Gabapentin in Infants: Critical Evaluation of a Novel Sedative/Analgesic Medication
Neonatal Netw. 2021 Jul 1;40(4):267-272. doi: 10.1891/11-T-687.ABSTRACTChronic pain and agitation can complicate the clinical course of critically ill infants. Randomized controlled trials of analgesia and sedation in neonatal intensive care have focused on relatively short durations of exposure. To date, clinicians have few options to treat chronic visceral pain and hyperalgesia. Gabapentin has emerged as a common therapy for a diverse group of pain syndromes and neurologic conditions in adults. In neonates, case reports and series describe the successful treatment of visceral hyperalgesia arising from gastrointestinal insults with or without concomitant neurologic morbidities. Additionally, a case report and series describe the utility of gabapentin for neonatal abstinence syndrome refractory to standard pharmacotherapy. The adverse effect profile of gabapentin, most notably bradycardia and sedation, compares favorably to alternative analgesics and sedatives. However, the long-term impacts of prolonged gabapentin therapy have not been studied. Therefore, candidates for therapy must be selected carefully, and response must be assessed objectively. Future studies must assess the short-term and long-term benefits and risks of gabapentin compared to standard therapies for chronic pain and agitation in infants and refractory neonatal abstinence syndrome.PMID:34330877 | DOI:10.1891/11-T-687
In conclusion, MK-801 induced antinociception effects for thermal stimuli in rats that were consistent with the decreased pain sensitivity observed in schizophrenia patients. Additionally, the amplified biphasic response exhibited by the MK-801 group in the formalin-induced spontaneous nociception test affirms the suitability of the test as a model of acute to delayed pain transition.
Conclusions: Of opioid-naive geriatric patients who underwent surgery for DSD, 0.3% developed chronic, continuous opioid use. Preoperative opioid use was the strongest predictor of prolonged utilization, which may represent suboptimal use of nonopioid alternatives, pre-existing opioid use disorders, delayed referral for surgical evaluation, or over-prescription of opioids for noncancer pain.
AbstractRheumatologic and musculoskeletal diseases (RMDs) are important causes of morbidity and mortality worldwide. The World Health Organization (WHO) considers musculoskeletal conditions to be the leading cause of disability worldwide, and the greatest independent contributors to chronic pain. Population-based surveys from low- and middle-income countries (LMICs) have demonstrated similar rates of RMDs compared with high-income countries.
MANY people with arthritis may experience chronic pain, and come to believe it is an inevitable part of their lives. Nonetheless, findings from a study suggest one simple lifestyle change, which may help to reduce joint pain.
Chronic pain conditions 40 demonstrate complex interactions between biological, psychological, environmental, and social factors, and their etiology and physiopathology remain obscure 19. In 2019, the International Association for the Study of Pain (IASP) defined two main types of pain, nociceptive and neuropathic, and established various criteria for their description. Concerning chronic nociceptive pain (NOCI), the trigger is an activation of the nociceptors, either at the surface of the body (i.e., skin) or at a deeper level (i.e., muscle, bones, joints, or tendons), without damage to the somatosensory nervous system.
BMI (body mass index), CLBP (chronic low back pain), CPR (clinical prediction rule), F8WT (Figure-of-Eight Walk Test), LBP (low back pain), NMES (neuromuscular electrical stimulation), PT (physical therapist), QBPDS (Quebec Back Pain Disability Scale), RCR (Repeated Chair Rise Test), SSGS (self-selected gait speed), 6MWT (Six Minute Walk Test), SC (Stair Climbing Test), SEM (Structural Equation Modeling), TUG (Timed Up-and-Go Test)
mer Adequate pain management, particularly chronic pain, remains a major challenge associated with modern-day medicine. Current pharmacotherapy offers unsatisfactory long-term solutions due to serious side effects related to the chronic administration of analgesic drugs. Morphine and structurally related derivatives (e.g., oxycodone, oxymorphone, buprenorphine) are highly effective opioid analgesics, mediating their effects via the activation of opioid receptors, with the mu-opioid receptor subtype as the primary molecular target. However, they also cause addiction and overdose deaths, which has led to a global opioid ...
Recurrence and persistence of low back pain (LBP) are major health [81,39] and economic [25,112,19] issues. Disappointingly, despite considerable efforts, outcomes are worsening . Understanding the etiological factors that underlie the transition from acute to recurrent/persistent LBP will likely aid reversal of this trend. Growing research points to involvement of a systemic inflammatory response. Studies have shown that inflammatory cytokines and mediators are systemically elevated in many chronic pain conditions, e.g., tumor necrosis factor (TNF) in chronic LBP [114,113], interleukin-6 (IL-6) in fibromyalgia , i...
Low back pain is a very common complaint and up to 84% of the adult population will suffer from it at some point in their lives. Degenerative disc disease has a strong relationship to chronic low back pain although it is mostly asymptomatic. Disc degeneration involves alterations to its microstructure, inability of the disc annulus and nucleous to share load, and loss of disc height. This could lead to conditions such as disc herniation, ligaments and facet joints hypertrophy and nerve compression.
ConclusionsPatients who have systemic lupus erythematous with high disease activity have the potential to develop fatal complications due to pancreatitis, so appropriate treatments are required for such patients.