Der Schmerz
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The perception and expression of pain are primarily psychological phenomena and are not directly correlated with the intensity of the nociceptive stimulus. They are often influenced by earlier experiences of pain, and also by current expectations and fears. The cancer patient interprets pain as a sign of the continued existence and of the progression of the malignant disease: if the pain can be controlled the patient will take this as an indication that the underlying disease can be cured. ⋯ In particular, antidepressants and neuroleptics have become an important component of the treatment of chronic pain in cancer patients. Due consideration of the emotional and motivational status of the patient will make it possible to choose between the different effect profiles of these drugs. However, the use of psychotropic drugs should complement, and cannot replace, empathic care from the physician.
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Since the ban of phenacetin and barbiturates in analgesics, caffeine as a constituent of analgesics has recently more often been blamed for promoting the abuse of analgesics. The available relevant literature was reviewed to perform a benefit/risk analysis. The results were as follows. ⋯ This however might cause a higher and unpredictable risk (e.g., gastrointestinal bleeding) with proper use in exchange for of a reduction in the predictable risk with misuse or abuse. This would raise major ethical and legal issues. Minimizing one special risk does not automatically reduce the overall risk.
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The relationship between painful pressure stimuli and induced pain intensity was examined. For experimental pain stimulation in 26 subjects, randomized local pressure on the middle phalanxes of fingers II-IV was used (pressure area 2.56 mm(2), six different pressure levels, three different pressure times). The induced pain intensity was measured by the category splitting procedure. ⋯ The intraindividual and interindividual deviations are normally distributed. The retest reliability between measurements in the morning and in the evening amount to 0.98. Thus, the procedure can be used to objectify the pain intensity experienced.