Relationship between Onset of Pain Relief and Patient Satisfaction with Fentanyl Pectin Nasal Spray for Breakthrough Pain in Cancer

2014 ◽  
Vol 17 (10) ◽  
pp. 1150-1157 ◽  
Author(s):  
Luis M. Torres ◽  
Julia Revnic ◽  
Alastair D. Knight ◽  
Michael Perelman
Keyword(s):  
Patient Satisfaction ◽  
Pain Relief ◽  
Nasal Spray ◽  
Breakthrough Pain

Relationship between time to onset of relief and total pain relief of breakthrough pain in patients with cancer using fentanyl pectin nasal spray.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e19544-e19544
Author(s):  
John D. Conroy ◽  
Luis M. Torres ◽  
Julia Revnic ◽  
Ravi Tayi ◽  
Michael Sidney Perelman ◽  
...  
Keyword(s):  
Pain Relief ◽  
Pain Intensity ◽  
Nasal Spray ◽  
Breakthrough Pain ◽  
Controlled Trial ◽  
Rapid Onset ◽  
Dose Titration ◽  
Total Pain ◽  
Time To Onset ◽  
The Relationship

e19544 Background: Breakthrough pain in cancer (BTPc) is typified by a rapid onset of severe pain with a limited duration. Treatment for BTPc requires rapid onset of pain relief. The main purpose of this analysis was to assess the relationship between time to onset of pain relief and overall pain relief in patients treating BTPc with fentanyl pectin nasal spray (FPNS, Lazanda, PecFent). Methods: Data were pooled from FPNS-treated episodes of 2 randomized, double-blind, crossover studies assessing efficacy of FPNS in adults who experienced BTPc despite background pain that was adequately controlled with at least 60 mg/day morphine (or equivalent). Patients initially entered a dose-titration phase to establish dose of FPNS (100 to 800 mcg) to be used during the treatment phase of each study. Pain intensity (PI) was assessed at baseline and scheduled time points on an 11-point scale (0=no pain, 10=worst possible pain). This analysis assessed the relationship of time to onset of pain relief (≥1 point reduction in PI from baseline) to total pain relief (Summed Pain Intensity Difference [SPID] at 30 and 60 min postdose [SPID30 and SPID60]) by ANOVA. Responses are also provided for the placebo-treated episodes during the placebo-controlled trial. Results: There were 831 episodes of BTPc that were treated with FPNS. Mean SPID was highest when pain relief was earliest (p<0.001). When PI difference (PID) ≥1 was attained by 5, 10, and 15 min postdose, mean (SD) SPID30 scores were 13.1 (6.7), 7.6 (4.0), and 3.5 (1.8). In the placebo-controlled trial, a similar overall response (p<0.001) was observed during the 200 placebo-treated episodes: among those attaining PID ≥1 by 5, 10, and 15 min postdose, SPID30 was 12.2 (7.0), 5.3 (3.3), and 2.5 (1.0), respectively. Similarly, significant differences were observed for SPID60 with both treatments. Conclusions: Earlier time to onset of pain intensity reduction in BTPc treatment resulted in higher SPID at 30 and 60 minutes postdose of FPNS and placebo. Results suggest that early onset of relief may be associated with a greater overall degree of relief for episodes of BTPc, which emphasizes the need for rapid-acting agents in the management of breakthrough pain.

scholarly journals Comparison of 3 Approaches to Percutaneous Epidural Adhesiolysis and Neuroplasty in Post Lumbar Surgery Syndrome

2018 ◽  
Vol 1 (21;1) ◽  
pp. E501-E508
Author(s):  
Haitham Hamdy Salem
Keyword(s):  
Patient Satisfaction ◽  
Pain Relief ◽  
Group Analysis ◽  
Pain Severity ◽  
University Hospital ◽  
Pain Clinic ◽  
Complication Rates ◽  
Lumbar Surgery ◽  
Time Intervals ◽  
Number Of Patients

Background: Percutaneous epidural adhesiolysis and neuroplasty (PEAN) has been proven to be safe and effective in treating different spine pathologies, in particular post lumbar surgery syndrome (PLSS). Objectives: The purpose of this study was to compare the efficacy and complication rates of the 3 different PEAN anatomical approaches (caudal, S1 foraminal, and L5-S1 transforaminal) used to treat PLSS. Study Design: This study used a case control, blind study. Setting: The research took place at the pain clinic and interventional pain practice room at Asyut University Hospital, Assiut, Egypt. Methods: Sixty consecutive PLSS patients were recruited and randomized into 3 groups (caudal, S1 foraminal, and L5-S1 transforaminal) before receiving adhesiolysis and neuroplasty. All patients underwent nerve conduction studies and magnetic resonance imaging (MRI). Pain severity levels were assessed and measured using the Oswestry Disability Questionnaire (OSW) and the Visual Analog Scale (VAS). Patient satisfaction was evaluated using a Likert scale. The first assessment was performed prior to the procedure to determine the patients’ baseline levels of pain severity. Followup assessments were performed 1-, 3-, and 6-months after the procedure. Results: Results of the group pairwise analysis indicated that, relative to baseline, there were significant decreases in pain relief scores (VAS and OWS) and functional assessment expressed by patients’ satisfaction across all time intervals and in all 3 groups (P < 0.01). Conversely, a between group analysis revealed that VAS, OWS, and patient satisfaction scores were comparable across the 3 groups at all time intervals (P > 0.05). There were no differences in rates of complications between the 3 different groups. Limitations: Our study was limited by the low number of patients and the short duration (6 months) of follow-up. Conclusion: The 3 anatomical approaches (caudal, S1 foraminal, and L5-S1 transforaminal) result in the same outcome with regard to pain relief and complication rate. Key words: Post lumber surgery syndrome, post laminectomy back pain, percutaneous adhesiolysis, Racz catheter, percutaneous neuroplasty

scholarly journals Patient-controlled epidural analgesia for labor – a step forward in Ukrainian obstetrics

Pain medicine ◽  
2019 ◽  
Vol 4 (3) ◽  
pp. 67-70
Author(s):  
Yevhenii Grizhimalsky ◽  
Andrii Harha
Keyword(s):  
Patient Satisfaction ◽  
Pain Relief ◽  
Epidural Analgesia ◽  
Local Anesthetics ◽  
Gold Standard ◽  
Severe Pain ◽  
Labour Pain ◽  
Randomized Controlled ◽  
Randomized Controlled Studies

Labour pain is recognized by some women as the most severe pain that they have ever felt in their life. Epidural analgesia is an effective method of pain relief in labour and is considered as the gold standard of analgesia for delivery. Traditionally, epidural analgesia in Ukraine is performed without the ability for the patient to control the process of anesthesia. The authors became interested in the delivery of local anesthetics by patient­controlled epidural analgesia instead of the traditional physician methods. In randomized controlled studies there is an evidence that the PCEA method tends to improve the quality of pain relief and increase the patient satisfaction.

Ultrasound-guided anterior and posterior quadratus lumborum block for analgesia after laparoscopic hysterectomy

2021 ◽  
Vol 11 (1) ◽  
pp. 5-8
Author(s):  
Neha Singh ◽  
Parnandi Bhaskar Rao ◽  
Anirudh Elayat
Keyword(s):  
Patient Satisfaction ◽  
Postoperative Pain ◽  
Pain Relief ◽  
Laparoscopic Hysterectomy ◽  
Multimodal Analgesia ◽  
Total Laparoscopic Hysterectomy ◽  
Opioid Consumption ◽  
Ultrasound Guided ◽  
Analog Scale ◽  
Quadratus Lumborum

Aim: Laparoscopic procedures are now preferred over open surgeries, and total laparoscopic hysterectomy is becoming increasingly popular. Quadratus lumborum (QL) block is an evolving technique for abdominal surgeries that blocks T5–L1 nerve branches. Methods: We used a combination of anterior and posterior QL block given bilaterally in two patients and evaluated perioperative opioid consumption, postoperative pain score and patient satisfaction. Results: There was reduced perioperative opioid consumption along with postoperative visual analog scale for pain over the first 24 h. Both patients appreciated the level and standard of pain relief. Conclusion: QL block is promising as a part of multimodal analgesia for laparoscopic abdominal surgeries. Further studies are needed to determine the best possible combination of different approaches to QL block.

Zolmitriptan Nasal Spray 5 mg Has a Very Fast Onset of Action and Provides Sustained Pain Relief in the Treatment of Migraine

Headache Care ◽  
2004 ◽  
Vol 1 (4) ◽  
pp. 261-266
Author(s):  
Andrew J. Dowson ◽  
Marek Gawel ◽  
Bruce R. Charlesworth ◽  
Nick Syrett ◽  
Graham Wilson ◽  
...  
Keyword(s):  
Pain Relief ◽  
Nasal Spray ◽  
Onset Of Action ◽  
Fast Onset ◽  
Zolmitriptan Nasal Spray

Resection Arthroplasty of the Metacarpophalangeal Joints in Rheumatoid Arthritis

1995 ◽  
Vol 20 (5) ◽  
pp. 707-715 ◽  
Author(s):  
W. RÜTHER ◽  
B. VERHESTRAETEN ◽  
B. FINK ◽  
K. TILLMANN
Keyword(s):  
Rheumatoid Arthritis ◽  
Patient Satisfaction ◽  
Retrospective Study ◽  
Pain Relief ◽  
Wrist Joint ◽  
Resection Arthroplasty ◽  
Full Extension ◽  
Active Motion ◽  
Ulnar Deviation ◽  
Careful Patient

In a retrospective study of resection arthroplasty of the MP joints in rheumatoid arthritis, 23 patients (32 hands, 128 joints) have been followed for 15 to 22 years. Patient satisfaction was high, and all patients had significant pain relief. Active motion of the joints averaged 35°, ranging from full extension to 35° of flexion. Ankyloses developed in five hands (13 joints, 10%). Ulnar deviation of more than 15° occurred in six patients (ten hands, 30%). Over the course of several years a significant remodelling of the joints was to be observed. In six hands (19%) the metacarpal heads became spontaneously restored to ball-shaped geometry. Gross metacarpal resorption was observed in nine hands (30%), causing significant shortening of the metacarpals. In one-third of patients the final result was rated as good, fair and poor, respectively. Careful patient selection is mandatory. Patients with mutilating arthritis should be excluded from the procedure; rheumatoid destruction of the wrist joint definitely influences the final result.

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