Pain medicine : the official journal of the American Academy of Pain Medicine
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Randomized Controlled Trial
Conventional Radiofrequency Thermocoagulation vs Pulsed Radiofrequency Neuromodulation of Ganglion Impar in Chronic Perineal Pain of Nononcological Origin.
Chronic nononcological perineal pain has been effectively managed by ganglion Impar block. Chemical neurolysis, cryoablation, and radiofrequency ablation have been the accepted methods of blockade. Recently, pulsed radiofrequency, a novel variant of conventional radiofrequency, has been used for this purpose. ⋯ The short-term follow-up period of only six weeks was a major drawback associated with this study.
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Randomized Controlled Trial
Pharmacokinetics and Abuse Potential of Benzhydrocodone, a Novel Prodrug of Hydrocodone, After Intranasal Administration in Recreational Drug Users.
Developing an acetaminophen-free, immediate-release hydrocodone product remains an unmet medical need; however, new opioid analgesics should not introduce new abuse risks. Benzhydrocodone is a prodrug of hydrocodone that must be metabolized into hydrocodone by enzymes in the intestinal tract to optimally deliver its pharmacologic effects. This study evaluated the intranasal pharmacokinetics and abuse potential of benzhydrocodone active pharmaceutical ingredient (API) compared with hydrocodone bitartrate (HB) API. ⋯ Reductions in hydrocodone exposure and associated decreases in Drug Liking relative to HB suggest that the prodrug benzhydrocodone may deter intranasal abuse.
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High intensity of acute postsurgical pain is one of the strongest predictors of chronic postsurgical pain (CPSP). We investigated if different types of patients with distinct combinations of initial pain intensity and rate of pain resolution exhibit different risks for increased pain intensity six months after surgery. ⋯ In this study, we demonstrated that there is substantial variation in postsurgical pain trajectories, not only with regard to postsurgical initial pain intensity, but also with regard to individual rates of pain resolution. Successful pain resolution appeared to be a better predictor of absence of increased pain intensities six months after surgery than initial pain immediately after surgery. Hence, attention should be given to appropriate pain treatment in order to minimize the risk of CPSP.
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Chronic pain is a serious health problem with high rates of health care utilization (HCU). Many patients become stymied in a perpetual cycle of unsuccessful attempts to find relief from suffering through frequent health care visits. Especially within low-income populations, the burdens of health care services are especially unpleasant due to significant financial costs, barriers to transportation, and high levels of stress. This study aimed to examine factors associated with HCU for chronic pain in low-income settings. ⋯ Depressive symptoms are an essential aspect of increased health care use. Study findings support the need for a biopsychosocial approach to chronic pain management.
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To assess the effect depression has on outcomes after cervical epidural steroid injections (CESIs). ⋯ Patients with cervical spondylosis and comorbid depression who undergo CESI are less likely to achieve successful outcomes in both pain and function compared with nondepressed patients at three months.