The Clinical journal of pain
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparison of patient-controlled analgesia and bolus PRN intravenous morphine in the intensive care environment.
We compared the use of patient-controlled analgesia (PCA) morphine and p.r.n. intravenous morphine in an intensive care unit setting. Thirty-eight patients scheduled for admission to the Surgical Intensive Care Unit (SICU) were prospectively randomized to either a PCA group or a p.r.n. intravenous morphine group. ⋯ PCA was found to be comparable in safety and efficacy to nurse-administered morphine in the intensive care environment. An unexpected finding was the higher initial morphine utilization seen in the patients utilizing PCA.
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Three patients with intractable chest wall pain due to diffusely metastatic thoracic neoplasm were successfully treated with intermittent interpleural steroid injections. Intermittent administration of 0.5% bupivacaine mixed with methylprednisolone suspension (Depo-Medrol) was effective in controlling intractable pain due to metastatic cancer. Pain relief with this technique lasted for periods in excess of 3 weeks between injections. Intermittent interpleural block may be a useful addition to the therapeutic armamentarium in dealing with chronic pain due to metastatic neoplasm.
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This study investigated the psychometric properties of eight pain intensity measures used with chronic low back pain patients. All measures were similar in terms of scale distribution and rates of incorrect responses, with all scales apart from the Pain Rating Index significantly correlated. ⋯ The 101-point Numeric Rating Scale and the Box Scale had the strongest relationship, with loadings of 0.90. The Numeric Rating Scale and the Box Scale appear to be the scales of choice for the measurement of pain intensity in the low back pain patient.