Pain medicine : the official journal of the American Academy of Pain Medicine
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The Self-Administered Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) is a 7-item self-report scale developed to identify pain of predominantly neuropathic origin. The aim of this study was to develop a Turkish version of the S-LANSS and to test its validity and reliability in chronic pain patients. ⋯ This study reports the first validation of a translated version of the S-LANNS into another language. The results suggest that the Turkish version of S-LANSS is a reliable and valid differential diagnostic measure of neuropathic pain in chronic pain patients.
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Opioids can be a safe and effective option for carefully selected patients with a structured treatment program that includes consistent monitoring. However, the benefits and risks of opioid therapy for patients with chronic pain, and society as a whole, have been sharply debated. A key component of this debate has involved the administration of rapid-onset opioids for the management of breakthrough pain. ⋯ Fentanyl buccal tablet can be an effective and generally safe treatment for breakthrough pain when appropriate patient selection, administration, dosing, and monitoring are applied.
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Review
Opioids, pain, the brain, and hyperkatifeia: a framework for the rational use of opioids for pain.
Opioids have relieved more human suffering than any other medication, but their use is still fraught with significant concerns of misuse, abuse, and addiction. This theoretical article explores the hypothesis that opioid misuse in the context of pain management produces a hypersensitivity to emotional distress, termed hyperkatifeia. ⋯ Repeated engagement of opponent processes without time for the brain's emotional systems to reestablish homeostasis will further drive changes in emotional processes that may produce opioid abuse or addiction, particularly in individuals with genetic or environmental vulnerability.
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Randomized Controlled Trial
Plasma adrenaline increases in anesthetized patients given electro-acupuncture before surgery.
In anesthetized patients, electro-acupuncture (EA) has been found to reduce sevoflurane-induced suppression of cranial and spinal motor responses to surgery without influencing the level of anesthesia. The underlying mechanisms are unclear. In the present study, blood samples were analyzed to evaluate if the increased clinical motor responses to surgery in patients subjected to EA under sevoflurane anesthesia are also reflected in higher plasma levels of catecholamines, adrenocorticotrophic hormone (ACTH), or cortisol. ⋯ The clinical facilitation of both cranial and spinal motor responses to surgery in patients given acupuncture under sevoflurane anesthesia is associated with increased plasma levels of adrenaline, possibly reflecting sympathetic activation.