Journal of pain & palliative care pharmacotherapy
-
J Pain Palliat Care Pharmacother · Sep 2021
ReviewA Recent Update on Drug Delivery Systems for Pain Management.
Pain remains a global health challenge affecting approximately 1.5 billion people worldwide. Pain has been an implicit variable in the equation of human life for many centuries considering different types and the magnitude of pain. Therefore, developing an efficacious drug delivery system for pain management remains an open challenge for researchers in the field of medicine. ⋯ This literature review firstly provides a brief introduction of pain as a sensation and its pharmacological interventions. Second, it highlights the most recent studies in the pharmaceutical field for pain management and serves as a strong base for future developments. Herein, we have classified drug delivery systems based on their sizes such as nano, micro, and macro systems, and for each of the reviewed systems, design, formulation strategies, and drug release performance has been discussed.
-
J Pain Palliat Care Pharmacother · Sep 2021
Multicenter StudyA Comparison of Two Regimens for Managing Sickle Cell Pain and Reducing Readmissions.
This was a multicenter retrospective analysis comparing intravenous push (IVP) analgesia versus patient-controlled analgesia (PCA) in patients admitted for sickle cell pain crisis. The primary objective was to compare the analgesic management, measured in total daily morphine milligram equivalents (MME). Secondary objectives included length of hospitalization, 30-day hospital readmissions and pain scores. ⋯ Length of hospitalization was not different between patients on IVP and PCA (7.14 vs. 6.39 days, p = 0.53). There was no difference in 30-day readmissions, average pain scores on days 1-3 of hospitalization and adverse side effects between the groups. This study showed patients on IVP had significantly lower total daily MME requirements compared to PCA within the first three calendar days of admission.
-
J Pain Palliat Care Pharmacother · Sep 2021
Randomized Controlled TrialEconomic Impact of Preoperative Meloxicam IV Administration in Total Knee Arthroplasty: A Randomized Trial Sub-Study.
We evaluated the economic impact associated with preoperative meloxicam IV 30 mg vs placebo administration among adult total knee arthroplasty (TKA) recipients enrolled in Phase IIIB NCT03434275 trial. Data on total hospital costs and length of stay (LOS) obtained from the trial were compared between meloxicam IV 30 mg and placebo groups. Patients in the meloxicam IV 30 mg vs placebo group (n = 93 vs 88) incurred an adjusted $2,266 (95% CI: -$1,035, $5,116; p = 0.1689) lower total hospital costs and an adjusted 8.6% (95% confidence interval [CI]: -2.0%, 18.1%; p = 0.1082) shorter LOS. While statistically non-significant, based on 95% CIs, the results from this sub-study may suggest a favorable impact associated with meloxicam IV 30 mg on hospital costs and LOS.
-
J Pain Palliat Care Pharmacother · Sep 2021
Subcutaneous Lidocaine Infusion for Complex Cancer Pain: A Retrospective Review.
This retrospective review assesses the safety and efficacy of subcutaneous lidocaine infusions for complex cancer pain, in a specialist palliative care unit. A retrospective chart review was undertaken of 18 infusions over a 2-year period. Data collected included patient demographics, use of adjuvant analgesics, methadone use and opioid requirements (as oral morphine equivalent daily dose, oMEDD) at three time periods: 24 hours prior to starting infusion, 24 hours after starting infusion and 24 hours after stopping infusion. ⋯ Events were reported in three out of 18 infusions, only one minor adverse event was attributed to lidocaine. Thirteen out of 18 infusions were perceived, by patients, to be effective for pain. This retrospective review has shown that a subcutaneous lidocaine infusion is a safe and effective means of managing complex cancer pain in a specialist palliative care unit.
-
J Pain Palliat Care Pharmacother · Sep 2021
Subcutaneous Patient-Controlled Analgesia in Palliative Care.
Subcutaneous patient-controlled analgesia (SCPCA) is an underutilized method of pain management in palliative care patients. In a select group of patients, including patients in whom enteral analgesia is ineffective or undeliverable, and in patients with limited access to healthcare due to geographical or other logistic issues, SCPCA can provide an effective and safe alternative.