The Clinical journal of pain
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Randomized Controlled Trial Clinical Trial
Eutectic mixture of local anesthetics reduces pain during intravenous catheter insertion in the pediatric patient.
The objective of this study was to explore the relation between the application of a mixture of lidocaine/prilocaine cream (eutectic mixture of local anesthetics [EMLA]) before intravenous cannula insertion and perceived pain in the pediatric patient. ⋯ The authors conclude that a topical preparation of lidocaine/prilocaine significantly reduces children's pain during intravenous cannula insertion when applied to an intact dermal layer of the skin and that this effect occurs within 45 minutes.
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Multicenter Study
Surgical patients' fear of addiction to pain medication: the effect of an educational program for clinicians.
The appropriate and optimal use of analgesics is essential for the adequate management of postoperative pain. Concern that use of opioid analgesics contributes to the development of addiction is a barrier to effective pain relief. The purpose of this study was to determine the prevalence of fear of addiction in postoperative patients in relation to surgical outcomes and staff participation in an educational program. ⋯ Fear of addiction is not prevalent among postoperative patients, yet clinician education can further decrease the proportion of surgical patients who fear of addiction to pain medication.
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The objectives of this study were to use a self-report pain scale to examine child pain treatment thresholds after major surgery (i.e., the level of pain they are comfortable with before requiring analgesia), as well as to examine agreement between mother-, nurse-, and child-rated pain treatment thresholds. ⋯ Pain treatment thresholds seem to be lower in children after major as compared with minor surgery. Parents and nurses are not accurate in rating child pain treatment thresholds. Parents tended to overestimate their child's pain treatment threshold, whereas nurses were less consistent in their scoring.
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Multicenter Study Clinical Trial
Facial expression of children receiving immunizations: a principal components analysis of the child facial coding system.
To identify the structure of facial reaction to procedural pain and to determine the subset of facial actions that best describe the response. ⋯ These results provide a preliminary indication that the Child Facial Coding System can be reduced to components that reflect several aspects of children's acute pain experience and predict self-reports and observer reports of children's pain.
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Physicians and patients alike find it easy to divide pain into mental pain and physical pain. But close examination of this distinction shows that it fails on clinical and philosophical grounds. The body is not a passive conduit for information about tissue damage. ⋯ The dualism of mental and physical pain cannot be overcome if the biological individual is considered in isolation. Mental and physical pain can only be reconciled if their common interpersonal roots are understood. This interpersonal view of pain can help clarify some clinical and moral dilemmas in the care of patients with pain.