The Use of Opioids for Treatment of Pediatric Neuropathic Pain: A Literature Review

Pediatric neuropathic pain is caused by a spectrum of disorders that are generally challenging to treat. Many of the underlying altered neurological processes are being elucidated through mechanistic studies. Few randomized control trials have evaluated the use of opioids for the treatment of adult neuropathic pain conditions, and there have been none in pediatric populations. With sparse data to provide guidance and an incomplete understanding of the underlying mechanisms, the use of opioids remains unclear. Our clinical experience and typical risk versus benefit considerations suggest a limited, if any, role for using opioids to treat pediatric neuropathic pain. In this literature review, we review the available adult and pediatric data and provide general guidance on this subject matter.
Source: The Clinical Journal of Pain - Category: Anesthesiology Tags: Special Topic Series on Opioid Therapeutics and Concerns in Pediatrics Source Type: research

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Authors: Licciardone JC, Schmitt ME, Aryal S Abstract Context: Comparisons of osteopathic physicians (ie, DOs) and allopathic physicians (ie, MDs) on interpersonal manner, including empathy and communication style, have been limited by such methodologic issues as self-assessment and a focus on medical students rather than practicing physicians. Objective: To compare perceptions of the interpersonal manner, empathy, and communication style of DOs and MDs and corresponding clinical measures reported by their patients. Methods: A cross-sectional study of adults with subacute or chronic low back pain was conduc...
Source: Journal of the American Osteopathic Association - Category: Complementary Medicine Tags: J Am Osteopath Assoc Source Type: research
Authors: Singh JR, Ibraheem K, Jain D, Yogendra K Abstract EBV associated nervous system complications includes encephalitis, meningitis, cerebellitis, polyradiculomyelitis, transverse myelitis, cranial and peripheral neuropathies, and psychiatric abnormalities are usually more commonly seen in immunocompromised patients and rarely in immunocompetent patients. Here we are reporting a 13 years old boy developed headache, malaise, sore throat and low back pain with radiation to both lower limbs. Next day he felt numbness below umbilicus followed by acute onset weakness in both lower limbs and urinary retention. Motor...
Source: Journal of the Association of Physicians of India - Category: General Medicine Tags: J Assoc Physicians India Source Type: research
Authors: Bhushan D, Kumar R PMID: 31304717 [PubMed - in process]
Source: Journal of the Association of Physicians of India - Category: General Medicine Tags: J Assoc Physicians India Source Type: research
ConclusionsThe results confirm both the traditional use of O. campechianum and the importance of the leaf infusion as a potential source of antihyperglycemic agents. The isolation of 5-demethyl nobiletin (1) and 5-demethyl sinensetin (2) from O. campechianum and other Ocimum spp. suggests that polymethoxyflavones can be considered chemotaxonomical markers for the genus.Graphical abstract
Source: Journal of Ethnopharmacology - Category: Drugs & Pharmacology Source Type: research
Publication date: Available online 15 July 2019Source: Anaesthesia Critical Care &Pain MedicineAuthor(s): Baptiste Deletombe, Thibaut Trouve-Buisson, Alexandre Godon, Dominique Falcon, Lise Giorgis-Allemand, Pierre Bouzat, Jean-Luc Bosson, Jean-Francois PayenAbstractBackground: Although non-invasive ventilation (NIV) is recommended in patients with chest trauma, this procedure may expose to discomfort and even failure due to agitation or excessive pain. We tested the impact of dexmedetomidine on the duration of the first session of NIV.Methods: This randomised, crossover study enrolled 19 patients with blunt chest trau...
Source: Anaesthesia, Critical Care and Pain Medicine - Category: Anesthesiology Source Type: research
Randomised Trial of Fentanyl Anesthesia in Preterm Babies Undergoing Surgery: Effects on the Stress Response. By Anand KJ, Sippell WG, and Aynsley-Green A. Lancet 1987; 1:243 –8. Reprinted with permission. In a randomised controlled trial, preterm babies undergoing ligation of a patent ductus arteriosus were given nitrous oxide andd-tubocurarine, with (n = 8) or without (n = 8) the addition of fentanyl (10 μg/kg intravenously) to the anesthetic regimen. Major hormonal responses to surgery, as indicated by changes in plasma adrenaline, noradrenaline, glucagon, aldosterone, corticosterone, 11-deoxycorticosterone, an...
Source: Anesthesiology - Category: Anesthesiology Source Type: research
“[Can] human pain models… facilitate the translation of mechanism-based targets identified in animal models to clinically effective drugs[?]”
Source: Anesthesiology - Category: Anesthesiology Source Type: research
Conclusions A system-wide initiative combining guideline dissemination with audit and feedback was effective in significantly decreasing opioid prescriptions in populations undergoing total knee arthroplasty, while minimally impacting pain scores.
Source: Anesthesiology - Category: Anesthesiology Source Type: research
Conclusions This study shows that low-dose (30-mg) dextromethorphan is antihyperalgesic in humans on the areas of primary and secondary hyperalgesia and reverses peripheral and central neuronal sensitization. Because dextromethorphan had no intrinsic antinociceptive effect in acute pain on healthy skin,N-methyl-d-aspartate receptor may need to be sensitized by pain for dextromethorphan to be effective.
Source: Anesthesiology - Category: Anesthesiology Source Type: research
Source: Journal of Pain Research - Category: Anesthesiology Tags: Journal of Pain Research Source Type: research
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