The Clinical journal of pain
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Randomized Controlled Trial Comparative Study
External thermomechanical stimulation versus vapocoolant for adult venipuncture pain: pilot data on a novel device.
Mechanoreceptor and noxious thermal inhibitory stimulation modulate pain conduction but have not been clinically tested in combination. Our objectives were to determine whether a vibrating cold device decreased adult venipuncture pain on a 10 cm visual analog scale more than no intervention, and compared with vapocoolant analgesia versus no intervention. ⋯ The combination of cold and vibration gave significant venipuncture pain relief without affecting cannulation success. Interventions were more helpful for those with greater preprocedural fear. Larger sample sizes and a prongless device could better compare equivalence or superiority to existing pain relief modalities.
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Multicenter Study Clinical Trial
Effects of transdermal buprenorphine on patients-reported outcomes in cancer patients: results from the Cancer Pain Outcome Research (CPOR) Study Group.
Pain still afflicts most cancer patients, mainly in the metastatic phases, and under-treatment is well documented. Transdermal delivery systems (TDS) containing fentanyl or buprenorphine could potentiality have advantages over oral and parenteral routes, but evidence from comparative trials are scanty. In the framework of a wider initiative, an Outcome Research Study was carried out in Italy in 2006 to evaluate the effects of various analgesic options, particularly buprenorphine TDS. ⋯ Despite the limitations owing to the observational design, these findings may be useful to clinicians to judge the value of the drug under evaluation better and to help researchers design further comparative studies.
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Randomized Controlled Trial
Can predictors of response to NSAIDs be identified in patients with acute low back pain?
The aim of this study was to determine whether certain patient characteristics could identify people with acute low back pain who were more likely to respond to nonsteroidal anti-inflammatory drugs (NSAIDs), when administered in combination with paracetamol. ⋯ This study did not find any baseline patient characteristics, which consistently identified patients with acute low back pain who respond best to NSAIDs when provided in addition to paracetamol and advice. A patient's sex and level of fear avoidance may be weak predictors and warrant further prospective investigation.
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To compare the predictive ability of the Orebro Musculoskeletal Pain Questionnaire-a screening tool for psychosocial factors in patients with low back pain across 2 cultural settings (Norway and Australasia) and to establish whether the Orebro provides additional information about outcome than that provided by the baseline value of the prognostic outcome. ⋯ The Orebro questionnaire had similar predictive ability in Norway and Australasia when pain was used as an outcome, whereas the Orebro tended to be a stronger predictor in Norway when disability was used as outcome.
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Dysaesthesias is a common symptom in patients with neuropathic pain after peripheral nerve injury (PNI). In contrast to neuropathies with comparable symptoms there is little knowledge of the underlying mechanisms in PNI patients. ⋯ In conclusion, even though patients presented with comparable clinical symptoms, their sensory profiles differed, supporting the concept of different underlying mechanisms leading to chronic pain in PNI patients. Skin biopsies support the validity of quantitative sensory testing.