ORLANDO – Pain medicine investigators will present preliminary research findings on Thursday, February 14, 2008, at poster sessions held during the 24th annual meeting of the American Academy of Pain Medicine at the Gaylord Palms, Orlando, February 12-16, 2008.
All abstract titles are listed in this document. The introduction, conclusion, investigator listing, and funding source are included for eight abstracts identified as being of interest to the media.
100
Smoking and Neuropathic Pain
Introduction: This study aims to determine the percentage of community subjects with chronic neuropathic pain that smoke. (205 subjects)
Conclusions: Smoking was twice as common (62% versus 33%) in subjects that were diagnosed by clinical assessment as having neuropathic versus nociceptive pain. Similar differences were not found among those positive and negative on screening assessment for neuropathic pain. The possible physiological relationship between smoking and development of chronic neuropathic pain deserves further evaluation.
Investigators: Todd G. Call, MD Mayo, Toby N. Weingarten, MD, James C. Watson, MD, W. Michael Hooten, MD, Peter C. Wollan, PhD Mayo, Lee J. Melton, MD, Barbara P. Yawn, MD, Mayo Clinic College of Medicine, Rochester, MN
Editor’s note: Funding was provided by AstraZeneca and NIH grant AR30852.
102
What Are the Variables That Are Associated with the Patient’s Wish to Sue His Physician in Patients with Acute and Chronic Pain?
Objectives: Although there is limited research on patient attributes that may be related to reasons for launching a malpractice suit, no such research has been performed in patients with acute (APPS) or chronic (CPPS) pain. The objective of this study was then to develop some statistical models that would describe such patients’ attributes.
Conclusions: CPPS are at greater risk than patients without pain and APPS for harboring the Sue-MD wish. Some patient attributes and the referral/treatment situation appear to be important predictors for harboring this issue but differ between APPS and CPPS.
Investigators: David A. Fishbain, MD FAPA University of Miami School of Medicine, Coconut Grove, FL, Daniel Bruns, PsyD Health Psychology Associates, Greeley, CO, John Mark Disorbio, EdD Integrated Therapies, Lakewood, CO, John E. Lewis, PhD University of Miami School of Medicine, Miami, FL.
Editor’s note: Funding was provided by Pearson Assessments.
105
The Immediate and Long-Term Benefits of Physical Conditioning in Chronic Pain Patients
Introduction: A frequent co-morbid condition of chronic pain is profound physical deconditioning that results from inactivity. Objective assessment of physical conditioning in patients with chronic pain has been impeded by several factors that this study attempted to overcome. Of primary importance is verifying the efficacy of a physical reconditioning program. Further, decreases in pain, depression, and anxiety following treatment in a pain rehabilitation program have been well documented; however, no study has determined the immediate effects of brief exercise on these factors. The purposes of this study are a) to determine the effect of a 3 week aerobic training program on physical conditioning, and b) to assess the acute effects of a brief (10 minute) exercise protocol on pain, mood, and perceived exertion.
Conclusion: This research suggests that relatively modest exercise leads to improved mood and physical capacity, which has further implications for mortality risk. Further, it suggests that brief exercise is a safe, cost-free, nonpharmacologic strategy for immediately reducing depression and anxiety.
Investigators: Amy M. Burleson, PsyD The Cleveland Clinic Foundation, University Hts, OH, Edward C. Covington, MD The Cleveland Clinic Foundation, Cleveland, OH, Judith Scheman, PhD The Cleveland Clinic Foundation, Cleveland, OH
107
Five-Year Follow Up of Back Pain Patients
Purpose: Lower back disorders are significant and increasing problem in USA and Europe. We assessed progression and current condition of patients with back pain 5y after initial treatment. (100 patients.) 93% of patients found BPSC treatment useful.
Conclusion: Significant symptomatic improvement is found in patients five years after initial treatment in BPSC. Time out of work is significantly increased in patients pursuing litigation compared with patients with spontaneous onset of back pain.
Investigators: Adnan Zubovic, MD Nuffield Orthopaedic Centre and John Radcliffe Hospital, Oxford, United Kingdom, Mary Cassels II AMNCH Tallaght, Dublin, IL, Eimear Cassidy AMNCH Tallaght, Frank Dowling AMNCH Tallaght.
153
Decline in Medication Costs for Patients with Chronic Non-Malignant Pain Completing a Pain Rehabilitation Program: A Prospective Analysis of Admission, Dismissal, and 6-Month Follow-up
Introduction: Chronic pain is both a prevalent and costly problem in our society. Pain rehabilitation programs have been shown to be cost-effective treatments for chronic non-malignant pain (CNMP). A treatment goal for some rehabilitation programs is the reduction in the use of pain-related medication. Medication costs represent a relatively small but significant portion of the cost of chronic pain. Medication costs changes following pain rehabilitation programs have not been analyzed in previous studies. (177 patients)
Conclusions: Patients benefited from significant medication cost savings at the completion of the 3 week outpatient pain rehabilitation program and maintained significant savings after 6 months. This study adds to the current literature on the economic value of comprehensive pain programs.
Investigators: Julie L. Cunningham, PharmD Mayo Clinic, Rochester, MN 55902 Jeffrey D. Rome Mayo Clinic, Rochester, MN 55905 Cynthia O. Townsend Mayo Clinic, Rochester, MN 55905 Jennifer L. Kerkvliet Mayo Clinic, Rochester, MN 55905
161
Determinants of the Chronic Pain Experience in Black and White Men
Pain severity, disability, and depression are significant hallmarks for chronic pain. In this investigation, 1,650 black (6.2%) and white (93.8%) men presenting for initial assessment at a tertiary pain center completed standardized measures of physical and psychosocial health. Socio-demographic data, coping behaviors, and stress-related co-morbidities were additionally ascertained. The University of Michigan Health System Institutional Review Board waived informed consent, since measures were collected as part of standard assessment. Being black, involved in litigation, and having high-blood pressure resulted in increased pain, disability, depression, post-traumatic stress disorder (PTSD), and affective distress. Higher education and income and being married were protective of poor health and co-morbidities. Alcohol and caffeine use was associated with better health and fewer co-morbidities while smoking and alcohol used for sleep were associated with poorer health. After accounting for socio-demographic, behavioral, medical, physical, and psychosocial factors via a series of hierarchical linear regressions, blacks (particularly young black men) were at greater risk for severe pain and marginally at greater risk for depression. Blacks were also at much greater risk for PTSD. Aging was associated with lower pain and affective distress scores, but resulted in higher disability scores. The positive effect of aging was greater in black when compared to white men, suggesting the possibility of a survival effect in older black men who were accessing the tertiary pain care. While previous reports support black women with chronic pain are more vulnerable to disability resulting in more depression, the current investigation found education and income completely explained the race effect on disability among men. Race was also a determinant of pain severity, depression, and PTSD in men. We additionally identified modifiable socio-demographic and behavioral factors that can improve the health of men with chronic pain in a clinical setting, if appropriately addressed.
Investigators: Carmen Green, MD University of Michigan Medical Center, Ann Arbor, MI, Tamera A. Hart-Johnson University of Michigan Medical Center.
166
A Retrospective Review of Initial Motives for Seeking Opioids as Reported by Patients Being Treated for Opioid Addiction
Introduction: An ongoing challenge is to determine the exact sources of opioids used nonmedically (1). This analysis sought to distinguish personal variables associated with self-reported motives for seeking subsequently abused opioids. (40 subjects)
Discussion: These results from a self-selected sample of treatment seekers from 1 center indicate that opioid pain prescriptions could be a risk factor for opioid addiction. Furthermore, age may be associated with the initial motive of seeking opioids that are subsequently abused.
Investigator: Lynn R. Webster, MD Lifetree Clinical Research, Salt Lake City, UT
198
Spinal Cord Stimulation Versus Conventional Medical Management: Preliminary Long-Term Results from the PROCESS Study: A Multicenter, Randomized, Controlled Trial of Patients with Failed Back Surgery Syndrome
Introduction: Patients with failed back surgery syndrome (FBSS) continue to experience persistent or recurrent pain, disability and reduced quality of life despite anatomically successful lumbosacral spine surgery. The aim of this randomized controlled trial was to evaluate the clinical effectiveness of the addition of spinal cord stimulation (SCS) to conventional medical management (CMM) in FBSS patients. (100 patients)
Conclusions: At 6 months, compared to CMM alone, SCS improves pain relief, health-related quality of life and functionality in predominantly neuropathic FBSS patients. The ability of SCS to provide significant pain relief is maintained over 24 months.
Investigator: Richard B. North, MD LifeBridge Brain & Spine Institute, Baltimore, MD
Editor’s note: Funding was provided by Medtronic.
All Abstract Numbers and Titles
100
Smoking and Neuropathic Pain
101
The Relationships Between Sleep and Pain in Patients with Diabetic PeripheralNeuropathic Pain: Responses to Treatment
with Duloxetine
102
What Are the Variables That AreAssociated with the Patient’s Wish to Sue His Physician in Patients with Acute and Chronic Pain?
103
What Variables Are Associated with a Wish to Kill a Physician in Acute and ChronicPain Patients?
104
Fluoroscopically-Guided Injections to Diagnose and Treat Baastrup’s Syndrome
105
The Immediate and Long-Term Benefits of Physical Conditioning in Chronic Pain Patients
106
Incidence of Spinal Surgery for Patients with Back Pain
107
Five-Year Follow Up of Back Pain Patients
108
Alfentanil-Morphine (ALFINE) in Postoperative Pain
109
The Safety and Efficacy of Duloxetine Hydrochloride for the Treatment of Fibromyalgia: Results from a 6-MonthRandomized, Double-Blind, Placebo-Controlled, Fixed-Dosed Trial
110
Duloxetine Hepatic Effects: 2006 Review
111
Chronic Abdominal Pain as a Presentation Symptom of Takayasu’s Arteritis
112
Radiation-Induced Alarm and Failure of an Implanted Programmable Intrathecal Pump
113
Percutaneous Thermal Disc Decompression in Patients with Symptomatic Contained Lumbar Disc Protrusion Refractory to
Conservative Treatment: A Prospective Cohort Study
114
Randomized, Double-Blind Trial of Carisoprodol 250-mg Tablets Compared to Placebo and Carisoprodol 350-mg Tablets in Patients with Acute, Painful Musculoskeletal Spasm of the Lower Back
115
Epidural Blood Patch Effective Treatment of Headache Caused by Subdural Hematoma/CSF leakage.
116
Peripheral Nerve Stimulation for Interscapular Neuropathic Pain
117
Successful Treatment of Post-Thoracotomy Pain Using Peripheral Nerve Stimulation—A Case Report
118
Smoking Related Gender Differences Among Patients Evaluated in a Tertiary PainClinic
119
Long-Term Safety of Fentanyl Buccal Tablet for the Treatment of Breakthrough Pain in Opioid-Tolerant Cancer Patients
120
The Impact of CYP2D6 Genetic Polymorphism on Postoperative MorphineConsumption
121
Comparing the Safety and Tolerability of Duloxetine for the Management of Diabetic Peripheral Neuropathic Pain
(DPNP) Between Patients with and Without Historical and/or Co-morbid CardiovascularConditions
122
Perils of Depomedrol Injections into the Vertebral Artery—An Animal Study
123
Transsacrococcygeal Approach to Ganglion Impar Block for Management of Chronic Perineal Pain: A Prospective Observational Study.
125
Methylnaltrexone Treatment of Opioid-Induced Constipation in Cancer Patients with Advanced Illness
126
Buccal and Sublingual Administration of Fentanyl Buccal Tablet Are Bioequivalent: A Randomized, Open-Label, Single-Dose,
Crossover Study
127
Modeling Work Productivity Loss from a Variety of Clinical Indicators of Health Status
128
Retroperitoneal Fluoroscopic Guided Approach to Iliopsoas Muscle Chemo-Denervation, Via Botulinum Toxin, for
Chronic Pelvic Pain: A Case Report
129
Axial Back Pain Relief and Patient Satisfaction Profiles with Spinal Cord Stimulation (SCS): A 50-Patient Series
130
Fentanyl Buccal Tablet (FBT) in Opioid-Tolerant Patients with Non-Cancer-Related Breakthrough Pain (BTP) on Around-the-
Clock Opioids: A 12-Week Study Using a Novel Double-Blind, Placebo-ControlledDesign
131
Spinal Cord Stimulation for Central Post-Stroke Pain.
132
Low Volume Interventional MRI-GuidedNeurolytic Celiac Plexus Block
133
Successful Acupuncture Treatment for Intractable Chronic Atypical Facial Pain After Failed Motor Cortex Stimulation
134
An Immediate Broadly Useful Method, 2-Minute Sciatic Nerves Press, for RapidRelief of Pain in Man: A Randomized Controlled Trial
135
Patient Preferences for Constant Current and Constant Voltage Stimulation
136
Restart of a Rechargeable Implantable Pulse Generator After 10 Months
137
The Effect of Voltage Multiplication Rates and Discharge Modes
138
BEMA (BioErodible MucoAdhesive) Fentanyl Demonstrates a Favorable Pharmacokinetic Profile Compared to Oral Transmucosal Fentanyl Citrate (Actiq ) in Healthy Volunteers
139
Initial Evaluation of Tripolar Leads for Spinal Cord Stimulation
140
Differences in Constant Current and Constant Voltage Stimulation—A Case Study
141
Effect of Methylnaltrexone Therapy On Global Clinical Impression of Change (GCIC) in Bowel Status Scores in Patients
with Advanced Illness and Opioid Induced Constipation (OIC)
142
Treating Post-Herpetic Neuralgia with Peripheral Nerve Stimulation—A Case Report
143
Long-Term Efficacy and Tolerability of 12-Hour, Extended-Release Hydrocodone/Acetaminophen: A 56-Week, Phase 3, Open-Label Study
144
Coccydynia Treated with Spinal Cord Stimulation: A Case Report
145
Use of Ultrasound Guidance for Placement of Percutaneous Trial Leads for Peripheral Nerve Stimulation of Ilioinguinal Neuralgia
146
Use of Coordinated PT/OT and Peripheral Nerve Block for in patient Treatment of Recalcitrant CRPS, Type 1
147
Epidural Hematoma in a Heparinized Patient
148
Correlates of Patient Satisfaction in Patients with Low Back Pain
149
Pulsed Radiofrequency of Pudendal Nerve to Treat Perineal Pain
150
ALO-01, An Investigational Extended-Release Opioid Formulation Containing Morphine Sulfate and Sequestered
Naltrexone: Pharmacodynamic (Drug Liking) Effects
151
Relative Analgesic Potencies of Intranasal Ketamine and Intranasal Morphine Compared to Intravenous Morphine
152
Opioid Combination Drug Therapy for Neuropathic Pain
153
Decline in Medication Costs for Patients with Chronic Non-Malignant Pain Completing a Pain Rehabilitation Program:
A Prospective Analysis of Admission, Dismissal, and 6-Month Follow-up
154
The Pharmacokinetics of Tapentadol Are Not Affected by Omeprazole: Results of a 2-Way Crossover Drug-Interaction Study in Healthy Subjects
155
The Efficacy and Tolerability of Tapentadol Immediate Release for the Treatment of Acute Pain Following Bunionectomy
156
Opioid Analgesic Abusers Can Be Subtyped by Preferred Route of Abuse: Results from the 2005 Treatment Episode Data Set (TEDS)
157
Evaluation of Lacosamide in Diabetic Neuropathic Pain Trials
158
A Pilot Study to Select a Dose of Naltrexone Hydrochloride That Will Reduce Subjective Euphoric Effects of Oxycodone Hydrochloride in Non-Dependent, Opioid-Preferring Subjects
159
Tapentadol Extended Release (ER) for the Relief of Moderate-to-Severe Chronic Pain Due to Osteoarthritis of the Knee
160
Pharmacokinetic and Pharmacodynamic Evaluations of Immediate Release Morphine in Combination with Ethanol in HealthySubjects
161
Determinants of the Chronic Pain Experience in Black and White Men
162
Single-Shot Intrathecal Ziconotide to Predict Its Pump Infusion Effect
163
Milnacipran Efficacy in the Treatment of Fibromyalgia Syndrome: A 15-Week, Randomized, Double-Blind, Placebo-
Controlled Trial
164
Safety and Efficacy of 12-Hour Extended-Release Hydrocodone/Acetaminophen for Acute Pain Following Bunionectomy: A Phase 3, Randomized, Multi-Center, Double-
Blind Study
165
Prospective, Multi-Centered Study to Evaluate the Safety and Effectiveness of Genesis® Implantable Pulse Generator in
Combination with Percutaneous Leads for the Management of Chronic Pain of the Trunk and/or Limbs
166
A Retrospective Review of Initial Motives for Seeking Opioids as Reported by PatientsBeing Treated for Opioid Addiction
167
Effects of 12-Hour, Extended-Release Hydrocodone/Acetaminophen on Pain-Related Work Productivity: A Subanalysis from a 56-Week, Open-Label Study
168
The Effects of Graded Concentrations of Oral Ethanol on the Pharmacokinetics of Oxymorphone Extended-Release Tablets in
Healthy Volunteers
169
Intrathecal Drug Delivery Pump Failure: The Inability to Refill a Pump Secondary to Increased Pressure
170
Contracts Designed for Emergency Department Treatment of Chronic Headache Breakthrough Pain Improve Physician and
Patient Satisfaction
171
Treatment of Persistent Testicular Pain: A Case Report
172
One-Year Durability of Response to Milnacipran Treatment for Fibromyalgia
173
Cognitive Complexity and Reading Demands of Patient Self-Administered Opioid Assessment Screening Tools
174
Safety and Effectiveness of C-Series Leads in Combination with the Genesis XP Implantable Pulse Generator for the Management of Chronic Pain of the Trunk and/or Limbs
175
Lacosamide in Long-Term Treatment of Painful Diabetic Neuropathy
176
Subdural Hygromas, A Complication of Epidural Catheter Implantation—A Case Report
177
Percutaneous Tripole Array Programming and Stimulation Coverage in a Patient with Failed Back Surgery Syndrome Implanted with an Eon Rechargeable IPG and Three
Percutaneous Leads: A Case Study
178
Efficacy of Tapentadol, a Novel, Centrally Active Analgesic with a Dual Mode of Action, in Animal Models of Visceral Pain
179
The Efficacy and Safety of Milnacipran in the Treatment of Fibromyalgia
180
Lacosamide in Painful Distal Diabetic Neuropathy: Results of a Multi-Center, Placebo-Controlled U.S. Trial
181
The Opioid Renewal Clinic (ORC), a Primary Care Program for Chronic Pain at the Philadelphia VA Medical Center: Characteristics of Patients Referred with Aberrant Behavior or At Risk for Substance Misuse
182
Predictors of the Resolution of Aberrant Drug Behavior in a Sample of Patients Treated in the Opioid Renewal Clinic at the
Philadelphia VA Medical Center
183
Lacosamide in Patients with Painful Diabetic Neuropathy: 1-Year Interim Results from a Long-Term, Multi-Center, Open-Label
Trial
184
Changes in Blood Glucose Levels in Diabetics After Epidural Steroid Injection
185
The Tolerability and Safety Profile of
Fentanyl Buccal Tablet in Opioid-Tolerant Patients with Cancer and Breakthrough Pain: A Pooled Analysis
186
Bipolar Radiofrequency Ablation in the Presence of Pacemaker and Peripheral Nerve Stimulator
187
Sensory Nerve Action Potentials of Adelta Fibers Have Different Amplitudes and Morphologies in Acute and Chronic Spine
Pain Patients
188
Immediate Relief of Non-Painful Discomfort with an Acute Sciatic Nerve Press
189
Changes in Glycosylated Hemoglobin After Epidural Steroid Injection
190
Stimulation Coverage of Transverse Tripole Programming Using the Lamitrode Tripole 16 Surgical Lead: PreliminaryEvaluation of a Prospective, Multi-Centered, Post-Market Study
191
Efficacy of Oxymorphone Extended Release in Hydrocodone-Experienced Patients with Chronic Low Back Pain: Subgroup Analysis of a 12-Week, Randomized, Double-Blind, Placebo-Controlled Study
192
Treating Atypical Facial Pain with Peripheral Nerve Stimulation: A Collection of 10 Case Reports
193
Pain Medicine and Primary Care: A Community Solution to a Population with Chronic Pain
194
Effects of 12-Hour, Extended-Release Hydrocodone/Acetaminophen on Pain-Related Physical Function, Work Productivity, and Sleep Quality: A 56-Week,
Open-Label Study
195
The Safety of Light to Moderate Conscious Sedation in Ambulatory Interventional Spinal Procedures
196
Preliminary Results of a Novel Method for the Treatment of Chronic Plantar Fasciitis with Botulinum Toxin Type A: A
Randomized, Double-Blind Study
197
Efficacy of Oxymorphone Extended Release in Opioid-Experienced Patients with Degenerative Disc Disease: Subgroup
Analysis of a 12-Week, Randomized, Double-Blind, Placebo-Controlled Trial
198
Spinal Cord Stimulation Versus Conventional Medical Management: Preliminary Long-Term Results from
the PROCESS Study: A Multicenter, Randomized, Controlled Trial of Patients with Failed Back Surgery Syndrome
199
Oxycodone: Using Pharmacogenomics and TDM to Guide Pain Management Therapy
200
Allergic Reaction to Epidural Methylprednisolone Acetate
201
Targeted Cervical Epidural Steroid Injection Using a Radiopaque Catheter—A Technique Report
202
Predictors of Sustained Pain Improvement
or Worsening in Community Dwelling Elders
203
A Prospective, Multi-Centered, 1-Year Post-Implantation Clinical Evaluation of the Genesis Implantable Pulse Generator
(IPG) in Combination with Paddle or Percutaneous Leads for the Management of Chronic Pain of the Trunk and Limbs
204
Spinal Cord Stimulation Versus Conventional Medical Management: Quality of Life, Resource Use and Cost
from the PROCESS Study: A Multi-Center Randomized Controlled Trial of Patients with Failed Back Surgery Syndrome
206
Efficacy of Cyclobenzaprine Hydrochloride Extended-Release 15 mg and 30 mg Once-Daily for Low Back and Neck Pain
Associated with Muscle Spasms: A Pooled Analysis of Two Randomized, Double-Blind, Parallel-Group, Placebo-Controlled,
Multicenter Studies
207
Pharmacogenomic Evaluation of Methadone Toxicity in a Therapeutic Pain Management Patient: A Case Report
209
Efficacy of a Single, Percutaneous, Across Midline, Octrode® Lead Using a “Midline Anchoring” Technique in the Treatment of
Chronic Low Back and/or Lower Extremity Pain: A Retrospective Study
210
Characteristics and Outcomes of Patients Discharged from the Opioid Renewal Clinic of the Philadelphia VAMC
211
Eon Battery Recharging: Preliminary Findings of Three Prospective, Multi-Centered, Post-Market Studies
212
A Possible Solution to Objective Muscle Pain Assessment: The Muscle Pain Detection Device (MPDD)
213
A Single 1-Hour Application of NGX-4010 (Capsaicin Dermal Patch) SignificantlyReduced Pain for Up to 12 Weeks: Results
of a Second Randomized, Double-Blind,12-Week Controlled Study in Postherpetic Neuralgia Patients
214
Efficacy and Safety of IV Acetaminophen in the Treatment of Pain Following Vaginal Hysterectomy: Results of a Double-Blind,
Randomized, Placebo-Controlled, Multiple-Dose, 24-Hour Study
215
Pharmacokinetics, Efficacy, and Safety of IV Acetaminophen in the Treatment of Pain Following Total Hip Arthroplasty: Results
of a Double-Blind, Randomized, Placebo-Controlled, Single-Dose Study
216
Efficacy and Safety of IV Acetaminophen in the Treatment of Pain Following PrimaryTotal Hip Arthroplasty: Results of a Double-Blind, Randomized, Placebo-Controlled, Multiple-Dose, 24-Hour Study
Founded in 1983, AAPM is the medical specialty society representing physicians practicing in the field of pain medicine. The Academy is involved in education, training, advocacy and research in the specialty of pain medicine. Information is available on the practice of pain medicine at www.painmed.org. For additional meeting details, please link to www.painmed.org/annualmeeting/2008/index.html /
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Pain Medicine