{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T14:41:45Z","timestamp":1790260905537,"version":"4.1.0"},"reference-count":44,"publisher":"Walter de Gruyter GmbH","issue":"4","license":[{"start":{"date-parts":[[2014,10,1]],"date-time":"2014-10-01T00:00:00Z","timestamp":1412121600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"}],"funder":[{"name":"Helsinki University Central Hospital Research Funds","award":["T102010066"],"award-info":[{"award-number":["T102010066"]}]}],"content-domain":{"domain":["scandinavianjournalpain.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2014,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_j.sjpain.2014.07.001_s_001\">\n                    <jats:title>Background and aims<\/jats:title>\n                    <jats:p>Thoracotomies can cause severe pain, which persists in 21\u201367% of patients. We investigated whether NSAID + intravenous patient-controlled analgesia (IV-PCA) with morphine is an efficacious alternative to thoracic epidural analgesia (TEA). We also wanted to find out whether an extended controlled pain management protocol within a clinical study can decrease the incidence of persistent post-thoracotomy pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_j.sjpain.2014.07.001_s_002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Thirty thoracotomy patients were randomized into 3 intervention groups with 10 patients in each. G1: preoperative diclofenac 75mg orally+150 mg\/24h IV for 44h, then PO; G2: valdecoxib 40mg orally+parecoxib 80mg\/24h IV for 44h, then PO. IV-PCA morphine was available in groups 1 and 2 during pleural drainage, and an intercostal nerve block at the end of surgery was performed; G3: parac-etamol+patient controlled epidural analgesia (PCEA) with a background infusion of bupivacaine with fentanyl. After PCA\/PCEA oxycodone PO was provided when needed. These patients were contacted one week, 3 and 6 months after discharge. Patients (\n                      <jats:italic>N<\/jats:italic>\n                      = 111) not involved in the study were treated according to hospital practice and served as a control group. The control patients\u2019 data from the perioperative period were extracted, and a prospective follow-up questionnaire at 6 months after surgery similar to the intervention group was mailed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_j.sjpain.2014.07.001_s_003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The intended sample size was not reached in the intervention group because of the global withdrawal of valdecoxib, and the study was terminated prematurely. At 6 months 3% of the intervention patients and 24%ofthe control patients reported persistent pain (\n                      <jats:italic>p<\/jats:italic>\n                      &lt;0.01). Diclofenac and valdecoxib provided similar analgesia, and in the combined NSAID group (diclofenac+valdecoxib) movement-related pain was milder in the PCEA group compared with the NSAID group. The duration of pain after coughing was shorter in the PCEA group compared with the NSAID+IV-PCA group. The only patient with persistent painat6 months postoperatively had a considerably longer duration ofpain after coughing than the other Study patients. The patients with mechanical hyperalgesia had more pain on movement.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_j.sjpain.2014.07.001_s_004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Both PCEA and NSAID+IV-PCA morphine provided sufficient analgesia with little persistent pain compared with the incidence of persistent pain in the control group. High quality acute pain management and follow-up continuing after discharge could be more important than the analgesic method per se in preventing persistent post-thoracotomy pain. In the acute phase the measurement of pain when coughing and the duration of pain after coughing could be easy measures to recognize patients having a higher risk for persistent post-thoracotomy pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_j.sjpain.2014.07.001_s_005\">\n                    <jats:title>Implications<\/jats:title>\n                    <jats:p>To prevent persistent post-thoracotomy pain, the extended protocol for high quality pain management in hospital covering also the sub-acute phase at home, is important. This study also provides some evidence that safe and effective alternatives to thoracic epidural analgesia do exist. The idea to include the standard \u201cas usual\u201d care patients as a control group and to compare them with the intervention patients provides valuable information of the added value of being a study patient, and deserves further consideration in future studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.sjpain.2014.07.001","type":"journal-article","created":{"date-parts":[[2014,7,31]],"date-time":"2014-07-31T10:02:52Z","timestamp":1406800972000},"page":"240-247","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":21,"title":["Managing post-thoracotomy pain: Epidural or systemic analgesia and extended care \u2013 A randomized study with an \u201cas usual\u201d control group"],"prefix":"10.1515","volume":"5","author":[{"given":"Elina","family":"Tiippana","sequence":"first","affiliation":[{"name":"Helsinki University Central Hospital , Department of Anaesthesia, Intensive Care Medicine, Emergency Medicine and Pain Medicine , Helsinki , Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaisa","family":"Nelskyl\u00e4","sequence":"additional","affiliation":[{"name":"Helsinki University Central Hospital , Department of Anaesthesia, Intensive Care Medicine, Emergency Medicine and Pain Medicine , Helsinki , Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eija","family":"Nilsson","sequence":"additional","affiliation":[{"name":"Helsinki University Central Hospital , Department of Anaesthesia, Intensive Care Medicine, Emergency Medicine and Pain Medicine , Helsinki , Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eero","family":"Sihvo","sequence":"additional","affiliation":[{"name":"Helsinki University Central Hospital , Department of Surgery , Helsinki , Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matti","family":"Kataja","sequence":"additional","affiliation":[{"name":"National Institute for Health and Welfare , Helsinki , Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eija","family":"Kalso","sequence":"additional","affiliation":[{"name":"Helsinki University Central Hospital , Department of Anaesthesia, Intensive Care Medicine, Emergency Medicine and Pain Medicine , Helsinki , Finland"},{"name":"University of Helsinki , Institute of Clinical Medicine , Helsinki , Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2014,10,1]]},"reference":[{"key":"2025120909544283181_j_j.sjpain.2014.07.001_ref_001","unstructured":"Sandler AN. Post-thoracotomy analgesia and perioperative outcome. Minerva Anestesiol 1999;65:267\u201374."},{"key":"2025120909544283181_j_j.sjpain.2014.07.001_ref_002","doi-asserted-by":"crossref","unstructured":"Ballantyne JC, Carr DB, deFerranti  S, Suarez  T, Lau  J, Chalmers TC, Angelillo IF, Mosteller F. The comparative effects of postoperative analgesic therapies on pulmonary outcome: cumulative meta-analyses of randomized, controlled trials. Anesth Analg 1998;86:598\u2013612.","DOI":"10.1213\/00000539-199803000-00032"},{"key":"2025120909544283181_j_j.sjpain.2014.07.001_ref_003","doi-asserted-by":"crossref","unstructured":"Tiippana  E, Nilsson  E, Kalso E. Post-thoracotomy pain after thoracic epidural analgesia: a prospective follow-up study. Acta Anaesthesiol Scand 2003;47:433\u20138.","DOI":"10.1034\/j.1399-6576.2003.00056.x"},{"key":"2025120909544283181_j_j.sjpain.2014.07.001_ref_004","doi-asserted-by":"crossref","unstructured":"Bong CL, Samuel  M, Ng JM, Ip-Yam C. Effects of pre-emptive epidural analgesia on post-thoracotomy pain. J Cardiothorac Vasc Anesth 2005;19:786\u201393.","DOI":"10.1053\/j.jvca.2005.08.012"},{"key":"2025120909544283181_j_j.sjpain.2014.07.001_ref_005","doi-asserted-by":"crossref","unstructured":"Gottschalk  A, Cohen SP, Yang  S, Ochroch A. Preventing and treating pain after thoracic surgery. Anesthesiology 2006;104:594\u2013600.","DOI":"10.1097\/00000542-200603000-00027"},{"key":"2025120909544283181_j_j.sjpain.2014.07.001_ref_006","doi-asserted-by":"crossref","unstructured":"Ng  A, Swanevelder J. Pain relief after thoracotomy: is epidural analgesia the optimal technique? Br J Anaesth 2007;98:159\u201362.","DOI":"10.1093\/bja\/ael360"},{"key":"2025120909544283181_j_j.sjpain.2014.07.001_ref_007","doi-asserted-by":"crossref","unstructured":"Wildgaard  K, Ringsted TK, Aasvang EK, Ravn  J, Werner MU, Kehlet H. Neuro-physiological characterization of persistent postthoracotomy pain. Clin J Pain 2012;28:136\u201342.","DOI":"10.1097\/AJP.0b013e3182261650"},{"key":"2025120909544283181_j_j.sjpain.2014.07.001_ref_008","doi-asserted-by":"crossref","unstructured":"Kalso  E, Perttunen  K, Kaasinen S. Pain after thoracic surgery. Acta Anaesthesiol Scand 1992;36:96\u2013100.","DOI":"10.1111\/j.1399-6576.1992.tb03430.x"},{"key":"2025120909544283181_j_j.sjpain.2014.07.001_ref_009","doi-asserted-by":"crossref","unstructured":"Perttunen  K, Tasmuth  T, Kalso E. Chronic pain after thoracic surgery: a follow-up study. Acta Anaesthesiol Scand 1999;43:563\u20137.","DOI":"10.1034\/j.1399-6576.1999.430513.x"},{"key":"2025120909544283181_j_j.sjpain.2014.07.001_ref_010","doi-asserted-by":"crossref","unstructured":"Pluijms WA, Steegers MAH, Verhagen AF, Scheffer GJ, Wilder-Smith OHG. Chronic post-thoracotomy pain: a retrospective study. Acta Anaesthesiol Scand 2006;50:804\u20138.","DOI":"10.1111\/j.1399-6576.2006.01065.x"},{"key":"2025120909544283181_j_j.sjpain.2014.07.001_ref_011","doi-asserted-by":"crossref","unstructured":"Steegers MAH, Snik DM, Verhagen AF, van der Drift MA, Wilder-Smith OHG. Only half of the chronic pain after thoracic surgery shows a neuropathic component. J Pain 2008;9:955\u201361.","DOI":"10.1016\/j.jpain.2008.05.009"},{"key":"2025120909544283181_j_j.sjpain.2014.07.001_ref_012","doi-asserted-by":"crossref","unstructured":"Gottschalk  A, Ochroch EA. Clinical and demographic characteristics of patients with chronic pain after major thoracotomy. Clin J Pain 2008;24:708\u201316.","DOI":"10.1097\/AJP.0b013e318174badd"},{"key":"2025120909544283181_j_j.sjpain.2014.07.001_ref_013","doi-asserted-by":"crossref","unstructured":"Ochroch EA, Gottschalk  A, Augostides  J, Carson KA, Kent  L, Mlayman  N, Kaiser LR, Aukburg SJ. Long-term pain and activity during recovery from major thoracotomy using thoracic epidural analgesia. Anesthesiology 2002;97: 1234\u201344.","DOI":"10.1097\/00000542-200211000-00029"},{"key":"2025120909544283181_j_j.sjpain.2014.07.001_ref_014","doi-asserted-by":"crossref","unstructured":"Katz  J, Jackson  M, Kavanagh BP, Sandler AN. Acute pain after thoracic surgery predicts long-term post-thoracotomy pain. Clin J Pain 1996;12:50\u20135.","DOI":"10.1097\/00002508-199603000-00009"},{"key":"2025120909544283181_j_j.sjpain.2014.07.001_ref_015","doi-asserted-by":"crossref","unstructured":"Wildgaard  K, Ravn  J, Kehlet H. Chronic post-thoracotomy pain: a critical review of pathogenic mechanisms and strategies for prevention. Eur J Cardiothorac Surg 2009;36:170\u201380.","DOI":"10.1016\/j.ejcts.2009.02.005"},{"key":"2025120909544283181_j_j.sjpain.2014.07.001_ref_016","doi-asserted-by":"crossref","unstructured":"Liu  S, Carpenter RL, Neal JM. Epidural anesthesia and analgesia: their role in postoperative outcome. Anesthesiology 1995;82:1474\u2013506.","DOI":"10.1097\/00000542-199506000-00019"},{"key":"2025120909544283181_j_j.sjpain.2014.07.001_ref_017","doi-asserted-by":"crossref","unstructured":"Peeters-Asdourian  C, Gupta S. Choices in pain management following thoracotomy. Chest 1999;115:122\u20134.","DOI":"10.1378\/chest.115.suppl_2.122S"},{"key":"2025120909544283181_j_j.sjpain.2014.07.001_ref_018","doi-asserted-by":"crossref","unstructured":"Sent\u00fcrk M, \u00d6zcan PE, Talu GK, Kiyan  E, Camci  E, Ozyal\u00e7in S, Dilege  S, Pembeci K. The effects of three different analgesia techniques on long-term postthoracotomy pain. Anesth Analg 2002;94:11\u20135.","DOI":"10.1213\/00000539-200201000-00003"},{"key":"2025120909544283181_j_j.sjpain.2014.07.001_ref_019","doi-asserted-by":"crossref","unstructured":"Bauer  C, Hentz JG, Ducrocq  X, Nicolas  M, Oswald-Mammosser  M, Steib  A, Dupeyron JP. Lung function after lobectomy: a randomized, double-blinded trial comparing thoracic epidural ropivacaine\/sufentanil and intravenous morphine for patient-controlled analgesia. Anesth Analg 2007;105:238\u201344.","DOI":"10.1213\/01.ane.0000266441.58308.42"},{"key":"2025120909544283181_j_j.sjpain.2014.07.001_ref_020","doi-asserted-by":"crossref","unstructured":"Joshi GP, Bonnet  F, Shah  R, Wilkinson RC, Camu  F, Fischer  B, Neugebauer EAM, Rawal  N, Schug SA, Simanski  C, Kehlet H. A systematic review of randomized trials evaluating regional techniques for postthoracotomy analgesia. Anesth Analg 2008;107:1026\u201340.","DOI":"10.1213\/01.ane.0000333274.63501.ff"},{"key":"2025120909544283181_j_j.sjpain.2014.07.001_ref_021","doi-asserted-by":"crossref","unstructured":"Behera BK, Puri GD, Ghai B. Patient-controlled epidural analgesia with fentanyl and bupivacaine provides better analgesia than intravenous morphine patient-controlled analgesia for early thoracotomy pain. J Postgrad Med 2008;54:86\u201390.","DOI":"10.4103\/0022-3859.40772"},{"key":"2025120909544283181_j_j.sjpain.2014.07.001_ref_022","doi-asserted-by":"crossref","unstructured":"Burlacu CL. PCEA vs. PCA for post-thoracotomy pain: is there any longer the question? J Postgrad Med 2008;54:80\u20131.","DOI":"10.4103\/0022-3859.40767"},{"key":"2025120909544283181_j_j.sjpain.2014.07.001_ref_023","doi-asserted-by":"crossref","unstructured":"Wu CL, Cohen SR, Richman JM, Rowlingson AJ, Courpas GE, Cheung  K, Lin EE, Liu SS. Efficacy of postoperative patient-controlled and continuous infusion epidural analgesia versus intravenous patient-controlled analgesia with opioids. Anesthesiology 2005;103:1079\u201388.","DOI":"10.1097\/00000542-200511000-00023"},{"key":"2025120909544283181_j_j.sjpain.2014.07.001_ref_024","doi-asserted-by":"crossref","unstructured":"McLeod GA, Davies HTO, Munnoch  N, Bannister  J, Mcrae W. Postoperative pain relief using thoracic epidural analgesia: outstanding success and disappointing failures. Anaesthesia 2001;56:47\u201381.","DOI":"10.1046\/j.1365-2044.2001.01763-7.x"},{"key":"2025120909544283181_j_j.sjpain.2014.07.001_ref_025","doi-asserted-by":"crossref","unstructured":"P\u00f6pping DM, Elia  N, Marret  E, Remy  C, Tram\u00e8r MR. Protective effects of epidural analgesia on pulmonary complications after abdominal and thoracic surgery. Arch Surg 2008;143 (10):990\u20139.","DOI":"10.1001\/archsurg.143.10.990"},{"key":"2025120909544283181_j_j.sjpain.2014.07.001_ref_026","doi-asserted-by":"crossref","unstructured":"Davies RG, Myles PS, Graham JM. A comparison of the analgesic efficacy and side-effects of paravertebral vs epidural blockade for thoracotomy \u2013 a systematic review and meta-analysis of randomized trials. Br J Anaesth 2006;96:418\u201326.","DOI":"10.1093\/bja\/ael020"},{"key":"2025120909544283181_j_j.sjpain.2014.07.001_ref_027","doi-asserted-by":"crossref","unstructured":"Perttunen  K, Kalso  E, Heinonen  J, Salo J. IV diclofenac in post-thoracotomy pain. Br J Anaesth 1992;68:474\u201380.","DOI":"10.1093\/bja\/68.5.474"},{"key":"2025120909544283181_j_j.sjpain.2014.07.001_ref_028","doi-asserted-by":"crossref","unstructured":"Ormrod  D, Wellington  K, Wagstaff AJ. Valdecoxib. Drugs 2002;62:2059\u201371.","DOI":"10.2165\/00003495-200262140-00005"},{"key":"2025120909544283181_j_j.sjpain.2014.07.001_ref_029","doi-asserted-by":"crossref","unstructured":"Gilron  I, Milne  B, Hong M. Cyclooxygenase-2 inhibitors in postoperative pain management. Anesthesiology 2003;99:1198\u2013208.","DOI":"10.1097\/00000542-200311000-00029"},{"key":"2025120909544283181_j_j.sjpain.2014.07.001_ref_030","doi-asserted-by":"crossref","unstructured":"Tang  J, Li  S, White PF, Chen  X, Wender RH, Quon  R, Sloninsky  A, Naruse  R, Kariger  R, Webb  T, Norel E. Effect of parecoxib, a novel intravenous cyclo-oxygenase type-2 inhibitor, on the postoperative opioid requirement and quality of pain control. Anesthesiology 2002;96:1305\u20139.","DOI":"10.1097\/00000542-200206000-00007"},{"key":"2025120909544283181_j_j.sjpain.2014.07.001_ref_031","unstructured":"Wickerts  L, Warr\u00e9n Stomberg  M, Brattwall  M, Jakobsson J. Coxibs: is there a benefit when compared to traditional non-selective NSAIDs in postoperative pain management? Minerva Anestesiol 2011;77:1084\u201398."},{"key":"2025120909544283181_j_j.sjpain.2014.07.001_ref_032","doi-asserted-by":"crossref","unstructured":"Breivik  H, Borchgrevink PC, Allen SM, Rosseland LA, Romundstad  L, Hals EK, Kvarstein  G, Stubhaug A. Assessment of pain. Br J Anaesth 2008;101:17\u201324.","DOI":"10.1093\/bja\/aen103"},{"key":"2025120909544283181_j_j.sjpain.2014.07.001_ref_033","doi-asserted-by":"crossref","unstructured":"Breivik EK, Bj\u00f6rnsson GA, Skovlund E. A comparison of pain rating scales by sampling from clinical trial data. Clin J Pain 2000;16:22\u20138.","DOI":"10.1097\/00002508-200003000-00005"},{"key":"2025120909544283181_j_j.sjpain.2014.07.001_ref_034","doi-asserted-by":"crossref","unstructured":"Stubhaug  A, Breivik  H, Eide PK, Kreunen  M, Foss A. Mapping of punctuate hyperalgesia around a surgical incision demonstrates that ketamine is a powerful suppressor of central sensitization to pain following surgery. Acta Anaesthesiol Scand 1997;41:1124\u201332.","DOI":"10.1111\/j.1399-6576.1997.tb04854.x"},{"key":"2025120909544283181_j_j.sjpain.2014.07.001_ref_035","doi-asserted-by":"crossref","unstructured":"Nussmeier NA, Whelton AA, Brown MT, Langford RM, Hoeft  A, Parlow JL, Boyce SW, Verburg KM. Complications of the COX-2 inhibitors parecoxib and valde-coxib after cardiac surgery. N Engl J Med 2005;352:1081\u20139.","DOI":"10.1056\/NEJMoa050330"},{"key":"2025120909544283181_j_j.sjpain.2014.07.001_ref_036","doi-asserted-by":"crossref","unstructured":"Woolf CJ. Central sensitization: implications for the diagnosis and treatment of pain. Pain 2011;152:2\u201315.","DOI":"10.1016\/j.pain.2010.09.030"},{"key":"2025120909544283181_j_j.sjpain.2014.07.001_ref_037","doi-asserted-by":"crossref","unstructured":"Kokki  H, Kumpulainen  E, Laisalmi  M, Savolainen  J, Rautio  J, Lehtonen M. Diclofenac readily penetrates the cerebrospinal fluid in children. Br J Clin Pharmacol 2008;65:879\u201384.","DOI":"10.1111\/j.1365-2125.2008.03126.x"},{"key":"2025120909544283181_j_j.sjpain.2014.07.001_ref_038","doi-asserted-by":"crossref","unstructured":"Dembo  G, Park SB, Kharasch ED. Central nervous system concentrations of cyclooxygenase-2 inhibitors in humans. Anesthesiology 2005;102:409\u201315.","DOI":"10.1097\/00000542-200502000-00026"},{"key":"2025120909544283181_j_j.sjpain.2014.07.001_ref_039","doi-asserted-by":"crossref","unstructured":"Mehta  V, Johnston  A, Cheung  R, Bello  A, Langford RM. Intravenous parecoxib rapidly leads to COX-2 inhibitory concentration of valdecoxib in the central nervous system. Clin Pharmacol Ther 2008;83:430\u20135.","DOI":"10.1038\/sj.clpt.6100304"},{"key":"2025120909544283181_j_j.sjpain.2014.07.001_ref_040","doi-asserted-by":"crossref","unstructured":"Scarci  M, Joshi  A, Attia R. In patients undergoing thoracic surgery is paraver-tebral block as effective as epidural analgesia for pain management? Interact Cardiovasc Thorac Surg 2010;10:92\u20136.","DOI":"10.1510\/icvts.2009.221127"},{"key":"2025120909544283181_j_j.sjpain.2014.07.001_ref_041","doi-asserted-by":"crossref","unstructured":"Norum HM, Breivik H. A systematic review of comparative studies indicates that paravertebral block is neither superior nor safer than epidural analgesia for pain after thoracotomy. Scand J Pain 2010;1:12\u201323.","DOI":"10.1016\/j.sjpain.2009.10.003"},{"key":"2025120909544283181_j_j.sjpain.2014.07.001_ref_042","doi-asserted-by":"crossref","unstructured":"Nussmeier NA, Whelton AA, Brown MT, Joshi GP, Langford RM, Singla NK, Boye ME, Verburg KM. Safety and efficacy of the cyclooxygenase-2 inhibitors parecoxib and valdecoxib after noncardiac surgery. Anesthesiology 2006;104:518\u201326.","DOI":"10.1097\/00000542-200603000-00020"},{"key":"2025120909544283181_j_j.sjpain.2014.07.001_ref_043","doi-asserted-by":"crossref","unstructured":"Kearney PM, Baigent  C, Godwin  J, Halls  H, Emberson JR, Patrono C. Do selective cyclooxygenase-2 inhibitors and traditional non-steroidal anti-inflammatory drugs increase the risk of atherothrombosis? Meta-analysis of randomized trials. Br J Anaesth 2006;332:1302\u20138.","DOI":"10.1136\/bmj.332.7553.1302"},{"key":"2025120909544283181_j_j.sjpain.2014.07.001_ref_044","doi-asserted-by":"crossref","unstructured":"Coxib and traditional NSAID Trialists\u2019 (CNT) Collaboration. Vascular and upper gastrointestinal effects of non-steroidal anti-inflammatory drugs: meta-analyses of individual participant data from randomised trials. Lancet 2013;382:769\u201379.","DOI":"10.1016\/S0140-6736(13)60900-9"}],"container-title":["Scandinavian Journal of Pain"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.degruyter.com\/view\/journals\/sjpain\/5\/4\/article-p240.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/api.elsevier.com\/content\/article\/PII:S1877886014001244?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/api.elsevier.com\/content\/article\/PII:S1877886014001244?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1016\/j.sjpain.2014.07.001\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1016\/j.sjpain.2014.07.001\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T11:43:43Z","timestamp":1765280623000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1016\/j.sjpain.2014.07.001\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,10,1]]},"references-count":44,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2014,10,1]]},"published-print":{"date-parts":[[2014,10,1]]}},"alternative-id":["10.1016\/j.sjpain.2014.07.001"],"URL":"https:\/\/doi.org\/10.1016\/j.sjpain.2014.07.001","relation":{},"ISSN":["1877-8860","1877-8879"],"issn-type":[{"value":"1877-8860","type":"print"},{"value":"1877-8879","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,10,1]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Managing post-thoracotomy pain: Epidural or systemic analgesia and extended care \u2013 A randomized study with an \u201cas usual\u201d control group","name":"articletitle","label":"Article Title"},{"value":"Scandinavian Journal of Pain","name":"journaltitle","label":"Journal Title"},{"value":"http:\/\/dx.doi.org\/10.1016\/j.sjpain.2014.07.001","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"http:\/\/dx.doi.org\/10.1016\/j.sjpain.2014.08.005","name":"associatedlink","label":"CrossRef DOI link to the associated document"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"Copyright \u00a9 2014 Scandinavian Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.","name":"copyright","label":"Copyright"}]}}