European journal of pain : EJP
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Randomized Controlled Trial Clinical Trial
Induction of non-painful and painful intestinal sensations by hypertonic saline: a new human experimental model.
To develop a pain model for chemical stimulation of the human gut. ⋯ The model represents a safe method for direct chemical activation of the sensory endings in the human gut. The model may be used for pharmacological screening of analgesics and for basic investigations in patients suffering from gastrointestinal diseases.
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While morphine is historically the gold standard for the management of severe cancer pain, some patients either do not achieve adequate analgesia, or suffer intolerable side-effects. For these patients an alternative opioid is recommended. ⋯ Similar to morphine, transdermal fentanyl is effective for the management of moderate to severe cancer pain. However, inappropriate prescribing of transdermal fentanyl, particularly in the clinical setting of unstable pain, can cause significant opioid toxicity, as highlighted in the case reports described.
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The effects of the S enantiomer of RB101, a complete inhibitor of enkephalin-catabolizing enzymes, alone or in combination with a functional NMDA receptor antagonist, (+)-HA966 were studied on the spinal c-Fos protein expression in the carrageenan model of inflammatory nociception. One hour 30min after intraplantar carrageenan in awake rats, c-Fos immunoreactive (c-Fos-IR) nuclei were preferentially located in the laminae I-II and V-VI of the spinal dorsal horn, i.e., spinal areas containing numerous neurons responding exclusively, or not, to peripheral nociceptive stimuli. RB101(S) (5, 10, 20 and 40mg/kg i.v.) dose-dependently reduced the total number of carrageenan-evoked c-Fos-IR nuclei (r=0.63, P<0.01), with 49+/-3% reduction (P<0.001) for the highest dose. ⋯ These effects were partially reversed by naloxone. These results provide evidence for the potent effects of combination of RB101(S) and (+)-HA966. Considering the absence of major opioid side effects of RB101(S) and the marked increase of its antinociceptive effects by NMDA receptor antagonist, this type of drug combination could have beneficial therapeutical application.
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Parents' perceptions of children's pain may have influence on how children's postoperative pain is alleviated at home after discharge from hospital. ⋯ Parents' perceptions of children's pain were related to children's pain after surgery at home. Adequate information of children's pain should be provided to the parents before discharge to promote children's pain alleviation at home. Special attention should be paid on parents' expectations of boys' higher pain tolerance.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Low-dose diclofenac potassium in the treatment of episodic tension-type headache.
Several clinical trials have demonstrated that low doses of non-steroidal anti-inflammatory drugs relieve episodic tension-type headache (ETH). ⋯ Diclofenac-K, administered as single doses of 12.5 and 25mg effectively relieves ETH and is comparable to ibuprofen 400mg.