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Comparison of Postoperative Pain in 70 Women with Breast Cancer Following General Anesthesia for Mastectomy with and without Serratus Anterior Plane Nerve Block.

BACKGROUND [color=black]This study was conducted at a single center and aimed to compare postoperative pain in 70 women with breast cancer following general anesthesia for mastectomy with and without serratus anterior plane (SAP) block.[/color] MATERIAL AND METHODS [color=black]A total of 70 breast cancer patients who met the criteria were randomly divided into the general anesthesia combined with SAP block group (group S) and the general anesthesia only group (group G). Perioperative anesthetic drug dosage, the visual analog scale (VAS) score at different time points, and the patient's satisf

Pilot clinical and pharmacokinetic study of Δ9-Tetrahydrocannabinol (THC)/Cannabidiol (CBD) nanoparticle oro-buccal spray in patients with advanced cancer experiencing uncontrolled pain.

This pilot study aimed to assess the safety, tolerability, pharmacokinetics and exploratory analgesic effect of a novel water-soluble oro-buccal nanoparticle spray of a cannabis-based medicine (MDCNS-01) in patients with advanced incurable malignancy with unrelieved pain from opioid analgesic. The study was a non-blinded single arm 2 stage study. Stage I was a single escalating dose (n = 5) [2.5 mg Δ9-THC and 2.5 mg CBD) versus a 3-fold escalated dose. Stage II was an up-titrated dose in patients with advanced cancers and intractable pain (n = 25). During Stage I with an increased cannabis-bas

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… There is significant interest in the use of cannabis for the management of chronic cancer or non-cancer pain [ 26 , 27 ] irrespective of any adverse outcomes that have been reported. … Efficacy, tolerability and safety of cannabis-based medicines for cancer pain: A systematic review with meta-analysis of randomised controlled trials . Schmerz . 2019 ; 33 ( 5 ): 424 – 36 . …

Post-prostatic-massage urine exosomes of men with chronic prostatitis/chronic pelvic pain syndrome carry prostate-cancer-typical microRNAs and activate proto-oncogenes.

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) has a high prevalence of up to 15% and accounts for 90-95% of prostatitis diagnoses, and yet its etiopathogenesis and link to prostate cancer (PCa) are still unclear. Here, we investigated microRNAs in exosomes isolated from blood and post-prostatic-massage urine of CP/CPPS type IIIb patients and healthy men. THP-1 monocytes (human leukemia monocytic cell line) were treated with exosomes and subjected to mRNA arrays "Cancer Inflammation and Immunity Crosstalk" and "Transcription Factors." Using The Cancer Genome Atlas, the expression o

Prevalence of Myofascial Pain Syndrome and Efficacy of Trigger Point Injection in Patients with Incurable Cancer: A Multicenter, Prospective Observational Study (MyCar Study).

OBJECTIVE: Myofascial pain syndrome (MPS) is caused by overload or disuse of skeletal muscles. Patients with cancer are often forced to restrict their movement or posture for several reasons. The study was conducted to investigate the prevalence and risks of MPS in patients with incurable cancer. The efficacy of trigger point injection (TPI) was also explored. METHODS: This was a multicenter, prospective observational study. Patients with incurable cancer who started receiving specialist palliative care were enrolled. We investigated the MPS in this population and accompanying risk factors fo

Chronic pain severity, impact, and opioid use among patients with cancer: An analysis of biopsychosocial factors using the CHOIR learning health care system.

BACKGROUND: Despite the biopsychosocial underpinnings of chronic noncancer pain, relatively little is known about the contribution of psychosocial factors to chronic cancer pain. The authors aimed to characterize associations between biopsychosocial factors and pain and opioid use among individuals with chronic pain and cancer. METHODS: The authors conducted a retrospective, cross-sectional study of 700 patients with chronic pain and cancer seeking treatment at an academic tertiary pain clinic. Patients completed demographic questionnaires and validated psychosocial and pain measures. Multiva…

EUS-guided celiac ganglion radiofrequency ablation versus celiac plexus neurolysis for palliation of pain in pancreatic cancer: a randomized controlled trial (with videos).

BACKGROUND AND AIMS: Although EUS-guided celiac plexus neurolysis (EUS-CPN) is frequently performed, its efficacy for palliation of pain in pancreatic cancer is suboptimal. Recently, EUS-guided radiofrequency ablation (EUS-RFA) has been proposed as a palliative treatment option for pancreatic neoplasms. We performed a single-blind, randomized trial to compare the effectiveness of EUS-CPN and EUS-RFA for palliation of pain in pancreatic cancer. METHODS: Patients with abdominal pain because of locally advanced or metastatic pancreatic cancer underwent EUS-CPN (n = 14) or EUS-RFA (n = 12). EUS-R

Body mass index and persistent pain after breast cancer surgery: findings from the women's healthy eating and living study and a meta-analysis.

BACKGROUND: The need for classification systems for cardiovascular disease (CVD) that is population-specific is important towards understanding the clinical disease and diagnostics associated with the disease. This paper presents the form and validation results of this classification system. METHOD: The survey data used was captured from 778 participants, 526 persons with no prior CVD, and 252 who reported prior CVD. Binomial logistic regression and Discriminant analysis were utilised to develop classification models. This classification system provided a general measure of severity of diseas

Efficacy of Prophylactic Treatment for Oxycodone-Induced Nausea and Vomiting Among Patients with Cancer Pain (POINT): A Randomized, Placebo-Controlled, Double-Blind Trial.

BACKGROUND: Although opioid-induced nausea and vomiting (OINV) often result in analgesic undertreatment in patients with cancer, no randomized controlled trials have evaluated the efficacy of prophylactic antiemetics for preventing OINV. We conducted this randomized, placebo-controlled, double-blind trial to evaluate the efficacy and safety of prophylactic treatment with prochlorperazine for preventing OINV. MATERIALS AND METHODS: Cancer patients who started to receive oral oxycodone were randomly assigned in a 1:1 ratio to receive either prochlorperazine 5 mg or placebo prophylactically, giv

Agreement between definitions of pharmaceutical opioid use disorders and dependence in people taking opioids for chronic non-cancer pain (POINT): a cohort study.

BACKGROUND: Classification of patients with pharmaceutical opioid use disorder and dependence varies depending on which definition is used. We compared how WHO's ICD-10 and proposed ICD-11 and the American Psychiatric Association's DSM-IV and DSM-5 classified individuals in a community-based sample of Australians with chronic non-cancer pain for which opioids have been prescribed. METHODS: We studied participants in the Pain and Opioid IN Treatment (POINT) cohort, a 2 year prospective cohort study of 1514 people prescribed pharmaceutical opioids for their chronic pain who were recruited in 20…

Systematic literature review and meta-analysis of the efficacy and safety of prescription opioids, including abuse-deterrent formulations, in non-cancer pain management.

OBJECTIVE: This study was conducted to compare safety and efficacy outcomes between opioids formulated with technologies designed to deter or resist tampering (i.e., abuse-deterrent formulations [ADFs]) and non-ADFs for commonly prescribed opioids for treatment of non-cancer pain in adults. METHODS: PubMed and Cochrane Library databases were searched for opioid publications between September 1, 2001 and August 31, 2011, and pivotal clinical trials from all years; abstracts from key pain conferences (2010-2011) were also reviewed. One hundred and ninety-one publications were initially identifi…

Clinical effectiveness and safety of OROS® hydromorphone in break-through cancer pain treatment: a multicenter, prospective, open-label study in Korean patients.

OBJECTIVE: To evaluate the effectiveness of OROS® hydromorphone in reducing breakthrough pain (BTP) medication frequency in Korean patients with chronic cancer pain. SETTINGS AND DESIGN: Multicenter, prospective, open-label, phase IV study. PARTICIPANTS: Patients with chronic malignant pain using immediate-release oxycodone more than two times per day for BTP. INTERVENTIONS: Patients were stabilized on their ongoing drug for 3 days immediately before baseline measurements (day 0). Medication was changed to OROS® hydromorphone at a dose equianalgesic to oxycodone using a 2.5:1 controlled-rel…

Population pharmacokinetics of oral morphine and its glucuronides in children receiving morphine as immediate-release liquid or sustained-release tablets for cancer pain.

OBJECTIVES: (1) To determine the pharmacokinetics of morphine, morphine-6-glucuronide (M6G), and morphine-3-glucuronide (M3G) in children wi … ng dose of 1.5 to 2. 0 mg/kg/d to provide plasma morphine concentrations >12 ng/mL in children with cancer pain unrelieved by mild to moderate strength analgesia.

Intravenous high-dose methadone administered by patient controlled analgesia and continuous infusion for the treatment of cancer pain refractory to high-dose morphine.

The management of severe tumor-related pain in the patient with cancer may be problematic. Systemically administered opioids remain the cornerstone of treatment for moderate to severe cancer pain, while parenteral routes should be considered for patients who require rapid onset of analgesia, and for highly tolerant patients whose dose requirements cannot be conveniently administered. The use of intravenous methadone by patient controlled analgesia (PCA) is attractive for the management of severe, intractable cancer pain and may offer some advantages over morphine. We describe the safe and effe…

Effects of resistance training on quality of life, fatigue, and pain in patients undergoing cancer treatment: A systematic review and dose-response meta-analysis.

BACKGROUND: Cancer remains a major global health problem, with multiple treatment modalities generating side effects that can be managed through resistance exercise. OBJECTIVE: The objective was to determine the effects of resistance training (RT) on quality of life (QoL), fatigue, and pain in patients undergoing cancer treatment and to determine the prescription of exercise programs. METHODS: We searched in PubMed, Web of Science, CINAHL and SCOPUS databases for randomized clinical trials (RCTs) of RT in patients with any type of cancer undergoing any cancer therapy. ROB2 and GRADE were use

Comparison of the Effects of Intraoperative Pectoral Nerve Block and Local Wound Infiltration in Pain Management for Breast Cancer Surgery: A Randomized Controlled Trial.

PURPOSE: To evaluate the postoperative analgesic effects and opioid-sparing benefits of the intraoperative surgeon-performed pectoral nerve (PECS) block technique in mastectomy patients, compared with traditional local infiltration anesthesia. DESIGN: The research is a randomized controlled clinical trial. METHODS: Participants were randomly assigned to two groups: the PECS group, which received PECS I and II and a serratus plane block, and the control group, which received local infiltration anesthesia. After surgical resection, the PECS group received 0.5% bupivacaine around the pectoralis

Efficacy of oral tapentadol immediate-release for the management of moderate-to-severe cancer pain in patients presenting to the oncology ward of a tertiary care hospital.

OBJECTIVES: To assess the efficacy and determine an effective dosing range of oral tapentadol immediate-release (IR) for managing chronic, moderate-to-severe pain in cancer patients in Pakistan, where extended-release formulations are not readily available. METHODOLOGY: This dose-response study was conducted at the Department of Medical Oncology, JPMC, Karachi over a one-week period. Forty-five patients were given 75 mg BID of oral tapentadol IR and the medication was titrated as necessary to achieve optimum analgesic effects. Pain before and after one week of commencing the medication was as

Development of a self-management manual for patients with refractory cancer pain treated with a semi-implantable intrathecal drug delivery system: a Delphi study.

OBJECTIVE: The aim of this study was to develop a self-management manual for individuals with refractory cancer pain treated with a semi-implantable intrathecal drug delivery system (IDDS), using the Delphi method. METHODS: An initial draft of the self-management manual was developed through a comprehensive literature review and expert panel discussions. The Delphi method was used to conduct two rounds of expert consultations with a total of 23 experts covering pain management, oncology, palliative care, and oncology nursing aimed at refining and finalizing the content of the manual, which fu…

Dilated Gallbladder Causing Right Iliac Fossa Pain in a Patient with Advanced Pancreatic Cancer: A Diagnostic and Symptom Management Challenge at End of Life.

INTRODUCTION: Gallbladder distension secondary to malignant biliary obstruction is an under-recognized cause of abdominal pain in advanced pancreatic cancer and may present atypically outside the right upper quadrant. Pain assessment can be further complicated in older adults with cognitive impairment and superimposed delirium. CASE PRESENTATION: We present an 83-year-old female with locally advanced pancreatic adenocarcinoma and baseline cognitive impairment, admitted to an acute tertiary hospital with painless jaundice. She subsequently developed persistent right iliac fossa pain that was p

The determination of the effect of music on pain, anxiety, and vital findings in cancer patients treated in palliative care centres: a cluster quasi-experimental study.

AIM: This study aimed to determine the effect of a single-session music intervention on pain intensity, state anxiety, and vital signs in cancer patients receiving palliative care. BACKGROUND: While music therapy is recognized as a non-pharmacological complementary tool, its simultaneous effect on both physiological and psychological parameters requires robust methodological evaluation within specific palliative care settings. METHODS: A cluster quasi-experimental pre-test/post-test control group design was conducted across two palliative care centres. The sample comprised 32 patients (Inter

Respiratory muscle training reduces painful swallowing and opioid use during radiation therapy for head and neck cancer: a matched pair analysis.

BACKGROUND: Patients with head and neck cancer (HNC) receiving radiation therapy (RT) are at increased risk for symptoms of oral mucositis (OM), opioid use, and declines in physical function, outcomes that contribute to increased morbidity and mortality. The study objective was to determine the effects of respiratory muscle training (RMT) on OM and opioid use, as well as functional performance in patients with HNC receiving RT with or without concurrent chemotherapy (CCRT). METHODS: Patients aged ≥ 18 years of age with stage I to IV HNC being treated with RT or CCRT receiving a home-based res