Pain medicine : the official journal of the American Academy of Pain Medicine
-
Randomized Controlled Trial
Comparative Analgesic Efficacy of Oxycodone/Acetaminophen vs Codeine/Acetaminophen for Short-Term Pain Management Following ED Discharge.
To test the hypothesis that oxycodone/acetaminophen provides analgesia superior to codeine/acetaminophen following emergency department (ED) discharge. ⋯ Our hypothesis that oxycodone/acetaminophen provides analgesia superior to codeine/acetaminophen was rejected. Although pain within each group was reduced by more than half, the between-group difference was not significant. Pending independent validation, these unexpected findings suggest that codeine/acetaminophen, a Schedule III agent, may be a clinically reasonable outpatient opioid alternative to oxycodone/acetaminophen, a more tightly restricted Schedule II agent thought to be more prone to misuse.
-
In recent years, there has been increased attention to pain management after surgery in the hospital setting along with financial enticement from the US government. The aim of this study is to evaluate the current efficacy of postoperative pain management. ⋯ The incidence of severe-to-extreme pain in patients before and after discharge following inpatient surgery is 12-13%, and this is a reduction from 10 years ago.
-
The experiential acquisition of pain-related fear has been demonstrated by pairing a painful electrocutaneous stimulus pain-US; unconditioned pain stimulus) with one movement (CS+; conditioned stimulus) but not with another (CS-). However, it is expected that during acquisition through direct experience, pain-related fear can be intensified or weakened by verbally/visually transmitted information about the pain and its meaning. ⋯ The results suggest that our threat manipulation might not have worked or that it was not sensitive enough to yield group-specific effects. We replicated acquisition, extinction, and return of experimentally conditioned fear of movement-related pain, but the threat manipulation failed to generate any additional effects.
-
International research has consistently found increased risk for physical health and psychological difficulties among prison officers including elevated risk of assault resulting in acute pain. This study represented an exploratory examination of the experience of chronic pain conditions among Irish prison officers with particular reference to the psychosocial predictors of pain severity, pain interference, and depression. ⋯ Chronic pain appears to be prevalent in prison officers and is associated with both physical and psychological impairment. Health care staff in correctional facilities should be aware that these health difficulties are prevalent in the prison work environment.
-
Review
Consensus Recommendations on Initiating Prescription Therapies for Opioid-Induced Constipation.
Aims of this consensus panel were to determine (1) an optimal symptom-based method for assessing opioid-induced constipation in clinical practice and (2) a threshold of symptom severity to prompt consideration of prescription therapy. ⋯ The BFI is a simple assessment tool with a validated threshold of clinically significant constipation. Prescription treatments for opioid-induced constipation should be considered for patients who have a BFI score of ≥30 points and an inadequate response to first-line interventions.