Articles: chronic.
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Minerva anestesiologica · Oct 2014
ReviewPharmacological and clinical differences among transmucosal fentanyl formulations for the treatment of breakthrough cancer pain. A review article.
Breakthrough pain (BTP) is highly prevalent (59.2%) in chronic cancer patients and normally needs rescue treatments' with opioids when pain flares up. Transmucosal oral/nasal fentanyl formulations are commonly used in clinical practice. The different methods of release influence the pharmacokinetics and clinical properties of these formulations. ⋯ In parallel, we report the differences in delivery systems, bioavailability, maximum plasma concentration (Cmax), plasma half-life, and time to reach Cmax (tmax). Considerable variability emerged between formulations. This suggests some considerations on the choice of the fentanyl formulation in the light of the BTP features in each clinical case.
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Chronic pain patients show increased peripheral activity when exposed to stimuli relevant to their pain problem. It has been suggested that in migraine there is a highly specific conditioning or sensitization to pain stimuli. The aims of this study were to analyse whether migraineurs (1) are sensitive not only to pain-related but also to other negative emotional words; and (2) show a memory bias for pain words, when compared to headache-free controls. ⋯ The findings suggest that in migraine, not only pain-related but also negative emotional words may act as triggers. These outcomes may have therapeutic implications as interventions could target problematic pain-related memories that influence migraine pain perception and pain-related physiological responses.
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Smokers report more pain and worse functioning. The evidence from pain clinics suggests that depression affects this relationship: The association between smoking and chronic pain is weakened when controlling for depression. This study explored the relationship between smoking, pain and depression in a large general population-based cohort (Generation Scotland: Scottish Family Health Study). ⋯ In contrast to smokers treated in pain clinics, a history of MDD mediated the relationship between smoking and pain intensity, but not pain-related disability in smokers in the community.
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Acta Anaesthesiol Scand · Oct 2014
Pain management following the Nuss procedure: a survey of practice and review.
Pectus excavatum is the most common congenital chest wall deformity. The Nuss procedure is frequently used for surgical correction and this technique has been associated with severe and prolonged post-operative pain. At the present time, the optimal analgesic strategy for managing patients following this procedure has not been determined. ⋯ Post-operative pain management following the Nuss procedure is variable and poorly characterized. Clinical trials or large observational registries comparing the safety and efficacy of primary modalities and long-term outcomes are needed to enable evidence-based decision-making for the management of these patients.
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Anesthesia and analgesia · Oct 2014
The Antihypersensitive and Anti-inflammatory Activities of a Benzofuranone Derivative in Different Experimental Models in Mice: The Importance of the Protein Kinase C Pathway.
Benzofuranone (BF1) was synthesized and its effects evaluated on mechanical hypersensitivity and paw edema models induced by different agents and on neuropathic pain induced by partial ligation of the sciatic nerve. An attempt was also made to elucidate the mechanism of action. ⋯ BF1 has dose-dependent antihypersensitive and antiinflammatory effects in both acute and chronic models of pain and inflammation, possibly mediated through interference with the PKC activation pathway. The easy and fast synthesis of this compound, low-cost, low-concentration-requirement, and once-daily-administration drug suggest it as a candidate for future clinical studies.