Pain medicine : the official journal of the American Academy of Pain Medicine
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Randomized Controlled Trial Multicenter Study
Duloxetine for the management of diabetic peripheral neuropathic pain: evaluation of functional outcomes.
To assess the effectiveness of duloxetine, compared with placebo, on patient-reported health outcomes over a 12-week period, in the management of diabetic peripheral neuropathic pain (DPNP). ⋯ Acute treatment with duloxetine was associated with significant improvement in functional outcomes in persons with DPNP.
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In several high profile prosecutions of physicians for prescribing opioids, prosecutors claimed that the doctors should have known the individuals were feigning pain solely to obtain the prescriptions. This study was to determine how readily physicians can tell that patients lie. ⋯ Deception is difficult to detect. In the current legal climate surrounding prescribing opioids, accepting patients' reports of pain at face value can have significant legal consequences for the doctor. While doctors must make every reasonable effort to confirm the diagnosis and need for opioid therapy, allowance must be made for the fact that conscientious doctors can be deceived.
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Randomized Controlled Trial Multicenter Study
Duloxetine for the management of diabetic peripheral neuropathic pain: response profile.
The current analysis examines the response profile in patients receiving duloxetine for the management of diabetic peripheral neuropathic pain (DPNP). ⋯ Patients with DPNP receiving duloxetine 60 mg QD or 60 mg BID had significantly higher rates of treatment response, when compared with patients receiving placebo, regardless of the chosen response criterion. Response to duloxetine treatment tended to occur early in therapy.
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Randomized Controlled Trial
Efficacy of pre- and postoperative oral dextromethorphan for reduction of intra- and 24-hour postoperative morphine consumption for transabdominal hysterectomy.
We studied the effect of dextromethorphan (DEX), an N-methyl-D-aspartate receptor antagonist, on analgesic consumption and pain scores after abdominal hysterectomy. We aimed to compare the analgesic effectiveness and incidence of adverse side effects of oral DEX with placebo (P). ⋯ During PACU, however, there were two differences between the DEX and placebo groups: 1) a lower pain score at PACU; and 2) a prolonged time to the first use of morphine at PACU in the DEX group as compared with the placebo group. A low-dose DEX had a weaker though still measurable effect in this clinical trial compared with trials using higher doses.