate that persistent breast pain negatively impacts women with a history of breast-conserving cancer surgery compared with women without that history. Strategies to ameliorate persistent breast pain and to improve adjustment among women with persistent breast pain should be explored for incorporation into standard care for breast cancer survivors.
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Skin sensitivity to sensory stimuli varies among different body areas. A standardized clinical quantitative sensory testing (QST) battery, established for the diagnosis of neuropathic pain, was used to assess whether the magnitude of differences between test sites reaches clinical significance. ⋯ Sensory differences between neighboring body areas are statistically significant, reproducing prior knowledge. This has to be considered in scientific assessments where a small variation of the tested body areas may not be an option. However, the magnitude of these differences was below the difference in sensory parameters that is judged as abnormal, indicating a robustness of the QST instrument against protocol deviations with respect to the test area when using the method of comparison with a 95 % confidence interval of a reference dataset.