Pain physician
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Review Comparative Study
Chronic opioid therapy for chronic non-cancer pain: a review and comparison of treatment guidelines.
Long-term opioid use for chronic non-cancer pain has increased substantially in recent years despite the paucity of strong supporting scientific data and concerns regarding adverse effects and potential misuse. ⋯ There is a growing body of scientific evidence to support opioid use in chronic pain. Future work should focus on continuing to generate good-quality evidence on the long-term benefits of opioid therapy, as well as scientific data to guide drug choice and dosing for specific conditions, populations, and situations.
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Randomized Controlled Trial
Dexmedetomidine as an adjunctive analgesic with bupivacaine in paravertebral analgesia for breast cancer surgery.
There is little systematic research on the efficacy and tolerability of the addition of adjunctive analgesic agents in paravertebral analgesia. The addition of adjunctive analgesics, such as fentanyl and clonidine, to local anesthetics has been shown to enhance the quality and duration of sensory neural blockades, and decrease the dose of local anesthetic and supplemental analgesia. ⋯ The addition of dexmedetomidine 1 μg/kg to bupivacaine 0.25% in thoracic PVB in patients undergoing modified radical mastectomy improves the quality and the duration of analgesia and also provides an analgesic sparing effect with no serious side effects.
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Chronic low back pain is considered as a high-impact condition that affects the working population of Latin America, with long reaching social and economic repercussions. Its true frequency is unknown due to the absence of well-designed clinical trials that use standardized definitions and criteria. ⋯ Despite the sparse information and the methodological heterogeneity of the studies, pooled results allowed for an indirect estimation of the prevalence of low back pain in the region that was pretty consistent with the published results obtained from other settings. New studies need to be carried out to supplement and overcome the methodological weaknesses of those previously conducted.