Pain medicine : the official journal of the American Academy of Pain Medicine
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Randomized Controlled Trial
Thoracic paravertebral block for nephrectomy: a randomized, controlled, observer-blinded study.
This study evaluated whether adding a preoperative single thoracic paravertebral block (TPVB) to intravenous patient-controlled analgesia (IV PCA) would improve postoperative analgesia compared with using IV PCA alone in patients undergoing nephrectomy. ⋯ A preoperative single TPVB improved postoperative analgesia by reducing the postoperative pain score and fentanyl consumption in patients undergoing nephrectomy.
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Post-traumatic stress disorder (PTSD) and pain have a well-documented high comorbidity; however, the underlying mechanisms of this comorbidity are currently poorly understood. The aim of this psychophysical study was to investigate the behavioral response to a prolonged suprathreshold pain stimulus in subjects with combat-related PTSD and combat controls (CC) for clinical evidence of central sensitization. ⋯ These findings are consistent with a significantly higher degree of acute central sensitization in individuals with PTSD. Increased acute central sensitization may underlie increased vulnerability for developing pain-related conditions following combat trauma.
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Randomized Controlled Trial
Personalized oxycodone dosing: using pharmacogenetic testing and clinical pharmacokinetics to reduce toxicity risk and increase effectiveness.
To develop a framework for integrating pharmacogenetics with clinical pharmacokinetics for personalized oxycodone dosing based on a patient's CYP2D6 phenotype. ⋯ Personalized oxycodone dosing is a new tool for a clinician treating chronic pain patients requiring oxycodone. By expressing a patient's CYP2D6 phenotype pharmacokinetically, a clinician (at least theoretically) can improve the safety and efficacy of oxycodone and decrease the risk for iatrogenically induced overdose or death. Pharmacokinomics provides a general framework for the integration of pharmacogenetics with clinical pharmacokinetics into clinical practice for gene-based prescribing.
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To investigate associations of pain intensity in those with long-term back pain, with their partners' rating of key constructs of relationship quality: cohesion (activities together), consensus (affection, sexual relations), satisfaction (conflict, regrets). ⋯ These findings illustrate the association of pain outcomes beyond the patient within a primary care sample. Moderators of the responses about the relationship construct of consensus generated by partners appear to be partners' own level of depressive symptoms and whether their depressive symptoms are associated with the patients' pain intensity. Consultations should consider the social context of patients with pain.
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Observational Study
Thermal quantitative sensory testing to predict postoperative pain outcomes following gynecologic surgery.
To evaluate the relationship of preoperative thermal quantitative sensory testing (QST) values with postoperative pain and opiate consumption in opiate-naïve patients following gynecologic surgery. ⋯ Reduced tolerance to both heat and cold thermal pain stimulus was associated with increased postoperative analgesic requirements. Combined responses to multiple pain modalities may be more useful than a single stimulus paradigm.