Der Schmerz
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In repeated clinical studies a preponderance of pain syndromes on the left side of the body has frequently been observed. Experimental studies in humans revealed a lower pain threshold on the left, nondominant side. On the other hand, some studies do not confirm this lateralization. ⋯ For pain induced by pressure, lateral asymmetry increased with pain intensity, for the other two methods it was constant. Lateral asymmetry was found in all subjects, but significant differences could only be demonstrated in female Ss. It is concluded that both gender and handedness contribute to lateral asymmetry of pain sensitivity in man.
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A review of studies on migraine therapy shows a large heterogeneity in the clinical evaluation of different drugs and behavioral approaches. The percentages of efficacy of beta-blockers or behavior therapy (relaxation, biofeedback) range from 30% to 80%. Methodological differences from one author to another in the design and conduct of the studies might be causes of this variation. ⋯ Double-blind and placebo-controlled studies are often required, but this demand often cannot be niet in empirical reality because of the individuality of the patient or the heterogeneity of the symptoms. We discuss some alternative approaches that could be used in empirical research on headache therapy. The application of single-case experiments as well as methods of time-series analysis are described as a more appropriate approach to the evaluation of studies on chronic headaches.
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Acute postoperative pain has an important psychological component. This psychological element could be registered by observing or measuring interindividual differences in pain experience, expressions of pain, and pain-coping behavior. Emotions such as anxiety, anger, and helplessness accompany postoperative pain, and postoperative pain can also be elicited by very intense preoperative anxiety. ⋯ Psychological factors also influence pain reduction. Postoperative aggression and its underlying metabolism facilitates recovery if the physicians or nurses can cope with the anger of the patient. Providing sensory descriptions of the pain during the preoperative visit and careful attention to both the pain-experiencing and the pain-free patient help to reduce pain or prevent its escalation.