Pain medicine : the official journal of the American Academy of Pain Medicine
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Tramadol is one of the most extensively used centrally acting synthetic opioid analgesics. Recently, a number of studies have explored the associations of the CYP2D6*10 C188T polymorphism with pharmacokinetic and clinical outcomes of tramadol. However, the results of these previous reports remain controversial. Therefore, a meta-analysis was needed to reach a consensus. ⋯ CYP2D6*10 C188T polymorphism had a significant influence on tramadol pharmacokinetics and analgesic effect, but there was insufficient evidence to demonstrate that this polymorphism was associated with incidence of nausea and vomiting.
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The objective was to perform a systematic review and meta-analysis of the literature on the effects of buprenorphine on chronic pain outcomes (i.e., patient-reported pain intensity) in patients with and without opioid use disorder (OUD). ⋯ Our results indicate that buprenorphine is modestly beneficial in reducing pain intensity in patients without OUD. Although informative, these findings should be carefully interpreted due to the small amount of data available and the variation in study designs.
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Randomized Controlled Trial
Effects of Adding Motor Imagery to Early Physical Therapy in Patients with Knee Osteoarthritis who Had Received Total Knee Arthroplasty: A Randomized Clinical Trial.
To investigate the effects of the inclusion of motor imagery (MI) principles into early physical therapy on pain, disability, pressure pain thresholds (PPTs), and range of motion in the early postsurgical phase after total knee arthroplasty (TKA). ⋯ The application of MI to early physiotherapy was effective for improving pain and disability, but not range of motion or pressure pain sensitivity, in the early postsurgical phase after TKA in people with knee osteoarthritis.
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Utilization of nonpharmacological pain management may prevent unnecessary use of opioids. Our objective was to evaluate the impact of chiropractic utilization upon use of prescription opioids among patients with spinal pain. ⋯ Patients with spinal pain who saw a chiropractor had half the risk of filling an opioid prescription. Among those who saw a chiropractor within 30 days of diagnosis, the reduction in risk was greater as compared with those with their first visit after the acute phase.