Pain and Therapy最新文献

{"title":"A Decades-Long Journey of Palmitoylethanolamide (PEA) for Chronic Neuropathic Pain Management: A Comprehensive Narrative Review.","authors":"Giustino Varrassi, Martina Rekatsina, Matteo Luigi Giuseppe Leoni, Marco Cascella, Gabriele Finco, Salvatore Sardo, Chiara Corno, Domenico Tiso, Vittorio Schweiger, Diego Maria Michele Fornasari, Antonella Paladini","doi":"10.1007/s40122-024-00685-4","DOIUrl":"10.1007/s40122-024-00685-4","url":null,"abstract":"<p><p>Palmitoylethanolamide (PEA) has been prescribed in neuropathic pain management for over 20 years. This study aims to summarize what has been published on the topic in the last 15 years and determine the appropriateness of the prescribing. It describes the pharmacological aspect of PEA, especially focusing on its pharmacodynamics and pharmacokinetics. Then, it deeply explores why PEA may be useful in the pharmacological management of both neuropathic and mixed pain. Finally, it examines some innovative patent, which aims to address obstacles encountered with conventional PEA formulations, for its pharmacodynamic characteristics. One of them (Equisetum-PEA) seems promising. It partially ameliorates the bioavailability and the targeted distribution. It seems to introduce novel advancements that can potentially enhance the therapeutic effectiveness of PEA in terms of its anti-inflammatory, antioxidant, and analgesic properties. The deep literature analysis aims to examine the potential advantages of PEA, in the context of several pathological conditions that may benefit from this molecule. It focuses on various published data regarding the clinical efficacy of PEA in managing neuropathic and mixed pain. Also, it tries to understand if it can modernize the field of therapy based on PEA, thus offering a better treatment option for individuals with chronic long-term inflammation, oxidative stress, and neuropathic or mixed pain with a neuropathic component. The study examines the possible impact of PEA on personalized medicine strategies and its potential for translation into clinical practice. It analyses the possibilities that PEA has in enhancing patient outcomes in a range of central nervous system and inflammatory conditions. A complete analysis of the therapeutic potentialities of this product was missing. This extensive narrative review makes a valuable contribution to the ongoing comprehension of PEA therapy. It establishes a foundation for further exploration in research and potential uses in clinical settings.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"81-101"},"PeriodicalIF":4.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11751209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study on the Analgesic Efficacy of Femoral Nerve Block for Post-Hip Arthroscopy Pain.","authors":"Mengwen Xue, Li Zhang, Ruiping Bai, Rui An, Jiarui Li, Xin Shen","doi":"10.1007/s40122-024-00681-8","DOIUrl":"10.1007/s40122-024-00681-8","url":null,"abstract":"<p><strong>Introduction: </strong>Postoperative pain management is challenging for hip arthroscopy, and the effectiveness and specific protocols of femoral nerve block (FNB) in hip surgeries remain insufficient. Therefore, we designed this study to investigate the analgesic efficacy and optimal drug concentrations of FNB after hip arthroscopy.</p><p><strong>Methods: </strong>A total of 148 patients undergoing hip arthroscopy were included and randomly divided into three groups: 0.3% ropivacaine FNB group, 0.4% ropivacaine FNB group, and 0.4% ropivacaine intra-articular injection (IAI) group (positive control). The main outcomes included dynamic and static visual analog scale (VAS) scores at various time points postoperatively, total intraoperative remifentanil consumption, and cumulative consumption of morphine within 24 h postoperatively. Secondary outcomes included total intraoperative dexmedetomidine consumption, RASMAY sedation scores, and patients' satisfaction scores postoperatively.</p><p><strong>Results: </strong>Both FNB and IAI anesthesia were shown to be safe for post-hip arthroscopy analgesia. Compared with IAI anesthesia, FNB showed no significant differences in analgesic effect within 12 h postoperatively but had a better analgesic effect after 24 h and lower remifentanil consumption intraoperatively. Group 0.4% ropivacaine showed lower dynamic VAS scores within the first 12 h compared with 0.3% ropivacaine for FNB, however, there were no significant differences in patient satisfaction and sedation, and postoperative ambulation was delayed, indicating that the higher concentration of ropivacaine correlated with a longer time to ambulation. The IAI group had greater intraoperative opioid consumption and more side effects.</p><p><strong>Conclusions: </strong>Compared with IAI anesthesia, FNB can better alleviate post-hip arthroscopy pain and reduce opioid consumption. However, it requires specialized equipment and technical support and carries a certain risk of puncture.</p><p><strong>Trial registration: </strong>Chinese Clinical Trials Registry (ChiCTR2400091579).</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"257-268"},"PeriodicalIF":4.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11751215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Response to: Letter to the Editor Regarding \"Analgesic Effectiveness of Truncal Plane Blocks in Patients Undergoing the Nuss Procedure: A Randomized Controlled Trial\".","authors":"Tao Chen, Yu Xu, Yu Chen, Shibiao Chen, Yang Zhang","doi":"10.1007/s40122-024-00680-9","DOIUrl":"10.1007/s40122-024-00680-9","url":null,"abstract":"","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"439-440"},"PeriodicalIF":4.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11751194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Restorative Neurostimulation Therapy Compared to Optimal Medical Management: A Randomized Evaluation (RESTORE) for the Treatment of Chronic Mechanical Low Back Pain due to Multifidus Dysfunction.","authors":"Frank Schwab, Nagy Mekhail, Kiran V Patel, Meredith Langhorst, Robert D Heros, Jonathan Gentile, Sherif Costandi, Gregory Moore, Christopher Gilmore, Smith Manion, Krishnan Chakravarthy, S Craig Meyer, Justin V Bundy, Jordan L Tate, Rebecca Sanders, Sandeep Vaid, Oszkar Szentirmai, Johnathan Goree, Vikas V Patel, Jeff Lehmen, Mehul J Desai, Jason E Pope, Anthony Giuffrida, Salim Hayek, Sohrab Singh Virk, Richard Paicius, William R Klemme, Robert Levy, Christopher Gilligan","doi":"10.1007/s40122-024-00689-0","DOIUrl":"10.1007/s40122-024-00689-0","url":null,"abstract":"<p><strong>Introduction: </strong>Many interventional strategies are commonly used to treat chronic low back pain (CLBP), though few are specifically intended to target the distinct underlying pathomechanisms causing low back pain. Restorative neurostimulation has been suggested as a specific treatment for mechanical CLBP resulting from multifidus dysfunction. In this randomized controlled trial, we report outcomes from a cohort of patients with CLBP associated with multifidus dysfunction treated with restorative neurostimulation compared to those randomized to a control group receiving optimal medical management (OMM) over 1 year.</p><p><strong>Methods: </strong>RESTORE is a multicenter, open-label randomized controlled trial. Candidates were assessed for CLBP associated with multifidus dysfunction, with no indication for or history of lumbar spine surgery. Participants were randomized to either restorative neurostimulation with the ReActiv8 system or OMM. The primary endpoint was a comparison of the mean change in the Oswestry Disability Index (ODI) between the treatment and control arms at 1 year, and secondary endpoints included pain (numeric rating scale [NRS]) and health-related quality of life (EuroQol Five-Dimension [EQ-5D-5L]).</p><p><strong>Results: </strong>A total of 203 patients, average age 47 years, and with an average 11-year history of low back pain, were included in the analysis. The primary endpoint was a statistically significant demonstration of a clinically relevant mean improvement in the Oswestry Disability Index (ODI) between restorative neurostimulation and OMM arms: ODI (-19.7 ± 1.4 vs. -2.9 ± 1.4; p < 0.001). Additionally, improvements in both the numeric rating scale (NRS) (-3.6 ± 0.2 vs. -0.6 ± 0.2; p < 0.001) and EuroQol Five-Dimension (EQ-5D-5L) (0.155 ± 0.012 vs. 0.008 ± 0.012; p < 0.001) were statistically and clinically significant in the restorative neurostimulation arm compared to the OMM arm.</p><p><strong>Conclusion: </strong>The RESTORE trial demonstrates that restorative neurostimulation is a safe, reversible, clinically effective, and highly durable option for patients suffering with nonoperative CLBP associated with multifidus dysfunction. This demonstration of treatment superiority over OMM through 1 year is a significant milestone in addressing a major health burden and unmet clinical need.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT04803214.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"401-423"},"PeriodicalIF":4.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11751280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Collagenase Chemonucleolysis for Treating Cervical Disc Herniation: An Exploratory, Single-Arm, Open-Label, Multicenter Clinical Trial.","authors":"Zhijian Wang, Bifa Fan, Lili Gu, Xuexue Zhang, Tao Sun, Hui Liu, Rongchun Li, Likui Wang, Kaiqiang Wang, Shun Li, Yong Ma, Haibo You, Daying Zhang","doi":"10.1007/s40122-024-00678-3","DOIUrl":"10.1007/s40122-024-00678-3","url":null,"abstract":"<p><strong>Introduction: </strong>Cervical disc herniation (CDH) is the most common cause of cervical radiculopathy and causes persistent neck pain and neurological deficits. Collagenase chemonucleolysis has been successfully applied to treat lumbar disc herniation, which has a similar pathological mechanism to CDH. However, its application for CDH remains under-researched, and there is an even greater lack of high-quality clinical evidence. This study aims to evaluate the efficacy and safety of collagenase chemonucleolysis for treating CDH.</p><p><strong>Methods: </strong>Eligible patients with CDH underwent collagenase chemonucleolysis via anterior cervical intradiscal injection or epidural injection. The primary efficacy endpoint showed an excellent and good rate regarding the Odom criteria, which was not lower than the reference value (≥ 78%) at 6 months postoperatively. The secondary efficacy endpoints were the percentage reduction in Numeric Rating Scale (NRS) and Neck Disability Index (NDI) scores from baseline, which were not lower than the reference values (≥ 40%, ≥ 30%), and improvement in the 36-Item Short Form Health Survey (SF-36) score compared to the preoperative value. The pre- and postoperative CDH index of patients were also compared. Safety endpoints included the incidence of adverse events (AEs) and serious adverse events (SAEs).</p><p><strong>Results: </strong>An excellent and good rate regarding the Odom criteria 6 months postoperatively was 90.5% (133/147), which was significantly higher than 78% (P < 0.004, 95% confidence interval 85.7-95.2%). The reduction in NRS and NDI scores exceeded 40% (P < 0.001) and 30% (P < 0.001), respectively. The SF-36 scores at 3 months and 6 months postoperatively were significantly higher than those preoperatively (P < 0.001). A significant difference was observed in the pre- and postoperative CDH index (109.6 ± 119.1 vs. 70.8 ± 74.8, P < 0.001). The incidence of AEs was 22.5% (33/147), of which 97.8% were grade 1-2. No collagenase-related AEs and SAEs occurred.</p><p><strong>Conclusion: </strong>Collagenase chemonucleolysis treatment for CDH exhibited favorable efficacy and safety and may be a better choice for patients in whom conservative treatment is ineffective.</p><p><strong>Trial registration: </strong>The trial was registered on www.Chictr.org.cn (ChiCTR2200063043).</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"217-235"},"PeriodicalIF":4.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11751348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lumbar Sympathetic Block to Treat CRPS in an 18-Month-Old Girl: A Breaking Barriers Case Report and Review of Literature.","authors":"Amany E Ayad, Nora A Agiza, Amr H Elrifay, Ahmed M Mortada, Marian Y Girgis, Giustino Varrassi","doi":"10.1007/s40122-024-00650-1","DOIUrl":"10.1007/s40122-024-00650-1","url":null,"abstract":"<p><strong>Background: </strong>Children under the age of 3 years have been diagnosed with complex regional pain syndrome (CRPS). They were found to be functionally disadvantaged and psychologically distressed in relation to children with other painful conditions.</p><p><strong>Case presentation: </strong>An 18-month-old baby girl was referred to the pain clinic with a history of severe right lower limb pain that had begun 2 months earlier. The parents were unable to recall any trauma before the painful situation. Pain and allodynia were severe and extended from the toes to the gluteus area. She was low weight for her age (6700 g). The patient was on the maximum doses of gabapentin and amitriptyline accepted for her body weight and did not have the possibility to start rehabilitation due to severe pain and allodynia. After discussing the risks and potential benefits of a planned lumbar sympathetic block (LSB), the parents approved the interventional procedure. This is the first case report describing the LSB technique at such a young age.</p><p><strong>Method: </strong>A lumbar sympathetic block was carried on at the third lumbar vertebral level, fluoroscopy-guided, and under general anesthesia (GA) initiated with ketamine iv. A 4-cm needle was introduced using a tunneled vision approach in an oblique view at the L3 level until adequate depth was confirmed in the lateral position. Safety considerations were taken in relation to the radiation dose and all drugs injected with dose adjustment to her body weight. The block was successful (the skin temperature increased by 2.8 °C) and was uneventful. Pain and allodynia were completely alleviated in the recovery room. At the follow-up after 3 and 8 weeks, the parents reported an 80% improvement in pain and allodynia, a 70% improvement in sleep, a weight gain of 900 g, and that she had started rehabilitation.</p><p><strong>Conclusions: </strong>Lumbar sympathetic blocks can be considered at a very young age to treat CRPS if other non-invasive measures fail.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"1325-1334"},"PeriodicalIF":4.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11544111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142133428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Oliceridine to Remifentanil for Optimal Analgesia in Mechanical Ventilation (CO-ROAM): Study Protocol for a Multicenter Randomized Controlled Trial.","authors":"Jing-Chao Luo, Sen Lu, Xi-Liang Fu, Jun Shen, Hong-Li He, Chun Pan, Xiao-Bo Huang","doi":"10.1007/s40122-024-00669-4","DOIUrl":"10.1007/s40122-024-00669-4","url":null,"abstract":"<p><strong>Introduction: </strong>Critically ill patients often endure pain, a distressing experience that can trigger diverse pathophysiological consequences. While remifentanil, with its rapid kinetics, is commonly used for analgesia in intensive care units (ICU), it frequently leads to opioid-related adverse effects. A promising alternative has emerged in oliceridine, a novel G protein-biased μ-opioid receptor agonist. This new drug offers the potential for effective pain relief with fewer side effects. However, its efficacy and safety profile in mechanically ventilated ICU patients remain to be fully elucidated.</p><p><strong>Methods: </strong>This is a multicenter, prospective, randomized, single-blind, active-controlled trial conducted across 24 ICUs in China. A total of 292 mechanically ventilated patients requiring analgesia and sedation will be randomly assigned in a 1:1 ratio to either the oliceridine or remifentanil group. The oliceridine group will receive oliceridine (2-20 μg/kg/h), while the remifentanil group will receive remifentanil (1.5-12 μg/kg/h). Both groups will receive propofol for sedation if necessary. The target for analgesia is Critical-Care Pain Observation Tool (CPOT) < 3, and for sedation is Richmond Agitation-Sedation Scale (RASS) - 2 to 0.</p><p><strong>Planned outcomes: </strong>The primary outcome will be the percentage of time within target analgesia during study drug administration. Secondary outcomes will include gastrointestinal dysfunction, respiratory depression, sedative usage, mechanical ventilation duration, ICU stay length, extubation failure rate, etc. TRIAL REGISTRATION: NCT06454292. Registered on June 11, 2024.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"1695-1704"},"PeriodicalIF":4.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11543959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142472130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding Headaches Attributed to Cranial and/or Cervical Vascular Disorders: Insights and Challenges for Neurologists.","authors":"Wei Wang, Chenlu Zhu, Paolo Martelletti","doi":"10.1007/s40122-024-00668-5","DOIUrl":"10.1007/s40122-024-00668-5","url":null,"abstract":"<p><p>In recent decades, cranial and cervical vascular disorders have become major global health concerns, significantly impacting patients, families, and societies. Headache is a prevalent symptom of these vascular diseases and can often be the initial, primary, or sole manifestation. The intricate relationship between headaches and cranial/cervical vascular disorders poses a diagnostic and therapeutic challenge, with the underlying mechanisms remaining largely elusive. Understanding this association is crucial for the early diagnosis, prevention, and intervention of such conditions. This review aims to provide a comprehensive overview of the clinical features and potential pathogenesis of headaches attributed to cranial and cervical vascular disorders and provide a reference for disease management and a basis for potential pathological mechanisms.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"1429-1445"},"PeriodicalIF":4.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11543962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142472134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor Regarding \"Clinical Application of Different Doses of Hydromorphone Slow-Release Analgesia in Lumbar Fusion in Elderly Patients\".","authors":"Guanyu Yang, Qinjun Chu","doi":"10.1007/s40122-024-00664-9","DOIUrl":"10.1007/s40122-024-00664-9","url":null,"abstract":"","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"1715-1716"},"PeriodicalIF":4.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11543970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methadone Conversion Using a 3-Day Switch Strategy in Patients with Cancer on High-Dose Opioids: A Retrospective Study.","authors":"Lei Lei, Qinfei Zhou, Xi Liu, Guanai Bao, Haiying Ding, Qunfang Ding, Liyan Gong","doi":"10.1007/s40122-024-00651-0","DOIUrl":"10.1007/s40122-024-00651-0","url":null,"abstract":"<p><strong>Introduction: </strong>Methadone has shown effectiveness in pain control in patients with cancer who are intolerant to other opioids in China. However, the optimal strategy for methadone conversion from previous high doses of opioids in refractory cancer pain remains debatable. This study aimed to describe the efficacy and safety of a 3-day switch (3DS) strategy for methadone conversion in patients with refractory cancer pain on high doses of opioids.</p><p><strong>Methods: </strong>We retrospectively reviewed 30-day medical records of 70 patients with refractory cancer pain who used a 3DS strategy for methadone conversion from previous high doses of opioids from July 2018 to December 2022. The 3DS strategy indicated that the methadone dose was increased by one third every day for 3 days. Data on the rate of successful conversion, the time to stable analgesia after conversion, the conversion efficiency, the corrected QT (QTc) interval, the actual conversion ratios, adverse events (AEs), and quality of life were analyzed.</p><p><strong>Results: </strong>Seventy patients received 3DS methadone conversion and 64 patients were eligible for analysis. Fifty patients (78%) achieved stable analgesia, and the median time to stable analgesia was 8.14 ± 2.70 (range 6-14) days. The average dose of methadone was 77.94 ± 42.74 mg. The most common AEs (≥ 10%) included constipation, dry mouth, nausea, and cold sweats. The incidence of constipation was reduced post-methadone conversion, and a statistically significant but asymptomatic prolongation of the QTc interval was observed. Additionally, the actual conversion ratios were lower than Ayonrinde's recommended ratios.</p><p><strong>Conclusions: </strong>The 3DS strategy for methadone conversion is applicable in Chinese patients with refractory cancer pain on high doses of opioids.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"1499-1509"},"PeriodicalIF":4.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11543960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}