Pain medicine : the official journal of the American Academy of Pain Medicine
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The present study builds on research to model abusers' perceptions of particular analgesics' attractiveness for abuse and extends these methods to derive an estimate of attractiveness for abuse of a not-yet-marketed abuse-deterrent formulation (ADF) of a prescription opioid (Remoxy), Pain Therapeutics, Inc., San Mateo, CA, and King Pharmaceuticals, Inc., Bristol, TN). In a previous study, the Opioid Attractiveness Technology Scaling (OATS) method identified, from a drug abuser's point of view, the particular features of a prescription opioid relevant to its attractiveness for recreational use. A second online sample rated the extent to which these features applied to particular products they had actually used/abused. These data were used to model the abusers' overall preference for prescription opioids they had used/abused. ⋯ The OATS method shows promise for providing pre-marketing estimates of attractiveness for abuse of not-yet-marketed ADFs.
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We report a case of central pain successfully treated by epidural placement of spinal cord stimulator electrodes. Neuromodulation of primary afferent fibers and the underlying dorsal root entry zone provided effective analgesia whereas traditional lead placement over the dorsal columns on a prior occasion had not been effective. The rationale for this technique based on current understanding of the mechanisms of central pain and the risk/benefit considerations are discussed. ⋯ Lateral-lead spinal cord stimulation may be effective for some central pain syndromes through a partial restoration of homeostatic small-fiber signaling. Neuroanatomical and physiological data in a larger population of patients will be required to predict the best responders to this therapeutic modality.
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The sacroiliac joint is a common source of chronic low back pain. We recently described the use of cooled radiofrequency (RF) electrodes for performing lateral branch neurotomy to treat sacroiliac joint pain. The procedure involves lesioning the lateral branches of the posterior primary rami at S1-S3, and the L5 dorsal ramus (L5DR). While the cooled RF electrode has been adopted as a means for lesioning the lateral branches, conventional RF electrodes are used to lesion the L5DR. The objective of this technical report is to evaluate the acute safety of denervating the L5DR using cooled RF electrode. ⋯ This review demonstrates the acute safety of using cooled RF for L5DR denervation with no report of significant or unusual patient complications. To establish frequency of complication associated with the treatment, a larger registry is required.
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This study aims to evaluate the effectiveness of trans-electric nerve stimulation (TENS) for phantom limb pain applied to contralateral limb (nonamputated limb). ⋯ Both patients showed a significant improvement in their perception of phantom limb pain and sensations that was maintained at one-year follow-up. A randomized blinded controlled trial to confirm these positive outcomes is required.
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To determine whether ranolazine, a new anti-angina medication, could be an effective analgesic agent in complete Freund's adjuvant-induced inflammatory pain. ⋯ Ranolazine's potential as a new option for managing both angina and chronic inflammatory pain warrants further study.