Pain medicine : the official journal of the American Academy of Pain Medicine
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Randomized Controlled Trial
The effect of anxiety and depression on improvements in pain in a randomized, controlled trial of pregabalin for treatment of fibromyalgia.
To assess symptoms of anxiety and depression in a large cohort of fibromyalgia patients and to determine the impact of these symptoms on response of pain to pregabalin treatment. ⋯ Anxiety symptoms were more common than depressive symptoms in this cohort. Our results suggest patients with fibromyalgia should be routinely assessed for the presence of both anxiety and depression. The pain treatment effect of pregabalin did not depend on baseline anxiety or depressive symptoms, suggesting pregabalin improves pain in patients with or without these symptoms. Much of the pain reduction appears to be independent of improvements in anxiety or mood symptoms.
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Randomized Controlled Trial Comparative Study
Regression of sensory and motor blockade, and analgesia during continuous epidural infusion of ropivacaine and fentanyl in comparison with other local anesthetics.
To compare the regression of sensory and motor blockade, and the analgesia during continuous epidural infusion between ropivacaine and other local anesthetics. ⋯ Continuous epidural infusion of ropivacaine may induce a slower regression of sensory blockade compared with bupivacaine and lidocaine. The addition of fentanyl to ropivacaine can enhance this prolonged analgesic effect with little effect on motor blockade. Epidural infusion of ropivacaine with fentanyl provides effective pain relief, possibly because of the maintenance of sensory blockade by ropivacaine and fentanyl.
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Randomized Controlled Trial
Electronic diaries as a tool to improve pain management: is there any evidence?
Chronic pain is a common and costly syndrome which affects approximately one in three US adults. Factors such as shortened length of the medical visit, increased availability of technological approaches to care, and a more informed patient all suggest that a new paradigm is required for chronic pain management. Although much has been written about the use of electronic diaries in clinical trials, little has been presented about the use of these diaries in clinic practice and their potential for changing pain behavior. The intent of this preliminary study is to measure accessibility and usability of a software program designed for use on a personal digital assistant and to discuss how the software program may impact clinic practice and patient behavior. ⋯ This study goes beyond previous research on preference and data quality to investigate how the information provided may affect patient and physician perspectives toward pain management. Although not the initial intent of this study, findings indicate that electronic tracking may provide information which can affect management decisions. A follow-up study is ongoing to investigate these initial results. If found to be true, electronic monitoring may have broad implications for health care, policy, and improvement in quality of care for chronic pain sufferers in the future.
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Randomized Controlled Trial Multicenter Study
Use of the Synera patch for local anesthesia before vascular access procedures: a randomized, double-blind, placebo-controlled study.
This randomized, double-blind, placebo-controlled, paired study compared the Synera patch, a drug delivery device comprised of an eutectic mixture of lidocaine (70 mg) and tetracaine (70 mg) whose onset is accelerated by a controlled heating device, with placebo. The objective of the study was to evaluate the efficacy of Synera in inducing local anesthesia before a vascular access procedure. ⋯ A 20-minute application of Synera consistently provided clinically useful anesthesia for vascular access procedures, and appears to be well suited for topical dermal anesthesia due to its reduced time required to produce adequate anesthesia and high subject and investigator acceptance.
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Randomized Controlled Trial Multicenter Study
An open-label 52-week clinical extension comparing duloxetine with routine care in patients with diabetic peripheral neuropathic pain.
To assess the safety of duloxetine at a fixed-dose of 60 mg twice daily (BID) for up to 52 weeks, and compare duloxetine with routine care in the management of patients with diabetic peripheral neuropathic pain (DPNP). ⋯ The results of this study provide support for the use of duloxetine in the long-term management of DPNP.