An overview of the use and misuse/abuse of opioid analgesics in different world regions and future perspectives.

Opioids are an important therapeutic option for severe resistant chronic pain but, in the absence of proper oversight, their use has risks. The level of prescription opioid misuse/abuse differs among countries, due to differences in healthcare systems and pain management approaches. However, evaluating the true dimension of prescription opioid misuse/abuse is complicated by statistical reporting which often does not differentiate between prescription and illicit opioid use, or between prescription opioid use by patients and nonpatients, highlighting a need for greater uniformity.

Localised neuropathic pain in the primary care setting: a cross-sectional study of prevalence, clinical characteristics, treatment patterns, quality of life and sleep performance.

Background: Localised Neuropathic Pain (LNP) is challenging to diagnose and manage in primary care.

Objective: To describe clinical characteristics, treatment patterns, quality of life and sleep performance of patients with LNP and estimate its prevalence in primary care.

Methods: Cross-sectional study in 4 European countries.

Diagnostic accuracy of an identification tool for localized neuropathic pain based on the IASP criteria.

Objective: Based on the clear neuroanatomical delineation of many neuropathic pain (NP) symptoms, a simple tool for performing a short structured clinical encounter based on the IASP diagnostic criteria was developed to identify NP. This study evaluated its accuracy and usefulness.

Methods: A case-control study was performed in 19 pain clinics within Spain.

The 5% Lidocaine-Medicated Plaster: Its Inclusion in International Treatment Guidelines for Treating Localized Neuropathic Pain, and Clinical Evidence Supporting its Use.

When peripheral neuropathic pain affects a specific, clearly demarcated area of the body, it may be described as localized neuropathic pain (LNP). Examples include postherpetic neuralgia and painful diabetic neuropathy, as well as post-surgical and post-traumatic pain. These conditions may respond to topical treatment, i.

The topical 5% lidocaine medicated plaster in localized neuropathic pain: a reappraisal of the clinical evidence.

Topical 5% lidocaine medicated plasters represent a well-established first-line option for the treatment of peripheral localized neuropathic pain (LNP). This review provides an updated overview of the clinical evidence (randomized, controlled, and open-label clinical studies, real-life daily clinical practice, and case series). The 5% lidocaine medicated plaster effectively provides pain relief in postherpetic neuralgia, and data from a large open-label controlled study indicate that the 5% lidocaine medicated plaster is as effective as systemic pregabalin in postherpetic neuralgia and painful diabetic polyneuropathy but with an improved tolerability profile.

Is an easy and reliable diagnosis of localized neuropathic pain (LNP) possible in general practice? Development of a screening tool based on IASP criteria.

Background And Objective: Neuropathic pain (NP) is a common type of chronic pain in which 60% of patients present with localized symptoms. Early diagnosis of NP is often a challenge in primary care. Moreover, so far no standard diagnostic procedure for localized NP (LNP) is available.

Collaborative intervention to improve airway assessment and safety in management for anaesthesia: the Qualitat & Via Aèria (QUAVA) study.

Background: Airway assessment and management are cornerstones of anaesthesia, yet airway complications remain an important source of morbidity.

Objective: We performed a before-and-after evaluation of a collaborative intervention to improve adherence to airway assessment and management guidelines in patients scheduled for surgery under general anaesthesia.

Design: A prospective, multicentre before-and-after evaluation of a collaborative intervention.

Is interfascial block with ultrasound-guided puncture useful in treatment of myofascial pain of the trapezius muscle?

Objectives: Ultrasound-guided puncture is indispensable for the injection of local anesthetic in the interfascial space, the space between 2 muscle fasciae. Interfascial infiltration or block may be useful in treating myofascial pain in the trapezius muscle.

Methods: (1) In 5 cadavers, we studied the diffusion of a physiological saline and latex solution in the interfascial space of the upper muscles of the back, and performed a histological study of the fasciae.

5% lidocaine medicated plaster versus pregabalin in post-herpetic neuralgia and diabetic polyneuropathy: an open-label, non-inferiority two-stage RCT study.

Objective: To compare efficacy and safety of 5% lidocaine medicated plaster with pregabalin in patients with post-herpetic neuralgia (PHN) or painful diabetic polyneuropathy (DPN).

Study Design And Methods: This was a two-stage adaptive, randomized, open-label, multicentre, non-inferiority study. Data are reported from the initial 4-week comparative phase, in which adults with PHN or painful DPN received either topical 5% lidocaine medicated plaster applied to the most painful skin area or twice-daily pregabalin capsules titrated to effect according to the Summary of Product Characteristics.

Efficacy and safety of combination therapy with 5% lidocaine medicated plaster and pregabalin in post-herpetic neuralgia and diabetic polyneuropathy.

Objective: Neuropathic pain is often difficult to treat due to a complex pathophysiology. This study evaluated the efficacy, tolerability and safety of combination therapy with 5% lidocaine medicated plaster and pregabalin for neuropathic pain in patients with post-herpetic neuralgia (PHN) or painful diabetic polyneuropathy (DPN).

Methods: Patients completing 4-week monotherapy with 5% lidocaine medicated plaster or pregabalin were enrolled in an 8-week combination phase.

Efficacy and safety of 5% lidocaine (lignocaine) medicated plaster in comparison with pregabalin in patients with postherpetic neuralgia and diabetic polyneuropathy: interim analysis from an open-label, two-stage adaptive, randomized, controlled trial.

Background And Objective: Postherpetic neuralgia (PHN) and diabetic polyneuropathy (DPN) are two common causes of peripheral neuropathic pain. Typical localized symptoms can include burning sensations or intermittent shooting or stabbing pains with or without allodynia. Evidence-based treatment guidelines recommend the 5% lidocaine (lignocaine) medicated plaster or pregabalin as first-line therapy for relief of peripheral neuropathic pain.

Celiac plexus block: a new technique using the left lateral approach.

We describe a new celiac plexus block approach in a patient with cholangiocarcinoma who was referred to the Pain Clinic due to uncontrollable abdominal pain. The patient was initially programmed for a neurolytic celiac plexus block using the anterior approach with helical computerized tomography (CT) guidance. The CT scan revealed interposition of the transverse colon in the anterior approach territory, which made the anterior approach technique difficult, and also difficulty to practice the posterior approach without injuring the kidneys.

[Perioperative care and treatment of chronic pain in Catalonia, Spain].

Background And Objective: Perioperative care and chronic pain therapy are anesthesia practices that aim to improve patient safety and well-being. The purpose of this arm of the ANESCAT survey of anesthesia practices in Catalonia, Spain, in 2003 was to describe and quantify these 2 services.

Patients And Method: Taking relevant responses to the ANESCAT 2003 questionnaires, we analyzed type of preanesthetic assessment, use of specialized techniques for postoperative analgesia, and provision of postoperative critical care.

[Distribution of anesthesia practice, types of anesthesia, and human resources in Catalonia, Spain, in 2003].

Background And Objective: The aim of this arm of the ANESCAT 2003 study was to describe the temporal distribution and types of anesthesia used in Catalonia, Spain, in 2003, along with the associated human resources used.

Patients And Method: Data were used from a survey of 23,136 anesthetic procedures collected on 14 randomly selected days in 2003 and an individual questionnaire was completed by 765 anesthesiologists working in Catalonia.

Results: Anesthesia practice was divided into that associated with surgery (78.

[Epidemiology of anesthesia in Catalonia, Spain, in 2003].

Background And Objective: This article provides an epidemiological description of anesthesia practice in Catalonia, Spain, in 2003.

Patients And Method: Descriptive data on sex, age, and physical status of patients according to American Society of Anesthesiologists (ASA) classification were taken from responses to the questionnaire used in the ANESCAT 2003 survey. The results were extrapolated to the population of Catalonia in 2003 and the annual rates of anesthesia per 100 inhabitants calculated.