Articles: analgesics.
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Review Meta Analysis
Meta-analysis of epidural analgesia versus parenteral opioid analgesia after colorectal surgery.
Epidural analgesia (EA) with local anaesthetic is considered to play a key role after colorectal surgery. However, its effect on postoperative recovery is still a matter of debate. ⋯ Despite improved analgesia and a decrease in ileus, EA has some adverse effects and does not shorten the duration of hospital stay after colorectal surgery.
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Review Meta Analysis
Tramadol for osteoarthritis: a systematic review and metaanalysis.
Tramadol is increasingly used for the treatment of osteoarthritis (OA) because it does not produce gastrointestinal bleeding or renal problems and does not affect articular cartilage. We sought to determine the analgesic effectiveness, the effect on physical function, the duration of benefit, and the safety of oral tramadol in people with OA. ⋯ Tramadol or tramadol/paracetamol decreases pain intensity, produces symptom relief, and improves function in patients with OA, but these benefits are small.
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Pain is the most debilitating symptom in osteoarthritis of the knee (OAK). ⋯ Clinical effects from pharmacological interventions in OAK are small and limited to the first 2-3 weeks after start of treatment. The pain-relieving effects over placebo in OAK are smaller than the patient-reported thresholds for relevant improvement.
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Breakthrough pain is a prevalent and serious problem in patients with cancer. However, it is not known how best to predict the effective dose of breakthrough opioid for any given patient. ⋯ This is the largest study to date of the relationship between clinical variables and the effective dose of OTFC when titrated to effect for breakthrough cancer pain. These results suggest that use of breakthrough medication should routinely be individualized with a titration strategy separate from the around-the-clock medication, according to each patient's response to their breakthrough opioid.
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Review Meta Analysis
Systematic review: opioid treatment for chronic back pain: prevalence, efficacy, and association with addiction.
The prevalence, efficacy, and risk for addiction for persons receiving opioids for chronic back pain are unclear. ⋯ Opioids are commonly prescribed for chronic back pain and may be efficacious for short-term pain relief. Long-term efficacy (> or =16 weeks) is unclear. Substance use disorders are common in patients taking opioids for back pain, and aberrant medication-taking behaviors occur in up to 24% of cases.