Articles: pain.
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Acta Anaesthesiol Scand · Sep 2006
Randomized Controlled Trial Multicenter StudyLack of analgesic effect of parecoxib following laparoscopic cholecystectomy.
The cyclo-oxygenase-2 inhibitor, parecoxib, can be administered parenterally. The recommended dose for post-operative use is 40 mg twice daily, which may not be the appropriate dose for the treatment of visceral pain. We studied the effect of a single dose of parecoxib of either 40 or 80 mg in laparoscopic cholecystectomy, and its effect on opioid-induced side-effects. ⋯ The recommended dose of parecoxib, 40 mg, is not effective for the treatment of pain during the early post-operative period after laparoscopic cholecystectomy. Doubling the dose to 80 mg seems to improve the results.
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J Am Podiatr Med Assoc · Sep 2006
Randomized Controlled Trial Multicenter StudyAnalgesic efficacy of valdecoxib for acute postoperative pain after bunionectomy.
Two randomized, double-blind, placebo-controlled studies assessed the analgesic efficacy of valdecoxib in patients with moderate-to-severe pain after bunionectomy. Study 1 (N = 374) assessed the efficacy of two regimens of valdecoxib on the day after surgery (valdecoxib, 40 mg, with a 20-mg redose [n = 127]; valdecoxib, 40 mg, with a placebo redose [n = 122]; and placebo/placebo [n = 125]), and study 2 (N = 478) examined the efficacy of two different multiple-dose regimens on postoperative days 2 through 5 (valdecoxib, 20 mg, twice daily [n = 160]; valdecoxib, 20 mg, once daily [n = 159]; and placebo [n = 159]). Valdecoxib provided significant pain relief and reduced the use of opioid rescue medication. This efficacy was accompanied by improved global scores, decreased pain interference with function, and increased patient satisfaction.
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Randomized Controlled Trial Multicenter Study
Ibuprofen as a pre-emptive analgesic is as effective as rofecoxib for mandibular third molar surgery.
The objective of this study was to compare the pre-emptive analgesic effect of rofecoxib, a cyclooxygenase (COX)-2 inhibitor, with a more traditional and commonly used analgesic, ibuprofen, for mandibular third molar surgery, utilizing a prospective, randomized, double-blind, placebo-controlled clinical trial. Fifty-five healthy patients who were scheduled to undergo surgical removal of an impacted mandibular third molar as outpatients at one of two government dental clinics in Fiji were enrolled. The patients were divided randomly into three groups to receive 50 mg rofecoxib or 400 mg ibuprofen, or a placebo 1 h prior to surgery. ⋯ Rescue medication use was significantly lower in the rofecoxib and ibuprofen groups by comparison with the placebo group; however, there was no significant difference between the two therapeutic groups. Rescue medication was used by 50%, 25%, and 94% of patients receiving rofecoxib, ibuprofen, and placebo, respectively. Ibuprofen, a commonly used over-the-counter analgesic, is as effective as rofecoxib for the relief of acute postoperative pain following third molar surgery when used pre-emptively.
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Two important influences on pain underestimation by health care professionals were investigated by varying specific cues with reference to underestimation of patients' pain: when observers are not allowed to talk to patients and when observers expect social cheating. One hundred and twenty health care professionals watched videotaped facial expressions of pain patients and estimated their pain. The first group only saw the faces, the second group was given patients' self-reports in addition and the last group was given a context cue priming them to expect cheating in addition to faces and patients' ratings. ⋯ Those viewing the face without patients' ratings underestimated pain to a greater extent than health care professionals provided with patients' ratings. Health care professionals primed to expect cheating underestimated pain as much as those seeing only patients' faces. Therefore, both accounts, verbal report as important but missing cue as well as an alerted cheating detection device, could account for underestimation.
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Randomized Controlled Trial Multicenter Study Comparative Study
Randomized trial comparing polymer-coated extended-release morphine sulfate to controlled-release oxycodone HCl in moderate to severe nonmalignant pain.
To assess the long-term efficacy, tolerability and safety of polymer-coated extended-release morphine sulfate (P-ERMS) (KADIAN) compared with controlled-release oxycodone HCl (CRO) (OxyContin) in treating chronic, nonmalignant, moderate to severe pain in a community-based outpatient population. ⋯ P-ERMS and CRO both relieved chronic nonmalignant pain in this community-based population; however, patients taking P-ERMS dosed in accordance with FDA-approved frequencies (QD/BID); 44% of those taking CRO dosed more frequently (TID/QID).