Articles: pain.
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Usually, pain is caused by the excitation of nociceptors or of nociceptive afferent fibers. The responsiveness of the nociceptors can be modulated by endogenously released algesic substances or local hormones. Lesioned and regenerating nerve fibers show enhanced excitability and spontaneous activity. ⋯ Inhibition of spinal neurons, and analgesia, can be produced by stimulation of brain stem structures. Pharmacologically, pain inhibitory systems may involve serotonin and endogenous opioids as transmitter or modulator substances. For pain therapy, pain inhibitory systems may be activated e.g. by morphine and ther analgesic drugs, focal brain stimulation, various means of somatosensory afferent stimulation and by psychological influences such as stress.
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In a pain management program (200 patients), a group of daily users of oxycodone compound (29 patients) and a subgroup who were taking a "high dose" of oxycodone compound (13 patients) were compared with a group of 171 non-users of oxycodone compound. A significantly lower treatment success rate was observed in the users (P = 0.04) and high-dose users (P = 0.03). ⋯ Continued study of these findings is necessary. Meanwhile, in patients with chronic pain, there should be cautious use of this compound.