European journal of pain : EJP
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Randomized Controlled Trial
Intraoperative S-ketamine for the reduction of opioid consumption and pain one year after spine surgery: A randomized clinical trial of opioid dependent patients.
We aimed to explore the effect of intraoperative S-ketamine on analgesic consumption and pain one year after spine surgery in chronic opioid-dependent patients undergoing spinal fusion surgery. ⋯ This randomized clinical trial shows that intraoperative ketamine may reduce opioid use and pain and improve labour market attachment one year after spine surgery in an opioid-dependent population.
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Randomized Controlled Trial
Cancer-related chronic pain: Investigation of the novel analgesic drug candidate cebranopadol in a randomized, double-blind, noninferiority trial.
Cancer-related pain is a growing health problem given the increasing life expectancy of cancer patients. Opioids are commonly used to treat cancer-related pain, but carry the risk of severe side effects, limiting their use. Cebranopadol is a first-in-class drug candidate, combining nociceptin/orphanin FQ peptide and opioid peptide receptor agonism. This trial examined the analgesic efficacy of cebranopadol compared with morphine prolonged release (PR) in patients with moderate-to-severe cancer-related pain. ⋯ Cebranopadol presents a new approach to treat cancer pain. The drug candidate was easy to titrate, safe and well tolerated, and as effective as morphine PR in patients suffering from chronic moderate-to-severe cancer-related pain.
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Sensorimotor conflicts are well known to induce sensory disturbances. However, explanations as to why patients with chronic pain are more sensitive to sensorimotor conflicts remain elusive. The main objectives of this study were (a) to assess and compare the sensory disturbances induced by sensorimotor conflict in complex regional pain syndrome (n = 38), fibromyalgia (n = 36), arthritis (n = 34) as well as in healthy volunteers (HV) (n = 32); (b) to assess whether these disturbances were related to the intensity and duration of pain, or to other clinical variables assessed using questionnaires (abnormalities in sensory perception, depression and anxiety); and (c) to categorize different subgroups of conflict-induced sensory disturbances. ⋯ Individuals with complex regional pain syndrome and fibromyalgia were more sensitive to sensorimotor conflicts than arthritis patients and controls. Moreover, conflict-induced sensory disturbances were specific to higher pain intensity and higher sensory abnormalities in all groups, suggesting that pain lowers the threshold for the detection of sensorimotor conflicts.
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Individuals born preterm are at risk of later developmental problems and long-term morbidities. There is conflicting evidence regarding musculoskeletal pain in young adulthood. We investigated the prevalence of self-reported musculoskeletal pain in young adults born across the range of preterm birth compared with a term-born reference group. ⋯ Young adults born preterm do not have increased rates of musculoskeletal pain. Our findings rather suggest that these rates may be slightly lower than among those born at term.
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In complex regional pain syndrome (CRPS), altered perception of the affected hand and neglect-like symptoms of the affected body side are common features. In this study, we presented tactile stimuli to the affected hands in CRPS patients and matched healthy controls. ⋯ CRPS patients performed poorly in localizing positions on their affected hands via pointing and exhibited increased spatiotemporal integration. The presented method may prove useful in diagnostics as well as psychophysical and neurofunctional research on CRPS and other chronic pain disorders.