Journal of opioid management
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Untreated emotional distress negatively impacts the management of cancer pain. ⋯ The major findings of this study are that in persons with cancer pain, lower social support and existential wellbeing, but not higher DMED, were associated with shorter survival time. Treatment of cancer pain was associated with lessening of emotional distress. Lower levels of existential wellbeing and physical performance status appear to be associated with greater DHD.
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The 3-glucuronide metabolites of morphine and hydromorphone have been implicated as a causative factor for patients exhibiting myoclonus. ⋯ In this small pilot study, it appears that the serum levels of metabolites M3G and H3G do not correlate with myoclonus.
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Meta Analysis Comparative Study
Comparison of the postoperative analgesic efficacy of intravenous patient-controlled analgesia with tramadol to intravenous patient-controlled analgesia with opioids.
Intravenous patient-controlled analgesia (IV PCA) with tramadol is an accepted method to deliver postoperative analgesia outside North America; however, the analgesic efficacy of this analgesic agent when compared with IVPCA with opioids is uncertain. As such, the authors undertook a systematic review to compare the analgesic efficacy of IVPCA tramadol with that of IVPCA with opioids. ⋯ IVPCA tramadol appears to produce similar pain scores when compared with that from IVPCA opioids; however, the side effect profile is different between the two groups. Because of the relatively small sample size, no determination of the relative "safety" (eg, respiratory depression) of one regimen over the other can be made, and larger RCTs would be needed for such a determination.
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Multicenter Study Comparative Study
Breakthrough pain in community-dwelling patients with cancer pain and noncancer pain, part 2: impact on function, mood, and quality of life.
Prior studies of breakthrough pain (BTP) largely focus on patients with advanced cancer or those receiving inpatient care. Very few studies have evaluated BTP in populations with chronic noncancer pain. Data that illuminate the impact of BTP may not generalize to other, less selected patient populations. ⋯ These data extend published observations about the association between BTP and adverse effects on mood and function to populations undergoing routine treatment in the community setting and provide evidence that these associations are greater in those with noncancer pain. They suggest the need for additional studies to clarify causality and determine whether undertreatment of BTP is a factor contributing to adverse pain-related outcomes.
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Multicenter Study
Breakthrough pain in community-dwelling patients with cancer pain and noncancer pain, part 1: prevalence and characteristics.
Most breakthrough pain (BTP) studies assess patients with advanced cancer or those receiving inpatient care. Studies in noncancer populations are limited to surveys of pain clinics and patients with other advanced diseases. To better understand BTP, data are needed from less selected populations. ⋯ The prevalence of BTP among community-dwelling patients is lower than that found in prior studies of more selected populations. BTP is more prevalent among patients with noncancer pain than patients with cancer pain, and although there are many similarities, some differences may be relevant to treatment strategies.