Journal of pain and symptom management
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Much recent attention has focused on the development and refinement of pain measures, as well as on the use of more effective pain control methods for infants, children, and adolescents. This article reviews the primary categories of pediatric pain measures, with a specific focus on the selection of the most appropriate behavioral, physiologic, or subjective method for assessing a child's pain. The optimum pain measure depends on the age and cognitive level of a child, the type of pain experienced, and the situation in which the pain occurs. While no single measure is adequate for all children for all types of acute, recurrent, and chronic pain, it is possible to choose practical, valid, and reliable methods for evaluating any child's pain experience.
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Pain in children from the neonate to the teenager has recently begun to achieve the attention it deserves in the medical literature. Practitioners have been slow to apply both old and new techniques in this patient population. This review focuses on the perioperative management of pain and its associated symptoms in pediatric patients.
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Pain in neonates has only recently become the focus of clinical and research attention. Measurement of pain in this population presents special problems. ⋯ Nurses used similar classes of behavior to indicate pain, but varied somewhat in the specific behavioral indicators for different levels of pain. A very wide range of sources of pain was identified.
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J Pain Symptom Manage · Sep 1989
Influence of the pain and symptom control team (PSCT) on the patterns of treatment of pain and other symptoms in a cancer center.
To assess the influence of a pain and symptom control team on the pattern of prescription of pharmacologic and nonpharmacologic treatments for cancer pain, we reviewed the charts of 100 consecutive patients admitted to the Cross Cancer Institute during 1987 and 100 patients admitted during 1984. The average daily dose of parenteral morphine per patient was 44 +/- 26 mg in 1987 versus 34 +/- 38 mg in 1984 (p less than 0.05). In 1987 and 1984, only 31 and 22% of the analgesics were ordered around the clock respectively (P:NS). ⋯ The pattern of prescription of narcotics by residents changed significantly during the last four weeks of rotation as compared to the first four weeks. We conclude that there have been some changes in the modality of treatment of pain that are probably due to changes in the pattern of prescription by the residents and continued improvement in assessment of pain by nurses. However, in several areas of treatment the impact of a pain and symptom control team remains minimal.
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J Pain Symptom Manage · Jun 1989
Randomized Controlled Trial Comparative Study Clinical TrialEvaluation of neurolytic blocks using phenol and cryogenic block in the management of chronic pain.
This study compared the use of phenol and cryogenic blocks for neurolysis in 28 patients. Patients were assigned randomly to receive peripheral nerve blocks with either phenol or cryoanalgesia. Significantly more patients in the phenol group received 20% or greater relief at 2, 12, and 24 wk than patients in the cryogenic group. Only 27% of patients received significant relief, however, indicating that neurolytic blocks were not particularly effective even though local anesthetic blocks produced significant but temporary pain relief.