Pain medicine : the official journal of the American Academy of Pain Medicine
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Comparative Study
Surface electromyography findings in unilateral myofascial pain patients: comparison of painful vs. non painful sides.
To answer the clinical research question: in patients with myofascial pain, are there any differences in the surface electromyography (sEMG) activity of muscles of the painful and nonpainful sides that can be detected by commercially available devices? ⋯ The above findings were not supportive of the existence of any detectable difference in sEMG activity between jaw muscles of the painful and nonpainful sides in patients with unilateral myofascial pain. Centrally mediated mechanism for pain adaptation may explain these findings, and the role of sEMG as a diagnostic tool for muscle pain needs to be carefully reconceptualized.
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Observational Study
Noninterventional observational study using high-dose controlled-release oxycodone (CR oxycodone) for cancer pain management in outpatient clinics.
Efficacy, safety, and quality of life (QoL) for patients receiving larger doses of controlled-release oxycodone (CR oxycodone) in outpatient clinics are evaluated. ⋯ This study suggests that over an 8-week period, the use of high-dose CR oxycodone for cancer pain management is efficient, safe, and tolerable in outpatient clinics.
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ABCB1 is a major determinant of opioid bioavailability; however, no previous studies have provided positive evidence of an association between single-nucleotide polymorphisms (SNPs) of ABCB1 and opioid usage in acute pain management. The aim of this study was to test the association between the functional SNP C3435T in ABCB1 and opioid consumption in postoperative pain in patients undergoing a nephrectomy. Additionally, we explored the association between C3435T and opioid side effect. ⋯ Our results demonstrate an association between the ABCB1 polymorphism (C3435T) and interindividual variations in opioid consumption in the acute postoperative period after nephrectomy. The ABCB1 polymorphism may serve as an important factor to guide acute pain therapy in postoperative patients.
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It can be challenging to successfully monitor medication compliance in pain management. Clinicians and laboratorians need to collaborate to optimize patient care and maximize operational efficiency. The test menu, assay cutoffs, and testing algorithms utilized in the urine drug testing panels should be periodically reviewed and tailored to the patient population to effectively assess compliance and avoid unnecessary testing and cost to the patient. ⋯ Conducting an interdisciplinary quality improvement project allowed us to optimize our testing panel for monitoring medication compliance in pain management and reduce cost.
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Available evidence to help guide efficacious nonsteroidal anti-inflammatory drug and opioid analgesic prescribing will be reviewed. ⋯ The available evidence can guide but cannot provide any prescriber with absolute knowledge regarding outcome for these frequently prescribed and potentially dangerous agents. Knowledge of the available evidence and application of such to our patients on an individualized basis hopefully will help to optimize therapeutic goals and minimize harms.