Pain medicine : the official journal of the American Academy of Pain Medicine
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Randomized Controlled Trial Comparative Study
Comparison of cutaneous anesthetic effect of 8% lidocaine spray with lidocaine patch using current perception threshold test.
A lidocaine patch is often used for topical anesthesia prior to venipuncture, but needs to be applied for several hours before the puncture, and the site is fixed. A metered-dose lidocaine pump spray could be used to produce cutaneous topical anesthesia. In this study, we compared the anesthesia between the spray and the patch. ⋯ Similar to the lidocaine patch, the lidocaine spray produces cutaneous weak anesthesia at 30 minutes after treatment. The spray seems to produce local anesthesia faster than the patch.
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Spinal cord stimulation (SCS) may reduce pain scores and improve function in patients with chronic visceral abdominal pain. We thus present our large clinical experience in SCS for visceral abdominal pain. ⋯ Spinal cord stimulation may be a useful therapeutic option for patients with severe visceral pain.
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Opioid/acetaminophen combination products are widely prescribed for the management of moderate to moderately severe pain. Acetaminophen, when improperly used, can lead to liver damage and even acute liver failure. ⋯ The FDA advisory committee reviewed numerous observational studies and adverse event reporting data. The aims of this article are to: 1) provide a summary and epidemiologic critique of the studies and evidence the FDA advisory committee reviewed; 2) examine the potential consequences, such as poorly managed pain or a shift to treatment with other medications with greater potential toxicity and/or restricted availability, if the FDA follows the advisory committee vote; and 3) outline alternate strategies the FDA should consider for reducing hepatotoxicity associated with opioid/acetaminophen combination products.
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Randomized Controlled Trial Comparative Study
Comparing the psychometric properties of the Checklist of Nonverbal Pain Behaviors (CNPI) and the Pain Assessment in Advanced Dementia (PAIN-AD) instruments.
To examine and compare the psychometric properties of two common observational pain assessment tools used in persons with dementia. ⋯ Despite earlier studies supporting the reliability and validity of the CNPI and the PAINAD, findings from the current study indicate that these measures warrant further study with clinical users, should be used cautiously both in research and clinical settings and only as part of a comprehensive approach to pain assessment.
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Opioid analgesics are the drugs of choice for the treatment of moderate to severe acute and cancer pain. Although their role in the management of chronic pain not related to cancer is controversial, there is increasing evidence for their benefit in certain patient populations. ⋯ Wisconsin physicians who responded to this survey held many misconceptions about the prescribing of opioids. Such views, coupled with a lack of knowledge about laws and regulations governing the prescribing of controlled substances, may result in inadequate prescribing of opioids with resultant inadequate management of pain.