Pain
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Randomized Controlled Trial Clinical Trial
Nimodipine fails to enhance the analgesic effect of slow release morphine in the early phases of cancer pain treatment.
We assessed nimodipine's ability to increase the analgesic effect of morphine in 32 patients suffering from cancer pain in a double-blind, placebo controlled cross-over study. Morphine administration began a few days before the start of the study. The analgesic effects of two combinations were compared: morphine (M) plus placebo (P) and morphine plus 90 mg/24 h of nimodipine (N). ⋯ However, when the same statistical tests were used for comparison of results with pre-treatment baseline values, highly significant differences between mean scores on the scales for pain relief and pain intensity were found. Based on these negative results we conclude that nimodipine given orally at a dose of 30 mg every 8 h does not enhance analgesia when associated with morphine in the early phases of treatment for cancer pain. Our study also gives clear evidence of a placebo effect.
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Clinical Trial Controlled Clinical Trial
Development and preliminary validation of a postoperative pain measure for parents.
Parents are now primarily responsible for the at home assessment and treatment of their children's pain following minor surgery. Although some research has suggested that parents underestimate their children's pain following surgery, no behavioral measure exists to assist parents in pain assessment. The Postoperative Pain Measure for Parents was developed based on cues parents reported using to assess their children's pain (e.g. changes in appetite, activity level). ⋯ This study provides preliminary evidence for the use of the Postoperative Pain Measure for Parents as a valid assessment tool with children between the ages of 7-12 years following day surgery. It is internally consistent and strongly related to child-rated pain. Future research should explore the use of this measure with a younger sample and children with developmental delays.
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The objective of this study was to review the effectiveness and safety of antidepressants in neuropathic pain. In a systematic review of randomised controlled trials, the main outcomes were global judgements, pain relief or fall in pain intensity which approximated to more than 50% pain relief, and information about minor and major adverse effects. Dichotomous data for effectiveness and adverse effects were analysed using odds ratio and number needed-to-treat (NNT) methods. ⋯ Compared with placebo, of 100 patients with neuropathic pain who are given antidepressants, 30 will obtain more than 50% pain relief, 30 will have minor adverse reactions and four will have to stop treatment because of major adverse effects. With very similar results for anticonvulsants it is still unclear which drug class should be first choice. Treatment would be improved if we could harness the dramatic improvement seen on placebo in some of the trials.
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Clinical Trial Controlled Clinical Trial
Effect of present pain and mood on the memory of past postoperative pain in women treated surgically for breast cancer.
In our recent retrospective study on breast cancer patients, the intensity of the past postoperative pain was a primary factor in predisposing the development of chronic post-treatment pain. The present prospective study was designed to find out if the remembered intensity of postoperative pain (RIPP) after breast surgery was influenced by the development of chronic pain and if the RIPP had any correlation with the development of depression or anxiety. The patient's estimation of the severity of the RIPP was determined three times in the year after surgery. ⋯ Their depression remained at a higher level during the first year after surgery. The results suggest that the amount of postoperative pain may play a role in the development of chronic pain. However, the development of chronic pain is connected to a tendency to overestimate previous pain and to higher levels of depression.