The Clinical journal of pain
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Letter Case Reports
The term "chronic" with respect to pain should be dropped.
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One aim of this study was to evaluate the relation of scores on the Multidimensional Affect and Pain Survey (MAPS) that was administered before surgery to postoperative morphine consumption and patient-controlled analgesia. A second aim of the study was to compare the ability of MAPS administered postsurgery with the commonly used Numerical Pain Rating Scale to predict patient-controlled analgesia behavior. ⋯ The emotional states and attitudes of the patients toward pain before surgery are important factors in determining patient-controlled analgesia pressing behavior and postoperative demand for analgesics.
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The objective of this study was to determine if intractable pain from erythromelalgia could be successfully treated with intrathecal hydromorphone and clonidine. ⋯ Administration of intrathecal opioid and an alpha2-agonist can be effective in the treatment of the pain of erythromelalgia and offers an alternative pain treatment modality for patients with unremitting pain refractory to more conservative therapy.
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Randomized Controlled Trial Clinical Trial
Agency orientation and chronic musculoskeletal pain: effects of a group learning program based on the personal construct theory.
This study evaluated the effects of a group learning program on patients with chronic musculoskeletal pain and high absenteeism and investigates what characterizes those patients who may benefit from such a program. The learning program was based on personal construct theory. The theory included the following: (1) participation in an educational program is related to a favorable outcome across the outcome measures (pain, pain coping, management of daily life, absenteeism, and use of health care), (2) patients with high agency orientation (i.e., inner-directed) cope with their pain and manage daily life in a better manner than do patients with low agency orientation (i.e., outer-directed), and (3) patients with high personal control, measured in terms of agency orientation, in terms of health locus of control, or in both terms, will benefit more from the educational program than will patients with low personal control. ⋯ The intervention group reported a significantly higher score for the variable "management of everyday life" (p <0.005) and for the variable "health care consumption" (p <0.001) than did the control group. Patients with high agency orientation benefited more from the program with regard to pain reduction and improved pain coping than did those patients with low agency orientation (p <0.05). Patients with high agency orientation also reported less absenteeism than did those patients with low agency orientation (p <0.05).
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To determine the general risk and the prognostic factors of postherpetic neuralgia and focal sensory denervation in ophthalmic zoster disease. ⋯ The severity of acute skin rash, based on a specific manifestation of cutaneous herpes zoster eruptions, and the extent of infection to other neural pathways were clearly associated with postherpetic neuralgia and focal sensory denervation at a 2-month follow-up. These findings suggest that the inability of the immune system to control the spread of replicating varicella-zoster virus in the initial phase of the disease is an important factor in the pathogenesis of chronic zoster-related neuropathy.