Pain medicine : the official journal of the American Academy of Pain Medicine
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Surgery in concert with anesthesia is a key part of the management of advanced-stage cancers. Anesthetic agents such as opioids and volatile anesthetics have been shown to promote recurrence in preclinical models, whereas some animal models have shown that the use of lidocaine may be beneficial in reducing cancer recurrence. The purpose of this article is to review the current literature to highlight the mechanisms of action by which local anesthetics are thought to reduce cancer recurrence. ⋯ In vivo models suggest that local anesthetic administration leads to reduced cancer recurrence. The etiology of this effect is likely multifactorial through both inhibition of certain pathways and direct induction of apoptosis, a decrease in tumor migration, and an association with cell cycle-mediated and DNA-mediated effects. Additional research is required to further define the clinical implications.
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Randomized Controlled Trial Multicenter Study
Is a Combination of Exercise and Dry Needling Effective for Knee OA?
To assess the effectiveness of adding dry needling (DN) to an exercise program on pain intensity and disability in patients with knee osteoarthritis. ⋯ The inclusion of DN to an exercise program does not reduce pain or disability in patients with knee osteoarthritis.
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Randomized Controlled Trial
Human Abuse Potential of Oral NKTR-181 in Recreational Opioid Users: A Randomized, Double-Blind, Crossover Study.
To evaluate the human abuse potential, pharmacokinetics, pharmacodynamics, and safety of oral NKTR-181 (oxycodegol), a novel full mu-opioid receptor agonist, relative to oral oxycodone. ⋯ NKTR-181 at oral doses of 400 and 600 mg showed significantly fewer and less severe subjective effects accepted as representative of opioid abuse potential, such as lower peak Drug Liking in recreational opioid users, than 40 and 60 mg of oxycodone.
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To evaluate measurement and associations between pain severity and opioid craving in individuals with chronic pain on long-term opioid therapy and/or with opioid use disorder. ⋯ Pain severity and opioid craving are likely related, but inconsistencies in measurement limit confidence. The overall quality of evidence is moderate, and careful consideration of how pain and craving are assessed in both chronic pain and opioid use disorder patients is warranted.