The Clinical journal of pain
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Randomized Controlled Trial Comparative Study Clinical Trial
Double-blind parallel comparison of multiple doses of apraclonidine, clonidine, and placebo administered intra-articularly to patients undergoing arthroscopic knee surgery.
This clinical study assessed and compared the potential analgesic and adverse effect of IA apraclonidine with IA clonidine. ⋯ The IA application of 150 microg apraclonidine and 150 microg clonidine provide similar degree of postoperative analgesia following knee arthroscopic surgery without any difference in adverse events.
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Review Comparative Study
Pharmacological management of persistent pain in older patients.
The purpose of this manuscript is to foster understanding of the unique attributes of aging as they relate to the treatment of persistent pain in order to improve care of older patients. ⋯ Adherence to contemporary clinical guidelines should serve to promote improved outcomes in older patients who suffer from ongoing and debilitating pain. Since outcomes studies are lacking, attention to principles of care as they apply to this particular population is advised. Since each patient's experience and response to drug therapy will be unique, individualized assessment that incorporates an analysis of the patient's physiological state (comorbidities and concurrent drug therapies), a determination of realistic goals, and monitoring of outcomes on a regular basis will provide the optimum balance between benefits and risks of analgesic pharmacotherapy.
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The purpose of this paper is to present salient principles of pain management in nursing homes and other long-term care settings. ⋯ Clinicians who care for patients receiving long-term care services must help establish a treatment plan that is reasonable given the limited resources and skills available in nursing homes and other long-term care facilities. Medication regimens should be simplified as much as possible. Contingency plans for pain management must be anticipated and made available so that delays do not occur during medication changes or dosage adjustments. Long-term care facilities need substantial support from physicians and other pain experts for education to continuously update their skills and knowledge. As the need for health systems for frail elderly persons continues to grow, it is important to provide comfort and effective pain control appropriate for these new settings.
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Review
Complementary and alternative approaches to the treatment of persistent musculoskeletal pain.
To review common complementary and alternative treatment modalities for the treatment of persistent musculoskeletal pain in older adults. ⋯ While the use of complementary and alternative modalities for the treatment of persistent musculoskeletal pain continues to increase, rigorous clinical trials examining their efficacy are needed before definitive recommendations regarding the application of these modalities can be made.
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Comparative Study
Psychosocial profiles of people with pain associated with spinal cord injury: identification and comparison with other chronic pain syndromes.
The objectives of the study were to: (1) identify psychosocial profiles of people with pain associated with spinal cord injuries (SCI), and (2) compare the psychosocial profiles with other chronic pain syndromes. ⋯ The similarities and differences between SCI and other CPSs suggest that although a general measure assessing psychosocial impact can be used across pain syndromes, it is important to use different norms for comparison of particular pain syndromes. The failure to identify a subgroup of patients characterized by low levels of S and high levels of NR, and the low SR and DR for SCICP compared with other CPSs warrants examination.