Articles: analgesics.
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Anesthesia and analgesia · Aug 2014
Multicenter Study Observational StudyTransversus Abdominis Plane Block in Children: A Multicenter Safety Analysis of 1994 Cases from the PRAN (Pediatric Regional Anesthesia Network) Database.
Currently, there is not enough evidence to support the safety of the transversus abdominis plane (TAP) block when used to ameliorate postoperative pain in children. Safety concerns have been repeatedly mentioned as a major barrier to performing large randomized trials in children. The main objective of the current investigation was to determine the incidence of overall and specific complications resulting from the performance of the TAP block in children. In addition, we evaluated patterns of local anesthetic dosage selection in the same population. ⋯ The upper incidence of overall complications associated with the TAP block in children was 0.3%. More important, complications were very minor and did not require any additional interventions. In contrast, the large variability of local anesthetic dosage used can not only minimize potential analgesic benefits of the TAP block but also result in local anesthetic toxicity. Safety concerns should not be a major barrier to performing randomized trials to test the efficacy of the TAP block in children as long as appropriate local anesthetic dose regimens are selected.
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J Pain Symptom Manage · Aug 2014
Multicenter Study Comparative StudyComparative effectiveness of senna to prevent problematic constipation in pediatric oncology patients receiving opioids: a multicenter study of clinically detailed administrative data.
Pediatric oncology patients often receive prolonged courses of opioids, which can result in constipation. ⋯ Initiating senna therapy, compared with other oral bowel medications, diminishes the subsequent risk of surrogate markers of problematic constipation in this population.
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J Subst Abuse Treat · Aug 2014
Randomized Controlled Trial Multicenter StudyReasons for opioid use among patients with dependence on prescription opioids: the role of chronic pain.
The number of individuals seeking treatment for prescription opioid dependence has increased dramatically, fostering a need for research on this population. The aim of this study was to examine reasons for prescription opioid use among 653 participants with and without chronic pain, enrolled in the Prescription Opioid Addiction Treatment Study, a randomized controlled trial of treatment for prescription opioid dependence. ⋯ Participants with chronic pain rated using opioids to cope with physical pain as more important, and using opioids in response to social interactions and craving as less important, than those without chronic pain. Results highlight the importance of physical pain as a reason for opioid use among patients with chronic pain.
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Multicenter Study
An evidence-based program to improve analgesic practice and pain outcomes in residential aged care facilities.
Pain is common in individuals living in residential aged care facilities (RACFs), and a number of obstacles have been identified as recurring barriers to adequate pain management. To address this, the Australian Pain Society developed 27 recommendations for comprehensive good practice in the identification, assessment, and management of pain. This study reviewed preexisting pain management practice at five Australian RACFs and identified changes needed to implement the recommendations and then implemented an evidence-based program that aimed to facilitate better pain management. ⋯ Better evidence-based practice and outcomes in RACFs can be achieved with appropriate training and education. Investing resources in the aged care workforce using this program improved analgesic practice and pain relief in participating sites. Further attention to the continued targeted pain management training of aged care staff is likely to improve pain-focused care for residents.
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Randomized Controlled Trial Multicenter Study
A double-blind, randomized, placebo-controlled, parallel group study of THC/CBD spray in peripheral neuropathic pain treatment.
Peripheral neuropathic pain (PNP) associated with allodynia poses a significant clinical challenge. The efficacy of Δ(9) -tetrahydrocannabinol/cannabidiol (THC/CBD) oromucosal spray, a novel cannabinoid formulation, was investigated in this 15-week randomized, double-blind, placebo-controlled parallel group study. ⋯ These findings demonstrate that, in a meaningful proportion of otherwise treatment-resistant patients, clinically important improvements in pain, sleep quality and SGIC of the severity of their condition are obtained with THC/CBD spray. THC/CBD spray was well tolerated and no new safety concerns were identified.