Journal of pain and symptom management
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J Pain Symptom Manage · Oct 2013
Review Meta AnalysisThe evidence for pharmacologic treatment of neuropathic cancer pain: beneficial and adverse effects.
The prevalence of neuropathic pain in patients with cancer pain has been estimated to be around 40%. Neuropathic pain may be caused by tumor invasion and is considered as mixed nociceptive-neuropathic pain, or caused by an anticancer treatment and considered as purely neuropathic pain. The use of adjuvant analgesics in patients with cancer is usually extrapolated from their efficacy in nononcological neuropathic pain syndromes. ⋯ Once a diagnosis of neuropathic pain has been established in patients with cancer, antidepressants, anticonvulsants, or other adjuvant analgesics should be considered in addition to or instead of opioids.
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J Pain Symptom Manage · Oct 2013
Randomized Controlled TrialCaffeine as an adjuvant therapy to opioids in cancer pain: a randomized, double-blind, placebo-controlled trial.
Opioid therapy often shows insufficient efficacy and substantial adverse events in patients with advanced cancer. ⋯ Caffeine infusion significantly reduced pain and drowsiness, but the reduction did not reach clinical significance in patients with advanced cancer undergoing opioid therapy. Further investigations are warranted.
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J Pain Symptom Manage · Oct 2013
Clinical TrialFactors to inform clinicians about the end of life in severe chronic obstructive pulmonary disease.
Palliative services have historically been offered to terminal patients with cancer, but much less so in other chronic illnesses such as chronic obstructive pulmonary disease (COPD) because of difficulties in predicting the trajectory to death. ⋯ The changes in defined variables and patient-reported outcomes by defined cutpoints were independently associated with increased 12-month mortality in patients with severe COPD. These results may inform clinicians when to initiate end-of-life communications and palliative care.