Der Schmerz
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Randomized Controlled Trial Comparative Study
[Impact of preoperative patient education on postoperative pain in consideration of the individual coping style].
the German guideline for the treatment of acute perioperative and post-traumatic pain (S3-Leitlinie zur Behandlung akuter perioperativer und posttraumatischer Schmerzen) recommends giving preoperative information about postoperative pain and how to influence it. It is expected that the effect of preoperative information is modified by psychological characteristics of the patient. One of these psychological characteristics is the individual coping style. The purpose of the study is to evaluate whether or not patients benefit from preoperative education in relation to their level of negative coping style. ⋯ preoperative patient information has positive effects on the postoperative development of pain. Patient information is a valuable addition to the drug pain treatment. The application can be recommended regardless of the level of the patients' negative coping style.
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Calciphylaxis, or calcific uremic arteriopathy, is a rare complication of end-stage renal impairment. It is characterized by calcification of arterioles and development of intensely painful subcutaneous ischemic ulcerations. ⋯ Conventional analgesic concepts have mostly proved to be insufficient which increases the extreme suffering of patients. This case report describes the successful analgesic treatment of calciphylaxis with levomethadone.
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Chronic postoperative pain is known to be a significant clinical and economic problem. The estimated mean incidence is high and varies between 10 and 50%, with variations mostly related to procedure-specific conditions. High-risk types of surgeries are e.g. thoracotomy, breast or inguinal hernia surgery and amputations. ⋯ The perioperative identification of patients who are at high risk for developing chronic pain after surgery is therefore a major goal for the future. This may help to develop preventive treatment strategies and avoid treatments with side effects for patients who are not at risk for developing chronic pain after surgery. Due to a lack of appropriate data for sufficient preventive approaches an effective postoperative acute pain management and a nerve-conserving surgical technique are the major keys in the prophylaxis of chronic postoperative pain.
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Emotional and physical abuse and neglect in childhood and adolescence [childhood maltreatments (CMs)] are considered to play a role in the etiology of fibromyalgia syndrome (FMS). Whether the association between FMS and CMs can be explained by mediators has not been studied. ⋯ Prospective population-based studies controlling for depression are necessary to determine the role of CMs in the etiology of FMS.