Pain medicine : the official journal of the American Academy of Pain Medicine
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Review Meta Analysis
Time to take stock: a meta-analysis and systematic review of analgesic treatment disparities for pain in the United States.
The recent Institute of Medicine Report assessing the state of pain care in the United States acknowledged the lack of consistent data to describe the nature and magnitude of unrelieved pain and identify subpopulations with disproportionate burdens. ⋯ Our study quantifies the magnitude of analgesic treatment disparities in subgroups of minorities. The size of the difference was sufficiently large to raise not only normative but quality and safety concerns. The treatment gap does not appear to be closing with time or existing policy initiatives. A concerted strategy is needed to reduce pain care disparities within the larger quality of care initiatives.
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We evaluated whether outpatient intravenous ketamine infusions were satisfactory for pain relief in patients suffering from various chronic intractable pain syndromes. ⋯ We conclude that in patients with severe refractory pain of multiple etiologies, subanesthetic ketamine infusions may improve VAS scores. In half of our patients, relief lasted for up to 3 weeks with minimal side effects.
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Randomized Controlled Trial Multicenter Study Comparative Study
Efficacy and safety of dextromethorphan/quinidine at two dosage levels for diabetic neuropathic pain: a double-blind, placebo-controlled, multicenter study.
To evaluate dextromethorphan coadministered with quinidine as treatment of diabetic peripheral neuropathic pain. ⋯ Throughout a 13-week trial, DMQ was effective, with an acceptable safety profile, for treatment of DPN pain. Other fixed-dose combinations of DMQ should be studied to improve overall tolerability while maintaining significant efficacy.
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Comparative Study
The impact of sexual or physical abuse history on pain-related outcomes among blacks and whites with chronic pain: gender influence.
Physical and sexual abuses commonly co-occur with chronic pain. We hypothesized that: 1) abuse history questions would form distinct factors that relate differently to pain perceptions and pain outcomes; 2) abuse history consequences on physical and mental health differ by gender; and 3) different abuse types and age of occurrence (childhood vs adolescent/adulthood) predict different negative outcomes. ⋯ Our study confirms physical and mental health, and pain-related outcomes are affected by abuse history for men and women. These results support screening all patients for abuse to improve the survivor's overall health and well-being.
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The objective of this study was to delineate the relationship between noncancer pain and cognitive impairment with social vulnerability. ⋯ Pain and cognitive impairment are independently associated with social vulnerability. Improvements in pain management might mitigate social vulnerability in a growing number of older adults with either or both conditions.