The Clinical journal of pain
-
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.
-
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.
-
The aim of this study is to examine the difference in the report of bodily pain experienced by patients who develop temporomandibular disorders (TMD) and by those who do not develop TMD over a 3-year observation period. ⋯ The development of TMD was accompanied by increases in headaches, muscle soreness or pain, and other pains that were not observed in the Participants who did not develop TMD. Participants who developed TMD also report higher experience of joint, back, chest, and menstrual pain at baseline.
-
Malfunction of the sympathetic nervous system (SNS) is common in early complex regional pain syndrome type I (CRPS I). This study was designed to evaluate the function of the SNS in patients with chronic CRPS I and to correlate the obtained data with hand function measurements. ⋯ Even 5 years after the diagnosis of CRPS I of the upper extremity we detected significant impairments of the pSNS in nearly two thirds of our patients. Patients still have pain and present with a significant deterioration of their hand function in comparison with the not affected hand. In our study we could not identify any correlation between pSNS function and clinical outcome as measured by MHQ.
-
Medication nonadherence is a frequent problem in chronic conditions. In chronic noncancer pain, medication is often used as an important cornerstone of the treatment. Studies on medication nonadherence in this population, however, are scarce. ⋯ We can conclude that medication nonadherence, especially underuse of medication, occurs frequently among patients with chronic nonmalignant pain. Prospective research is needed to learn about the impact of medication overuse or underuse on clinical outcomes. Future research should examine underuse and overuse as different types of nonadherence as different factors might predict this behavior.