Pain medicine : the official journal of the American Academy of Pain Medicine
-
Muscle fatigue is prevalent in acute and chronic musculoskeletal pain conditions in which myofascial trigger points (MTPs) are involved. The aim of this study was to investigate the association of latent MTPs with muscle fatigue. ⋯ A latent MTP is associated with an accelerated development of muscle fatigue and simultaneously overloading active motor units close to an MTP. Elimination of latent MTPs and inactivation of active MTPs may effectively reduce accelerated muscle fatigue and prevent overload spreading within a muscle.
-
Traditionally, urine drug screens have only been concerned with positive or negative results. Those results provide physicians treating patients for pain with chronic opioid therapy with information about medication compliance, use of nonprescribed medications, and use of illicit drugs. However, the analysis of urine for drugs offers additional information that, when compiled and accurately interpreted, may also be of great value to these doctors. ⋯ The article provides pertinent information about interpretation of urine drug testing, which is separated into six categories: which drugs and metabolites to test for; which analytical cutoffs to use; pain medication metabolism; identification of alcohol use; determination of patient compliance; and which patient groups to consider for more frequent testing.
-
Randomized Controlled Trial Comparative Study
A randomized trial of epidural analgesia followed by continuous femoral analgesia compared with oral opioid analgesia on short- and long-term functional recovery after total knee replacement.
The purpose of this study was to compare continuous femoral nerve analgesia to oral opioid analgesics after discontinuation of epidural analgesia following total knee replacement. ⋯ CFA for 24 hours following discontinuation of epidural analgesia was associated with lower pain scores, greater compliance with physical therapy, increased range of motion, reduced opioid analgesia use, and greater patient satisfaction during hospitalization. The increased flexion of the operated joint was still evident at 1 month postoperatively.
-
Letter Case Reports
Methemoglobinemia in the setting of chronic transdermal lidocaine patch use.