The Clinical journal of pain
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Comparative Study
The utility and validity of the modified brief pain inventory in a multiple-dose postoperative analgesic trial.
Patients undergoing major surgery often require several days of postoperative analgesia. However, few data exist on the longitudinal course of postoperative pain and the psychometric properties of pain assessment tools used in this setting. Our objective was to validate use of the modified Brief Pain Inventory through reanalysis of pain data from a multiple-dose, placebo-controlled, randomized trial of analgesia after coronary artery bypass graft surgery. ⋯ The modified Brief Pain Inventory was stable and valid over the assessment period, suggesting that it can be used during the subacute postoperative period to assess postoperative pain among patients with coronary artery bypass graft surgery.
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Comparative Study
Prospective diary study of nonpainful and painful phantom sensations in a preselected sample of child and adolescent amputees reporting phantom limbs.
To prospectively study factors associated with the occurrence of phantom sensations and pains in a pre-selected sample of child and adolescent amputees reporting phantom limbs. ⋯ Child and adolescent amputees experience phantom sensations and pains on a regular basis over a 1-month period. Differences in triggers of phantom phenomena between boys and girls may be due to differences in activities, awareness, attribution, and willingness to report psychosocial triggers.
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Comparative Study
Evidence-based assessment of acute pain in older adults: current nursing practices and perceived barriers.
To report data on current nurse practice behaviors related to evidence-based assessment of acute pain in older adults, perceived stage of adoption of pain assessment practices, and perceptions of barriers to optimal assessment in this population. ⋯ Our data suggest that pain is not being assessed and reassessed in a manner that is consistent with current practice recommendations in older adult patients with pathologic processes that highly suggest the presence of acute pain.
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The objective of this study is to investigate sympathetic nervous system involvement in 2 patients with painful legs and moving toes. The first case was studied several years after the initiating trauma produced a peripheral nerve lesion and demonstrated the characteristic sequence of progression of pain and moving toes from the injured leg to the contralateral leg. The second case was initially studied within 3 months of an injury that did not produce definitive signs of a peripheral nerve lesion. ⋯ These symptoms and signs disappeared after lumbar sympathectomy, and re-emerged when signs of sympathetic reinnervation were detected. We concluded that sympathetic neuronal discharge may provoke pain by activating an impulse generator in the affected limb. Sympathetic involvement in the painful legs and moving toes syndrome appeared to be greater in the second case than the first, presumably due to differences in the initial injury or stage of the condition.
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Randomized Controlled Trial Comparative Study Clinical Trial
Endogenous opioids and chronic pain intensity: interactions with level of disability.
To test whether endogenous opioid antinociceptive system dysfunction evidenced in response to acute pain stimuli is associated with increased clinical pain intensity in chronic pain sufferers, and to determine whether this association is moderated by disability level. ⋯ These results suggest that endogenous opioid antinociceptive system dysfunction may contribute to elevated acute and chronic pain sensitivity among more disabled chronic pain patients. Among less disabled patients, chronic pain may serve as a primer producing up-regulated opioid antinociceptive responses to acute pain