The Clinical journal of pain
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To determine the relationship between pain provocation and the analgesic response in lumbar zygapophyseal joint blocks. ⋯ This study calls into question the validity of pain provocation alone as a criterion standard in patients undergoing diagnostic lumbar zygapophyseal joint blocks.
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The aim of this study was to assess the ability of specific and clinically relevant Minnesota Multiphasic Personality Inventory (MMPI) profile types to predict outcomes in a structured interdisciplinary pain-management program for patients with low back pain. ⋯ Even when subjects with chronic pain are divided into cluster groups associated with highly similar clinical interpretations, the MMPI for the most part fails to predict self-reported outcomes in an interdisciplinary pain-management program.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of morphine and ketorolac for intravenous patient-controlled analgesia in postoperative cancer patients.
To compare the effectiveness of intravenous patient-controlled (i.v.-PCA) ketorolac to i.v.-PCA morphine in the treatment of postoperative pain in cancer patients. ⋯ These results indicate that ketorolac supplemented with small doses of morphine is associated with a lower incidence of nausea, vomiting, and pruritus compared to morphine alone. This combination should be considered where immunosuppression from operation and administration of morphine is undesirable.
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Randomized Controlled Trial Clinical Trial
Epidural morphine pretreatment for postepisiotomy pain.
A randomized double-blind controlled study was conducted on two groups of 45 parturients to evaluate the importance of the timing of epidural morphine administration for the relief of postepisiotomy pain. Both groups had preemptive analgesia by continuous lumbar epidural bupivacaine blockade. Upon completion of the episiotomy repair and before the onset of pain, the patients received epidural injections of 3 ml saline with or without 2 mg morphine in groups A and B respectively. When pain appeared, group A patients received an epidural injection of 3 ml saline while group B patients received 2 mg morphine in 3 ml saline. Postepisiotomy pain level was evaluated by a visual analogue scale. ⋯ Epidural morphine for postepisiotomy pain is much more effective if administered before the onset of pain.