Journal of pain & palliative care pharmacotherapy
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J Pain Palliat Care Pharmacother · Sep 2010
Emergency department visits involving nonmedical use of selected prescription drugs in the United States, 2004-2008.
This report, adapted from the lead article in the June 10, 2010, issue of Morbidity and Mortality Weekly Reports, describes the alarming increase in overdose deaths involving prescription drugs. Oxycodone, hydrocodone, and methadone were the drugs most highly implicated. Data were derived from the federal Drug Abuse Warning Network (Dawn). Other drugs commonly used in managing pain patients, including benzodiazepines and muscle relaxants, also were implicated.
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J Pain Palliat Care Pharmacother · Sep 2010
Patient controlled analgesia: redefining its role in an Indian cancer hospital.
This report describes a noninterventional audit of current patient-controlled analgesia (PCA) use in an Indian cancer hospital over a 1-year period. Because there appeared to be an underutilization of PCA in the authors' hospital, they performed this audit. A major reason to start PCA was inadequate analgesia despite ongoing epidural or standard PRN analgesic regimes, especially in thoracic, major abdominal, and pelvic bone surgeries. ⋯ A blocked intravenous (IV) line was encountered in 12 patients. Thirty-one patients ranked their pain relief with PCA as excellent and 39 patients stated it as good. Their protocols shall be suitably amended to ensure that PCA shall be used in immediate postoperative period as a principal modality of pain relief, especially in the above-mentioned group in absence of epidural analgesia.
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J Pain Palliat Care Pharmacother · Jun 2010
Patients with chronic pain after abdominal surgery show less preoperative endogenous pain inhibition and more postoperative hyperalgesia: a pilot study.
Chronic pain is common and undesirable after surgery. Progression from acute to chronic pain involves altered pain processing. The authors studied relationships between presence of chronic pain versus preoperative descending pain control (diffuse noxious inhibitory controls; DNICs) and postoperative persistence and spread of skin and deep tissue hyperalgesia (change in electric/pressure pain tolerance thresholds; ePTT/pPTT) up to 6 months postoperatively. ⋯ More inhibitory pDNIC was linked to less postoperative leg deep tissue hyperalgesia, without affecting pain VAS. This pilot study for the first time links chronic pain after surgery, poorer preoperative inhibitory pain modulation (DNIC), and greater postoperative degree, persistence, and spread of hyperalgesia. If confirmed, these results support the potential clinical utility of perioperative pain processing testing.