Pain medicine : the official journal of the American Academy of Pain Medicine
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About 50% of patients with cancer who have undergone surgery suffer from cancer-related pain (CP). The use of opioids for postoperative pain management presents the potential for overdose, especially among these patients. ⋯ CP is an independent risk factor for opioid overdose, increased length of stay, and increased total hospital charges.
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To analyze 1) the independent association of physical fitness, positive affect, and negative affect with the different dimensions of fatigue (general fatigue, physical fatigue, reduced activity, reduced motivation, and mental fatigue) and 2) whether the interactions of physical fitness, positive affect, and negative affect were associated with fatigue over and above the independent association. ⋯ In women with fibromyalgia, positive affect was independently and consistently associated with all dimensions of fatigue. The combination of higher levels of overall physical fitness and positive affect might serve as a buffer against general and physical fatigue in women with fibromyalgia.
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Observational Study
Intensity of Withdrawal Symptoms During Opioid Taper in Patients with Chronic Pain-Individualized or Fixed Starting Dosage?
Controlled opioid withdrawal is recommended for patients with chronic noncancer pain (CNCP) with insufficient pain reduction or intolerable side effects while on opioid treatment. Few studies have investigated the management of opioid withdrawal (OW). Most common are protocols with an individualized starting dosage (ISD), calculated from the last opioid intake. After two cases of overdose, we introduced a novel withdrawal protocol using a low fixed starting dosage (FSD) for safety reasons. The present study compares the intensity of withdrawal symptoms using the Subjective Opioid Withdrawal Scale (SOWS) and incidences of serious adverse events (SAE) and dropouts in each taper schedule in 195 CNCP patients with OW in an inpatient facility. ⋯ The FSD protocol provides a lesser burden of withdrawal symptoms and equal patient safety. It can be recommended for OW in CNCP patients.