Pain practice : the official journal of World Institute of Pain
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The development and implementation of a pharmacist-led patient-controlled analgesia (PCA) dosing service in a large academic institution are described. ⋯ After implementation of the pharmacist-led PCA dosing service, pharmacists at our institution provide PCA pain management services as part of our pharmacy department's standard practice.
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Prescription opioid pain reliever (OPR) misuse and diversion is an important and growing public health problem in the United States that is responsible for significant morbidity and mortality. Emergency physicians are among the top prescribers of OPRs, yet the relative contribution of emergency department (ED) OPR prescriptions to the overall opioid abuse epidemic remains unclear. ⋯ Among patients who suffer an OPR-related death, approximately 1.8% of the OPR pills given to the decedents will have come from the ED. In addition to the need for more research, the existing literature suggests an urgent need for interventions in the ED to reduce OPR misuse and diversion.
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Pain is a highly prevalent and distressing symptom in patients with cancer but at the same time inadequately treated in many of these patients. The major reason for such imbalance is inappropriate pain assessment. To overcome such a barrier, the use of a valid and reliable pain assessment tool in the language the patient understands is invaluable. Unfortunately, until now, no such standardized tool has been utilized in Ethiopian patients with cancer for both clinical and research purposes. ⋯ The BPI-Am is a valid and reliable tool for use in Ethiopian patients with cancer. The inadequacy of cancer pain management in these groups of patients is high, which calls for needed attention.
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Cebranopadol is a novel and highly potent analgesic acting via nociceptin/orphanin FQ peptide (NOP) and opioid receptors. Since NOP and opioid receptors are expressed in the central nervous system as well as in the periphery, this study addressed the question of where cebranopadol exerts its effects in animal models of chronic neuropathic pain. Mechanical hypersensitivity in streptozotocin (STZ)-treated diabetic rats, cold allodynia in the chronic constriction injury (CCI) model in rats, and heat hyperalgesia and nociception in STZ-treated diabetic and control mice was determined after intraplantar (i.pl.), intracerebroventricular (i.c.v.), or intrathecal (i.th.) administration. ⋯ After central administration of cebranopadol, antihyperalgesic efficacy is reached at doses that are not yet antinociceptive. This study shows that cebranopadol is effective after peripheral as well as central administration in nociceptive and chronic neuropathic pain. Thus, it may be well-suited for the treatment of chronic pain conditions with a neuropathic component.
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Randomized Controlled Trial
Lumbopelvic Core Stabilization Exercise and Pain Modulation Among Individuals with Chronic Nonspecific Low Back Pain.
Lumbopelvic stabilization training (LPST) may provide therapeutic benefits on pain modulation in chronic nonspecific low back pain conditions. This study aimed to examine the effects of LPST on pain threshold and pain intensity in comparison with the passive automated cycling intervention and control intervention among patients with chronic nonspecific low back pain. ⋯ Lumbopelvic stabilization training may provide therapeutic effects by inducing pain modulation through an improvement in the pain threshold and reduction in pain intensity. LPST may be considered as part of the management programs for treatment of chronic low back pain.