APS 2010 Acute Pain

Low back pain is one of the top 10 most common reasons for doctor office visits in the United States; approximately 80% of adults seek care at some time for acute low back pain. The differential diagnosis for low back pain and the importance of identifying clinical red and yellow flags during evaluation was presented at the 29th Annual Scientific Meeting of the American Pain Society.

Intranasal ketorolac provides an efficacious option for management of acute moderate-to-severe pain, results of phase 2/3 placebo-controlled trials have found. These results, which were presented at the American Pain Society’s 29th Annual Scientific Meeting, may be particularly useful for ambulatory patients, when opioid use should be avoided or reduced, Lincoln Bynum, MD, and colleagues of ICON Development Solutions, Redwood City, Calif., reported.

The novel therapeutic agent PA65020 (enteric-coated aspirin plus immediate-release omeprazole) significantly reduced gastrointestinal mucosal damage after 28 days of treatment compared with enteric-coated aspirin (EC-ASA) alone. Results of this single-center, phase I, randomized, double-blind study suggest that for at-risk patients requiring analgesic doses of aspirin, PA65020 may be an important option according to a study presented at the 29th Annual Scientific Meeting of the American Pain Society.

Despite receiving ibuprofen and codeine, children presenting to an emergency department (ED) with limb trauma had moderately high pain scores after 120 minutes. These results suggest that to reach a clinically significant decrease in pain, an NSAID should be combined with an opioid stronger than codeine, researchers reported at the American Pain Society’s 29th Annual Scientific Meeting.

Lower incidences and rates of discontinuation due to gastrointestinal treatment-emergent adverse events (TEAEs) among elderly patients with moderate-to-severe low back or osteoarthritis pain suggest that tapentadol immediate-release (IR) may be a better treatment option than oxycodone IR, according to a study presented during the 29th Annual Scientific Meeting of the American Pain Society.

Patients with acute, painful musculoskeletal conditions can be returned to normal activities rapidly if the spasm-pain-spasm cycle is interrupted promptly. Therefore, time to response following medication administration is a clinically meaningful assessment in this patient population, investigators reported during the American Pain Society’s 29th Annual Scientific Meeting.

Oxymorphone immediate-release is generally well tolerated in children, but a single dose ≤10 mg may not provide analgesia for up to 6 hours in some patients, results from the first part of a two-part study have found. The study was presented at the 29th Annual Scientific Meeting of the American Pain Society.

Pretreatment with indomethacin associated with phosphatidylcholine (INDO-PC) has both analgesic and anti-inflammatory effects without the gastrointestinal toxicity usually observed with the NSAID indomethacin, according to results of a postsurgical incision pain model that was presented at the American Pain Society’s 29th Annual Scientific Meeting.

A structured plan for tapering opioid therapy results in minimal risk of opioid withdrawal syndrome, concluded a study of patients with chronic, moderate-to-severe pain from osteoarthritis of the hip or knee. These results provide much-needed objective data regarding withdrawal symptoms from opioid treatment, researchers reported at the 29th Annual Scientific Meeting of the American Pain Society.

Continuous epidural infusion of bupivacaine with either morphine or fentanyl—or both—is equally safe and effective for pain relief in children undergoing lower abdominal surgeries, according to results of a study presented at the American Pain Society’s 29th Annual Scientific Meeting.