The Clinical journal of pain
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Previous reviewers of the literature on transcutaneous electrical nerve stimulation (TENS) outcome have concluded the following: (a) there are few long-term TENS follow-up studies, and (b) fewer studies have addressed the effect of long-term TENS use on outcome variables other than pain (e.g., function). DESIGN/SETTING/PARTICIPANTS/OUTCOME MEASURES: From a population of 2,003 chronic pain patients (CPPs) who bought a TENS device for pain management, 506 patients were randomly selected and interviewed by telephone long enough after purchase to allow at least 6 months of TENS use. The interview process used a structured "skip" questionnaire designed to assess the CPPs' perceptions regarding the effectiveness of TENS for a variety of outcome variables. Of the 506 CPPs interviewed, 376 (74.3%) had used their TENS device for 6 months or longer and were defined as long-term users. The responses of this group of CPPs to the telephone questionnaire were then subjected to statistical analysis. ⋯ The results suggest that TENS is associated with improvement on multiple outcome variables in addition to pain relief for CPPs who are long-term users. Also, for some CPPs, long-term TENS use continues to be effective.
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The present study employed causal modeling to examine the impact of somatic and cognitive symptoms of depression on the functioning of patients with chronic pain. ⋯ This study indicates that depression is directly related to both the physical and the psychosocial functioning of facial pain patients, while self-reported level of pain is not. A better understanding of the impact of depression on chronic pain and the relationship of these two disorders could lead to improved assessment and treatment of chronic pain disorders.
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We describe two patients with cancer-related low back and bilateral lower extremity pain that failed pharmacologic treatment. ⋯ In both cases, commissural myelotomy provided significant pain relief. The role of myelotomy in the management of cancer pain is discussed.
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Inadequate assessment of pain in premature infants is a persistent clinical problem. The objective of this research was to develop and validate a measure for assessing pain in premature infants that could be used by both clinicians and researchers. ⋯ The PIPP is a newly developed pain assessment measure for premature infants with beginning content and construct validity. The practicality and feasibility for using the PIPP in clinical practice will be determined in prospective research in the clinical setting.
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Randomized Controlled Trial Clinical Trial
Acute pain after thoracic surgery predicts long-term post-thoracotomy pain.
Long-term pain is a common sequela of thoracotomy, occurring in approximately 50% of patients 2 years after thoracic surgery. Despite this alarming statistic, little is known about the factors responsible for the transition of acute to chronic pain. The aim of the present study is to identify predictors of long-term post-thoracotomy pain. ⋯ Aggressive management of early postoperative pain may reduce the likelihood of long-term post-thoracotomy pain.