Pain medicine : the official journal of the American Academy of Pain Medicine
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ABCB1 is a major determinant of opioid bioavailability; however, no previous studies have provided positive evidence of an association between single-nucleotide polymorphisms (SNPs) of ABCB1 and opioid usage in acute pain management. The aim of this study was to test the association between the functional SNP C3435T in ABCB1 and opioid consumption in postoperative pain in patients undergoing a nephrectomy. Additionally, we explored the association between C3435T and opioid side effect. ⋯ Our results demonstrate an association between the ABCB1 polymorphism (C3435T) and interindividual variations in opioid consumption in the acute postoperative period after nephrectomy. The ABCB1 polymorphism may serve as an important factor to guide acute pain therapy in postoperative patients.
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To identify and quantify the rate of aberrant drug-taking behaviors using objective data. ⋯ Patient report and the medical record are inadequate to screen for aberrant drug-related behaviors. Addition of PMP and POC UDS contribute significantly to identification of inconsistencies through higher IS scores and differentiate patients at higher risk of medication misuse, abuse, or diversion. Comparison of multiple sources of objective information provides better insight into inconsistencies of report and behavior, and may assist in more appropriate and safer prescribing decisions.
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To assess the feasibility and efficacy of microwave ablation (MWA) of painful refractory bone and soft tissue tumors performed under local anesthesia. ⋯ MWA is feasible, safe, and effective in the management of painful refractory bone and soft tissue tumors. It may therefore be considered as a potential alternative to existing percutaneous ablation techniques in the management of bone and soft tissue tumors.
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Available evidence to help guide efficacious nonsteroidal anti-inflammatory drug and opioid analgesic prescribing will be reviewed. ⋯ The available evidence can guide but cannot provide any prescriber with absolute knowledge regarding outcome for these frequently prescribed and potentially dangerous agents. Knowledge of the available evidence and application of such to our patients on an individualized basis hopefully will help to optimize therapeutic goals and minimize harms.