Articles: analgesics.
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Review Meta Analysis
Protective effects of epidural analgesia on pulmonary complications after abdominal and thoracic surgery: a meta-analysis.
To review the impact of epidural vs systemic analgesia on postoperative pulmonary complications. ⋯ Epidural analgesia protects against pneumonia following abdominal or thoracic surgery, although this beneficial effect has lessened over the last 35 years because of a decrease in the baseline risk.
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Reg Anesth Pain Med · Sep 2008
Review Meta AnalysisPregabalin as a treatment for painful diabetic peripheral neuropathy: a meta-analysis.
Painful diabetic peripheral neuropathy (DPN) is an increasingly prevalent disorder that is best managed through a multimodal approach. We examined the effects of pregabalin on pain control, sleep disturbance, and the patient's global impression of change (PGIC) for the treatment of this disorder. ⋯ Pregabalin has significant effects on the pain associated with DPN as well as secondary endpoints that affect patients' quality of life.
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Review Meta Analysis
Efficacy and safety of mu-opioid antagonists in the treatment of opioid-induced bowel dysfunction: systematic review and meta-analysis of randomized controlled trials.
Opioid-induced bowel dysfunction (OBD) is characterized by constipation, incomplete evacuation, bloating, and increased gastric reflux. OBD occurs both acutely and chronically, in multiple disease states, resulting in increased morbidity and reduced quality of life. ⋯ Insufficient evidence exists for the safety or efficacy of naloxone or nalbuphine in the treatment of OBD. Long-term efficacy and safety of any of the opioid antagonists is unknown, as is the incidence or nature of rare adverse events. Alvimopan and methylnaltrexone both show promise in treating OBD, but further data will be required to fully assess their place in therapy.
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To evaluate the efficacy, safety, and tolerability of pregabalin across the effective dosing range, to determine differences in the efficacy of three times daily (TID) versus twice daily (BID) dosage schedules, and to use time-to-event analysis to determine the time to onset of a sustained therapeutic effect using data from seven trials of pregabalin in painful diabetic peripheral neuropathy (DPN). ⋯ Treatment with pregabalin across its effective dosing range is associated with significant, dose-related improvement in pain in patients with DPN.
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This is a structured evidence-based review of all available studies on the development of abuse/addiction and aberrant drug-related behaviors (ADRBs) in chronic pain patients (CPPs) with nonmalignant pain on exposure to chronic opioid analgesic therapy (COAT). ⋯ The results of this evidence-based structured review indicate that COAT exposure will lead to abuse/addiction in a small percentage of CPPs, but a larger percentage will demonstrate ADRBs and illicit drug use. These percentages appear to be much less if CPPs are preselected for the absence of a current or past history of alcohol/illicit drug use or abuse/addiction.