The Clinical journal of pain
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Clinical Trial
Determinants of patient-controlled epidural analgesia requirements: a prospective analysis of 1753 patients.
Patient-controlled epidural analgesia (PCEA) has been widely used in postoperative pain management. Many factors may correlate with PCEA requirements but no previous study has ever investigated this subject. Therefore, we conducted this study to explore the relationship among patients' characteristics and total PCEA consumption during the 3-day postoperative course. ⋯ Our study demonstrated the association between patients' characteristics and total PCEA requirements from a large-scaled clinical data. Surgical procedures have more influence on PCEA consumption than demographic variables. Background infusion rate of PCEA could be determined from our predictive model.
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Controlled Clinical Trial
Contribution of nonspinal comorbidity to low back pain outcomes.
To determine the involvement of comorbidity to outcomes in a cohort of acute mechanical low back pain patients. ⋯ Significant ORs were barely greater than 1.00 and were likely the result of the large sample size. The clinical course for comorbid patients, who may seem more complicated at the start of treatment, is just as favorable.
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To describe a patient with spontaneous intracranial hypotension (SIH) secondary to multiple sites of cerebrospinal fluid (CSF) leaks, a rarely described phenomenon. To compare computerized tomography-myelography with radionuclide cisternography as confirmatory diagnostic aids in SIH. ⋯ In a patient with SIH, a computerized tomography-myelography should be performed if an initial epidural blood patch is ineffective. This is to show the vertebral level and site(s) of CSF leak and to guide the physician to the ideal vertebral level for the epidural blood patch.
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Multicenter Study Clinical Trial
The validity and reliability of the graphic rating scale and verbal rating scale for measuring pain across cultures: a study in Egyptian and Dutch women with rheumatoid arthritis.
To compare the validity and reliability of a graphic rating scale (GRS) and a verbal rating scale (VRS) for measuring pain intensity in young female Egyptian and Dutch patients with rheumatoid arthritis (RA). ⋯ The study confirmed that the GRS and VRS were reliable and valid in the total study cohort. Within the individual countries, the GRS seemed to perform better than the VRS.
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Randomized Controlled Trial
A randomized, placebo-controlled study of fentanyl buccal tablet for breakthrough pain in opioid-treated patients with cancer.
Cancer-related breakthrough pain (BTP) is typically managed with a short-acting oral opioid, taken as needed during a fixed-schedule opioid regimen. The conventional approach may not provide the onset of analgesia required for BTP for many patients, because the onset of analgesia with short-acting opioids lags behind the time course of the majority of episodes of BTP. The fentanyl buccal tablet (FBT) employs a novel delivery system that enhances the rate and extent of absorption of fentanyl through the buccal mucosa. This double-blind, randomized, placebo-controlled study evaluated the efficacy, safety, and tolerability of FBT in opioid-treated patients with cancer-related BTP. ⋯ FBT is efficacious and safe in the treatment of cancer-related BTP.