Pain research & management : the journal of the Canadian Pain Society = journal de la société canadienne pour le traitement de la douleur
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The issue of how to address patient pain in the outpatient setting remains challenging. At the London Regional Cancer Program (London, Ontario), patients complete the Edmonton Symptom Assessment System (ESAS) before most visits. ⋯ Active pain management plans were documented in 83% of visits. However, patients who reported severe pain that was assessed as benign or unknown in etiology received intervention less frequently, perhaps indicating that oncologists either consider themselves less responsible for noncancer pain, or believe that pain chronicity may lead to a higher ESAS pain score without indicating a need for acute intervention. Further study is needed to determine the subsequent effect of the care plans on patient-reported ESAS pain scores at future clinic visits.
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Pregabalin administration is occasionally abandoned due to adverse events such as somnolence, dizziness, unsteadiness, weight gain and edema. However, the exact causes of these differences in adverse events associated with pregabalin have not been elucidated. ⋯ The results of the present study indicate that care is warranted regarding long durations of therapy for somnolence, advanced age rather than dose-dependent adverse events for unsteadiness, elevated serum creatinine level for weight gain, and elevated serum creatinine level and combination use of neurotropin for edema. The safety of the combined use of pregabalin and nonsteroidal anti-inflammatory drugs were also suggested.
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Rho-kinases (ROCKs), a family of small GTP-dependent enzymes, are involved in a range of pain models, and their inhibition typically leads to antinociceptive effects. ⋯ The results of the present study suggest that ROCKs participate in the local mechanisms associated with nociception⁄antinociception and inflammation, with a possible involvement of the nitric oxide⁄cGMP⁄protein kinase G pathway. Also, drug effects following local administration may differ markedly from the effects following systemic administration. Finally, separate treatment of pain and edema may be needed to maximize clinical benefit in inflammatory pain.