OBJECTIVE: To evaluate driving performance, cognition, and balance in patients with chronic nonmalignant pain before and after the addition of transdermal fentanyl to their treatments. DESIGN: Prospective, one-group pretest-posttest design. SETTING: Outpatient pain center associated with a large, urban medical school. INTERVENTIONS: Patients taking less than a 15-mg equivalent of oxycodone per day took baseline driving performance, cognitive, and balance tests. Transdermal fentanyl was initiated and titrated in 25-microg/hour increments, weighing benefits and side effects. At the end of a 1-month period, the achieved dose was maintained for another month. After they were stabilized for 1 month, patients repeated driving, cognitive, and balance tests. RESULTS: Twenty three patients completed the study; three discontinued secondary to side effects. The median dose at the end of the titration period was 50 microg/hour (48%). No differences were found in driving simulation measures between the pretreatment and posttreatment periods. No decrements in cognitive performance were found. Improvements in visual motor tracking, visual memory, and attention were found during treatment with transdermal fentanyl. No differences in balance or body sway were found. Pain decreased over the course of treatment. CONCLUSIONS: The addition of transdermal fentanyl to a treatment regimen containing no opiates or small amounts of opiates for patients with chronic nonmalignant pain did not negatively affect their driving performances, reaction times, cognition, or balance. Future studies in this area are needed to guide treatment decisions. Copyright American Academy of Pain Medicine
OBJECTIVE: To evaluate driving performance, cognition, and balance in patients with chronic nonmalignant pain before and after the addition of transdermal fentanyl to their treatments. DESIGN: Prospective, one-group pretest-posttest design. SETTING:Outpatientpain center associated with a large, urban medical school. INTERVENTIONS:Patients taking less than a 15-mg equivalent of oxycodone per day took baseline driving performance, cognitive, and balance tests. Transdermal fentanyl was initiated and titrated in 25-microg/hour increments, weighing benefits and side effects. At the end of a 1-month period, the achieved dose was maintained for another month. After they were stabilized for 1 month, patients repeated driving, cognitive, and balance tests. RESULTS: Twenty three patients completed the study; three discontinued secondary to side effects. The median dose at the end of the titration period was 50 microg/hour (48%). No differences were found in driving simulation measures between the pretreatment and posttreatment periods. No decrements in cognitive performance were found. Improvements in visual motor tracking, visual memory, and attention were found during treatment with transdermal fentanyl. No differences in balance or body sway were found. Pain decreased over the course of treatment. CONCLUSIONS: The addition of transdermal fentanyl to a treatment regimen containing no opiates or small amounts of opiates for patients with chronic nonmalignant pain did not negatively affect their driving performances, reaction times, cognition, or balance. Future studies in this area are needed to guide treatment decisions. Copyright American Academy of Pain Medicine
Authors: Diana M Higgins; Aaron M Martin; Dewleen G Baker; Jennifer J Vasterling; Victoria Risbrough Journal: Clin J Pain Date: 2018-03 Impact factor: 3.442
Authors: Debra Lynch Kelly; David Buchbinder; Rafael F Duarte; Jeffrey J Auletta; Neel Bhatt; Michael Byrne; Zachariah DeFilipp; Melissa Gabriel; Anuj Mahindra; Maxim Norkin; Helene Schoemans; Ami J Shah; Ibrahim Ahmed; Yoshiko Atsuta; Grzegorz W Basak; Sara Beattie; Sita Bhella; Christopher Bredeson; Nancy Bunin; Jignesh Dalal; Andrew Daly; James Gajewski; Robert Peter Gale; John Galvin; Mehdi Hamadani; Robert J Hayashi; Kehinde Adekola; Jason Law; Catherine J Lee; Jane Liesveld; Adriana K Malone; Arnon Nagler; Seema Naik; Taiga Nishihori; Susan K Parsons; Angela Scherwath; Hannah-Lise Schofield; Robert Soiffer; Jeff Szer; Ida Twist; Anne Warwick; Baldeep M Wirk; Jean Yi; Minoo Battiwalla; Mary E Flowers; Bipin Savani; Bronwen E Shaw Journal: Biol Blood Marrow Transplant Date: 2017-09-20 Impact factor: 5.742
Authors: Roger Chou; Gilbert J Fanciullo; Perry G Fine; Jeremy A Adler; Jane C Ballantyne; Pamela Davies; Marilee I Donovan; David A Fishbain; Kathy M Foley; Jeffrey Fudin; Aaron M Gilson; Alexander Kelter; Alexander Mauskop; Patrick G O'Connor; Steven D Passik; Gavril W Pasternak; Russell K Portenoy; Ben A Rich; Richard G Roberts; Knox H Todd; Christine Miaskowski Journal: J Pain Date: 2009-02 Impact factor: 5.820
Authors: David Buchbinder; Debra Lynch Kelly; Rafael F Duarte; Jeffery J Auletta; Neel Bhatt; Michael Byrne; Zachariah DeFilipp; Melissa Gabriel; Anuj Mahindra; Maxim Norkin; Helene Schoemans; Ami J Shah; Ibrahim Ahmed; Yoshiko Atsuta; Grzegorz W Basak; Sara Beattie; Sita Bhella; Christopher Bredeson; Nancy Bunin; Jignesh Dalal; Andrew Daly; James Gajewski; Robert Peter Gale; John Galvin; Mehdi Hamadani; Robert J Hayashi; Kehinde Adekola; Jason Law; Catherine J Lee; Jane Liesveld; Adriana K Malone; Arnon Nagler; Seema Naik; Taiga Nishihori; Susan K Parsons; Angela Scherwath; Hannah-Lise Schofield; Robert Soiffer; Jeff Szer; Ida Twist; Anne B Warwick; Baldeep M Wirk; Jean Yi; Minoo Battiwalla; Mary D E Flowers; Bipin Savani; Bronwen E Shaw Journal: Bone Marrow Transplant Date: 2018-01-17 Impact factor: 5.483