Journal of pain & palliative care pharmacotherapy
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J Pain Palliat Care Pharmacother · Jun 2016
Clinical TrialSubanesthetic, Subcutaneous Ketamine Infusion Therapy in the Treatment of Chronic Nonmalignant Pain.
This study was designed to describe the efficacy and toxicity of subcutaneous ketamine infusions and sublingual ketamine lozenges for the treatment of chronic nonmalignant pain. Data were collected prospectively on 70 subjects managed in an academic, tertiary care hospital between 2007 and 2012 who received between 3 and 7 days of subanesthetic, subcutaneous ketamine infusion. Data were analyzed for efficacy, adverse effects, and reduction in use of opioid medication. ⋯ The infusion provided significant pain relief in subjects who had failed a wide range of pharmacological and cognitive behavioral therapies. In addition, the results indicate that sublingual ketamine lozenges offer a promising therapeutic option for longer-term relief of chronic nonmalignant pain. The ketamine lozenges have been shown to have acceptable storage stability, and the sublingual bioavailability is sufficiently high and reproducible to support its use in this context.
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J Pain Palliat Care Pharmacother · Jun 2016
Medication Overuse Headache Due to Butalbital, Acetaminophen, and Caffeine Tablets.
Questions from patients about pain conditions and analgesic pharmacotherapy and responses from authors are presented to help educate patients and make them more effective self-advocates. Medication overuse headache is a relatively common cause for chronic daily headache in the migraine patient. In reply to a question, medication overuse headache is reviewed, acute and preventive medications are discussed, and quality of life is considered.
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J Pain Palliat Care Pharmacother · Jun 2016
Case ReportsUltrasound-Guided Continuous Superficial Radial Nerve Block for Complex Regional Pain Syndrome.
Although there are many potentially effective therapeutic options for complex regional pain syndrome (CRPS), no definitive treatment exists. Therefore, patients often exhaust both medical and surgical treatment options attempting to find relief for their symptoms. ⋯ This treatment approach also assisted in the decision-making process related to future treatment options. Although the use of regional anesthesia and perineural infusions of local anesthetic have previously been described as viable treatment options for CRPS, this case report represents the first known use of a superficial radial nerve catheter for treating CRPS as well as the first description of a technique for placing a superficial radial nerve (SRN) catheter using ultrasound guidance.