Pain medicine : the official journal of the American Academy of Pain Medicine
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Clinical Trial
Pain quality predicts lidocaine analgesia among patients with suspected neuropathic pain.
Oral sodium channel blockers have shown mixed results in randomized controlled trials despite the known importance of sodium channels in generating pain. We hypothesized that differing baseline pain qualities (e.g. "stabbing" vs "dull") might define specific subgroups responsive to intravenous (IV) lidocaine-a potent sodium channel blocker. ⋯ "Heavy" pain quality may indentify patients with enhanced lidocaine responsiveness. Pain quality may identify subgroups among patients with suspected neuropathic pain responsive to IV lidocaine. Further investigation is warranted to validate and extend these findings.
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This preliminary study assessed possible relationships between plasma and/or cerebrospinal fluid (CSF) concentrations of the pleiotropic cytokine, interleukin (IL)-6, the anti-inflammatory cytokine, IL-10, and levels of pain reported by patients receiving intrathecal (i.t.) opioids. ⋯ The significant inverse correlations observed between pain intensity and the plasma IL-6 and IL-10 concentrations in patients receiving longterm i.t. opioids for chronic pain management, suggests that these cytokines are worthy of further investigation as possible biomarkers of persistent pain.
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Randomized Controlled Trial
Effects of intravenous prostaglandin E1 on pain and body temperature in patients with post-herpetic neuralgia.
Bathing, heating, or sympathetic blockade often alleviates pain due to post-herpetic neuralgia (PHN), suggesting that blood flow may affect PHN pain. Here, we examined the effect of prostaglandin E1 (PGE), which improves blood circulation, on pain and body temperature in patients with PHN. ⋯ Intravenous infusion of PGE produces analgesia associated with elevation of skin temperature in patients with PHN.
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Prescription opioid abuse is a major public health problem in the United States. Physicians who prescribe opioid analgesics are sometimes confronted with patients who request early refills, claiming that they have been "shorted" by their pharmacy. While a substantial differential diagnosis exists for apparent opioid overuse, the underfilling of opioid prescriptions at the level of retail pharmacies has not yet been systematically investigated. ⋯ There was no evidence supporting patients' claims of significant opioid analgesic underfilling by retail pharmacies. Patients who repeatedly report medication shortages should be evaluated for opioid use disorders.