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Scientific poster abstracts from the 24th annual meeting of the American Academy of Pain Medicine

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.

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

Editors note: Funding was provided by AstraZeneca and NIH grant AR30852.

What Are the Variables That Are Associated with the Patients 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 ent of Fibromyalgia Syndrome: A 15-Week, Randomized, Double-Blind, Placebo- Controlled Trial

Safety and Efficacy of 12-Hour Extended-Release Hydrocodone/Acetaminophen for Acute Pain Following Bunionectomy: A Phase 3, Randomized, Multi-Center, Double- Blind Study

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

A Retrospective Review of Initial Motives for Seeking Opioids as Reported by PatientsBeing Treated for Opioid Addiction

Effects of 12-Hour, Extended-Release Hydrocodone/Acetaminophen on Pain-Related Work Productivity: A Subanalysis from a 56-Week, Open-Label Study

The Effects of Graded Concentrations of Oral Ethanol on the Pharmacokinetics of Oxymorphone Extended-Release Tablets in Healthy Volunteers

Intrathecal Drug Delivery Pump Failure: The Inability to Refill a Pump Secondary to Increased Pressure

Contracts Designed for Emergency Department Treatment of Chronic Headache Breakthrough Pain Improve Physician and Patient Satisfaction

Treatment of Persistent Testicular Pain: A Case Report

One-Year Durability of Response to Milnacipran Treatment for Fibromyalgia

Cognitive Complexity and Reading Demands of Patient Self-Administered Opioid Assessment Screening Tools

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

Lacosamide in Long-Term Treatment of Painful Diabetic Neuropathy

Subdural Hygromas, A Complication of Epidural Catheter ImplantationA Case Report

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

Efficacy of Tapentadol, a Novel, Centrally Active Analgesic with a Dual Mode of Action, in Animal Models of Visceral Pain

The Efficacy and Safety of Milnacipran in the Treatment of Fibromyalgia

Lacosamide in Painful Distal Diabetic Neuropathy: Results of a Multi-Center, Placebo-Controlled U.S. Trial

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

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

Lacosamide in Patients with Painful Diabetic Neuropathy: 1-Year Interim Results from a Long-Term, Multi-Center, Open-Label Trial

Changes in Blood Glucose Levels in Diabetics After Epidural Steroid Injection

The Tolerability and Safety Profile of Fentanyl Buccal Tablet in Opioid-Tolerant Patients with Cancer and Breakthrough Pain: A Pooled Analysis

Bipolar Radiofrequency Ablation in the Presence of Pacemaker and Peripheral Nerve Stimulator

Sensory Nerve Action Potentials of Adelta Fibers Have Different Amplitudes and Morphologies in Acute and Chronic Spine Pain Patients

Immediate Relief of Non-Painful Discomfort with an Acute Sciatic Nerve Press

Changes in Glycosylated Hemoglobin After Epidural Steroid Injection

Stimulation Coverage of Transverse Tripole Programming Using the Lamitrode Tripole 16 Surgical Lead: PreliminaryEvaluation of a Prospective, Multi-Centered, Post-Market Study

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

Treating Atypical Facial Pain with Peripheral Nerve Stimulation: A Collection of 10 Case Reports

Pain Medicine and Primary Care: A Community Solution to a Population with Chronic Pain

Effects of 12-Hour, Extended-Release Hydrocodone/Acetaminophen on Pain-Related Physical Function, Work Productivity, and Sleep Quality: A 56-Week, Open-Label Study

The Safety of Light to Moderate Conscious Sedation in Ambulatory Interventional Spinal Procedures

Preliminary Results of a Novel Method for the Treatment of Chronic Plantar Fasciitis with Botulinum Toxin Type A: A Randomized, Double-Blind Study

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

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

Oxycodone: Using Pharmacogenomics and TDM to Guide Pain Management Therapy

Allergic Reaction to Epidural Methylprednisolone Acetate

Targeted Cervical Epidural Steroid Injection Using a Radiopaque CatheterA Technique Report

Predictors of Sustained Pain Improvement or Worsening in Community Dwelling Elders

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

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

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

Pharmacogenomic Evaluation of Methadone Toxicity in a Therapeutic Pain Management Patient: A Case Report

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

Characteristics and Outcomes of Patients Discharged from the Opioid Renewal Clinic of the Philadelphia VAMC

Eon Battery Recharging: Preliminary Findings of Three Prospective, Multi-Centered, Post-Market Studies

A Possible Solution to Objective Muscle Pain Assessment: The Muscle Pain Detection Device (MPDD)

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

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

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

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

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.

Editors note: Funding was provided by Pearson Assessments.

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

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.

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

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.

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

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

Editors note: Funding was provided by Medtronic.

All Abstract Numbers and Titles

Smoking and Neuropathic Pain

The Relationships Between Sleep and Pain in Patients with Diabetic PeripheralNeuropathic Pain: Responses to Treatment with Duloxetine

What Are the Variables That AreAssociated with the Patients Wish to Sue His Physician in Patients with Acute and Chronic Pain?

What Variables Are Associated with a Wish to Kill a Physician in Acute and ChronicPain Patients?

Fluoroscopically-Guided Injections to Diagnose and Treat Baastrups Syndrome

The Immediate and Long-Term Benefits of Physical Conditioning in Chronic Pain Patients

Incidence of Spinal Surgery for Patients with Back Pain

Five-Year Follow Up of Back Pain Patients

Alfentanil-Morphine (ALFINE) in Postoperative Pain

The Safety and Efficacy of Duloxetine Hydrochloride for the Treatment of Fibromyalgia: Results from a 6-MonthRandomized, Double-Blind, Placebo-Controlled, Fixed-Dosed Trial

Duloxetine Hepatic Effects: 2006 Review

Chronic Abdominal Pain as a Presentation Symptom of Takayasus Arteritis

Radiation-Induced Alarm and Failure of an Implanted Programmable Intrathecal Pump

Percutaneous Thermal Disc Decompression in Patients with Symptomatic Contained Lumbar Disc Protrusion Refractory to Conservative Treatment: A Prospective Cohort Study

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

Epidural Blood Patch Effective Treatment of Headache Caused by Subdural Hematoma/CSF leakage.

Peripheral Nerve Stimulation for Interscapular Neuropathic Pain

Successful Treatment of Post-Thoracotomy Pain Using Peripheral Nerve StimulationA Case Report

Smoking Related Gender Differences Among Patients Evaluated in a Tertiary PainClinic

Long-Term Safety of Fentanyl Buccal Tablet for the Treatment of Breakthrough Pain in Opioid-Tolerant Cancer Patients

The Impact of CYP2D6 Genetic Polymorphism on Postoperative MorphineConsumption

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

Perils of Depomedrol Injections into the Vertebral ArteryAn Animal Study

Transsacrococcygeal Approach to Ganglion Impar Block for Management of Chronic Perineal Pain: A Prospective Observational Study.

Methylnaltrexone Treatment of Opioid-Induced Constipation in Cancer Patients with Advanced Illness

Buccal and Sublingual Administration of Fentanyl Buccal Tablet Are Bioequivalent: A Randomized, Open-Label, Single-Dose, Crossover Study

Modeling Work Productivity Loss from a Variety of Clinical Indicators of Health Status

Retroperitoneal Fluoroscopic Guided Approach to Iliopsoas Muscle Chemo-Denervation, Via Botulinum Toxin, for Chronic Pelvic Pain: A Case Report

Axial Back Pain Relief and Patient Satisfaction Profiles with Spinal Cord Stimulation (SCS): A 50-Patient Series

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

Spinal Cord Stimulation for Central Post-Stroke Pain.

Low Volume Interventional MRI-GuidedNeurolytic Celiac Plexus Block

Successful Acupuncture Treatment for Intractable Chronic Atypical Facial Pain After Failed Motor Cortex Stimulation

An Immediate Broadly Useful Method, 2-Minute Sciatic Nerves Press, for RapidRelief of Pain in Man: A Randomized Controlled Trial

Patient Preferences for Constant Current and Constant Voltage Stimulation

Restart of a Rechargeable Implantable Pulse Generator After 10 Months

The Effect of Voltage Multiplication Rates and Discharge Modes

BEMA (BioErodible MucoAdhesive) Fentanyl Demonstrates a Favorable Pharmacokinetic Profile Compared to Oral Transmucosal Fentanyl Citrate (Actiq ) in Healthy Volunteers

Initial Evaluation of Tripolar Leads for Spinal Cord Stimulation

Differences in Constant Current and Constant Voltage StimulationA Case Study

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)

Treating Post-Herpetic Neuralgia with Peripheral Nerve StimulationA Case Report

Long-Term Efficacy and Tolerability of 12-Hour, Extended-Release Hydrocodone/Acetaminophen: A 56-Week, Phase 3, Open-Label Study

Coccydynia Treated with Spinal Cord Stimulation: A Case Report

Use of Ultrasound Guidance for Placement of Percutaneous Trial Leads for Peripheral Nerve Stimulation of Ilioinguinal Neuralgia

Use of Coordinated PT/OT and Peripheral Nerve Block for in patient Treatment of Recalcitrant CRPS, Type 1

Epidural Hematoma in a Heparinized Patient

Correlates of Patient Satisfaction in Patients with Low Back Pain

Pulsed Radiofrequency of Pudendal Nerve to Treat Perineal Pain

ALO-01, An Investigational Extended-Release Opioid Formulation Containing Morphine Sulfate and Sequestered Naltrexone: Pharmacodynamic (Drug Liking) Effects

Relative Analgesic Potencies of Intranasal Ketamine and Intranasal Morphine Compared to Intravenous Morphine

Opioid Combination Drug Therapy for Neuropathic Pain

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

The Pharmacokinetics of Tapentadol Are Not Affected by Omeprazole: Results of a 2-Way Crossover Drug-Interaction Study in Healthy Subjects

The Efficacy and Tolerability of Tapentadol Immediate Release for the Treatment of Acute Pain Following Bunionectomy

Opioid Analgesic Abusers Can Be Subtyped by Preferred Route of Abuse: Results from the 2005 Treatment Episode Data Set (TEDS)

Evaluation of Lacosamide in Diabetic Neuropathic Pain Trials

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

Tapentadol Extended Release (ER) for the Relief of Moderate-to-Severe Chronic Pain Due to Osteoarthritis of the Knee

Pharmacokinetic and Pharmacodynamic Evaluations of Immediate Release Morphine in Combination with Ethanol in HealthySubjects

Determinants of the Chronic Pain Experience in Black and White Men

Single-Shot Intrathecal Ziconotide to Predict Its Pump Infusion Effect

Milnacipran Efficacy in the Treatm

Contact: Amy Jenkins
American Academy of Pain Medicine

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