The Clinical journal of pain
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Randomized Controlled Trial
A randomized clinical trial of the efficacy of scheduled dosing of acetaminophen and hydrocodone for the management of postoperative pain in children after tonsillectomy.
To determine the effectiveness of around-the-clock (ATC) analgesic administration, with or without nurse coaching, compared with standard care with as needed (PRN) dosing in children undergoing outpatient tonsillectomy. ⋯ Scheduled dosing of acetaminophen and hydrocodone is more effective than PRN dosing in reducing pain intensity in children after tonsillectomy. Nurse coaching does not impact parent's adherence to ATC dosing.
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Sickle cell disease-related pain is difficult to treat adequately. Pain secondary to vasoocclusive episodes (VOE) may be unresponsive to high-dose intravenous opiates. Alternative treatment options for VOE are needed. We sought to review our experience with low-dose ketamine for children hospitalized with VOE. ⋯ Further research into ketamine for vasoocclusive pain is warranted.
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To investigate the changes in surface and intramuscular electromyographic (EMG) activity at latent trigger points (TrPs) in the extensor carpi radialis brevis muscle after injection of either glutamate or isotonic saline into latent TrPs in the infraspinatus muscle. ⋯ Our results show that an increased nociceptive activity at latent TrPs in the infraspinatus muscle may increase motor activity and sensitivity of a TrP in distant muscles at a same segmental level.
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Randomized Controlled Trial Clinical Trial
Intraperitoneal lidocaine instillation and postcesarean pain after parietal peritoneal closure: a randomized double blind placebo-controlled trial.
To evaluate the effects of intraperitoneal instillation of lidocaine on postcesarean pain in patients with pariental periotoneal closure. ⋯ Intraperitoneal instillation of 200 mg of lidocaine decreased the incidence and scores of postcesarean pain when the parietal peritoneum was sutured. Further studies in a setting offering more effective acute pain control protocols, preferably with patient-controlled analgesia, are recommended to assess the use of lidocaine before it can be widely practiced.
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Objectives:Despite efforts to improve acute postoperative pain management, a substantial number of patients still experience moderate to severe pain during the immediate postoperative days. The purpose of the present study was to identify predictors of moderate to severe acute postoperative pain. ⋯ Discussion: Several predictive factors of postoperative pain were identified in this study. These factors could be taken into account in postoperative pain management.