This cross-sectional study aimed to investigate cancer patients'cognitive level of pain control and to evaluate the patient-related factors or barriers to effective cancer pain management in China.In seven tertiar...This cross-sectional study aimed to investigate cancer patients'cognitive level of pain control and to evaluate the patient-related factors or barriers to effective cancer pain management in China.In seven tertiary hospitals across China,372 patients experiencing cancer pain were surveyed through a self-designed questionnaire to assess the factors associated with effective pain control.Patients'demographic data and pain control-related factors were recorded.Cluster sampling and binary logistic regression models were used to investigate the association between predictive factors and effective pain control.The survey showed that the majority of the patients were more than 45 years old(76.3%),and 64.4%had an average annual income of more than 20000 RMB.One-third of the patients suffered from cancer pain for more than 3 months,and 75.1%received professional guidance during medication.The barriers to pain control for patients included preference to enduring pain and refusing analgesics(62.9%),negligence towards drug usage(28.5%),concerns about the addiction(48.2%)and adverse reaction(56.4%).The average annual family income,pro fessional guidance,knowledge of pain medication,adherence to analgesics,and concerns about addiction to analgesics were significantly correlated to the effect of patients'pain control.The study presents major barriers to optimal pain control among patients with cancer in China.Our findings suggest that educational programs and medical insurance reimbursement support from the government are urgently needed to overcome the cognitive barriers toward effective pain management and to relieve the economic burden among patients with cancer pain in China.展开更多
Introduction: Virtual reality (VR) utilizing a head-mounted display allows viewers to immerse themselves in a virtual environment. This technology may be useful in attenuating pain and anxiety and reducing patient sub...Introduction: Virtual reality (VR) utilizing a head-mounted display allows viewers to immerse themselves in a virtual environment. This technology may be useful in attenuating pain and anxiety and reducing patient subjective stress as well as objective physiological increase in heart rate and blood pressure. Aside from the improved experience, physiological stress is reduced which results in improved patient outcomes. Patients and methods: Eligible participants were all adults aged 18 or over who had non craniofacial lesions requiring minor surgery. A total of 99 adult patients who were capable of independent consent were randomized to receive a virtual reality experience (VR) or standard music distraction (no VR). Patients were recruited for the study during their office visit when scheduling minor procedure surgery. This was a single center, double-blind, controlled study conducted at Guthrie Clinic Robert Packer Hospital in Sayre, Pennsylvania between March 2019 to January 2020 (pre-pandemic). Ethics approval for this study was obtained from the Institutional Review Board of the Guthrie Clinic. Results: The change in systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) significantly decreased from pre-procedure to mid-procedure in the VR group compared with standard. Herein our results are presented. Conclusions: Reductions in intraprocedural SBP, DBP and HR can be achieved when using VR. Although subjective reporting of pain and anxiety were not different between groups, VR significantly improves patient satisfaction compared with non VR standards.展开更多
When designing a study on dental movement acceleration or pain control during orthodontic treatment,it is crucial to consider effective parameters.The objective of this editorial is to compile the most effective param...When designing a study on dental movement acceleration or pain control during orthodontic treatment,it is crucial to consider effective parameters.The objective of this editorial is to compile the most effective parameters supported by evidence that should be considered in future studies to achieve complete parameter homogenization.The protocol currently recommended to homogenize the parameters and facilitate the development of further meta-analysis in terms of acceleration of movement and pain control in orthodontics is Wavelength:810 nm,2.2 J per surface,0.1 W in continuous mode/0.1 W average power in a superpulsed,sweeping movement,1mm from the mucosa,22 seconds along the vestibular surface and 22 seconds along the lingual surface,the recommended speed of movement is 2 mm/sec,1 application during each orthodontic control,to achieve dental movement acceleration and repeat the dose at 24 h to ensure pain elimination.The energy density and power density will depend on the spot size used in the equipment and the distance from the mucosa.It will strengthen the evidence of photobiomodulation as the best therapy to accelerate tooth movement and at the same time control the pain produced by orthodontic treatments.展开更多
Over the last decades,the number of total knee arthroplasty procedures performed in the United States has been increasing dramatically.This very successful intervention,however,is associated with significant postopera...Over the last decades,the number of total knee arthroplasty procedures performed in the United States has been increasing dramatically.This very successful intervention,however,is associated with significant postoperative pain,and adequate postoperative analgesia is mandatory in order to allow for successful rehabilitation and recovery.The use of regional anesthesia and peripheral nerve blocks has facilitated and improved this goal.Many different approaches and techniques for peripheral nerve blockades,either landmark or,more recently,ultrasound guided have been described over the last decades.This includes but is not restricted to techniques discussed in this review.The introduction of ultrasound has improved many approaches to peripheral nerves either in success rate and/or time to block.Moreover,ultrasound has enhanced the safety of peripheral nerve blocks due to immediate needle visualization and as consequence needle guidance during the block.In contrast to patient controlled analgesia using opioids,patients with a regional anesthetic technique suffer from fewer adverse events and show higher patient satisfaction;this is important as hospital rank-ings and advertisement have become more common worldwide and many patients use these factors in order to choose a certain institution for a specific procedure.This review provides a short overview of currently used regional anesthetic and analgesic techniques focusing on related implications,considerations and outcomes.展开更多
Non-steroidal anti-inflammatory drugs like Ibupro- fen alleviate mild to moderate postoperative pain caused by the third molar extractions. Moreover, Acetaminophen is a non-opioid analgesic with anti-pyretic propertie...Non-steroidal anti-inflammatory drugs like Ibupro- fen alleviate mild to moderate postoperative pain caused by the third molar extractions. Moreover, Acetaminophen is a non-opioid analgesic with anti-pyretic properties, effective in relieving mild to moderate pain. On the other hand, recent studies have demonstrated that Caffeine also acts as an analgesic adjuvant when combined with Acetaminophen, Aspirin, or their mixture. The objective of study is to compare the efficacy of a combination of Ibuprofen 200 mg and Acetaminophen 325 mg plus Caffeine 40 mg with Ibuprofen 400 mg alone for relieving the pain after surgical removal of impacted mandibular third molar. 80 adult patients (56 females, 24 males) were randomly placed into two groups. Preoperative pain recorded prior to the surgery and compare with patients’ pain after the operation. According to findings, there was no significant relationship between preoperative and postoperative pain (P value > 0.05) and also between surgical trauma and postoperative pain (P value > 0.05). The mean pain showed a slight numerical superiority for the group which used Ibu-profen plus Acetaminophen plus Caffeine especially 3hours after surgery, but there was no significant difference between the two groups (P value = 0.073). In conclusion, combination of Ibuprofen plus aceta-minophen plus caffeine does not offer any clinical advantages compared with Ibuprofen for alleviating acute postoperative pain after third molar surgeries.展开更多
In this article,we evaluate the findings of the study by Qian et al,which explores the efficacy of combining hyperthermia with opioid therapy for enhanced cancer pain management in patients with middle and late-stage ...In this article,we evaluate the findings of the study by Qian et al,which explores the efficacy of combining hyperthermia with opioid therapy for enhanced cancer pain management in patients with middle and late-stage gastrointestinal tumors.The study undertakes a retrospective analysis comparing traditional opioid therapy to an integrated approach of hyperthermia and opioids across 70 patients,highlighting significant benefits in pain control,reduction of opioid dosage,and minimization of adverse reactions.In our article,we not only discuss these fin-dings but also emphasize the broader implications for clinical practice,parti-cularly in enhancing patient outcomes through innovative pain management strategies.We advocate for further research to establish more robust data su-pporting this approach and to explore the mechanistic insights that enable these benefits.This discussion reflects on the potential paradigm shift in managing debilitating cancer-related pain,urging a reevaluation of current practices to incorporate these findings effectively.展开更多
In this editorial,we comment on the article published in a recent issue of the World Journal of Orthopedics.Although substantial literature regarding pain management of acute musculoskeletal injury has been published ...In this editorial,we comment on the article published in a recent issue of the World Journal of Orthopedics.Although substantial literature regarding pain management of acute musculoskeletal injury has been published over the last three decades,there is still a lack of evidence-based protocol for individual and population disparities.This systematic review gives us a comprehensive view of the evidence-based use of opioid vs opioid-free analgesia.Nevertheless,there is still a need for further investigation at a high level regarding this topic.展开更多
Objective To study and verify the efficacy of acupuncture on depression caused by chronic pain and to further analyze the advantages of acupuncture. Methods According to random number table, the cases were randomized ...Objective To study and verify the efficacy of acupuncture on depression caused by chronic pain and to further analyze the advantages of acupuncture. Methods According to random number table, the cases were randomized into experimental group and western medicine group, treated with acupuncture and antidepression drug （deanxit） respectively. Hamilton Depressive Scale （HAMD） and Visual Analogue Scale （VAS） were adopted for the evaluation before treatment and in the 1, 2 and 4 weeks after treatment in two groups successively. Results ① Very significant differences had been achieved on the comparisons of HAMD, VAS and HAMD reducing rate before and after treatment in experimental group （P 〈 0.01）. Very significant differences had been achieved in the comparisons of HAMD, VAS and HAMD reducing rate before and after treatment in western medicine group （P 〈 0.01 ）. ③Significant differences in HAMD reducing rate^＊ and VAS score^＊ ＊ had been achieved in the comparison between experiment group and western medicine group 1 week after treatment （^＊ P〈0.01, ^＊ ＊ P〈0.05）. ④ The significant differences had not been received in HAMD, VAS score and HAMD reducing rate in 2 and 4 weeks after treatment in the comparison between experimental group and western medicine group （P 〉0.05）. ⑤ No any harmful effect happened in experimental group after treatment, but it happened in western medicine group. Conclusion Both acupuncture and deanxit have achieved the definite therapeutic effects on depression caused by chronic pain, with similar efficacy. But the effects of acupuncture are obtained more quickly. In comparison of western medicine, acupuncture has no side and harmful effect. Additionally, acupuncture applies the multi-targeting and holistic modulation to the whole body.展开更多
BACKGROUND The use of opioids for pain is linked to an increased risk of developing opioid use disorder,and has resulted in the emergence of the opioid crisis over the last few years.AIM The systematic review question...BACKGROUND The use of opioids for pain is linked to an increased risk of developing opioid use disorder,and has resulted in the emergence of the opioid crisis over the last few years.AIM The systematic review question is“How does the use of opioid medications in pain management,compared with non-opioid medications,affect pain intensity over the short,intermediate,and long-term in adults with acute traumatic pain?”.METHODS The protocol was prospectively registered on the International Prospective Re-gister of Systematic Reviews:CRD42021279639.Medline and Google Scholar were electronically searched for controlled peer-reviewed studies published in full,with the PICO framework:P:Adult patients with traumatic injuries,I:Opioid medications,C:Non-opioid medi-cations,O:A minimum clinically important difference(MCID)in pain.RESULTS After full-text screening,we included 14 studies in the qualitative synthesis.Of these 14 studies,12 were rando-mized clinical trials(RCTs)and 2 were pseudo-RCTs with a total of 2347 patients enrolled.There was heteroge-neity in both medication utilized and outcome in these studies;only two studies were homogeneous regarding the type of study conducted,the opioid used,its comparator,and the outcome explored.The MCID was evaluated in 8 studies,while in 6 studies,any measured pain reduction was considered as an outcome.In 11 cases,the setting of care was the Emergency Department;in 2 cases,care occurred out-of-hospital;and in one case,the setting was not well-specified.The included studies were found to have a low-moderate risk of bias.CONCLUSION Non-opioids can be considered an alternative to opioids for short-term pain management of acute musculoskeletal injury.Intravenous ketamine may cause more adverse events than other routes of administration.展开更多
<b><span>Introduction:</span></b><span> Blind fascia iliaca compartment block (FICB) and ultrasound guided femoral nerve block (FNB) are two types of peripheral nerve blocks, commonl...<b><span>Introduction:</span></b><span> Blind fascia iliaca compartment block (FICB) and ultrasound guided femoral nerve block (FNB) are two types of peripheral nerve blocks, commonly used in preoperative pain management in patients with hip fractures in Danish emergency departments. The aim of this study was to compare the efficacy </span><span>in pain management of </span><span>these two types of peripheral nerve blocks in the preoperative period in patients with hip fractures. </span><b><span>Method:</span></b><span> We performed a randomized controlled study. The primary outcome was the proportion of patients with a numeric rating scale (NRS) pain score equal to three or less at rest and after passive leg raise</span><span> </span><span>test</span><span> three hours after block administration. </span><b><span>Results:</span></b><span> A total of 88 patients were included in the study and 67 patients in the statistical analysis with 33 in the FICB group and 34 in the FNB group. The results showed a significant reduction in the proportion of patients with a</span><span>n</span><span> NRS score higher than three, three hours after administration of either FICB or FNB compared to at inclusion. There was no significant difference in pain scores between patients receiving FICB versus patients receiving FNB at rest or after passive leg raise (p = 0.25 and p = 0.86, respectively). </span><b><span>Conclusion:</span></b><span> Blind FICB and ultrasound guided FNB were effective in preoperative pain management in patients with hip fractures. The results showed that the two types of peripheral nerve blocks were equally </span><span>efficient</span><span> in providing pain management in the preoperative period.</span>展开更多
OBJECTIVE: To evaluate the effectiveness of acupuncture analgesia(AA) compared with combined spinal-epidural anesthesia(CSEA) for labor pain relief and labor outcomes.METHODS: We evaluated 131 primiparous women who re...OBJECTIVE: To evaluate the effectiveness of acupuncture analgesia(AA) compared with combined spinal-epidural anesthesia(CSEA) for labor pain relief and labor outcomes.METHODS: We evaluated 131 primiparous women who received respiratory guidance during maternal uterine contractions and received either AA(n =43), CSEA(n = 45), or no additional treatment(control, n = 43). The groups were compared regarding visual analog scale(VAS) scores for abdominal and back pain, and labor outcomes.RESULTS: The abdominal VAS scores of the AA and CSEA groups were significantly lower than that of the control group. In addition, the VAS scores of the CSEA group were significantly lower than that of the AA group at 10 and 60 min after intervention.The back pain VAS scores of the AA and CSEA groups were significantly lower than that of the control group at 5, 10, and 60 min after intervention. The duration of the active phase of labor in the CSEA group was significantly longer than that of the AA and control groups. The rates of oxytocin use(4.70%), urinary retention(4.70%), and postpartum hemorrhage [(273.7 ± 53.6) m L] in the AA group were significantly lower than in the CSEA group [46.70%, 24.20%, and(320.0 ± 85.6) m L, respectively].CONCLUSION: Both AA and CSEA were effective for labor pain relief, CSEA provided more effective pain relief, while AA was associated with a shorter duration of labor and fewer adverse effects.and each has its advantages and disadvantages.展开更多
BACKGROUND： Analgesic and wound-healing effects of cinnamon, a widely used spice, have been shown in laboratory rats. However, we found no human studies in this area. OBJECTIVE： The aim of this study was to assess t...BACKGROUND： Analgesic and wound-healing effects of cinnamon, a widely used spice, have been shown in laboratory rats. However, we found no human studies in this area. OBJECTIVE： The aim of this study was to assess the effect of cinnamon on perineal pain and healing of episiotomy incision. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS： In this double-blind, randomized, placebo-controlled trial, 144 postpartum women were allocated into two groups, using stratified block randomization, 1 h after completion of episiotomy repair. They received cinnamon or placebo ointment, 2 mL every 12 h for 10 d. MAIN OUTCOME MEASURES： Perineal pain and wound healing were assessed using visual analogue scale （0-10）and Redness, Edema, Ecchymosis, Discharge, Approximation scale （0-15）, respectively. General linear model was used to compare the groups on the outcomes adjusted for baseline values and stratified factors. RESULTS： Follow-up rate was 100% up to the 8 h time point in both groups, and 86% （62 of 72） in the cinnamon group and 85% （61 of 72） in the placebo group at day 10-11 after delivery. Pain score in the cinnamon group was significantly lower than that in the placebo group at （4±1） h （adjusted difference： -0.6, 95% confidence interval： -1.0 to -0.2） and （8＋1） h （-0.9, -1.4 to -0.3） after intervention, and on the 10-11th day after delivery （-1.4, -2.0 to -0.7）. Also the cinnamon group showed significantly more improvement than the control group in healing score at （8±1） h （-0.2, -0.4 to -0.04） and the 10-11th day after delivery （-1.6, -2.0 to -1.1）. CONCLUSION： Cinnamon can be used for reducing perineal pain and improving healing of episiotomy incision.展开更多
Pain is normally treated with oral nonsteroidal anti-inflammatory agents and opioids. These drugs are dangerous and are responsible for many hospitalizations and deaths. It is much safer to use topical preparations ma...Pain is normally treated with oral nonsteroidal anti-inflammatory agents and opioids. These drugs are dangerous and are responsible for many hospitalizations and deaths. It is much safer to use topical preparations made from plants to treat pain, even severe pain. Topical preparations must contain compounds that penetrate the skin, inhibit pain receptors such as transient receptor potential cation channels and cyclooxygenase-2, to relieve pain. Inhibition of pain in the skin disrupts the pain cycle and avoids exposure of internal organs to large amounts of toxic compounds. Use of topical pain relievers has the potential to save many lives, decrease medical costs and improve therapy.展开更多
OBJECTIVE:To investigate the effect of acupressure on postpartum low back pain(LBP),salivary cortisol,physical limitations,and postpartum depression.METHODS:Participants were 70 postpartum women who were randomly assi...OBJECTIVE:To investigate the effect of acupressure on postpartum low back pain(LBP),salivary cortisol,physical limitations,and postpartum depression.METHODS:Participants were 70 postpartum women who were randomly assigned to either an intervention(n=35)or a control(n=35)group.The intervention group received 10 acupressure sessions(1 session per day,5 d per week).The control group received 10 sham acupressure sessions.Outcomes were assessed using a visual analogue scale(LBP intensity),salivary cortisol values(LBP biomarker),and Chinese versions of the Roland-Morris Disability Questionnaire(daily activity limitations),Oswes-try Disability Index(physical activity limitations),and the Edinburgh Postnatal Depression Scale(postpartum depression).RESULTS:Participants in the intervention group had significantly lower levels of LBP intensity,daily activity limitations,physical activity limitations,and postpartum depression than those in the control group.There was no significant between-group difference in salivary cortisol.CONCLUSION:Acupressure may reduce postpartum LBP intensity and limitations in daily and physical activity,and alleviate postpartum depressive symptoms.Acupressure should be offered in postpartum care settings as an alternative treatment for postpartum women with LBP.展开更多
Objective To explore the risk factors of low back pain among the Chinese occupational population in several major industries. Methods A total of 7200 subjects （3600 cases and 3600 controls） were randomly sampled fro...Objective To explore the risk factors of low back pain among the Chinese occupational population in several major industries. Methods A total of 7200 subjects （3600 cases and 3600 controls） were randomly sampled from a cross-sectional study, and they were investigated for individual and occupational factors of low back pain. The potential risk factors were first selected by using chi-square tests. Secondly, collinearity diagnosis proceeded by using the Kendall＇s rank correlation. Finally, binary logistic regression model was used for multi-factor analysis. Results Collinearity diagnosis showed that there was a severe collinearity problem among the potential risk factors of low back pain. Logistic regression model included 20 variables with statistical significance. Bending neck forward or holding neck in a forward posturefor long periods （0R=1.408） was the most important risk factor inducing low back pain in this study, followed by bending heavily with the trunk （0R=1.402）, carrying out identical work almost for the whole day （0R=1.340）. Additionally, suHicient normal break was a protective factor of low back pain. Conclusion Low back pain among the Chinese occupational population was associated with body height, occupation, work organization, physical work, working posture, and others. All these risk factors could be regarded as the indicators of low back pain, and some relevant preventive measures should be taken to reduce low back pain risk.展开更多
Background: Patellofemoral pain (PFP) is considered one of the most common dysfunctions of the lower extremities. Faulty lower limb mechanics and increased of knee valgus on loaded tasks are believed to play an import...Background: Patellofemoral pain (PFP) is considered one of the most common dysfunctions of the lower extremities. Faulty lower limb mechanics and increased of knee valgus on loaded tasks are believed to play an important role in the development of PFP. Objective: To figure out if male PFP patients during single leg horizontal hop for distance and squat with greater knee valgus than controls, and if the nature of the task changes the angles of knee valgus. Methods: Twenty males with unilateral PFP formed the patient group and forty-five asymptomatic males formed the control group. Two dimensional (2-D) frontal plane projection angle (FPPA) was used during single leg squatting and horizontal hop for distance tasks. Results: For the single leg squat, the mean of 6.96<span style="white-space:nowrap;">°</span>, 9.80<span style="white-space:nowrap;">°</span>, 15.04<span style="white-space:nowrap;">°</span> was reported in the control, PFP asymptomatic knee, and PFP symptomatic knee, respectively. For the single leg horizontal hop for distance, the mean of 11.63<span style="white-space:nowrap;">°</span>, 13.72<span style="white-space:nowrap;">°</span>, 19.17<span style="white-space:nowrap;">°</span> was reported in the control, PFP asymptomatic knee, and PFP symptomatic knee, respectively. These differences were significant (<em>p </em>< 0.002) for both tasks. Conclusions: Patients with PFP represented with greater knee valgus angle than what was found in either their asymptomatic limb or in the control group.展开更多
To establish an effective method of continuous quality control of acute pain service, a retrospective study on incident reporting during postoperative anal-gesia period was conducted. Incidents were reported and analy...To establish an effective method of continuous quality control of acute pain service, a retrospective study on incident reporting during postoperative anal-gesia period was conducted. Incidents were reported and analyzed in 1507 patients who received epidural postoperative analgesia, and the results of satisfaction of pain relief was compared with those of incident analysis. In this study, an incident was defined as any factor that might or had affected patient's safety during analgesia period. Our results showed that 1203 incidents were reported in 641 of 1507 patients, of which 122 incidents were critical. 78. 3 % of all incidents were detect-ed by acute pain service stuff. The most common incidents included complica-tions, insufficient analgesia and problems with delivery circuits. Human factors were involved in 28. 9 % of the incidents, most being associated with technical failure due to unskillfu1ness, poor communications between APS stuff and pa-tients and lack of cooperation with surgeons and nurses. The general satisfactionrate of the patients was 90. 8 %. There was a very significant difference between the satisfaction of the patients who suffered from incidents and who did not (P<t0.001). It is concluded that incidents affect the satisfaction of the patients who received postoperative pain relief. Incident reporting is a more effective method for quality control of acute pain service.展开更多
BACKGROUND： Some research exists on the effect of non-pharmacological approaches for labor pain relief However, there is limited information about effectiveness of breathing exercises in pregnant women to reduce mate...BACKGROUND： Some research exists on the effect of non-pharmacological approaches for labor pain relief However, there is limited information about effectiveness of breathing exercises in pregnant women to reduce maternal pain during labor. OBJECTIVE： To determine whether breathing exercises for pregnant women during the second stage of labor have beneficial effects on maternal pain, duration of labor, and the first-minute Appearance, Pulse, Grimace, Activity and Respiration （APGAR） scores. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS： This randomized clinical trial involved 250 pregnant women, who were randomly divided into two groups： intervention group （IG; n = 125） and control group （CG; n = 125）. IG received one session breathing exercise training and performed breathing exercises during the second stage of labor versus the CG that did not receive any breathing exercise training. MAIN OUTCOME MEASURES： The effects of breathing exercises on maternal pain were determined by Visual Analogue Scale （VAS）, duration of the second stage of labor, and the first-minute APGAR scores. RESULTS： The mean age of the participants was （23.2 _＋ 4.2） （range： 18 to 42） years. Both IG and CG had similar baseline characteristics in terms of age, education level, occupation, and smoking （P 〉 0.05）. The mean VAS scores of IG and CG were （88.2 ＋_ 6.3） and （90.5 ＋_ 7.0）, respectively （P 〈 0.001）. The duration of the second stage of labor was （369.6 ＋ 92.0） s for IG and （440.7 ＋ 142.5） s for CG （P 〈 0.001 ）. The mean first-minute APGAR scores were （8.84 ＋ 0.50） for IG and （8.73 ＋ 0.89） for CG （P 〉 0.05）. CONCLUSION： Based on this study, breathing exercises with deep inhalation and exhalation in pregnant women are effective in reducing the perception of labor pain and shortening the duration of the second stage of delivery. Therefore, we recommend breathing exercises as an effective modality for labor pain management and shortening the duration of labor. TRIAL REGISTRATION： This study is registered on the website of ClinicalTrials.gov （www.clinicaltrials.gov） with the number of NCT03066973.展开更多
OBJECTIVE: To evaluate the safety and efficacy of Tongkuaixiao ointment(TKXO) in treating moderate-to-severe cancer induced somatalgia.METHODS: Totally 130 patients with moderateto-severe cancer induced somatalgia wer...OBJECTIVE: To evaluate the safety and efficacy of Tongkuaixiao ointment(TKXO) in treating moderate-to-severe cancer induced somatalgia.METHODS: Totally 130 patients with moderateto-severe cancer induced somatalgia were randomly divided into a TKXO group and a control group.The patients were treated with either TKXO applied externally or placebo, with opioid analgesics orally at the same time. Observation parameters were included numerical rating scale(NRS) scores,analgesic efficacy, initiation effective time, persistent analgesic time, equivalent morphine dose,National Comprehensive Cancer Network(NCCN)grade in Impact of Pain Measurement Scores, and safety and satisfaction extent investigation.RESULTS: NRS scores and NCCN grade in Impact of Pain Measurement Scores decreased significantly after 5-days' treatment in the two groups(P <0.0001). Compared to the control group, initiation effective time was significantly shorter(P < 0.05)and persistent analgesic time was significantly longer(P < 0.01), equivalent oral morphine doses of the first day and the whole treatment course were significantly decreased in the TKXO treatment group(P < 0.01 or P < 0.05). No obvious adverse effects were found in the TKXO group.CONCLUSION: TKXO combined with opioid analgesics possesses the advantages of high efficacy,fast action, long persistent action, safety and convenience in use, and it can reduce the dose of opioid.展开更多
基金This work was financially supported by Hubei Provincial Natural Science Foundation of China(No.2016CFB678).
文摘This cross-sectional study aimed to investigate cancer patients'cognitive level of pain control and to evaluate the patient-related factors or barriers to effective cancer pain management in China.In seven tertiary hospitals across China,372 patients experiencing cancer pain were surveyed through a self-designed questionnaire to assess the factors associated with effective pain control.Patients'demographic data and pain control-related factors were recorded.Cluster sampling and binary logistic regression models were used to investigate the association between predictive factors and effective pain control.The survey showed that the majority of the patients were more than 45 years old(76.3%),and 64.4%had an average annual income of more than 20000 RMB.One-third of the patients suffered from cancer pain for more than 3 months,and 75.1%received professional guidance during medication.The barriers to pain control for patients included preference to enduring pain and refusing analgesics(62.9%),negligence towards drug usage(28.5%),concerns about the addiction(48.2%)and adverse reaction(56.4%).The average annual family income,pro fessional guidance,knowledge of pain medication,adherence to analgesics,and concerns about addiction to analgesics were significantly correlated to the effect of patients'pain control.The study presents major barriers to optimal pain control among patients with cancer in China.Our findings suggest that educational programs and medical insurance reimbursement support from the government are urgently needed to overcome the cognitive barriers toward effective pain management and to relieve the economic burden among patients with cancer pain in China.
文摘Introduction: Virtual reality (VR) utilizing a head-mounted display allows viewers to immerse themselves in a virtual environment. This technology may be useful in attenuating pain and anxiety and reducing patient subjective stress as well as objective physiological increase in heart rate and blood pressure. Aside from the improved experience, physiological stress is reduced which results in improved patient outcomes. Patients and methods: Eligible participants were all adults aged 18 or over who had non craniofacial lesions requiring minor surgery. A total of 99 adult patients who were capable of independent consent were randomized to receive a virtual reality experience (VR) or standard music distraction (no VR). Patients were recruited for the study during their office visit when scheduling minor procedure surgery. This was a single center, double-blind, controlled study conducted at Guthrie Clinic Robert Packer Hospital in Sayre, Pennsylvania between March 2019 to January 2020 (pre-pandemic). Ethics approval for this study was obtained from the Institutional Review Board of the Guthrie Clinic. Results: The change in systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) significantly decreased from pre-procedure to mid-procedure in the VR group compared with standard. Herein our results are presented. Conclusions: Reductions in intraprocedural SBP, DBP and HR can be achieved when using VR. Although subjective reporting of pain and anxiety were not different between groups, VR significantly improves patient satisfaction compared with non VR standards.
文摘When designing a study on dental movement acceleration or pain control during orthodontic treatment,it is crucial to consider effective parameters.The objective of this editorial is to compile the most effective parameters supported by evidence that should be considered in future studies to achieve complete parameter homogenization.The protocol currently recommended to homogenize the parameters and facilitate the development of further meta-analysis in terms of acceleration of movement and pain control in orthodontics is Wavelength:810 nm,2.2 J per surface,0.1 W in continuous mode/0.1 W average power in a superpulsed,sweeping movement,1mm from the mucosa,22 seconds along the vestibular surface and 22 seconds along the lingual surface,the recommended speed of movement is 2 mm/sec,1 application during each orthodontic control,to achieve dental movement acceleration and repeat the dose at 24 h to ensure pain elimination.The energy density and power density will depend on the spot size used in the equipment and the distance from the mucosa.It will strengthen the evidence of photobiomodulation as the best therapy to accelerate tooth movement and at the same time control the pain produced by orthodontic treatments.
文摘Over the last decades,the number of total knee arthroplasty procedures performed in the United States has been increasing dramatically.This very successful intervention,however,is associated with significant postoperative pain,and adequate postoperative analgesia is mandatory in order to allow for successful rehabilitation and recovery.The use of regional anesthesia and peripheral nerve blocks has facilitated and improved this goal.Many different approaches and techniques for peripheral nerve blockades,either landmark or,more recently,ultrasound guided have been described over the last decades.This includes but is not restricted to techniques discussed in this review.The introduction of ultrasound has improved many approaches to peripheral nerves either in success rate and/or time to block.Moreover,ultrasound has enhanced the safety of peripheral nerve blocks due to immediate needle visualization and as consequence needle guidance during the block.In contrast to patient controlled analgesia using opioids,patients with a regional anesthetic technique suffer from fewer adverse events and show higher patient satisfaction;this is important as hospital rank-ings and advertisement have become more common worldwide and many patients use these factors in order to choose a certain institution for a specific procedure.This review provides a short overview of currently used regional anesthetic and analgesic techniques focusing on related implications,considerations and outcomes.
文摘Non-steroidal anti-inflammatory drugs like Ibupro- fen alleviate mild to moderate postoperative pain caused by the third molar extractions. Moreover, Acetaminophen is a non-opioid analgesic with anti-pyretic properties, effective in relieving mild to moderate pain. On the other hand, recent studies have demonstrated that Caffeine also acts as an analgesic adjuvant when combined with Acetaminophen, Aspirin, or their mixture. The objective of study is to compare the efficacy of a combination of Ibuprofen 200 mg and Acetaminophen 325 mg plus Caffeine 40 mg with Ibuprofen 400 mg alone for relieving the pain after surgical removal of impacted mandibular third molar. 80 adult patients (56 females, 24 males) were randomly placed into two groups. Preoperative pain recorded prior to the surgery and compare with patients’ pain after the operation. According to findings, there was no significant relationship between preoperative and postoperative pain (P value > 0.05) and also between surgical trauma and postoperative pain (P value > 0.05). The mean pain showed a slight numerical superiority for the group which used Ibu-profen plus Acetaminophen plus Caffeine especially 3hours after surgery, but there was no significant difference between the two groups (P value = 0.073). In conclusion, combination of Ibuprofen plus aceta-minophen plus caffeine does not offer any clinical advantages compared with Ibuprofen for alleviating acute postoperative pain after third molar surgeries.
基金Supported by the Shandong Province Medical and Health Science and Technology Development Plan Project,No.202203030713Science and Technology Program of Yantai Affiliated Hospital of Binzhou Medical University,No.YTFY2022KYQD06.
文摘In this article,we evaluate the findings of the study by Qian et al,which explores the efficacy of combining hyperthermia with opioid therapy for enhanced cancer pain management in patients with middle and late-stage gastrointestinal tumors.The study undertakes a retrospective analysis comparing traditional opioid therapy to an integrated approach of hyperthermia and opioids across 70 patients,highlighting significant benefits in pain control,reduction of opioid dosage,and minimization of adverse reactions.In our article,we not only discuss these fin-dings but also emphasize the broader implications for clinical practice,parti-cularly in enhancing patient outcomes through innovative pain management strategies.We advocate for further research to establish more robust data su-pporting this approach and to explore the mechanistic insights that enable these benefits.This discussion reflects on the potential paradigm shift in managing debilitating cancer-related pain,urging a reevaluation of current practices to incorporate these findings effectively.
基金Supported by Yuzhong District Natural Science Foundation of Chongqing,No.20240129。
文摘In this editorial,we comment on the article published in a recent issue of the World Journal of Orthopedics.Although substantial literature regarding pain management of acute musculoskeletal injury has been published over the last three decades,there is still a lack of evidence-based protocol for individual and population disparities.This systematic review gives us a comprehensive view of the evidence-based use of opioid vs opioid-free analgesia.Nevertheless,there is still a need for further investigation at a high level regarding this topic.
文摘Objective To study and verify the efficacy of acupuncture on depression caused by chronic pain and to further analyze the advantages of acupuncture. Methods According to random number table, the cases were randomized into experimental group and western medicine group, treated with acupuncture and antidepression drug （deanxit） respectively. Hamilton Depressive Scale （HAMD） and Visual Analogue Scale （VAS） were adopted for the evaluation before treatment and in the 1, 2 and 4 weeks after treatment in two groups successively. Results ① Very significant differences had been achieved on the comparisons of HAMD, VAS and HAMD reducing rate before and after treatment in experimental group （P 〈 0.01）. Very significant differences had been achieved in the comparisons of HAMD, VAS and HAMD reducing rate before and after treatment in western medicine group （P 〈 0.01 ）. ③Significant differences in HAMD reducing rate^＊ and VAS score^＊ ＊ had been achieved in the comparison between experiment group and western medicine group 1 week after treatment （^＊ P〈0.01, ^＊ ＊ P〈0.05）. ④ The significant differences had not been received in HAMD, VAS score and HAMD reducing rate in 2 and 4 weeks after treatment in the comparison between experimental group and western medicine group （P 〉0.05）. ⑤ No any harmful effect happened in experimental group after treatment, but it happened in western medicine group. Conclusion Both acupuncture and deanxit have achieved the definite therapeutic effects on depression caused by chronic pain, with similar efficacy. But the effects of acupuncture are obtained more quickly. In comparison of western medicine, acupuncture has no side and harmful effect. Additionally, acupuncture applies the multi-targeting and holistic modulation to the whole body.
文摘BACKGROUND The use of opioids for pain is linked to an increased risk of developing opioid use disorder,and has resulted in the emergence of the opioid crisis over the last few years.AIM The systematic review question is“How does the use of opioid medications in pain management,compared with non-opioid medications,affect pain intensity over the short,intermediate,and long-term in adults with acute traumatic pain?”.METHODS The protocol was prospectively registered on the International Prospective Re-gister of Systematic Reviews:CRD42021279639.Medline and Google Scholar were electronically searched for controlled peer-reviewed studies published in full,with the PICO framework:P:Adult patients with traumatic injuries,I:Opioid medications,C:Non-opioid medi-cations,O:A minimum clinically important difference(MCID)in pain.RESULTS After full-text screening,we included 14 studies in the qualitative synthesis.Of these 14 studies,12 were rando-mized clinical trials(RCTs)and 2 were pseudo-RCTs with a total of 2347 patients enrolled.There was heteroge-neity in both medication utilized and outcome in these studies;only two studies were homogeneous regarding the type of study conducted,the opioid used,its comparator,and the outcome explored.The MCID was evaluated in 8 studies,while in 6 studies,any measured pain reduction was considered as an outcome.In 11 cases,the setting of care was the Emergency Department;in 2 cases,care occurred out-of-hospital;and in one case,the setting was not well-specified.The included studies were found to have a low-moderate risk of bias.CONCLUSION Non-opioids can be considered an alternative to opioids for short-term pain management of acute musculoskeletal injury.Intravenous ketamine may cause more adverse events than other routes of administration.
文摘<b><span>Introduction:</span></b><span> Blind fascia iliaca compartment block (FICB) and ultrasound guided femoral nerve block (FNB) are two types of peripheral nerve blocks, commonly used in preoperative pain management in patients with hip fractures in Danish emergency departments. The aim of this study was to compare the efficacy </span><span>in pain management of </span><span>these two types of peripheral nerve blocks in the preoperative period in patients with hip fractures. </span><b><span>Method:</span></b><span> We performed a randomized controlled study. The primary outcome was the proportion of patients with a numeric rating scale (NRS) pain score equal to three or less at rest and after passive leg raise</span><span> </span><span>test</span><span> three hours after block administration. </span><b><span>Results:</span></b><span> A total of 88 patients were included in the study and 67 patients in the statistical analysis with 33 in the FICB group and 34 in the FNB group. The results showed a significant reduction in the proportion of patients with a</span><span>n</span><span> NRS score higher than three, three hours after administration of either FICB or FNB compared to at inclusion. There was no significant difference in pain scores between patients receiving FICB versus patients receiving FNB at rest or after passive leg raise (p = 0.25 and p = 0.86, respectively). </span><b><span>Conclusion:</span></b><span> Blind FICB and ultrasound guided FNB were effective in preoperative pain management in patients with hip fractures. The results showed that the two types of peripheral nerve blocks were equally </span><span>efficient</span><span> in providing pain management in the preoperative period.</span>
基金Supported by a Grant of the Guangdong Provincial Science and Technology Project(Application of Acupuncture Point Combined with Electroacupuncture in Labor Pain Relief,No.2011B031700024)
文摘OBJECTIVE: To evaluate the effectiveness of acupuncture analgesia(AA) compared with combined spinal-epidural anesthesia(CSEA) for labor pain relief and labor outcomes.METHODS: We evaluated 131 primiparous women who received respiratory guidance during maternal uterine contractions and received either AA(n =43), CSEA(n = 45), or no additional treatment(control, n = 43). The groups were compared regarding visual analog scale(VAS) scores for abdominal and back pain, and labor outcomes.RESULTS: The abdominal VAS scores of the AA and CSEA groups were significantly lower than that of the control group. In addition, the VAS scores of the CSEA group were significantly lower than that of the AA group at 10 and 60 min after intervention.The back pain VAS scores of the AA and CSEA groups were significantly lower than that of the control group at 5, 10, and 60 min after intervention. The duration of the active phase of labor in the CSEA group was significantly longer than that of the AA and control groups. The rates of oxytocin use(4.70%), urinary retention(4.70%), and postpartum hemorrhage [(273.7 ± 53.6) m L] in the AA group were significantly lower than in the CSEA group [46.70%, 24.20%, and(320.0 ± 85.6) m L, respectively].CONCLUSION: Both AA and CSEA were effective for labor pain relief, CSEA provided more effective pain relief, while AA was associated with a shorter duration of labor and fewer adverse effects.and each has its advantages and disadvantages.
文摘BACKGROUND： Analgesic and wound-healing effects of cinnamon, a widely used spice, have been shown in laboratory rats. However, we found no human studies in this area. OBJECTIVE： The aim of this study was to assess the effect of cinnamon on perineal pain and healing of episiotomy incision. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS： In this double-blind, randomized, placebo-controlled trial, 144 postpartum women were allocated into two groups, using stratified block randomization, 1 h after completion of episiotomy repair. They received cinnamon or placebo ointment, 2 mL every 12 h for 10 d. MAIN OUTCOME MEASURES： Perineal pain and wound healing were assessed using visual analogue scale （0-10）and Redness, Edema, Ecchymosis, Discharge, Approximation scale （0-15）, respectively. General linear model was used to compare the groups on the outcomes adjusted for baseline values and stratified factors. RESULTS： Follow-up rate was 100% up to the 8 h time point in both groups, and 86% （62 of 72） in the cinnamon group and 85% （61 of 72） in the placebo group at day 10-11 after delivery. Pain score in the cinnamon group was significantly lower than that in the placebo group at （4±1） h （adjusted difference： -0.6, 95% confidence interval： -1.0 to -0.2） and （8＋1） h （-0.9, -1.4 to -0.3） after intervention, and on the 10-11th day after delivery （-1.4, -2.0 to -0.7）. Also the cinnamon group showed significantly more improvement than the control group in healing score at （8±1） h （-0.2, -0.4 to -0.04） and the 10-11th day after delivery （-1.6, -2.0 to -1.1）. CONCLUSION： Cinnamon can be used for reducing perineal pain and improving healing of episiotomy incision.
文摘Pain is normally treated with oral nonsteroidal anti-inflammatory agents and opioids. These drugs are dangerous and are responsible for many hospitalizations and deaths. It is much safer to use topical preparations made from plants to treat pain, even severe pain. Topical preparations must contain compounds that penetrate the skin, inhibit pain receptors such as transient receptor potential cation channels and cyclooxygenase-2, to relieve pain. Inhibition of pain in the skin disrupts the pain cycle and avoids exposure of internal organs to large amounts of toxic compounds. Use of topical pain relievers has the potential to save many lives, decrease medical costs and improve therapy.
基金Supported by the Chang Gung Memorial Hospital:the Effects of Acupressure on Postpartum Low Back Pain(No.CMRPG8G0941).
文摘OBJECTIVE:To investigate the effect of acupressure on postpartum low back pain(LBP),salivary cortisol,physical limitations,and postpartum depression.METHODS:Participants were 70 postpartum women who were randomly assigned to either an intervention(n=35)or a control(n=35)group.The intervention group received 10 acupressure sessions(1 session per day,5 d per week).The control group received 10 sham acupressure sessions.Outcomes were assessed using a visual analogue scale(LBP intensity),salivary cortisol values(LBP biomarker),and Chinese versions of the Roland-Morris Disability Questionnaire(daily activity limitations),Oswes-try Disability Index(physical activity limitations),and the Edinburgh Postnatal Depression Scale(postpartum depression).RESULTS:Participants in the intervention group had significantly lower levels of LBP intensity,daily activity limitations,physical activity limitations,and postpartum depression than those in the control group.There was no significant between-group difference in salivary cortisol.CONCLUSION:Acupressure may reduce postpartum LBP intensity and limitations in daily and physical activity,and alleviate postpartum depressive symptoms.Acupressure should be offered in postpartum care settings as an alternative treatment for postpartum women with LBP.
基金supported by the Research Fund from National Science and Technology Infrastructure Program of the People's Republic of China, 2006BA106B08
文摘Objective To explore the risk factors of low back pain among the Chinese occupational population in several major industries. Methods A total of 7200 subjects （3600 cases and 3600 controls） were randomly sampled from a cross-sectional study, and they were investigated for individual and occupational factors of low back pain. The potential risk factors were first selected by using chi-square tests. Secondly, collinearity diagnosis proceeded by using the Kendall＇s rank correlation. Finally, binary logistic regression model was used for multi-factor analysis. Results Collinearity diagnosis showed that there was a severe collinearity problem among the potential risk factors of low back pain. Logistic regression model included 20 variables with statistical significance. Bending neck forward or holding neck in a forward posturefor long periods （0R=1.408） was the most important risk factor inducing low back pain in this study, followed by bending heavily with the trunk （0R=1.402）, carrying out identical work almost for the whole day （0R=1.340）. Additionally, suHicient normal break was a protective factor of low back pain. Conclusion Low back pain among the Chinese occupational population was associated with body height, occupation, work organization, physical work, working posture, and others. All these risk factors could be regarded as the indicators of low back pain, and some relevant preventive measures should be taken to reduce low back pain risk.
文摘Background: Patellofemoral pain (PFP) is considered one of the most common dysfunctions of the lower extremities. Faulty lower limb mechanics and increased of knee valgus on loaded tasks are believed to play an important role in the development of PFP. Objective: To figure out if male PFP patients during single leg horizontal hop for distance and squat with greater knee valgus than controls, and if the nature of the task changes the angles of knee valgus. Methods: Twenty males with unilateral PFP formed the patient group and forty-five asymptomatic males formed the control group. Two dimensional (2-D) frontal plane projection angle (FPPA) was used during single leg squatting and horizontal hop for distance tasks. Results: For the single leg squat, the mean of 6.96<span style="white-space:nowrap;">°</span>, 9.80<span style="white-space:nowrap;">°</span>, 15.04<span style="white-space:nowrap;">°</span> was reported in the control, PFP asymptomatic knee, and PFP symptomatic knee, respectively. For the single leg horizontal hop for distance, the mean of 11.63<span style="white-space:nowrap;">°</span>, 13.72<span style="white-space:nowrap;">°</span>, 19.17<span style="white-space:nowrap;">°</span> was reported in the control, PFP asymptomatic knee, and PFP symptomatic knee, respectively. These differences were significant (<em>p </em>< 0.002) for both tasks. Conclusions: Patients with PFP represented with greater knee valgus angle than what was found in either their asymptomatic limb or in the control group.
文摘To establish an effective method of continuous quality control of acute pain service, a retrospective study on incident reporting during postoperative anal-gesia period was conducted. Incidents were reported and analyzed in 1507 patients who received epidural postoperative analgesia, and the results of satisfaction of pain relief was compared with those of incident analysis. In this study, an incident was defined as any factor that might or had affected patient's safety during analgesia period. Our results showed that 1203 incidents were reported in 641 of 1507 patients, of which 122 incidents were critical. 78. 3 % of all incidents were detect-ed by acute pain service stuff. The most common incidents included complica-tions, insufficient analgesia and problems with delivery circuits. Human factors were involved in 28. 9 % of the incidents, most being associated with technical failure due to unskillfu1ness, poor communications between APS stuff and pa-tients and lack of cooperation with surgeons and nurses. The general satisfactionrate of the patients was 90. 8 %. There was a very significant difference between the satisfaction of the patients who suffered from incidents and who did not (P<t0.001). It is concluded that incidents affect the satisfaction of the patients who received postoperative pain relief. Incident reporting is a more effective method for quality control of acute pain service.
文摘BACKGROUND： Some research exists on the effect of non-pharmacological approaches for labor pain relief However, there is limited information about effectiveness of breathing exercises in pregnant women to reduce maternal pain during labor. OBJECTIVE： To determine whether breathing exercises for pregnant women during the second stage of labor have beneficial effects on maternal pain, duration of labor, and the first-minute Appearance, Pulse, Grimace, Activity and Respiration （APGAR） scores. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS： This randomized clinical trial involved 250 pregnant women, who were randomly divided into two groups： intervention group （IG; n = 125） and control group （CG; n = 125）. IG received one session breathing exercise training and performed breathing exercises during the second stage of labor versus the CG that did not receive any breathing exercise training. MAIN OUTCOME MEASURES： The effects of breathing exercises on maternal pain were determined by Visual Analogue Scale （VAS）, duration of the second stage of labor, and the first-minute APGAR scores. RESULTS： The mean age of the participants was （23.2 _＋ 4.2） （range： 18 to 42） years. Both IG and CG had similar baseline characteristics in terms of age, education level, occupation, and smoking （P 〉 0.05）. The mean VAS scores of IG and CG were （88.2 ＋_ 6.3） and （90.5 ＋_ 7.0）, respectively （P 〈 0.001）. The duration of the second stage of labor was （369.6 ＋ 92.0） s for IG and （440.7 ＋ 142.5） s for CG （P 〈 0.001 ）. The mean first-minute APGAR scores were （8.84 ＋ 0.50） for IG and （8.73 ＋ 0.89） for CG （P 〉 0.05）. CONCLUSION： Based on this study, breathing exercises with deep inhalation and exhalation in pregnant women are effective in reducing the perception of labor pain and shortening the duration of the second stage of delivery. Therefore, we recommend breathing exercises as an effective modality for labor pain management and shortening the duration of labor. TRIAL REGISTRATION： This study is registered on the website of ClinicalTrials.gov （www.clinicaltrials.gov） with the number of NCT03066973.
基金Supported by the Eleventh Five-year National Plan of Sciences and Technology(Clinical Research of Traditional Chinese Medicine External Treatment by Investigating Pathogenesis and Syndrome Differentiation of Cancer Pain,No.2008BAI53B023)Key Project of Beijing Municipal Science and Technology Commission(Standardization of Traditional Chinese Medicine External Treatment in Cancer Induced Pain,Ascites or Pleural Effusion,No.D13110002213004)the Postdoctoral Fund of Sciences(Effects of the Method for Tonifying Kidney to Strengthen the Bone in Treating Bone Cancer Pain,No.2012M510358)
文摘OBJECTIVE: To evaluate the safety and efficacy of Tongkuaixiao ointment(TKXO) in treating moderate-to-severe cancer induced somatalgia.METHODS: Totally 130 patients with moderateto-severe cancer induced somatalgia were randomly divided into a TKXO group and a control group.The patients were treated with either TKXO applied externally or placebo, with opioid analgesics orally at the same time. Observation parameters were included numerical rating scale(NRS) scores,analgesic efficacy, initiation effective time, persistent analgesic time, equivalent morphine dose,National Comprehensive Cancer Network(NCCN)grade in Impact of Pain Measurement Scores, and safety and satisfaction extent investigation.RESULTS: NRS scores and NCCN grade in Impact of Pain Measurement Scores decreased significantly after 5-days' treatment in the two groups(P <0.0001). Compared to the control group, initiation effective time was significantly shorter(P < 0.05)and persistent analgesic time was significantly longer(P < 0.01), equivalent oral morphine doses of the first day and the whole treatment course were significantly decreased in the TKXO treatment group(P < 0.01 or P < 0.05). No obvious adverse effects were found in the TKXO group.CONCLUSION: TKXO combined with opioid analgesics possesses the advantages of high efficacy,fast action, long persistent action, safety and convenience in use, and it can reduce the dose of opioid.
