Pain
-
This paper reports the development of a self-report instrument designed to assess pain in cancer and other diseases. It is argued that issues of reliability and validity should be considered for every pain questionnaire. ⋯ Data from patients with cancer at 4 primary sites and from patients with rheumatoid arthritis suggest that the BPQ is sufficiently reliable and valid for research purposes. Additional methodological and theoretical issues related to validity are discussed, and the need for continuing evaluation of the BPQ and other measures of clinical pain is stressed.
-
This review emphasizes how little we know about pain induced by a thermal stimulus. The study of the intensity of pain evoked by heat is relatively exhaustive: the influence of various local, stimulus-dependent or general factors upon threshold values has been well studied, as has the relation between pain and stimulus intensities. On the contrary, few studies have used very cold stimuli, since highly efficient stimulators allowing accurate control of the stimulus parameters have been obtainable only recently. ⋯ At supraspinal level, the thermal information reappears in the reticular formation; there it appears to be solely relative to the pain threshold and not to the intensity of a supraliminary stimulus [55]. In the posterior group of nuclei [134] and the ventroposterolateral nucleus of the thalamus [103], on the contrary, the activity of the neurons reflects the intensity of the stimulation. It has been proved that the neurons of the ventroposterolateral nucleus project onto the SI cortex [103].(ABSTRACT TRUNCATED AT 400 WORDS)
-
Clinical Trial Controlled Clinical Trial
Postoperative pain control: contribution of psychological factors and transcutaneous electrical stimulation.
The influence of transcutaneous electrical stimulation (TES) and psychological factors in determining the intensity of acute postoperative pain was examined in a prospective, double-blind controlled trial completed by 30 patients having elective surgery. Psychometric tests were administered prior to surgery. Postoperative pain was assessed by cumulative morphine requirement (M48) administered intramuscularly, and the mean score of a visual analogue scale of pain (VAS), in the first 48 h following surgery. ⋯ When the contribution of neuroticism to the variance of M48 was adjusted using multiple regression analysis, the effect of TES became significant at the 0.05 level. Covariance analysis showed that TES contributed some 19% to the explained variance of M48 while neuroticism contributed about 80%, and there was no interaction between these two factors. These findings allow a degree of prediction of the individual patient's postoperative pain and narcotic requirement, and point to a strong correlation between postoperative pain perception and personality.