Journal of pain & palliative care pharmacotherapy
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J Pain Palliat Care Pharmacother · Jun 2010
Development of acute pain service in an Indian cancer hospital.
Postoperative pain relief continues to be a major challenge for all health care professionals caring for such patients in India. Acute pain services are almost nonexistent, even in large private and university hospitals. As per our estimate not more than 10 such services are available. ⋯ Pain scores declined yet the patient satisfaction has not improved. Postoperative outcome studies are yet to be undertaken. The development and current activities of the APS that can be implemented in a country that does not have sophisticated acute pain management teams are described.
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J Pain Palliat Care Pharmacother · Jun 2010
Volume of prescription opioids used nonmedically in the United States.
ABSTRACT To understand the magnitude of prescription opioid abuse in the United States, it is critical to determine how many dosage units of prescription opioids are ingested nonmedically per year. Using several public and private databases, the authors estimated that in 2002-2003, among the 10.89 million individuals projected to have used prescription opioids nonmedically, a minimum of 430.61 million doses were used nonmedically per year (assuming only one dose consumed per nonmedical use per day per individual). This represented about 1/25 of all prescription opioid doses dispensed. This estimate provides a perspective on the magnitude of prescription opioids abuse and should help policy makers enact policies that reduce prescription opioid abuse and diversion without preventing legitimate access to opioid therapy.
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J Pain Palliat Care Pharmacother · Jun 2010
Complex regional pain syndrome/reflex sympathetic dystrophy.
Questions from patients about analgesic pharmacotherapy and responses from the authors are presented to help educate patients and make them more effective self-advocates. The topics addressed in this issue are the signs, symptoms, and diagnosis of complex regional pain syndrome/reflex sympathetic dystrophy.
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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.