Pain medicine : the official journal of the American Academy of Pain Medicine
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Randomized Controlled Trial
Single-dose pharmacokinetics of fentanyl buccal soluble film.
The objectives of the study were to determine the absolute bioavailability of fentanyl from fentanyl buccal soluble film, estimate the percentage of a fentanyl dose absorbed through the buccal mucosa, and compare the bioavailability of equivalent doses administered either as single or multiple dose units. ⋯ Fentanyl buccal soluble film effectively delivers a high percentage of the administered fentanyl dose and nearly identical plasma profiles are obtained when equivalent doses are delivered by single or multiple dosage units.
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Randomized Controlled Trial
painACTION-back pain: a self-management website for people with chronic back pain.
To determine whether an interactive self-management Website for people with chronic back pain would significantly improve emotional management, coping, self-efficacy to manage pain, pain levels, and physical functioning compared with standard text-based materials. ⋯ An online self-management program for people with chronic back pain can lead to improvements in stress, coping, and social support, and produce clinically significant differences in pain, depression, anxiety, and global rates of improvement.
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To describe characteristics of older adults who received opioids for chronic non-cancer pain (CP), ascertain types of opioid treatments received, and examine associations between patient characteristics and treatment outcomes. ⋯ Over 50% of older patients with CP tolerated treatment. Treatment was discontinued in 48% of cases, mostly due to side effects and lack of analgesic efficacy. Efforts are needed to establish the long-term safety and efficacy of opioid treatment for CP in diverse older patient populations.
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Case Reports
Intrathecal granuloma formation in a patient receiving long-term spinal infusion of tramadol.
Intrathecal granuloma associated to the tip of subarachnoid catheters implanted in patients receiving long-term spinal infusion is a rare but potentially catastrophic complication. Its development seems to be related to the intrathecal administration of opioid drugs, although not all opioids induce granuloma formation with the same frequency. ⋯ Chronic intrathecal administration of high-dose tramadol could cause an inflammatory mass as it can be caused by similar, off-label infusions of morphine or hydromorphone. Additionally, tramadol stimulates the activity of natural killers and the proliferation of lymphocytes.