Articles: analgesics.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Randomized clinical trial of an implantable drug delivery system compared with comprehensive medical management for refractory cancer pain: impact on pain, drug-related toxicity, and survival.
Implantable intrathecal drug delivery systems (IDDSs) have been used to manage refractory cancer pain, but there are no randomized clinical trial (RCT) data comparing them with comprehensive medical management (CMM). ⋯ IDDSs improved clinical success in pain control, reduced pain, significantly relieved common drug toxicities, and improved survival in patients with refractory cancer pain.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Remifentanil vs morphine for patients in intensive care unit who need short-term mechanical ventilation.
This randomized, double-blind study compared the safety and efficacy of remifentanil (9 microg/ kg/h) with morphine (0.045 mg/kg/h plus a bolus dose of 0.025 mg/kg). One hundred and eighty nine Intensive Care Unit (ICU) patients with normal renal function or mild renal impairment requiring mechanical ventilation were included in this study. A pre-defined dosing algorithm permitted initial titration of the opioids to predetermine the optimal level of sedation and pain score. ⋯ The dosing algorithm facilitated rapid extubation in both groups. Remifentanil provided comparable hemodynamic stability to morphine, and was not associated with an increase in cardiovascular adverse event. Remifentanil is therefore considered to be effective and well tolerated in ICU patients.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Routine sucrose analgesia during the first week of life in neonates younger than 31 weeks' postconceptional age.
To determine the efficacy of sucrose analgesia for procedural pain during the first week of life in preterm neonates in neonatal intensive care units on enhancing later clinical outcomes. ⋯ Repeated use of sucrose analgesia in infants <31 weeks' PCA may put infants at risk for poorer neurobehavioral development and physiologic outcomes. Additional study is needed to determine the most appropriate age and duration of sucrose analgesia in preterm infants.
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Clinical therapeutics · Jul 2002
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialA randomized, double-blind, placebo-controlled comparison of the analgesic efficacy, onset of action, and tolerability of ibuprofen arginate and ibuprofen in postoperative dental pain.
Because of its enhanced pharmacokinetic characteristics, ibuprofen arginate might be expected to provide faster pain relief than standard ibuprofen formulations in patients experiencing acute pain. ⋯ Ibuprofen arginate was effective in this population of patients experiencing moderate to severe pain after surgical extraction of > or = 1 impacted third molar, with 16 to 24 minutes' faster time to meaningful pain relief than with ibuprofen. The 2 formulations had similar tolerability profiles.
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Br J Clin Pharmacol · Jun 2002
Randomized Controlled Trial Multicenter Study Clinical TrialAnalgesic efficacy of sustained release paracetamol in patients with osteoarthritis of the knee.
Paracetamol is widely recommended as the initial treatment for pain associated with osteoarthritis (OA). A sustained release (SR) paracetamol formulation (Panadol Extend) was compared with standard immediate release (IR) paracetamol (Panadol) in patients with knee pain secondary to OA. The primary parameter for assessment of efficacy was patient-assessed global pain relief as determined on day 8 of the treatment period. ⋯ SR paracetamol taken three times daily was statistically and therapeutically noninferior to IR paracetamol taken four times daily in patients with knee pain due to OA. SR paracetamol may be more convenient for patients with chronic pain and has the potential to enhance compliance and therefore pain relief.