Pain medicine : the official journal of the American Academy of Pain Medicine
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Multicenter Study Clinical Trial
Defining patient-centered, multidimensional success criteria for treatment of chronic spine pain.
This study aimed to define patient-determined success criteria for treatment of chronic spine pain across four domains: pain, fatigue, emotional distress, and interference with daily activities. ⋯ Future research should validate these success criteria, particularly for the less studied domains of fatigue, distress, and interference, and investigate how these criteria evolve over the course of different treatments.
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Multicenter Study Clinical Trial
Cluster analysis of the pain outcomes questionnaire.
The purpose of this study was to derive and describe subtypes of Pain Outcomes Questionnaire (POQ) profiles produced by a large, heterogeneous multisite sample of chronic pain patients (N = 672). ⋯ The results of this study are generally consistent with those of previous cluster analytic investigations of pain patients and suggest that psychosocial/behavioral classification systems may serve a useful heuristic function in the assessment and treatment of chronic pain that is not provided by current diagnostic taxonomies.
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Randomized Controlled Trial
Reduction of topical anesthetic onset time using ultrasound: a randomized controlled trial prior to venipuncture in young children.
Ultrasound treatment prior to topical anesthetic application has been shown to speed anesthesia onset by enhancing anesthetic penetration into the skin. ⋯ Ultrasound treatment speeds time of onset of liposomal lidocaine cream anesthesia in young children undergoing venipuncture. Side effects were mild in our population.
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Controlled Clinical Trial
Interpreting urine drug tests: prevalence of morphine metabolism to hydromorphone in chronic pain patients treated with morphine.
Pain medicine practitioners frequently use urine drug testing (UDT) to monitor adherence to opioid therapy. It can be difficult to interpret a result as normal or abnormal in relation to which opioid compounds are expected to be found in the urine. We investigated whether hydromorphone may be a metabolite of morphine normally appearing in UDT of patients prescribed morphine. ⋯ Hydromorphone is likely a minor metabolite of morphine, normally appearing in the UDT of patients taking morphine. This finding assists in determining whether a UDT result is normal or abnormal, and subsequently whether a patient is compliant with opioid therapy. This observation should be confirmed by a prospective study in a controlled environment. Variables such as gender, morphine dose, morphine urine concentration, and genetic determinants of morphine metabolism should be investigated further.
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Clinical Trial
Experience of methadone therapy in 100 consecutive chronic pain patients in a multidisciplinary pain center.
The objective of the study was to describe the experience of methadone use in 100 consecutive chronic pain patients managed in a single multidisciplinary center. ⋯ From our experience, methadone is an effective alternative to conventional opioids for chronic pain management when used by experienced clinicians in a setting that allows for close monitoring and careful dose initiation and adjustment.