Current opinion in anaesthesiology
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Curr Opin Anaesthesiol · Oct 2007
ReviewGabapentin and pregabalin for chronic neuropathic and early postsurgical pain: current evidence and future directions.
Gabapentin and pregabalin bind to the alpha-2-delta calcium channel subunit and represent a novel analgesic drug class. The evidence base supporting their use for chronic neuropathic and early postsurgical pain is reviewed. ⋯ Gabapentin and pregabalin are efficacious treatments for neuropathic and postsurgical pain. Future research addressing several specific questions would serve to better delineate their optimal roles in treating these and other pain conditions.
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Curr Opin Anaesthesiol · Oct 2007
ReviewAn update on the role of opioids in the management of chronic pain of nonmalignant origin.
To summarize and reflect over primarily recent epidemiological and randomized controlled trials in opioid-treated chronic nonmalignant pain patients, focusing on effects, side effects, risks and long-term consequences of the treatment. ⋯ Much more research is needed concerning long-time effects and consequences of opioid therapy in chronic nonmalignant pain patients; however, some clear warning signals have been sent out within recent years.
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Curr Opin Anaesthesiol · Oct 2007
ReviewReassessment of the role of cannabinoids in the management of pain.
The aim of this article is to assess the role of cannabinoids in the treatment of acute and chronic pain in humans. ⋯ The precise role of cannabinoids in pain treatment still needs further evaluation. Cannabinoid compounds may be more effective in the context of chronic neuropathic pain than for the management of acute pain.
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Curr Opin Anaesthesiol · Oct 2007
ReviewGeneral anesthetic-induced neurotoxicity: an emerging problem for the young and old?
A growing body of evidence from cells, rodents, and sub-human primates suggests that general anesthetics can be neurotoxic to the developing and senescent brain. We review this evidence and put the studies into perspective for the practicing clinician. ⋯ General anesthetics produce neurotoxicity and enduring cognitive impairment in young and aged animals but it is premature to change clinical practice because the issue has not been adequately studied in humans.
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Genomic variations influencing basal pain sensitivity, the likelihood of developing chronic pain diseases as well as the response to pharmacotherapy of pain are currently under investigation Here, we review examples of promising approaches to diagnose genetic predisposition from recently published studies. ⋯ The article reviews recent studies on genetic variables influencing pain and pharmacotherapy. Examples of promising candidate genes have been intensively studied during recent years. Although the number of subjects investigated is often small, published data and current advances in genotyping and study design suggest valid and clinically relevant results to date and even more in the future.