Pain medicine : the official journal of the American Academy of Pain Medicine
-
Meta Analysis
Targeted pharmacotherapy of evoked phenomena in neuropathic pain: a review of the current evidence.
Evoked phenomena in clinical neuropathic pain are viewed as a window into the underlying pathophysiology. They are also potential therapeutic targets. This study sought evidence for the effect on such evoked phenomena of currently used agents. ⋯ There is minimal evidence to guide clinicians in treating evoked pain phenomena in clinical neuropathic pain states. There is little clinical evidence to either support or refute theoretical arguments for efficacy of specific agents in evoked neuropathic pain phenomena. More and larger trials are needed to examine these phenomena. Consensus is required with respect to methods used to elicit these evoked phenomena.
-
Randomized Controlled Trial Clinical Trial
Effect of local administration of transdermal fentanyl on peripheral opioid analgesia.
Transdermal fentanyl is a commonly used analgesic for the treatment of severe chronic pain. Recent investigations have shown the presence of mu-opioid receptors in the skin and opioid analgesic efficacy with alternative routes of administration of narcotics. This placebo-controlled, double-blind prospective study assessed whether transdermal fentanyl administration produces local peripheral opioid analgesia at the site of application. ⋯ These results suggest that the application of transdermal fentanyl patch for a period of 2 h does not produce local peripheral opioid analgesia at the site of patch application.
-
Clinical Trial
Effectiveness of prostaglandin E1 for the treatment of patients with neuropathic pain following herpes zoster.
Postherpetic neuralgia (PHN) is one of the most painful neuropathic conditions, the mechanism of which remains unclear. There is no universally accepted treatment. The pain in PHN is often relieved by bathing, heating, or sympathetic blockade, suggesting a circulation-dependent property of the pain. Therefore, we examined the effectiveness of prostaglandin E(1) (PGE(1)), which has an analgesic effect via improvement of peripheral blood circulation, for patients with PHN. ⋯ The results of the present study indicate that oral PGE(1) following the intravenous administration produces prompt and continuous analgesia in patients with PHN. Moreover, the intravenous treatment using PGE(1) appears useful for predicting the analgesic effect of PGE(1) in the patients.
-
This study of patients with a diagnosis of fibromyalgia (FM) was conducted to test the hypothesis that immediate posttreatment measures of psychosocial functioning, health attributes, negative pain-related emotions, and depressive symptoms improve significantly during multidisciplinary pain rehabilitation while concurrently withdrawing analgesic medications. ⋯ The results of this study support the hypothesis that immediate posttreatment measures of physical and emotional functioning are favorable for patients with FM following multidisciplinary pain rehabilitation that incorporates withdrawal of analgesic medications.