Pain medicine : the official journal of the American Academy of Pain Medicine
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Randomized Controlled Trial
The ability of single site, single depth sacral lateral branch blocks to anesthetize the sacroiliac joint complex.
To determine the physiologic effectiveness of single site, single depth sacral lateral branch injections. ⋯ Anatomic limitations exist with single site, single depth sacral lateral branch injections rendering them physiologically ineffective on a consistent basis.
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Controlled Clinical Trial
Interpreting urine drug tests: prevalence of morphine metabolism to hydromorphone in chronic pain patients treated with morphine.
Pain medicine practitioners frequently use urine drug testing (UDT) to monitor adherence to opioid therapy. It can be difficult to interpret a result as normal or abnormal in relation to which opioid compounds are expected to be found in the urine. We investigated whether hydromorphone may be a metabolite of morphine normally appearing in UDT of patients prescribed morphine. ⋯ Hydromorphone is likely a minor metabolite of morphine, normally appearing in the UDT of patients taking morphine. This finding assists in determining whether a UDT result is normal or abnormal, and subsequently whether a patient is compliant with opioid therapy. This observation should be confirmed by a prospective study in a controlled environment. Variables such as gender, morphine dose, morphine urine concentration, and genetic determinants of morphine metabolism should be investigated further.
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Randomized Controlled Trial
Facial pain: a possible therapy with stellate ganglion block.
The goal of the present study is to verify the efficacy of stellate ganglion block (SGB) in the treatment of facial pain that can be found in different pathological syndromes, and also to examine whether the efficacy is dependent upon when this therapy is administered. ⋯ Our results indicate that patients must be treated with SGB therapy precociously to receive its full benefits.
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Clinical Trial
Experience of methadone therapy in 100 consecutive chronic pain patients in a multidisciplinary pain center.
The objective of the study was to describe the experience of methadone use in 100 consecutive chronic pain patients managed in a single multidisciplinary center. ⋯ From our experience, methadone is an effective alternative to conventional opioids for chronic pain management when used by experienced clinicians in a setting that allows for close monitoring and careful dose initiation and adjustment.
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To assess the influence of fear avoidance beliefs (FAB) and catastrophizing on low back pain (LBP)-related disability in Spanish community dwelling retirees. ⋯ In Spanish community dwelling retirees, the influence of FAB and catastrophizing on LBP-related disability is clinically small.