Pain practice : the official journal of World Institute of Pain
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This study evaluated the clinical effects and pattern of use of AVINZA((r)), morphine sulfate extended-release tablets, under real-world treatment conditions. Opioid-naive subjects or subjects who have failed other opioids were eligible if they had chronic moderate-to-severe noncancer pain with an average pain score > or =4 (0-10 scale) in the preceding month. Subjects answered in-depth monthly questionnaires in three months. ⋯ Two hospitalizations for nausea and vomiting were the only reported drug-related serious adverse events. This study showed that once-daily AVINZA significantly reduced pain scores, and resulted in improved sleep and physical functioning in patients with chronic moderate-to-severe pain. These results were achieved with a stable daily morphine dose over the three-month study period.
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Comparative Study
Evaluation of aromatherapy in treating postoperative pain: pilot study.
This study compared the analgesic efficacy of postoperative lavender oil aromatherapy in 50 patients undergoing breast biopsy surgery. Twenty-five patients received supplemental oxygen through a face mask with two drops of 2% lavender oil postoperatively. The remainder of the patients received supplemental oxygen through a face mask with no lavender oil. ⋯ There were no significant differences in narcotic requirements and recovery room discharge times between the two groups. Postoperative lavender oil aromatherapy did not significantly affect pain scores. However, patients in the lavender group reported a higher satisfaction rate with pain control than patients in the control group (P = 0.0001).
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Randomized Controlled Trial
Preemptive analgesia in laparoscopic cholecystectomy: a randomized controlled study.
In pain control after laparoscopic cholecystectomy, subhepatic administration of bupivacaine immediately after the creation of pneumoperitoneum has been shown to be more effective than administration before the withdrawal of the trocars. We aimed to investigate the effect of intraperitoneal bupivacaine administration to the subhepatic area before the creation of the pneumoperitoneum. Eighty patients undergoing elective laparoscopic cholecystectomy under general anesthesia were included in a prospective, randomized study. ⋯ The pain scores of group 2 were lower at each time point compared to the other groups (P < 0.001). Postoperative analgesic consumption in group 2 was reduced compared to the other groups (23.4 +/- 35.9 mg vs. 80.0 +/- 66.3 mg, P = 0.005 [group 1], 69.6 +/- 62.2 mg, P = 0.026 [group 3], and 70.0 +/- 59.9 mg, P = 0.022 [group 4]). The subhepatic infiltration of 20 mL of 0.5% bupivacaine offers good postoperative analgesia when applied just after the creation of the pneumoperitoneum, not before the pneumoperitoneum or after the termination of the pneumoperitoneum.
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Case Reports
Management of cerebral spinal fluid leak complicating spinal cord stimulator implantation.
Accidental puncture of the dura mater with resultant leakage of cerebral spinal fluid (CSF) and development of postdural puncture headache (PDPH) is a known potential complication of percutaneous placement of spinal cord stimulator (SCS) leads. However, the implications and management strategies for this complication have not been thoroughly reported. We report two cases of SCS lead placement complicated by CSF leak and PDPH.
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Clinical Trial
Repetitive occipital nerve blockade for cervicogenic headache: expanded case report of 47 adults.
To evaluate the repetitive occipital nerve blocks using a nerve stimulator in the treatment of cervicogenic headache. ⋯ The repeated nerve stimulator-guided occipital nerve blockade is a treatment mode that may relieve cervicogenic headache with no recurrence for at least six months in addition to alleviation of associated symptoms.