The Clinical journal of pain
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Comparative Study
Psychiatric history and psychologic adjustment as risk factors for aberrant drug-related behavior among patients with chronic pain.
To investigate the role of psychiatric history and psychologic adjustment on aberrant drug-related behavior among patients prescribed opioids for noncancer pain. ⋯ Psychiatric factors, such as a history of mood disorder, psychologic problems, and psychosocial stressors, may place patients at risk for misuse of prescription opioids. Future studies to elucidate the risk of medication misuse and aberrant drug behavior among this patient population are needed.
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Assessment of pain in patients with whiplash-associated disorders has been previously reported using a variety of instruments. However, the reproducibility of the findings derived from such measurements has not been explored with respect to this particular patients group. ⋯ On the basis of the current patient sample, this study demonstrates that although PPT findings may generally be applied for monitoring change in chronic whiplash patients, the use of VAS scores should be limited to patients whose initial score is above 4. It is also suggested that if the PPT is to serve as an outcome measure, its measurement should be performed by the same tester.
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Review Historical Article
Opioids: after thousands of years, still getting to know you.
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Referred pain and pain characteristics evoked from the extensor carpi radialis brevis, extensor carpi radialis longus, extensor digitorum communis, and brachioradialis muscles was investigated in 20 patients with lateral epicondylalgia (LE) and 20-matched controls. ⋯ Our results suggest that in patients with LE, the evoked referred pain and its sensory characteristics shared similar patterns as their habitual elbow and forearm pain, consistent with active TrPs. Lower PPT and larger referred pain patterns suggest that peripheral and central sensitization exists in LE.
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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.