The Clinical journal of pain
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Physicians and other healthcare professionals may often be faced with the need to change opioids during the course of a patient's opioid analgesic care due to a number of clinical reasons. The act of converting opioid analgesics, for many physicians, nurses, and pharmacists, who do not receive adequate training, remains a challenging and often uncomfortable aspect of pain treatment. Part of the challenge clinicians face is secondary to the relatively weak literature evidence base that exists to support the equianalgesic ratios provided in textbooks, journals, and other medical resources. ⋯ The purpose of this paper is to provide the clinician with an approach for dealing with the conversion between opioid analgesics that is standardized, yet allows for individualized results to meet unique patient needs. We present a 5-step process as a guide for clinicians faced with the need to change a patient's opioid regimen. This approach may help to build a comfort level when dealing with the clinical challenges of converting from one opioid to another.
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Comparative Study Clinical Trial
Construct validity of the parents' postoperative pain measure.
Pain assessment can be a challenging task for parents, who increasingly provide the care for their children after surgery. This research provides evidence of the construct validity of the Parents' Postoperative Pain Measure (PPPM), a 15-item behavioral scale. ⋯ The results of these studies provide further support for the construct validity of the PPPM and confirm that the measure is a valid pain assessment tool for use by parents at home following children's surgeries.
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Clinical Trial Controlled Clinical Trial
Neuropathic pain questionnaire--short form.
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There is clinical experimental evidence that extracranial arterial vasodilation, extracranial neurogenic inflammation, and decreased inhibition of central pain transmission are involved in the pathogenesis of the migraine headache. The migraine aura is likely caused by a neurophysiologic phenomenon akin to Leão's cortical spreading depression, a wave of short-lasting neuronal excitation that travels over the cerebral cortex, followed by prolonged depression of cortical neuronal activity. ⋯ The process driving the pathogenesis of the migraine attack and susceptible to the migraine trigger factors may be located in the brain stem.
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To determine if psychosocial factors, as suggested by the demographic variables of widowhood and living alone, are associated with pain, particularly severe pain, in a representative sample of independent older people. ⋯ The mood disturbance related to spousal bereavement aggravates pain in older people. This lends support to the biopsychosocial model of pain.