The Clinical journal of pain
-
To begin to address the problem of heterogeneity of distribution of oxycodone (OC) in humans, we developed an organ-specific microcirculatory capillary-tissue exchange 2-compartment model for studying regional OC mass transport. ⋯ Organ-specific OC mass transport kinetics provide new information for OC dosing in pain management. The model promotes patient safety in opioid prescribing because it allows predictions to be made about the relative contribution that OC recycling makes to circulating OC levels. The model indicates that pharmacologic modulation of the microcirculation may give way to site-specific delivery of opioids in the future. Our study demonstrates that translation of bench in silico research data into clinical practice, although still challenging, is feasible and can assist in OC dose regimen design for patient safety.
-
Evidence of unrelieved childhood pain, adverse drug events (ADE), and deaths suggest that parents may inadequately respond to pain and opioid-related ADE signals. This study examined parents' recognition and response to pain and ADE signals using both dynamic hypothetical scenarios and real at-home opioid decisions. ⋯ Findings demonstrated that many parents failed to withhold a prescribed opioid dose for oversedation, suggesting a lack of awareness regarding this potentially serious ADE. Strategies to improve parents' recognition of oversedation and its potential consequences are warranted to improve opioid safety.
-
Neuropathic pain (NeP) is a prevalent, disabling, multidimensional condition with significant morbidity; however, there appears to be a variable approach in the use of outcome measures in NeP trials. A search of systematic reviews of interventional randomized-controlled trials for NeP was undertaken to investigate the range and types of outcome measures used to determine treatment effects. ⋯ These results demonstrate that measures of pain are predominantly used in trials of NeP conditions and highlight the scant usage of functional outcome measures. The lack of standardization for the diagnostic criteria in NeP trials is also an issue that needs to be considered for future research and guideline development.