Analgesic efficacy of intranasal butorphanol (Stadol NS) in the treatment of pain after dental impaction surgery

Desjardins, Paul J.; Norris, Lonnie H.; Cooper, Stephen A.; Reynolds, D. C.

doi:10.1053/joms.2000.17884

Cited by 29 publications

(8 citation statements)

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“…Due to the risk of blister formation with rectal manipulation, there is controversy regarding whether the rectal route of administration may be used in EB patients [ 44 ]. Intranasal opioids can be effective for short-term treatment, if other routes are not available [ 45 ]-[ 47 ], and may be particularly helpful for procedures of short duration when rapid-acting analgesia is desired in the absence of intravenous access. Oral disintegrating and trans-buccal formulations may be helpful as well, although they presume intact mucosa, which may not be applicable (see Box 2).…”

Section: Resultsmentioning

confidence: 99%

“…Fentanyl works well by this route for non-EB patients in the perioperative setting [ 45 ], for breakthrough cancer pain (see section on Breakthrough pain medication at the end of life) and has been used for acute pain management in the emergency department with success [ 46 ]. Butorphanol is a mixed agonist-antagonist that can be used via the intranasal route and is effective both for pain (for example, dental postoperative pain [ 47 ]) as well as for opioid-induced pruritus. Fixed dose spray is available for outpatient use in the United States, which limits the ability to adjust for patient size.…”

Section: Resultsmentioning

confidence: 99%

“… B All Gerik 2005 [ 13 ] (5a), Palermo 2005 [ 17 ] (5a) For acute pain management, offer the patient distraction, hypnosis, visualization, relaxation or other forms of CBT B All Green 2005 [ 14 ] (5a), Uman 2006 [ 21 ] Consider habit reversal training, and other psychological techniques for management of pruritus C All Chida 2007 [ 29 ] (1a), Ehlers 1995 [ 32 ] (2b), Azrin 1973 [ 30 ] (4b), Hagermark 1995 [ 28 ] (5a), Rosenbaum 1981 [ 31 ] (5a) B. Postoperative pain can be handled as for other patients in the same setting, with modifications. Basic perioperative assessment and pain treatments should be used as for non-EB patients, with modification A All Goldschneider 2010 [ 41 ] (5a), Goldschneider 2010b [ 42 ] (5a) Transmucosal (including intranasal fentanyl and transbuccal opioids) should be considered for short procedures and pain of brief duration when intravenous and enteral routes are unavailable B All Manjushree et al ., 2002 [ 45 ] (2b); Borland et al ., 2007 [ 46 ] (2b); Desjardins et al ., 2000 [ 47 ] (2a) Perioperative opioid use must account for preoperative exposure, with appropriate dose increases to account for tolerance B All Hartrick 2008 [ 56 ] (1a), Mhuircheartaigh 2009 [ 55 ] (1a), Viscusi 2005 [ 54 ] (2a) Regional anesthesia is appropriate for pain resulting from a number of major surgeries. Dressing of catheters must be non-adhesive and monitored carefully C All Diwan 2001 [ 51 ] (5a), Doi 2006 [ 53 ] (5b), Englbrecht 2010 [ 52 ] (5a), Kelly 1988 [ 48 ] (5b), Sopchak 1993 [ 49 ] (5a), Yee 1989 [ …”

Section: Methodsmentioning

confidence: 99%

“…A number of pharmacologic treatments are available Maintain optimal nutrition and mobility and treat infections as indicated D All Denyer 2010 [ 57 ] (5a) Consider topical therapies for pain C All Cepeda 2010 [ 77 ] (1a), Lander 2006 [ 76 ] (1a), LeBon 2009 [ 73 ] (1a), Twillman 1999 [ 72 ] (5a), Watterson 2004 [ 74 ](5a) Systemic pharmacologic therapy should be adapted to treat both acute and chronic forms of skin pain B All Noble 2010 [ 59 ] (1a), Moore, 2011 [ 67] (1a), Nicholson 2009 [ 65 ] (1a) Monitor potential long-term complications of chronically administered medications C Pediatric Huh 2010 [ 62 ] (4a), Camilleri 2011 [ 66 ] (5a), Chiu 1999 [ 68 ](5a), Cruciani 2008 [ 63 ] (5a), Gray 2008 [ 69 ] (5a) D. Baths and dressing changes require attention to both pain and anxiety Anxiolytics and analgesics should be used for procedural pain and fear. Care must be taken when combining such medications due to cumulative sedative effects B All Bell 2009 [ 85 ] (1a), Blonk 2010 [ 84 ] (1b), Ezike 2011 [ 82 ] (2a), Desjardins 2000 [ 47 ] (2a), Borland 2007 [ 46 ] (2b), Manjushree 2002 [ 45 ] (2b), Humphries 1997 [ 83 ] (2b), Wolfe 2010 [ 81 ] (5a), Ugur 2009 [ 86 ] (5a) Cognitive behavioral techniques should be implemented as the child becomes old enough to use them effectively. Specifically, distraction should be used for younger children B All Green 2005 [ 14 ] (5a); Gerik 2005 [ 13 ] (5a), Palermo 2005 [ 17 ] (5a) Environ...…”

Section: Methodsmentioning

confidence: 99%

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Pain care for patients with epidermolysis bullosa: best care practice guidelines

Goldschneider

Good

Harrop³

et al. 2014

BMC Med

119

108

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BackgroundInherited epidermolysis bullosa (EB) comprises a group of rare disorders that have multi-system effects and patients present with a number of both acute and chronic pain care needs. Effects on quality of life are substantial. Pain and itching are burdensome daily problems. Experience with, and knowledge of, the best pain and itch care for these patients is minimal. Evidence-based best care practice guidelines are needed to establish a base of knowledge and practice for practitioners of many disciplines to improve the quality of life for both adult and pediatric patients with EB.MethodsThe process was begun at the request of Dystrophic Epidermolysis Bullosa Research Association International (DEBRA International), an organization dedicated to improvement of care, research and dissemination of knowledge for EB patients worldwide. An international panel of experts in pain and palliative care who have extensive experience caring for patients with EB was assembled. Literature was reviewed and systematically evaluated. For areas of care without direct evidence, clinically relevant literature was assessed, and rounds of consensus building were conducted. The process involved a face-to-face consensus meeting that involved a family representative and methodologist, as well as the panel of clinical experts. During development, EB family input was obtained and the document was reviewed by a wide variety of experts representing several disciplines related to the care of patients with EB.ResultsThe first evidence-based care guidelines for the care of pain in EB were produced. The guidelines are clinically relevant for care of patients of all subtypes and ages, and apply to practitioners of all disciplines involved in the care of patients with EB. When the evidence suggests that the diagnosis or treatment of painful conditions differs between adults and children, it will be so noted.ConclusionsEvidence-based care guidelines are a means of standardizing optimal care for EB patients, whose disease is often times horrific in its effects on quality of life, and whose care is resource-intensive and difficult. The guideline development process also highlighted areas for research in order to improve further the evidence base for future care.Electronic supplementary materialThe online version of this article (doi:10.1186/s12916-014-0178-2) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Pain care for patients with epidermolysis bullosa: best care practice guidelines

Goldschneider

Good

Harrop³

et al. 2014

BMC Med

119

108

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“…Both the SPID and TOTPAR have been used in several other clinical studies assessing pain (Benrimoj and Langford, 2001;Desjardins et al, 2000;Farrar et al, 2000;Hersh et al, 2000;Schachtel et al, 1991).…”

Section: Remedy For Pharyngitismentioning

confidence: 99%

Safety and Efficacy of a Traditional Herbal Medicine (Throat Coat^®) in Symptomatic Temporary Relief of Pain in Patients with Acute Pharyngitis: A Multicenter, Prospective, Randomized, Double-Blinded, Placebo-Controlled Study

Brinckmann¹,

Sigwart²,

Taylor³

2003

The Journal of Alternative and Complementary Medicine

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Compared to placebo, intensity of throat pain when swallowing was significantly reduced by Throat Coat in intention to treat and valid for efficacy analysis (VEA). Significant differences in change from baseline pain were observed at 5 min (p = 0.007), 10 min (p = 0.005), 15 minutes (p = 0.01), 20 minutes (p = 0.05), and 30 minutes (p = 0.04) after completion of the first dose (VEA analysis). There was a statistically significant improvement of SPID in the Throat Coat-treated group: Least square means +/- standard error of the means (SEM) of SPID were -16.5 +/- 13.9 in the placebo group and -43.8 +/- 11.9 in the Throat Coat-treated group (p = 0.012). TOTPAR was also significantly higher in the Throat Coat-treated group: Least square means +/- SEM of TOTPAR were 32.4 +/- 12.8 in the placebo group and 53.6 +/- 10.9 in the Throat Coat-treated group (p = 0.031). This study shows that Throat Coat is significantly superior to placebo and provided a rapid, temporary relief of sore throat pain in patients with pharyngitis.

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The Value of the Dental Impaction Pain Model in Drug Development

Cooper

Desjardins²

2010

Methods in Molecular Biology

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The modern version of the Dental Impaction Pain Model (DIPM) was developed in the mid-1970s. Since that time, several hundred studies have been conducted by numerous investigators. Today it is arguably the most utilized of all the acute pain models. Its popularity is due to the success rate of the studies, fast subject entry, and cost effectiveness. The surgical procedure is extremely standardized, and the surgery requires either minimal or no use of CNS depressant anesthetics. The methodology is similar to that utilized in other acute pain models; however, the DIPM is much more versatile than most other models. The model can be easily adapted to perform multiple-dose studies, pharmacokinetics/pharmacodynamics (PK/PD) correlations, preemptive interventions, and sleep-pain studies. A few investigators have even developed microdialysis techniques, wherein they insert probes into extraction sockets to collect exudates for measuring biochemical mediators of pain or drug levels at the site of injury. In many instances, an accomplished site can complete a study of several hundred subjects in approximately 3 months. There are studies in the literature that have incorporated up to six treatment arms in one study and clearly separated the drugs from each other. The exquisite assay sensitivity is due to the homogeneity of the study population, the predictable level and appropriate intensity of the postsurgical pain, and the minimizing of variability by using only one or two study centers. The DIPM has been employed to evaluate NSAIDs (both nonselective and selective Cox inhibitors), opioids and combination analgesics, as well as some investigational drugs with unique mechanisms of action. The model is particularly useful for proof-of-concept studies that require dose-ranging and profiling the time-effect curve for efficacy including onset, peak effect, and duration of analgesic activity.

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Analgesic efficacy of intranasal butorphanol (Stadol NS) in the treatment of pain after dental impaction surgery

Cited by 29 publications

References 7 publications

Pain care for patients with epidermolysis bullosa: best care practice guidelines

Pain care for patients with epidermolysis bullosa: best care practice guidelines

Safety and Efficacy of a Traditional Herbal Medicine (Throat Coat^®) in Symptomatic Temporary Relief of Pain in Patients with Acute Pharyngitis: A Multicenter, Prospective, Randomized, Double-Blinded, Placebo-Controlled Study

The Value of the Dental Impaction Pain Model in Drug Development

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Analgesic efficacy of intranasal butorphanol (Stadol NS) in the treatment of pain after dental impaction surgery

Cited by 29 publications

References 7 publications

Pain care for patients with epidermolysis bullosa: best care practice guidelines

Pain care for patients with epidermolysis bullosa: best care practice guidelines

Safety and Efficacy of a Traditional Herbal Medicine (Throat Coat®) in Symptomatic Temporary Relief of Pain in Patients with Acute Pharyngitis: A Multicenter, Prospective, Randomized, Double-Blinded, Placebo-Controlled Study

The Value of the Dental Impaction Pain Model in Drug Development

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Product

Resources

About

Safety and Efficacy of a Traditional Herbal Medicine (Throat Coat^®) in Symptomatic Temporary Relief of Pain in Patients with Acute Pharyngitis: A Multicenter, Prospective, Randomized, Double-Blinded, Placebo-Controlled Study