Pain research & management : the journal of the Canadian Pain Society = journal de la société canadienne pour le traitement de la douleur
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Burning Mouth Syndrome (BMS) is a sensory disorder which results in constant, bilateral burning pain of the tongue, lips, and other oral mucous membranes. Atypical odontalgia (AO) is another sensory disorder, usually defined as a toothache-like pain for which no dental cause can be identified. Previous literature has suggested that AO is often associated with a concomitant temporomandibular disorder (TMD). This hypothesis paper explores the possibility that BMS, AO and TMD can be related through hyperactivity of both the sensory and motor components of the trigeminal nerve following loss of central inhibition as a result of taste damage in the chorda tympani and/or the glossopharyngeal nerves.
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The clinical utility of guidelines for conversion of patients from a combination analgesic preparation of acetaminophen 300 mg plus codeine 30 mg every 4h to 6h as needed to scheduled controlled-release (CR) codeine every 12h was evaluated. ⋯ The results confirm the safety, efficacy and patient acceptability of the initial conversion and maintenance dosing recommendations for CR codeine from a combination opioid/nonopioid analgesic.
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Case Reports
Treatment of chronic intractable neuropathic pain with dronabinol: case report of two adolescents.
To evaluate the effectiveness of dronabinol for the treatment of neuropathic pain refractory to previous treatment. ⋯ Dronabinol appeared to be effective in improving pain affect and psychosocial functioning in the treatment of refractory neuropathic pain and may be considered as an adjuvant medication in the rehabilitation process. Well-controlled placebo studies are required for further evaluation.
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Methadone, being an N-Methyl-D-Aspartate receptor antagonist, may have a potential role in the treatment of neuropathic pain. ⋯ Methadone at relatively low doses seems to be useful in the treatment of neuropathic pain.
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To measure chronic pain patient volumes seen in primary care practice; to determine what medications physicians choose for the treatment of moderate to severe chronic pain; to identify barriers to the use of opioids in the treatment of chronic pain; and to assess physicians' attitudes toward the current management of chronic pain in Canada. ⋯ Even among physicians experienced in chronic pain treatment, there is a reluctance to use opioids for severe nonmalignant pain. One-half of the survey participants believed that there was a need for improved physician education in pain management, including the use of opioids.