Articles: pain-management-methods.
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Randomized Controlled Trial
A combined pain consultation and pain education program decreases average and current pain and decreases interference in daily life by pain in oncology outpatients: a randomized controlled trial.
Pain education programs (PEP) and pain consultations (PC) have been studied to overcome patient-related and professional-related barriers in cancer pain management. These interventions were studied separately, not in combination, and half of the studies reported a significant improvement in pain. Moreover, most PEP studies did not mention the adequacy of pain treatment. ⋯ Adequacy of pain management did not differ between the groups. Patients were more adherent to analgesics after randomization to PC-PEP than to SC (P=.03). In conclusion, PC-PEP improves pain, daily interference, and patient adherence in oncology outpatients.
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Anesthesia and analgesia · Nov 2011
The interaction between antidepressant drugs and the pain-relieving effect of spinal cord stimulation in a rat model of neuropathy.
Spinal cord stimulation (SCS) has proven to be a valuable treatment in neuropathic pain. On the basis of our previous studies on the mode of action of SCS, intrathecal administration of subeffective doses of certain drugs has been shown to enhance the pain-relieving effect in patients with SCS. Antidepressants have a well-established beneficial effect in neuropathic pain. We performed the present study to examine potential synergistic or antagonistic effects on SCS of antidepressants: amitriptyline (tricyclic antidepressant), fluoxetine (selective serotonin reuptake inhibitor), and milnacipran (selective serotonin/noradrenaline reuptake inhibitor). ⋯ These findings suggest a possible clinical application with a combination of SCS and a tricyclic antidepressant or selective serotonin/noradrenaline reuptake inhibitor drug in cases in which SCS per se has proven inefficient.
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Minerva anestesiologica · Nov 2011
Review Comparative StudyCoxibs: is there a benefit when compared to traditional non-selective NSAIDs in postoperative pain management?
A multi-modal approach for the management of postoperative pain has become increasingly popular. Strategies to avoid the use of opioids and thus any opioid analgesic related side-effect is an important part of the expansion of ambulatory surgery. Combining long acting local anesthesia in the wound area and non-opioid analgesics are today a basic concept in management of day care, short stay patients. ⋯ The less pronounced effect on platelet function and subsequent lower risk for impaired hemeostasis makes them, in theory, a preferred option to the non-selective traditional NSAIDs. The benefit versus risk for a more generalized use of Coxibs must, however, be based on a thorough evaluation of the overall benefits and risks for the use of NSAIDs and a further evaluation on whether the specific therapeutic features of the Coxibs provide benefits outweighing their increased cost. This review aims at providing a background and an overview of the benefits versus risks for the use of Coxibs as part of a multimodal postoperative pain management.
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Clinical Trial
Prospective analysis of the trial period for spinal cord stimulation treatment for chronic pain.
To determine patient preferences regarding the duration of trial period. ⋯ In this study, all patients could make a decision in 15 days, with successful trials requiring a shorter duration. The conversion rate was similar to rates in literature despite patients making a decision without physician input.