Scandinavian Journal of Pain最新文献

{"title":"Patient characteristics in relation to opioid exposure in a chronic non-cancer pain population.","authors":"Henrik Grelz, Ulf Jakobsson, Patrik Midlöv, Marcelo Rivano Fischer, Åsa Ringqvist","doi":"10.1515/sjpain-2024-0025","DOIUrl":"https://doi.org/10.1515/sjpain-2024-0025","url":null,"abstract":"<p><strong>Objectives: </strong>The efficacy of long-term opioid therapy (LTOT) in treating patients with chronic non-cancer pain (CnCP) is questionable, and the potential risks of adverse effects are well established. The aims were as follows: (1) compare characteristics in patients exposed to LTOT vs non-exposed. (2) Regarding opioid-exposed patients, describe characteristics of patients with risk factors for opioid use disorder or overdose in relation to opioid dosage.</p><p><strong>Method: </strong>A cross-sectional study was conducted at a Swedish tertiary pain rehabilitation clinic serving CnCP patients. The study population comprised 1,604 patients ≥18 years old registered in the Swedish Quality Registry for Pain Rehabilitation between 2018 and 2020. Data on dispensed opioids were extracted from the Swedish Prescribed Drug Register. Dependent variables were as follows: LTOT vs non-LTOT and exposed opioid dosage <50 mg morphine equivalent/day (MME/day) vs ≥50 MME/day.</p><p><strong>Results: </strong>Of the included patients, 681 (42.5%) had at least one dispensation of opioids 180 days prior to assessment, 601 with a calculated opioid dosage ≥1 MME/day, and 424 (26.4%) were exposed to LTOT. The type of opioid prescribed was, in descending order, oxycodone (42.3% of all dispensations), codeine in combination with paracetamol (17.6%), tramadol (13.8%), and morphine (8.1%). A total of 89 cases had dosages of ≥50 MME/day and 430 patient dosages <50 MME/day. Patients exposed to LTOT exhibited an increased odds ratio (OR) of 2.685 (95% CI, 1.942-3.711) for concomitant use of benzodiazepines and male sex (OR, 1.694; 95% CI, 1.227-2.337). Patients receiving doses ≥50 MME/day were all, except one, exposed to LTOT. The concomitant use of benzodiazepines (OR 1.814, 95% CI 1.264-3.331) and male sex (OR, 1.777; 95% CI, 1.178-3.102) indicated a higher OR for opioid doses ≥50 MME/day.</p><p><strong>Conclusions: </strong>LTOT strongly influenced the opioid dose. Furthermore, concomitant benzodiazepine dispensation and male sex were over-represented in patients exposed to LTOT as well as those exposed to opioid doses ≥50 MME/day.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"24 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pain perception while listening to thrash heavy metal vs relaxing music at a heavy metal festival - the CoPainHell study - a factorial randomized non-blinded crossover trial.","authors":"Anders Holm Welling, Anders Blom Nathansen, Sandra Egedie Lyby Taylor Pitter, Jesper Mølgaard, Anthony Henry Dickenson, Eske Kvanner Aasvang","doi":"10.1515/sjpain-2024-0070","DOIUrl":"10.1515/sjpain-2024-0070","url":null,"abstract":"<p><strong>Objectives: </strong>Music festivals are often a source of joy, but also a risk of injury. While previous studies suggest music can relieve pain, its effect has not been tested in festival settings, nor has the effect of high-energy vs soothing music been compared. We hypothesized that guests at a heavy metal music festival would experience less pain when listening to thrash heavy metal compared to relaxing music, with the effect being influenced by music preference and increased with higher alcohol intake.</p><p><strong>Methods: </strong>This factorial randomized non-blinded crossover trial assessed pain during a 5°C cold pressor test (CPT) at a heavy metal festival. Participants were randomized to listen to either Slayer's \"Raining Blood\" or Enya's \"Orinoco Flow\" during their first CPT, and the opposite song during the second CPT. The primary outcome was pain during the CPT, assessed as area under the curve (AUC). Music fondness and breath alcohol concentration (BrAC) were measured before each CPT.</p><p><strong>Results: </strong>Forty-five adults, aged 19-58 years, were included, and completed both CPTs. Significantly more pain was reported while listening to Enya (AUC 1,155 [IQR 588-1,507]) vs Slayer (AUC 975 [IQR 682-1,492]) (<i>p</i> = 0.048). Higher BrAC was associated with decreased pain (<i>p</i> = 0.042). Participants with higher fondness of Enya experienced significantly more pain than those who liked the song less (<i>p</i> = 0.021). Fondness of Slayer had no effect on pain perception (<i>p</i> = 0.7).</p><p><strong>Conclusion: </strong>Listening to thrash heavy metal, specifically \"Raining Blood\" by Slayer during painful stimuli results in lower pain intensity than listening to relaxing music in the form of \"Orinoco Flow\" by Enya. The findings' impact on pain in a clinical setting should be explored.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"24 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Christmas greetings 2024 from the Editor-in-Chief.","authors":"Mads Werner","doi":"10.1515/sjpain-2024-9998","DOIUrl":"https://doi.org/10.1515/sjpain-2024-9998","url":null,"abstract":"","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"24 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of substance use disorder diagnoses in patients with chronic pain receiving reimbursed opioids: An epidemiological study of four Norwegian health registries.","authors":"Torunn Hatlen Nøst, Svetlana Skurtveit, Ingvild Odsbu, Line Pedersen, Petter C Borchgrevink, Marte Handal","doi":"10.1515/sjpain-2024-0059","DOIUrl":"10.1515/sjpain-2024-0059","url":null,"abstract":"<p><strong>Objectives: </strong>Since 2008, patients have had access to reimbursed analgesics, including opioids, for chronic pain in Norway. There is a need for knowledge on the occurrence and trends over time of substance use disorder (SUD) diagnoses among patients who receive reimbursed opioids for chronic pain. The primary aim of this study was to investigate the prevalence of SUD diagnoses in patients with chronic pain using reimbursed opioids from 2010 to 2019 in Norway. The secondary aim was to investigate the prevalence of other mental health diagnoses among those receiving reimbursed opioids in the subgroups with and without SUD diagnoses.</p><p><strong>Methods: </strong>A cross-sectional design utilising data from four Norwegian nationwide registries.</p><p><strong>Results: </strong>The annual number of individuals with SUD diagnoses increased from 377 to 932 from 2010 to 2019, while the annual prevalence of individuals with SUD remained relatively stable at around 5%. There was a higher prevalence for all categories of other mental health diagnoses among individuals with a SUD diagnosis, compared to those without a SUD diagnosis.</p><p><strong>Conclusion: </strong>The prevalence of SUD diagnoses was low in the population using reimbursed opioids for chronic pain in Norway, but the number of patients increased in the study period because the number of individuals receiving reimbursed opioids increased. Patients with a SUD used on average twice the daily doses of opioids compared to patients without a SUD. They were also more likely to have an additional mental health diagnosis.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"24 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revisiting opioid toxicity: Cellular effects of six commonly used opioids.","authors":"Erik Nylander, Frida Stam, Lenka Katila, Sofia Zelleroth, Jennifer Birgersson, Fred Nyberg, Mathias Hallberg, Alfhild Grönbladh","doi":"10.1515/sjpain-2024-0038","DOIUrl":"10.1515/sjpain-2024-0038","url":null,"abstract":"<p><strong>Objectives: </strong>There is an ongoing opioid crisis in the United States where the illicit and non-medical use of prescription opioids is associated with an increasing number of overdose deaths. Few studies have investigated opioid-induced effects on cell viability, and comparative studies are limited. Here, we examine the toxicity of six commonly used opioids: methadone, morphine, oxycodone, hydromorphone, ketobemidone, and fentanyl with respect to mitochondrial and membrane function <i>in vitro</i>.</p><p><strong>Methods: </strong>The opioids were tested in four different cell cultures: primary cortical cell cultures, human neuroblastoma SH-SY5Y cells, and both differentiated and undifferentiated neuroblastoma/glioma hybrid NG108-15 cells. The mitochondrial activity was assessed using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay and the membrane integrity was assessed by measuring the leakage of lactate dehydrogenase. To compare the different opioids, the toxic dose (TD₅₀) was calculated.</p><p><strong>Results: </strong>The results displayed a similar trend of opioid-reduced cell viability in all four cell cultures. The most toxic opioid was methadone, followed by fentanyl, while morphine was overall ranked as the least toxic opioid displaying little to no negative impact on cell viability. The remaining opioids varied in rank between the different cell types.</p><p><strong>Conclusion: </strong>This <i>in vitro</i> study highlights opioid-dependent variations in toxicity across all four tested cell types, with methadone emerging as the most potent opioid.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"24 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of social exclusion on pain perception and heart rate variability in healthy controls and somatoform pain patients.","authors":"Fabrice Kleber, Andreas Reif, Moritz de Greck","doi":"10.1515/sjpain-2024-0042","DOIUrl":"10.1515/sjpain-2024-0042","url":null,"abstract":"<p><strong>Objectives: </strong>The overlapping neural networks of social and physical pain have been investigated intensively in recent years. It was postulated that triggering social pain might result in greater physical pain. Nonetheless, how this affects somatoform pain disorder has not yet been considered. Since an increased pain processing activity is reported in these patients, the investigation of social exclusion and its effect on this group seems interesting. Hence, the aim of this study was to compare the influence of social exclusion on healthy controls and patients with somatoform pain disorder.</p><p><strong>Methods: </strong>Nineteen patients with somatoform pain disorder and 19 healthy controls were examined. Cyberball, a virtual ball-tossing paradigm, was used to experimentally induce social exclusion and inclusion. To measure effects on pain perception, pressure pain thresholds and heart rate variability (HRV) were recorded after each round of cyberball. Demographic data, pain medication, and potential psychosocial moderators were collected by questionnaires.</p><p><strong>Results: </strong>After social exclusion, pressure pain thresholds were significantly reduced in healthy controls (<i>p</i> < 0.01) as well as somatoform pain patients (<i>p</i> < 0.05), while HRV increased only in patients with somatoform pain disorder (<i>p</i> < 0.05) indicating increased parasympathetic activity.</p><p><strong>Conclusion: </strong>This study is the first to analyse the effects of social exclusion on pain perception in somatoform pain disorder. While the reduction in pressure pain thresholds is in line with the social pain literature, the effects on HRV could be interpreted as a form of pain regulation mechanism. However, further research is needed to investigate the role of parasympathetic activity in socially excluded somatoform pain patients.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"24 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pain catastrophizing levels differentiate between common diseases with pain: HIV, fibromyalgia, complex regional pain syndrome, and breast cancer survivors.","authors":"Reetta Sipilä, Eija Kalso, Harriet Kemp, Teemu Zetterman, Fabiola Escolano Lozano, Andrew S C Rice, Frank Birklein, Violeta Dimova","doi":"10.1515/sjpain-2024-0049","DOIUrl":"10.1515/sjpain-2024-0049","url":null,"abstract":"<p><strong>Objectives: </strong>Pain catastrophizing is a core psychological factor determining pain experience. We addressed the question of whether patients with different pain syndromes group into different pain catastrophizing phenotypes.</p><p><strong>Methods: </strong>A total of 727 patients with chronic pain associated with four primary syndromes: Breast cancer (BC) survivors (<i>n</i> = 400), fibromyalgia (FM, <i>n</i> = 52), complex regional pain syndrome (CRPS, <i>n</i> = 155), and HIV (<i>n</i> = 120) were first studied for differences in levels of pain catastrophizing (Pain Catastrophizing Scale, PCS) and pain intensity by analysis of variance. Subsequently, individual scores of the PCS subscales \"rumination\", \"magnification,\" and \"helplessness\" from the pooled cohorts were submitted to multivariate k-means clustering to explore subgroups.</p><p><strong>Results: </strong>Three clusters defined by the level of catastrophizing were identified. The \"low catastrophizing\" cluster (<i>n</i> = 377) included most of the BC patients (71.0%) and the \"moderate catastrophizing\" cluster (<i>n</i> = 256) most of the FM patients (61.5%). HIV (31.9%) and CRPS (44.7%) patients were over-represented in the \"high catastrophizing\" cluster (<i>n</i> = 94) with the highest catastrophizing tendencies in all dimensions. These patients reported more helplessness than the patients in the two other clusters.</p><p><strong>Conclusions: </strong>The primary syndrome causing the pain has an impact on self-reported pain-related catastrophizing. Helplessness is a predominant feature in HIV and CRPS patients and therefore an important target in pain rehabilitation.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"24 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"To speak or not to speak? A secondary data analysis to further explore the context-insensitive avoidance scale.","authors":"Pernilla Abrahamsson, Katja Boersma, Monica Buhrman","doi":"10.1515/sjpain-2024-0039","DOIUrl":"10.1515/sjpain-2024-0039","url":null,"abstract":"<p><strong>Objectives: </strong>Inflexibly relying on avoidance of expression may increase and perpetuate pain-related emotional distress in patients with chronic pain. The context-insensitive avoidance (CIA) scale was recently developed to measure the degree to which patients avoid expressing their pain and distress in social situations. This study explored the psychometric properties of the CIA scale in a new sample.</p><p><strong>Methods: </strong>This study uses baseline data from a treatment trial for <i>n</i> = 115 patients with chronic pain and co-occurring emotional distress. Reliability and construct and criteria validity were studied using the same instruments as in the original psychometric study and further explored in two new measures. A series of multiple regression analyses were conducted to assess the relationship between the CIA scale and criteria variables compared to the other psychological constructs.</p><p><strong>Results: </strong>The CIA scale showed good reliability. Significant correlations between high scores on the CIA scale and low scores on self-compassion and activity engagement could be replicated. Significant correlations between high scores on the CIA scale and high scores of pain intensity and pain interference could also be replicated. In the exploring part of this study, validity was extended to general problems with emotion regulation and to satisfaction with life in general and contact with friends but not to satisfaction with family, partner, or sexual life. Avoidance of expression was the only significant predictor of pain intensity.</p><p><strong>Conclusion: </strong>This study could replicate acceptable psychometric properties of a scale measuring CIA of expression. As in the original study, avoidance of expression was associated with increased suffering. Clinically, this instrument may be used to identify patients who may otherwise remain in aggravating silence. Theoretically, it introduces the important concept of context sensitivity to the field of chronic pain. Limitations include uncertainty about causal relationships, and that several important social situations were not examined.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"24 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dimensionality, reliability, and validity of the Finnish version of the pain catastrophizing scale in chronic low back pain.","authors":"Jani Mikkonen, Ville Leinonen, Tuomas Lähdeoja, Riikka Holopainen, Kristian Ekström, Petteri Koho, Olavi Airaksinen, Juan V Luciano, Jaime Navarrete, Randy Neblett","doi":"10.1515/sjpain-2024-0034","DOIUrl":"10.1515/sjpain-2024-0034","url":null,"abstract":"<p><strong>Objectives: </strong>The 13-item pain catastrophizing scale (PCS) is the most commonly used measure of pain catastrophizing. A validated Finnish version of the PCS has previously been unavailable. The objectives were to translate the original English version of the PCS into Finnish (PCS-FI), then to evaluate (i) structural validity of the PCS-FI with a confirmatory factor analysis (CFA), (ii) internal reliability with Cronbach's alpha, Omega, and Omega hierarchical, (iii) convergent validity with measures of well-being, quality of life, sleep quality, symptoms of central sensitization, and anxiety, and (iv) known-groups validity between participants with chronic low back pain (CLBP) and pain-free controls.</p><p><strong>Methods: </strong>The translation process was performed with established guidelines. The PCS-FI was psychometrically validated using 92 participants with CLBP and 53 pain-free controls.</p><p><strong>Results: </strong>Structural validity with CFA supported a bifactor solution. However, low reliability was found for the three specific factors (<i>ω</i> _h ranging from 0.14 to 0.18) compared to the general factor (<i>ω</i> _h = 0.88) suggesting that only the total score should be used. Convergent validity analysis showed satisfactory correlations and medium effect sizes with the other patient-reported outcome measures. Participants with CLBP had significantly higher total PCS-FI scores than pain-free controls.</p><p><strong>Conclusions: </strong>The PCS-FI appears to be a valid and reliable instrument for assessing pain-related catastrophizing in Finnish-speaking populations. Ethical approval for this study was obtained from the Research Ethics Committee of the Northern Savo Hospital District, identification number 2131/2022, on the 31st of January 2022.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"24 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intrathecal pain treatment for severe pain in patients with terminal cancer: A retrospective analysis of treatment-related complications and side effects.","authors":"Linda Bengtsson, Sven-Egron Thörn, Lars-Erik Dyrehag, Olaf Gräbel, Paulin Andréll","doi":"10.1515/sjpain-2024-0041","DOIUrl":"10.1515/sjpain-2024-0041","url":null,"abstract":"<p><strong>Objectives: </strong>Two-thirds of patients with advanced cancer experience pain. Some of these patients have severe pain refractory to oral and parenteral medication, for whom intrathecal pain treatment could be an option. While intrathecal therapy is presently used with good results in clinical practice, the current evidence is limited. Hence, increased knowledge of intrathecal pain treatment is needed. This retrospective study aimed to assess complications and side effects related to intrathecal pain treatment in patients with terminal cancer.</p><p><strong>Methods: </strong>A retrospective study on all patients who received intrathecal treatment with morphine and bupivacaine through externalized catheters for cancer-related pain at a single university hospital during a 5-year period.</p><p><strong>Results: </strong>Treatment-related complications were reported in 24 out of 53 patients. The most common complications were catheter dislocation (13%), catheter occlusion (9%), falls due to bupivacaine-related numbness or weakness (9%), and reversible respiratory depression (8%). There were five serious complications, i.e., meningitis or neurological impairment, of which four were reversible. Side effects related to intrathecal drugs, or the implantation procedure were observed in 35 patients. The most common were bupivacaine-related numbness or weakness (57%) and reversible post-dural puncture headache (19%). Systemic opioid doses decreased during the first 3 weeks of intrathecal treatment, from a median daily dose of 681 to 319 oral morphine milligram equivalents. The median treatment duration time was 62 days.</p><p><strong>Conclusions: </strong>Complications related to intrathecal treatment are common, but mostly minor and reversible. Side effects are predominantly related to unwanted pharmacological effects from intrathecal drugs. Intrathecal treatment enables the reduction of systemic opioid doses, which indicates a good treatment effect on pain. Hence, intrathecal therapy can be considered a safe pain-relieving treatment in patients with severe refractory cancer-related pain. Future research is warranted on patient acceptability and satisfaction of intrathecal pain treatment.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"24 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}