Articles: pain.
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Clinical therapeutics · Jun 2006
Multicenter StudyLong-term management of chronic pain with transdermal buprenorphine: a multicenter, open-label, follow-up study in patients from three short-term clinical trials.
Transdermal buprenorphine is available in Europe for the treatment of moderate to severe chronic pain. It has been evaluated at doses of 35, 52.5, and 70 microg/h for the management of moderate to severe chronic cancer and noncancer pain in 3 randomized, double-blind, placebo-controlled trials, each of limited duration (approximately 14 days each). Long-term data are essential to determining the performance of an analgesic in the management of chronic pain. ⋯ Transdermal buprenorphine was generally well tolerated and effective for the long-term treatment of chronic cancer or noncancer pain in these patients who had previously received buprenorphine in 3 short-term clinical trials.
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Multicenter Study Comparative Study Clinical Trial
Adverse effects and cognitive function among primary care patients taking opioids for chronic nonmalignant pain.
Chronic opioid therapy is commonly prescribed for chronic nonmalignant pain. Few published data describe the adverse effects experienced by patients with chronic nonmalignant pain being treated by primary care physicians. A prevalence study was conducted on a sample of 1,009 patients (889 receiving chronic opioids) being treated by 235 primary care physicians. ⋯ A regression model suggests that psychological measures and pain severity are more predictive of decrements in cognitive function than specific opioid preparations or daily opioid dose. Physicians should closely monitor patients for adverse effects and adequacy of pain control when using chronic opioid therapy for chronic pain treatment. Psychological health, an important predictor of cognitive dysfunction, is a particularly important measure to actively monitor and manage.
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Multicenter Study
A multicenter dose-escalation study of the analgesic and adverse effects of an oral cannabis extract (Cannador) for postoperative pain management.
Cannabinoids have dose-related antinociceptive effects in animals. This clinical study aimed to investigate whether a single oral dose of cannabis plant extract (Cannador; Institute for Clinical Research, IKF, Berlin, Germany) could provide pain relief with minimal side effects for postoperative pain. ⋯ These significant dose-related improvements in rescue analgesia requirements in the 10 mg and 15 mg groups provide a number needed to treat that is equivalent to many routinely used analgesics without frequent adverse effects.
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Knee pain is common among older adults but only a minority consult their doctor about it. ⋯ Knee pain is common in the older population but a minority consult their doctor about it. Severity of pain and disability is not a strong influence on consultation. For those more severely affected, depression may act as a barrier to healthcare use.
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Multicenter Study
The changing practice of thoracic epidural analgesia in the United Kingdom: 1997-2004.
The clinical governance framework and medico-legal climate in the United Kingdom has changed significantly in the past 7 years. We used a postal questionnaire to survey thoracic epidural practice in the United Kingdom in 1997 and repeated this survey in 2004. ⋯ Of the 2004 respondents, < 1% used the newer, less toxic local anaesthetics, 49% would consider inserting a thoracic epidural in patients receiving clopidogrel, and 34% would consider inserting a thoracic epidural in patients receiving both aspirin and clopidogrel. A central register of thoracic epidural complications would assist in further developing practice.