The Clinical journal of pain
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Comparative Study Clinical Trial
Sustained-release oxycodone dosing survey of chronic pain patients.
To determine the dosing of sustained-release oxycodone that is typically prescribed to achieve pain relief in a mixed group of chronic pain patients. ⋯ In a mixed group of chronic pain patients referred to a university pain management clinic, sustained-release oxycodone was prescribed more often than twice daily (usually every 8 hours) in 67% of patients. Patients maintained on every-12-hour dosing were twice as likely to use regularly scheduled, daily, short-acting opioids to achieve pain relief.
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Comparative Study
Evidence-based assessment of acute pain in older adults: current nursing practices and perceived barriers.
To report data on current nurse practice behaviors related to evidence-based assessment of acute pain in older adults, perceived stage of adoption of pain assessment practices, and perceptions of barriers to optimal assessment in this population. ⋯ Our data suggest that pain is not being assessed and reassessed in a manner that is consistent with current practice recommendations in older adult patients with pathologic processes that highly suggest the presence of acute pain.
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A 39-year-old male presented with penile pain related to ejaculation. No urogenital, infectious, or neurologic diseases were associated with the symptoms. The pain was refractory to conventional analgesics and several neuropathic pain therapies. Oral topiramate was titrated to 75 mg daily, and within a month, the patient's pain improved from 8 to 1 out of 10, which has been maintained for 6 months.
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Randomized Controlled Trial Comparative Study Clinical Trial
Endogenous opioids and chronic pain intensity: interactions with level of disability.
To test whether endogenous opioid antinociceptive system dysfunction evidenced in response to acute pain stimuli is associated with increased clinical pain intensity in chronic pain sufferers, and to determine whether this association is moderated by disability level. ⋯ These results suggest that endogenous opioid antinociceptive system dysfunction may contribute to elevated acute and chronic pain sensitivity among more disabled chronic pain patients. Among less disabled patients, chronic pain may serve as a primer producing up-regulated opioid antinociceptive responses to acute pain
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Comparative Study
Pain assessment in patients with fibromyalgia syndrome: a consideration of methods for clinical trials.
This study was designed to compare 3 commonly used methodologies for assessing clinical pain during trials involving patients diagnosed with fibromyalgia syndrome. Baseline characteristics, characteristics over time, and compliance were evaluated for each of the methods. ⋯ Pain assessment methods relying on recall might contribute to an apparent improvement in clinical trials in the absence of an intervention; such an effect has been considered a "placebo response." Future clinical trials might consider using a real-time approach to pain assessment, which in this study appeared to mitigate against seeing improvement in the absence of an intervention and demonstrated higher levels of patient adherence.