Pain medicine : the official journal of the American Academy of Pain Medicine
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Transdermal therapeutic system fentanyl with a drug release rate of 12 µg/h should be of special value in pediatric cancer pain control. Such a fentanyl formulation allows for a stepwise dose increase, similar to that reported for sustained-release morphine. ⋯ Transdermal fentanyl was found to be an effective, safe, and well-tolerated treatment for pediatric cancer-related pain in opioid-naive patients with chronic moderate to severe pain. In this study population, evaluation of vital signs and physical examination did not suggest any safety concerns while using transdermal fentanyl.
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This study evaluated the efficacy of IV cosyntropin as an alternative to epidural blood patch (EBP) for refractory or severe post-dural puncture headache (PDPH). ⋯ It is reasonable to consider IV cosyntropin as the treatment of choice for patients in whom EBP is contraindicated or in austere environments where there is limited or no access to anesthesia trained providers. Future research should compare efficacy and cost of prophylaxis to treatment of PDPH with intravenous cosyntropin and evaluate the most effective dosing regimen, including duration, number, and strength of doses.
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To estimate the prevalence and examine the associations of neuropathic-like pain in a community-based sample of older Australian women with arthritis. ⋯ Neuropathic-like pain in women with arthritis was common and is associated with greater disability and poorer quality of life.
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Pre-existing chronic pain has been associated with severe postoperative pain. To analyze the impact of chronic pain on non-surgical acute pain, a cohort of patients with acute herpes zoster was studied. ⋯ Patients with chronic pain had higher intensity of zoster-related acute pain. Furthermore, they showed more pain-related dysfunction and needed longer hospitalization than patients without chronic pain. These results go along with findings for acute postoperative pain.