The Clinical journal of pain
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Patients' beliefs and expectations about their pain have been identified as important disabling factors in chronic musculoskeletal pain. Besides fear-avoidance beliefs and pain-related fear, cognitions such as thought suppression as well as pain/task persistence behavior have been shown to be associated with pain and disability. The aim of this report is to present a critical evaluation of research, based on the avoidance-endurance model of pain. ⋯ Although both, fear-avoidance and endurance responses have been identified in patients with chronic musculoskeletal pain, currently evidence to confirm their hypothesized consequences for daily functioning is incomplete. Finally, thoughts on the development of differentially targeted and individually scheduled behavioral interventions are reported, including suggestions for further research.
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To describe the presence of widespread pressure pain hyperalgesia and myofascial trigger points (TrPs) in neck and shoulder muscles in patients with postmastectomy pain. ⋯ Our findings revealed bilateral widespread pressure pain hypersensitivity in patients with postmastectomy pain. In addition, the local and referred pain elicited by active TrPs reproduced neck and shoulder/axillary complaints in these patients. These results suggest peripheral and central sensitization in patients with postmastectomy pain.
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To review the (1) reliability, validation, feasibility, and clinical utility and (2) the use of the Premature Infant Pain Profile (PIPP) from 1996 to 2009 to determine the effectiveness of pain management strategies. ⋯ The PIPP continues to be a reliable and valid measure of acute pain in infants with numerous positive validation studies. There is substantial support for the use of the PIPP as an effective outcome measure in pain intervention studies in infants. Further research with health professionals is required to better support the feasibility and clinical utility of this measure.
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Systems controlling cardiovascular function are closely coupled with the perception of pain. Heart rate variability (HRV) is a well-established noninvasive measure of cardiac autonomic control. We hypothesized that pain may alter HRV in the newborn infant and that HRV analysis could be used as an indicator of prolonged pain in the newborn infant. ⋯ The results of this study indicate that postoperative pain is associated with a decreased high-frequency HRV in full-term newborn infants. Our findings suggest that HRV could be used as an indicator to assess prolonged pain in the newborn infants.
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Randomized Controlled Trial Comparative Study
Morphine versus oxycodone in pancreatic cancer pain: a randomized controlled study.
According to experimental findings, oxycodone (OX) could have some advantages over morphine (MO) in clinical models of visceral pain. It was hypothesized that OX could have some advantages over MO in terms of efficacy and dose escalation in pancreatic cancer pain. ⋯ OX and MO provided similar analgesia and adverse effects with similar escalating doses in patients with pancreatic cancer pain, resembling observations reported in the general cancer pain population. The experimental hypothesis that OX would be superior to MO in the clinical model of pancreatic cancer pain was not confirmed.