Pain medicine : the official journal of the American Academy of Pain Medicine
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Our case will demonstrate a safe and practical alternative location for an implantable drug delivery system (IDDS) pump. Traditionally, these pumps have been placed subcutaneously in the lower abdomen. We will describe the technique used for under the breast placement. ⋯ The retromammary location for the IDDS pump is a safe and aesthetically pleasing option for some patients. This location is a useful alternative for female cachectic patients, or patients with abdominal ostomies.
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Review Meta Analysis
Duloxetine and other antidepressants in the treatment of patients with fibromyalgia.
To review the use of duloxetine, a new selective serotonin and norepinephrine reuptake inhibitor (SNRI), and other antidepressants in the treatment of patients with fibromyalgia. ⋯ Antidepressants play an important role in the treatment of patients with fibromyalgia. Agents with dual effects on serotonin and norepinephrine appear to have more consistent benefits than selective serotonin antidepressants for the treatment of persistent pain associated with fibromyalgia.
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Review Meta Analysis
Epidemiology, public health burden, and treatment of diabetic peripheral neuropathic pain: a review.
The literature examining the epidemiology, quality of life burden, cost, and treatment of diabetic peripheral neuropathy pain (DPNP) in U.S. adults was reviewed. ⋯ This review of DPNP identifies gaps in the literature and highlights the need for further study. The establishment of a consistent definition and diagnostic code for DPNP would improve ability to collect data and understand the impact of DPNP on patients and the health care system. Well-designed, prospective studies are needed to better define the epidemiology and public health burden of DPNP.
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Randomized Controlled Trial Multicenter Study
Use of the Synera patch for local anesthesia before vascular access procedures: a randomized, double-blind, placebo-controlled study.
This randomized, double-blind, placebo-controlled, paired study compared the Synera patch, a drug delivery device comprised of an eutectic mixture of lidocaine (70 mg) and tetracaine (70 mg) whose onset is accelerated by a controlled heating device, with placebo. The objective of the study was to evaluate the efficacy of Synera in inducing local anesthesia before a vascular access procedure. ⋯ A 20-minute application of Synera consistently provided clinically useful anesthesia for vascular access procedures, and appears to be well suited for topical dermal anesthesia due to its reduced time required to produce adequate anesthesia and high subject and investigator acceptance.
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Randomized Controlled Trial Multicenter Study
An open-label 52-week clinical extension comparing duloxetine with routine care in patients with diabetic peripheral neuropathic pain.
To assess the safety of duloxetine at a fixed-dose of 60 mg twice daily (BID) for up to 52 weeks, and compare duloxetine with routine care in the management of patients with diabetic peripheral neuropathic pain (DPNP). ⋯ The results of this study provide support for the use of duloxetine in the long-term management of DPNP.