Opioids are one of the standard therapies used in the management of chronic pain. They were first widely adopted for the treatment of chronic pain associated with cancer and are now considered important in the alleviation of non-cancer and neuropathic pain. Around-the-clock (ATC) medication has been found to be an effective approach in treating chronic pain. Guidelines issued by the American Pain Society (1999) note that in most cases the preferred route of administering opioids is oral, because of convenience, flexibility, and relative steadiness of the opioid concentrations in the blood. The advantages of ATC therapy and oral medication are some of the reasons for the development of controlled-release, oral formulations of opioids (e.g. morphine, oxycodone, hydromorphone, and hydrocodone). The reduced dosing frequency makes the oral medication more convenient for patients, making it easier for them to comply with the dosing regimen. ATC therapeutic coverage and the possible increased compliance afforded by controlled-release formulations can make opioids even more effective in managing chronic pain.
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http://dx.doi.org/10.1053/eujp.2001.0291 | DOI Listing |
Eur J Pain
February 2025
Department of Health Science and Technology, Center for Pain and Neuroplasticity (CNAP), SMI, School of Medicine, Aalborg University, Aalborg, Denmark.
Aim: Identify values that could predict the presence of increased pressure-pain sensitivity independent of the migraine cycle through a single assessment.
Methods: This was a secondary analysis of a previous study in which 198 episodic and chronic migraine patients were assessed during all phases of the migraine cycle. Pressure pain threshold (PPT) was assessed over the temporalis, cervical spine, hand, and leg.
Schmerz
January 2025
University Pain Center, University Hospital Carl Gustav Carus, Dresden, Germany.
In addition to the usual evaluation approach (usually a clinical randomized trial in the sense of the question: does an intervention work), complex interventions require further systematic investigations to prove their effectiveness. The role of the context in which the intervention is delivered is essential here, as is consideration of the question of why an intervention works (or does not work). Detailed recommendations exist for the planning and implementation of effectiveness studies on complex interventions, to which interdisciplinary multimodal pain therapy undoubtedly belongs.
View Article and Find Full Text PDFSchmerz
January 2025
UniversitätsSchmerzCentrum, Klinik für Anästhesiologie, Universitätsklinikum Carl Gustav Carus Dresden, Dresden, Deutschland.
In addition to the usual evaluation approach (usually a clinical randomized trial in the sense of the question: does an intervention work), complex interventions require further systematic investigations to prove their effectiveness. The role of the context in which the intervention is delivered is essential here, as is consideration of the question of why an intervention works (or does not work). Detailed recommendations exist for the planning and implementation of effectiveness studies on complex interventions, to which interdisciplinary multimodal pain therapy undoubtedly belongs.
View Article and Find Full Text PDFPsychol Trauma
January 2025
VA New England Mental Illness Research, Education and Clinical Center, VA Connecticut Health Care System.
Objective: To elucidate the relationship between impaired sleep duration and trauma/posttraumatic stress disorder (PTSD) net of sociodemographic, behavioral, and comorbid diagnostic factors.
Method: We investigated this relationship using the National Epidemiologic Survey on Alcohol and Related Conditions-III data set, analyzing a nationally representative sample of 36,309 adults. Our study identified three groups: those without trauma/PTSD, those with trauma but no PTSD, and those with PTSD.
Agri
January 2025
Division of Algology, Department of Physical Medicine and Rehabilitation, Marmara University Faculty of Medicine, İstanbul, Türkiye.
The superior hypogastric plexus (SHP) contains afferent nociceptive fibers from the pelvic structures, thus the SHP block is employed in the chronic pelvic pain (CPP) treatment in patients who do not respond to conservative treatments. A 60-year-old female patient, who did not respond to conservative treatment, underwent SHP neurolytic block after a successful diagnostic block. An excessive oblique angle approach was applied due to physical restrictions, the needle passed through the intervertebral disc resulting in the contralateral side SHP block, and the procedure was also repeated to the other side SHP.
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