Intravenous Ketamine for Cancer Pain: A Single-Center Retrospective Analysis Comparing Fixed-Rate Versus Weight-Based Dosing.

Although weak evidence exists to support subanesthetic ketamine for cancer pain treatment, successful use may be hindered in the absence of standardized dosing guidance. We aimed to compare the success rates of intravenous ketamine fixed-rate versus weight-based dosing strategies for cancer pain treatment, and to assess patient characteristics that correlate with treatment success. We conducted a single-center retrospective review including non-critically ill adults with cancer pain who received subanesthetic ketamine for at least 24-h.

Risk Factors for the Development of Neuropsychiatric Adverse Effects in Ketamine-Treated Pain.

Ketamine use has increased recently for the management of acute and chronic pain. Ketamine can cause a variety of neuropsychiatric adverse effects, such as hallucinations, dysphoria, and nightmares. The objective of this study was to explore risk factors for the development of neuropsychiatric adverse effects in ketamine-treated pain.

Buprenorphine initiation strategies for opioid use disorder and pain management: A systematic review.

Buprenorphine possesses many unique attributes that make it a practical agent for adults and adolescents with opioid use disorder (OUD) and/or acute or chronic pain. Sublingual buprenorphine has been the standard of care for treating OUD, but its use in pain management is not as clearly defined. Current practice guidelines recommend a period of mild-to-moderate withdrawal from opioids before transitioning to buprenorphine due to its ability to displace full agonists from the μ-opioid receptor.

Buprenorphine Microdosing for the Pain and Palliative Care Clinician.

Buprenorphine (BUP) can be a safe and effective alternative to traditional opioids for many patients with chronic pain. For patients on higher doses of opioids, rotation to BUP is complicated by the requirement of an opioid-free interval or withdrawal during the transition. Microdosing inductions, in which BUP is gradually titrated, while full agonist opioids are continued, are a viable alternative to traditional inductions.

Strategies for Rotation between Gabapentinoids in the Inpatient Setting.

Guidance and evidence to support best practices in rotating between gabapentinoids is lacking. This retrospective cohort study was performed to describe and evaluate strategies for rotation. Patients rotated while admitted from June 1st, 2014 to April 25th, 2020 at a large, academic medical center were included.

Acetaminophen in Patients Receiving Strong Opioids for Cancer Pain.

The mainstay of treatment in advanced cancer pain is opioids; however, non-opioid medications such as acetaminophen continue to be included in guidelines despite a lack of clear, convincing evidence for their use. The aim of our study was to determine if acetaminophen improves pain control or reduces opioid utilization in hospitalized patients receiving strong opioids for cancer pain managed by the palliative care consult service (PCCS). We carried out at single-center retrospective cohort study of 194 adult cancer patients seen by the PCCS and who received strong opioids.

Sublingual Buprenorphine for Pediatric Cancer Pain: A Case Report and Review of the Literature.

Pain is a common symptom in pediatric patients with cancer, and most patients in palliative care will receive opioids. Traditional opioids have several drawbacks, including their adverse effects, inconsistent or diminishing efficacy, and limited available routes of administration. Buprenorphine is an attractive option for pain management because of its safety profile, unique pharmacology, and availability in transdermal, buccal, parenteral, and sublingual (SL) dosage forms.

Comparing Methadone Rotation to Consensus Opinion.

Context: Methadone is a complex but useful medication for pain management in palliative care. Recent expert opinions have been published on the safe and effective use of methadone.

Objectives: To determine the success of methadone rotations and evaluate concordance with consensus recommendations by a palliative care consult service.