The Clinical journal of pain
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Clinical Trial
Determinants of patient-controlled epidural analgesia requirements: a prospective analysis of 1753 patients.
Patient-controlled epidural analgesia (PCEA) has been widely used in postoperative pain management. Many factors may correlate with PCEA requirements but no previous study has ever investigated this subject. Therefore, we conducted this study to explore the relationship among patients' characteristics and total PCEA consumption during the 3-day postoperative course. ⋯ Our study demonstrated the association between patients' characteristics and total PCEA requirements from a large-scaled clinical data. Surgical procedures have more influence on PCEA consumption than demographic variables. Background infusion rate of PCEA could be determined from our predictive model.
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Randomized Controlled Trial
Efficacy of transcutaneous electrical nerve stimulation (tens) for chronic low-back pain in a multiple sclerosis population: a randomized, placebo-controlled clinical trial.
This study was designed to investigate the hypoalgesic effects of self-applied transcutaneous electrical nerve stimulation (TENS) on chronic low-back pain (LBP) in a multiple sclerosis (MS) population. ⋯ Although not statistically significant, the observed effects may have implications for the clinical prescription and the use of TENS within this population.
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Controlled Clinical Trial
Contribution of nonspinal comorbidity to low back pain outcomes.
To determine the involvement of comorbidity to outcomes in a cohort of acute mechanical low back pain patients. ⋯ Significant ORs were barely greater than 1.00 and were likely the result of the large sample size. The clinical course for comorbid patients, who may seem more complicated at the start of treatment, is just as favorable.
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Randomized Controlled Trial
Preoperative cotreatment with dextromethorphan and ketorolac provides an enhancement of pain relief after laparoscopic-assisted vaginal hysterectomy.
Both N-methyl-D-aspartate receptor antagonists and nonsteroidal anti-inflammatory drugs have been demonstrated to produce better postoperative pain relief. The concept of multimodal analgesia has also been used for clinical pain management. The aim of the present study was to examine the analgesic effect of preoperative cotreatment with dextromethorphan (DM) and ketorolac on postoperative pain management after laparoscopic-assisted vaginal hysterectomy (LAVH). ⋯ Preoperative treatment with both DM and ketorolac diminish postoperative pain. Our results suggest that the N-methyl-D-aspartate antagonist-DM and the nonsteroidal anti-inflammatory drugs-ketorolac cotreatment provide an enhancement of analgesia for postoperative pain management in patients after LAVH surgery.
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Randomized Controlled Trial
A randomized, placebo-controlled study of fentanyl buccal tablet for breakthrough pain in opioid-treated patients with cancer.
Cancer-related breakthrough pain (BTP) is typically managed with a short-acting oral opioid, taken as needed during a fixed-schedule opioid regimen. The conventional approach may not provide the onset of analgesia required for BTP for many patients, because the onset of analgesia with short-acting opioids lags behind the time course of the majority of episodes of BTP. The fentanyl buccal tablet (FBT) employs a novel delivery system that enhances the rate and extent of absorption of fentanyl through the buccal mucosa. This double-blind, randomized, placebo-controlled study evaluated the efficacy, safety, and tolerability of FBT in opioid-treated patients with cancer-related BTP. ⋯ FBT is efficacious and safe in the treatment of cancer-related BTP.