European journal of pain : EJP
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The response of skin to ultraviolet (UV) irradiation is an inflammation with pronounced vasodilation and hyperalgesia. Volunteers underwent UV irradiation of patches of forearm skin 3 cm in diameter. The intensity of the UV irradiation (290-320 nm) ranged between 133 mJ/cm2 and 400 mJ/cm2. ⋯ Pressure pain thresholds were lowered by up to 6 N in irradiated areas. Maximal hyperalgesia coincided with the second peak of skin blood flow between 30 h and 60 h post UV irradiation. The effects of topical application of capsaicin suggests an involvement of neuropeptide mechanisms in the late phase of the human sunburn reaction.
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The Japanese guidelines for the clinical practice of cancer pain management supported by evidence-based medicine were established by the Japanese Society for Palliative Medicine in 1999 [as their Evidence-based Medicine-supported Cancer Pain Management Guideline ]. To evaluate usefulness of the Guideline for the management of cancer pain, the same questionnaires were addressed to nurses and physicians of enrolled institutions twice. The first survey was conducted before the distribution of the Guideline in July, 1999 and the second was done after the distribution in January, 2000. ⋯ Cancer patients were divided into two groups depending on their stages (conservative or terminal). (1) Morbidity of pain in cancer patients at each stage having some analgesics did not change at each survey period. (2) At the first survey the rate of pain relief in each stage of cancer patients was essentially unchanged from a previous result obtained in 1998. (3) The rate of pain relief shown in the second survey tended to be higher than that shown in the first in both groups of patients. (4) The rate of pain relief with per os morphine was shown to be significantly higher in the second survey than in the first for each group of patients at conservative or terminal stage. (5) The rate of pain relief of patients staying in the ward where the guidance for dosing of morphine had been carried out was 37.5% at the first survey versus 47.9% at the second. (6) The answers from physicians to questions about treatment of cancer pain remained unchanged between the first and the second survey. The usefulness of the Guideline for cancer pain management is partly confirmed by these results. The significance of the Guideline will be totally discussed by comparing its effects on nurses, pharmacists and physicians.
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Randomized Controlled Trial Clinical Trial
Nalbuphine by PCA-pump for analgesia following hysterectomy: bolus application versus continuous infusion with bolus application.
The analgesic properties of the partial agonist-antagonist nalbuphine in the postoperative period are well known. When used for patient-controlled analgesia (PCA) the effectiveness of this substance is comparable to that of morphine or tramadol. However, the optimal programme for administration of nalbuphine in PCA-pumps has not been investigated. ⋯ Subjective rating of effectiveness by the patients was similar in both groups. The two administration settings of nalbuphine by PCA pump have shown to be equally effective in the treatment of postoperative pain following hysterectomy. However, as the total amount of nalbuphine was significantly lower in B-group, the use of this administration schedule should be encouraged.
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Clinical Trial Controlled Clinical Trial
The assessment of radiating low back pain by thermal sensory testing.
Low back pain radiating into the legs is a common pain syndrome. However, neurological examination, imaging and electromyographic studies are of limited value for prognosis or therapy. The origin of the pain remains unknown. ⋯ We propose that these findings indicate selective damage to the Adelta fibres which are involved in transmission of cold sensation and pain, presumably by root compression. We found no evidence of involvement of C fibres, which transmit warm sensation and pain. Thermal testing should be considered among the testing modalities that are capable of demonstrating objective findings in patients with radiating low back pain.
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Randomized Controlled Trial Clinical Trial
Pregabalin in patients with postoperative dental pain.
Pregabalin is an analogue of the inhibitory neurotransmitter gamma-aminobutyric acid. In preclinical models, it has shown activity as an analgesic agent. A randomized, double-blind, placebo-controlled, parallel-group trial was undertaken to compare pregabalin to placebo and 400 mg of ibuprofen using a dental pain model. ⋯ Adverse events were reported more frequently in the pregabalin 300-mg group. Pregabalin appears to have significant analgesic properties in the third molar extraction model. Further research is needed to confirm these findings.