Pain research & management : the journal of the Canadian Pain Society = journal de la société canadienne pour le traitement de la douleur
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In recent years, numerous studies have considered endometriosis to be a subclinical, local inflammatory process in the pelvic peritoneum, the main symptom of which is pain. ⋯ Ovarian endometriomas caused more pain than ovarian teratomas, likely due to the endometrial tissue component and not a mass effect. The assessment of pain and pain-related stress associated with the pelvis minor showed a high level of pain intensity and lower level of pain-related stress among patients with ovarian endometriomas.
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The aim of the present study was to explore the effectiveness of an alternative method to manage pain based on a time-limited intrathecal (IT) infusion of an analgesic medication mixture. Three patients (69, 64 and 94 years of age) with intractable and poorly controlled pain due to bed sores, pelvic metastatic mass, and thoracic vertebra and rib fractures, respectively, were treated. Daily doses of opioids could not be increased due to side effects. ⋯ One patient experienced a urinary tract infection followed by sepsis and meningitis, which was cured by antibiotics. The catheter was removed in this patient. IT infusion with a low-concentration multidrug mixture could be considered as an alternative modality for intractable pain relief in older adults or in malignancies.
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To maximize the benefit of therapies, patients must understand their condition, recall treatment suggestions and comply with treatments. The Pain Explanation and Treatment Diagram (PETD) is a one-page worksheet that identifies risk factors (health-related habits, sleep, exercise, ergonomics and psychosocial factors) involved in chronic pain. Clinician and patient complete the PETD together, and the clinician notes recommended treatments and lifestyle changes. ⋯ The PETD is a promising, feasible and inexpensive tool that can improve patients' recall of diagnostic- and treatment-related information.
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Randomized Controlled Trial
Is a single low dose of intrathecal morphine a useful adjunct to patient-controlled analgesia for postoperative pain control following lumbar spine surgery? A preliminary report.
Several studies addressing intrathecal morphine (ITM) use following spine surgery have been published either involving the pediatric population, using mid- to high-dose ITM, or not in conjunction with morphine patient-controlled analgesia (PCA). ⋯ ITM may be a useful adjunct to PCA, but did not decrease time to ambulation or length of stay.
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To evaluate the number of tender points, pressure pain threshold and presence of fibromyalgia among women with or without dyspareunia. ⋯ The finding of lower pressure pain thresholds and a higher number of tender points among patients with dyspareunia suggests that these patients may have increased generalized pain thresholds. Additional studies involving a larger number of patients are required to investigate the presence of central mechanisms in the pathogenesis of dyspareunia.