The Clinical journal of pain
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Randomized Controlled Trial Comparative Study Clinical Trial
Does the anesthetic technique influence the postoperative analgesic requirement?
In order to determine the effect of two standard general anesthetic techniques on the postoperative analgesic requirement, 53 adults undergoing elective intra-abdominal surgery were randomly assigned to one of two anesthetic treatment groups according to an open parallel protocol design. One of the groups received an opioid-based anesthetic; the other group was administered an inhaled anesthetic. The postoperative analgesic requirement was quantified using a Baxter PCA device. ⋯ During the first 8 hours after discharge from the recovery room there was a trend toward higher PCA morphine usage in the inhaled anesthetic group (25.6 +/- 15 mg vs. 18.6 +/- 13 mg); however, this difference was not statistically significant (p = 0.08). From 8 to 40 hours after surgery, the morphine usage was nonsignificantly higher in the opioid group (64 +/- 30 mg vs. 56 +/- 38 mg, p = 0.43). In conclusion, the general anesthetic technique used during an elective operation appeared to have little if any effect on the postoperative analgesic requirement after discharge from the recovery room.
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The relationship between pain perception and emotional states is well known. However, the nature of this relationship and how different emotional states affect sensory and cognitive dimensions of pain remains uncertain. Results from experimental investigations are often contradictory, which may be due to methodological difficulties in inducing pain and monitoring physiological responses. ⋯ No differences could be detected for either the happy or the fear-related condition compared with the baseline or neutral hypnotic condition. A significant positive correlation between the subjective intensity of depression and the increase in evoked potentials was found, but none for the other three emotions. The results support earlier findings that clinical depression is related to increased pain perception, and findings that the expression of anger can inhibit the experience of pain.(ABSTRACT TRUNCATED AT 250 WORDS)
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A study was conducted to determine symptom report patterns in a heterogenous population of orofacial pain patients and to evaluate how symptom patterns relate to various dimensions of the human pain experience. Results indicated that symptoms frequently associated with chronic orofacial pain disorders can be described by four indices related to the temporomandibular joint (TMJ) and its movement; discomfort of and parafunctional activities related to the masticatory muscles; interference of pain with activities of daily living; and presence of orofacial pain unrelated to myogeneous or arthrogenous TMJ disorders. Of these four symptom indices, only the pain interference (symptom) index was related to clinical pain and illness behavior. ⋯ Two of the indices were influenced by diagnosis. Biomechanical symptoms and parafunctional activities appear to be insignificantly related to perceived pain intensity, pain responsiveness, illness behavior, or personality, but are related to diagnosis. The results indicated that relatively simple symptom checklists have potential utility in screening orofacial pain patients and in evaluation of treatment outcome.
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Research tabulating the existence and effects of pain and related factors in the elderly is lacking, in spite of the continued growth of the aged population. Leg pain, in particular, may interfere with activities and interpersonal interactions. This study of 3,097 rural elderly examines the prevalence of complaints of leg pain and related factors in a geographically-defined population. Findings indicate that leg pain is clearly a common experience which impacts daily activities of the elderly.