BACKGROUND According to clinical data,a significant percentage of patients experience pain after surgery,highlighting the importance of alleviating postoperative pain.The current approach involves intravenous self-con...BACKGROUND According to clinical data,a significant percentage of patients experience pain after surgery,highlighting the importance of alleviating postoperative pain.The current approach involves intravenous self-control analgesia,often utilizing opioid analgesics such as morphine,sufentanil,and fentanyl.Surgery for colo-rectal cancer typically involves general anesthesia.Therefore,optimizing anes-thetic management and postoperative analgesic programs can effectively reduce perioperative stress and enhance postoperative recovery.The study aims to analyze the impact of different anesthesia modalities with multimodal analgesia on patients'postoperative pain.AIM To explore the effects of different anesthesia methods coupled with multi-mode analgesia on postoperative pain in patients with colorectal cancer.METHODS Following the inclusion criteria and exclusion criteria,a total of 126 patients with colorectal cancer admitted to our hospital from January 2020 to December 2022 were included,of which 63 received general anesthesia coupled with multi-mode labor pain and were set as the control group,and 63 received general anesthesia associated with epidural anesthesia coupled with multi-mode labor pain and were set as the research group.After data collection,the effects of postoperative analgesia,sedation,and recovery were compared.RESULTS Compared to the control group,the research group had shorter recovery times for orientation,extubation,eye-opening,and spontaneous respiration(P<0.05).The research group also showed lower Visual analog scale scores at 24 h and 48 h,higher Ramany scores at 6 h and 12 h,and improved cognitive function at 24 h,48 h,and 72 h(P<0.05).Additionally,interleukin-6 and interleukin-10 levels were significantly reduced at various time points in the research group compared to the control group(P<0.05).Levels of CD3+,CD4+,and CD4+/CD8+were also lower in the research group at multiple time points(P<0.05).CONCLUSION For patients with colorectal cancer,general anesthesia coupled with epidural anesthesia and multi-mode analgesia can achieve better postoperative analgesia and sedation effects,promote postoperative rehabilitation of patients,improve inflammatory stress and immune status,and have higher safety.展开更多
AIM To identify unique clusters of patients based on their concerns in using analgesia for cancer pain and predictors of the cluster membership.METHODS This was a 3-mo prospective observational study(n = 207).Patients...AIM To identify unique clusters of patients based on their concerns in using analgesia for cancer pain and predictors of the cluster membership.METHODS This was a 3-mo prospective observational study(n = 207).Patients were included if they were adults(≥ 18 years), diagnosed with solid tumors or multiple myelomas, and had at least one prescription of around the clock pain medication for cancer or cancer-treatment-related pain.Patients were recruited from two outpatient medical oncology clinics within a large health system in Philadelphia.A choice-based conjoint(CBC) analysis experiment was used to elicit analgesic treatment preferences(utilities).Patients employed trade-offs based on five analgesic attributes(percent relief from analgesics, type of analgesic, type of sideeffects, severity of side-effects, out of pocket cost).Patients were clustered based on CBC utilities using novel adaptive statistical methods.Multiple logistic regression was used to identify predictors of cluster membership.RESULTS The analyses found 4 unique clusters: Most patients made trade-offs based on the expectation of pain relief(cluster 1, 41%).For a subset, the main underlying concern was type of analgesic prescribed, i.e., opioid vs non-opioid(cluster 2, 11%) and type of analgesic side effects(cluster 4, 21%), respectively.About one in four made trade-offs based on multiple concerns simultaneously including pain relief, type of side effects, and severity of side effects(cluster 3, 27.5%).In multivariable analysis, to identify predictors of cluster membership, clinical and socioeconomic factors(education, health literacy, income, social support) rather than analgesic attitudes and beliefs were found important; only the belief, i.e., pain medications can mask changes in health or keep you from knowing what is going on in your body was found significant in predicting two of the four clusters [cluster 1(-); cluster 4(+)].CONCLUSION Most patients appear to be driven by a single salient concern in using analgesia for cancer pain.Addressing these concerns, perhaps through real time clinical assessments, may improve patients' analgesic adherence patterns and cancer pain outcomes.展开更多
Objective:The aim of the study was to evaluate the efficacy of acupuncture combined with opiates in the treatment of cancer pain through the meta-analysis system.Methods:China national knowledge infrastructure and VIP...Objective:The aim of the study was to evaluate the efficacy of acupuncture combined with opiates in the treatment of cancer pain through the meta-analysis system.Methods:China national knowledge infrastructure and VIP Database for Chinese technical periodicals,China Biology Medicine,PubMed,Embase databases were searched from January 2016 to February 8,2020 for the randomized controlled trials on the effects of acupuncture combined with opiates on cancer pain.Meta-analysis of ordered data was performed using Stata-MP64 and Review Manager 5.3 software.Results:A total of 242 Chinese studies and 25 English studies were retrieved.According to the inclusion and exclusion criteria,19 literatures finally were included.The fixed effect model was used to combine the total effect values,and the combined odds ratio(OR)(95%confidence interval(CI))was 2.981(2.384,3.729),suggesting that acupuncture combined with opiates was better than opiates alone in treating cancer pain(Z=9.57,P<0.05);the combination treatment could improve Karnofsky Performance Status score(Z=2.48,P=0.01),decrease Numerical Rating Scale score(Z=2.89,P=0.004);it also could reduce eruption pain frequency(Z=4.32,P<0.0001),improve the effects time(Z=2.51,P=0.01),and extend analgesia duration(Z=4.33,P<0.0001);the combination group also had lower Oxycodone dose than the control group(Z=3.193,P=0.001).At the same time,the incidence of adverse reactions was lower than that of the opiate treatment group alone,with a OR(95%CI)of 0.27(0.19,0.37)and statistical significance,Z=8.06,P<0.05.Conclusion:Acupuncture combined with opioids for cancer pain is superior to opioids alone with a lower incidence of adverse reactions.展开更多
Neuropathic pain often occurs during chemotherapy with oxaliplatin. AG490 has been shown to exert an antagonistic effect on inflammatory pain, but its effect on oxaliplatin-induced neuropathic pain remains poorly unde...Neuropathic pain often occurs during chemotherapy with oxaliplatin. AG490 has been shown to exert an antagonistic effect on inflammatory pain, but its effect on oxaliplatin-induced neuropathic pain remains poorly understood. This study sought to observe the analgesic effect of AG490 on acute neuropathic pain induced by a single oxaliplatin treatment and to address the possible mechanism. In this study, we estab- lished a model of oxaliplatin-induced acute neuropathic pain by intraperitoneal injection of 6 mg/kg oxaliplatin. On day 2 after injection, models were intraperitoneally injected with i, 5, or 10 mg/kg AG490. Paw withdrawal threshold to mechanical stimuli and tail withdrawal latency to cold stimuli were determined. Western blot assay was performed to detect the expression of spinal phosphorylated signal transducer and activator of transcription 3 （p-STAT3）. Immunohistochemistry was used to determine the immunoreactivity of p-STAT3 and inter- leukin-6. Results demonstrated that paw withdrawal threshold and tail withdrawal latency were significantly increased by the treatment of AG490 in rats. There was no significant difference in the effect among the different doses of AG490. AG490 10 mg/kg decreased the expression of p-STAT3, the immunoreactivity of p-STAT3 and interleukin-6 in spinal cord of acute neuropathic pain rats. These findings confirm that AG490 can attenuate oxaliplatin-induced acute neuropathic pain and is associated with the inhibition in the JAK/STAT3 signaling pathway.展开更多
Prostate cancer is the most common urogenital malignity of western communities and is the second leading cause of cancer-related deaths in this population. Pain is often due to bone metastasis in prostate cancer. For ...Prostate cancer is the most common urogenital malignity of western communities and is the second leading cause of cancer-related deaths in this population. Pain is often due to bone metastasis in prostate cancer. For the patient diagnosed with cancer and for his family, pain is the most feared aspect of cancer following the likelihood of failure to treat and death. Quality of life is severely impaired together with complaint of pain which arises high rates as 80% in advanced stage cancers.展开更多
文摘BACKGROUND According to clinical data,a significant percentage of patients experience pain after surgery,highlighting the importance of alleviating postoperative pain.The current approach involves intravenous self-control analgesia,often utilizing opioid analgesics such as morphine,sufentanil,and fentanyl.Surgery for colo-rectal cancer typically involves general anesthesia.Therefore,optimizing anes-thetic management and postoperative analgesic programs can effectively reduce perioperative stress and enhance postoperative recovery.The study aims to analyze the impact of different anesthesia modalities with multimodal analgesia on patients'postoperative pain.AIM To explore the effects of different anesthesia methods coupled with multi-mode analgesia on postoperative pain in patients with colorectal cancer.METHODS Following the inclusion criteria and exclusion criteria,a total of 126 patients with colorectal cancer admitted to our hospital from January 2020 to December 2022 were included,of which 63 received general anesthesia coupled with multi-mode labor pain and were set as the control group,and 63 received general anesthesia associated with epidural anesthesia coupled with multi-mode labor pain and were set as the research group.After data collection,the effects of postoperative analgesia,sedation,and recovery were compared.RESULTS Compared to the control group,the research group had shorter recovery times for orientation,extubation,eye-opening,and spontaneous respiration(P<0.05).The research group also showed lower Visual analog scale scores at 24 h and 48 h,higher Ramany scores at 6 h and 12 h,and improved cognitive function at 24 h,48 h,and 72 h(P<0.05).Additionally,interleukin-6 and interleukin-10 levels were significantly reduced at various time points in the research group compared to the control group(P<0.05).Levels of CD3+,CD4+,and CD4+/CD8+were also lower in the research group at multiple time points(P<0.05).CONCLUSION For patients with colorectal cancer,general anesthesia coupled with epidural anesthesia and multi-mode analgesia can achieve better postoperative analgesia and sedation effects,promote postoperative rehabilitation of patients,improve inflammatory stress and immune status,and have higher safety.
基金National Institutes of Health/National Institute of Nursing Research,No.NIH/NINR RC1-NR011591
文摘AIM To identify unique clusters of patients based on their concerns in using analgesia for cancer pain and predictors of the cluster membership.METHODS This was a 3-mo prospective observational study(n = 207).Patients were included if they were adults(≥ 18 years), diagnosed with solid tumors or multiple myelomas, and had at least one prescription of around the clock pain medication for cancer or cancer-treatment-related pain.Patients were recruited from two outpatient medical oncology clinics within a large health system in Philadelphia.A choice-based conjoint(CBC) analysis experiment was used to elicit analgesic treatment preferences(utilities).Patients employed trade-offs based on five analgesic attributes(percent relief from analgesics, type of analgesic, type of sideeffects, severity of side-effects, out of pocket cost).Patients were clustered based on CBC utilities using novel adaptive statistical methods.Multiple logistic regression was used to identify predictors of cluster membership.RESULTS The analyses found 4 unique clusters: Most patients made trade-offs based on the expectation of pain relief(cluster 1, 41%).For a subset, the main underlying concern was type of analgesic prescribed, i.e., opioid vs non-opioid(cluster 2, 11%) and type of analgesic side effects(cluster 4, 21%), respectively.About one in four made trade-offs based on multiple concerns simultaneously including pain relief, type of side effects, and severity of side effects(cluster 3, 27.5%).In multivariable analysis, to identify predictors of cluster membership, clinical and socioeconomic factors(education, health literacy, income, social support) rather than analgesic attitudes and beliefs were found important; only the belief, i.e., pain medications can mask changes in health or keep you from knowing what is going on in your body was found significant in predicting two of the four clusters [cluster 1(-); cluster 4(+)].CONCLUSION Most patients appear to be driven by a single salient concern in using analgesia for cancer pain.Addressing these concerns, perhaps through real time clinical assessments, may improve patients' analgesic adherence patterns and cancer pain outcomes.
基金the Fenghua Science and Technology Bureau Social Research Project(No.20186515).
文摘Objective:The aim of the study was to evaluate the efficacy of acupuncture combined with opiates in the treatment of cancer pain through the meta-analysis system.Methods:China national knowledge infrastructure and VIP Database for Chinese technical periodicals,China Biology Medicine,PubMed,Embase databases were searched from January 2016 to February 8,2020 for the randomized controlled trials on the effects of acupuncture combined with opiates on cancer pain.Meta-analysis of ordered data was performed using Stata-MP64 and Review Manager 5.3 software.Results:A total of 242 Chinese studies and 25 English studies were retrieved.According to the inclusion and exclusion criteria,19 literatures finally were included.The fixed effect model was used to combine the total effect values,and the combined odds ratio(OR)(95%confidence interval(CI))was 2.981(2.384,3.729),suggesting that acupuncture combined with opiates was better than opiates alone in treating cancer pain(Z=9.57,P<0.05);the combination treatment could improve Karnofsky Performance Status score(Z=2.48,P=0.01),decrease Numerical Rating Scale score(Z=2.89,P=0.004);it also could reduce eruption pain frequency(Z=4.32,P<0.0001),improve the effects time(Z=2.51,P=0.01),and extend analgesia duration(Z=4.33,P<0.0001);the combination group also had lower Oxycodone dose than the control group(Z=3.193,P=0.001).At the same time,the incidence of adverse reactions was lower than that of the opiate treatment group alone,with a OR(95%CI)of 0.27(0.19,0.37)and statistical significance,Z=8.06,P<0.05.Conclusion:Acupuncture combined with opioids for cancer pain is superior to opioids alone with a lower incidence of adverse reactions.
基金supported by the National Natural Science Foundation of China,No.81671962
文摘Neuropathic pain often occurs during chemotherapy with oxaliplatin. AG490 has been shown to exert an antagonistic effect on inflammatory pain, but its effect on oxaliplatin-induced neuropathic pain remains poorly understood. This study sought to observe the analgesic effect of AG490 on acute neuropathic pain induced by a single oxaliplatin treatment and to address the possible mechanism. In this study, we estab- lished a model of oxaliplatin-induced acute neuropathic pain by intraperitoneal injection of 6 mg/kg oxaliplatin. On day 2 after injection, models were intraperitoneally injected with i, 5, or 10 mg/kg AG490. Paw withdrawal threshold to mechanical stimuli and tail withdrawal latency to cold stimuli were determined. Western blot assay was performed to detect the expression of spinal phosphorylated signal transducer and activator of transcription 3 （p-STAT3）. Immunohistochemistry was used to determine the immunoreactivity of p-STAT3 and inter- leukin-6. Results demonstrated that paw withdrawal threshold and tail withdrawal latency were significantly increased by the treatment of AG490 in rats. There was no significant difference in the effect among the different doses of AG490. AG490 10 mg/kg decreased the expression of p-STAT3, the immunoreactivity of p-STAT3 and interleukin-6 in spinal cord of acute neuropathic pain rats. These findings confirm that AG490 can attenuate oxaliplatin-induced acute neuropathic pain and is associated with the inhibition in the JAK/STAT3 signaling pathway.
文摘Prostate cancer is the most common urogenital malignity of western communities and is the second leading cause of cancer-related deaths in this population. Pain is often due to bone metastasis in prostate cancer. For the patient diagnosed with cancer and for his family, pain is the most feared aspect of cancer following the likelihood of failure to treat and death. Quality of life is severely impaired together with complaint of pain which arises high rates as 80% in advanced stage cancers.
