The Clinical journal of pain
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Children with developmental delay are often unable to verbalize pain or advocate for themselves owing to cognitive, motor, or verbal limitations, which puts them at increased risk for poor pain assessment and management. Although patient-controlled analgesia has been shown to be safe, effective, and superior to intermittent opioid dosing, not all children can operate patient-controlled analgesia independently. Parent/nurse-controlled analgesia (PNCA) may be an option for these children. However, the safety and efficacy of PNCA have not been thoroughly evaluated and many practitioners are reluctant to use it. ⋯ Pain scores, side effects, and adverse events suggest that PNCA may be an effective method of pain control for children with developmental delay. Diligent monitoring and education are crucial to ensure safety.
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In contrast to the increasing knowledge of the sensory dysfunction involved in chronic whiplash associated disorders, the use of comprehensive quantitative sensory testing in the acute stage of the condition is sparse. In this study, we sought to investigate the presence of sensory hypoesthesia in participants with acute whiplash injury. ⋯ Our findings demonstrate generalized hypoesthesia in acute whiplash associated disorders suggesting adaptive central nervous system processing mechanisms are involved, regardless of pain and disability. The elevated levels of psychologic distress seen in both groups may also play a role.
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The aim of the present study was to investigate the presence of active and latent muscle trigger points (TrPs) in the forearm musculature on both affected and unaffected sides in patients with lateral epicondylalgia (LE) and healthy controls. ⋯ Latent TrPs are present in forearm muscles on the unaffected side in patients with LE where active TrPs contribute to the pain on the affected arm. The presence of latent TrPs on the unaffected side in unilateral LE may be related to central sensitization and be a mechanism explaining bilateral pain in some patients with unilateral pathologies.