European journal of pain : EJP
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Randomized Controlled Trial Multicenter Study Comparative Study
Randomized controlled trial of the combined monoaminergic and opioid investigational compound GRT9906 in painful polyneuropathy.
GRT9906 is an investigational novel compound with μ-opioid receptor agonism and inhibition of noradrenalin/serotonin re-uptake. In this randomized, double-blind, placebo-controlled, three-way cross-over trial in painful polyneuropathy, the efficacy and safety of GRT9906 was assessed and compared with tramadol. During 4-week treatment periods, daily oral doses of either GRT9906 120-240 mg, or placebo, or tramadol 200-400 mg were given. ⋯ The most frequently reported adverse events were nausea, fatigue, constipation and sleep disorder for GRT9906 and tramadol. Four patients dropped out due to adverse events during both GRT9906 and tramadol treatment and two dropped out during placebo treatment. In conclusion, in painful polyneuropathy, GRT9906 demonstrated analgesic efficacy with a magnitude of effect comparable with tramadol and was well tolerated.
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Randomized Controlled Trial
Attention focus, trait anxiety and pain perception in patients undergoing colposcopy.
Few studies have compared the relative efficacy of attention-focus strategies in reducing clinical pain. Colposcopy, a medical diagnostic examination performed to identify premalignant cervical cell changes, elicits both anxiety and pain in patients, while allowing little or no behavioural control over the event. Employing a multi-group experimental design, the present study sought to investigate how different types of attention-focus strategies impacted upon pain perception, state anxiety and affect, in a sample of 123 colposcopy patients. ⋯ Pre-colposcopy pain expectancy, but not trait anxiety, was found to be positively related to colposcopy-related pain. It was further demonstrated that heightened state anxiety following colposcopy was due to experienced pain and pain unpleasantness, rather than to aspects of the pre-colposcopy prediction of pain. The results have implications for management of acute clinical pain.
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Randomized Controlled Trial
Preoperative administration of etoricoxib in patients undergoing hip replacement causes inhibition of inflammatory mediators and pain relief.
Administering cyclooxygenase-2 inhibitors preoperatively appears attractive since these drugs reduce post-operative pain, but do not increase the risk of post-operative bleeds, asthmatic attacks and stress-related gastrointestinal ulcers. In a former investigation, we could show that post-operative administration of etoricoxib reduces prostaglandin production in wound fluid, but the onset of action is variable due to delayed post-operative absorption. ⋯ Administration of etoricoxib 2 h before surgery allows for an effective drug concentration in critical tissues, a reduction of the production of pro-inflammatory mediators and for better pain relief.
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Randomized Controlled Trial
A randomized, placebo-controlled trial of levetiracetam in central pain in multiple sclerosis.
Levetiracetam is an anticonvulsant which is assumed to act by modulating neurotransmitter release via binding to the vesicle protein SV2A. This could have an impact on signalling in the pain pathway. The aim of this study was to test the analgesic effect of levetiracetam in central pain in multiple sclerosis. ⋯ There were no differences in the ratings of pain relief (levetiracetam 2.4 vs. placebo 2.1, p = 0.169), total pain intensity (levetiracetam 5.3 vs. placebo 5.7, p = 0.147) or any of the other outcome measures (p = 0.086-0.715) in the total sample of patients. However, there was significant reduction of pain, increased pain relief and/or more favourable pain relief with levetiracetam than with placebo in patients with lancinating or without touch-evoked pain (p = 0.025-0.046). This study found no effect of the anticonvulsant levetiracetam in non-selected patients with central pain in multiple sclerosis, but an effect in subgroups with specific pain symptoms was indicated.