European journal of pain : EJP
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Randomized Controlled Trial Comparative Study
Do dialogues about concepts of pain reduce immigrant patients' reported spread of pain? A comparison between two consultation methods in primary care.
Do dialogues about concepts of pain reduce the reported spread of pain more than the usual consultations? ⋯ Particularly the women in both consultation groups demonstrated much less spread of pain after treatment, despite similar clinical findings and less anxiety about pain in group A. The initially wide spread of pain may thus have been a way of communicating with the doctors.
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Randomized Controlled Trial
Analgesic efficacy and safety of intravenous paracetamol (acetaminophen) administered as a 2 g starting dose following third molar surgery.
The recommended dose for intravenous (IV) paracetamol injection in adults is 1g, however pharmacokinetic and pharmacodynamic findings suggest that a better analgesia could be obtained with a 2 g starting dose. ⋯ The analgesic efficacy of a 2 g starting dose of IV paracetamol was superior over the recommended dose of 1g in terms of magnitude and duration of analgesic effect for postoperative pain following third molar surgery, with no significant difference between groups regarding safety.
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Randomized Controlled Trial
Reliability and validity of a modified Brief Pain Inventory short form in patients with osteoarthritis.
The Brief Pain Inventory short form (BPI-sf) is a validated, widely used, self-administered questionnaire developed to assess the severity of pain and the impact of pain on daily functions. A modified version was used daily in randomised control trials of patients with arthritis undergoing treatment with cyclooxygenase-2 specific inhibitors and non-steroidal anti-inflammatory drugs. ⋯ Each scale and individual pain intensity item refers to changes in osteoarthritis pain associated with medication use. The modified BPI-sf, like the parent scale, is a valid and reliable tool for situations in which pain is assessed daily and minimises the burden placed on patients to record information necessary for scientific investigations.
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Comparative Study
A comparison of the effects of preferred music, arithmetic and humour on cold pressor pain.
Research studies of 'audioanalgesia', the ability of music to affect pain perception, have significantly increased in number during the past two decades. Listening to preferred music in particular may provide an emotionally engaging distraction capable of reducing both the sensation of pain itself and the accompanying negative affective experience. The current study uses experimentally induced cold pressor pain to compare the effects of preferred music to two types of distracting stimuli found effective within the previous studies; mental arithmetic, a cognitive distraction, and humour, which may emotionally engage us in a similar manner to music. ⋯ Preferred music listening was found to significantly increase tolerance in comparison to the cognitive task, and significantly increase perceived control in comparison to humour. Ratings of pain intensity did not significantly differ. The results suggest preferred music listening to offer effective distraction and enhancement of control as a pain intervention under controlled laboratory conditions.
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This large scale computer-assisted telephone survey was undertaken to explore the prevalence, severity, treatment and impact of chronic pain in 15 European countries and Israel. Screening interviews identified respondents aged 18 years with chronic pain for in-depth interviews. 19% of 46,394 respondents willing to participate (refusal rate 46%) had suffered pain for 6 months, had experienced pain in the last month and several times during the last week. Their pain intensity was 5 on a 10-point Numeric Rating Scale (NRS) (1 = no pain, 10 = worst pain imaginable) during last episode of pain. In-depth interviews with 4839 respondents with chronic pain (about 300 per country) showed: 66% had moderate pain (NRS = 5-7), 34% had severe pain (NRS = 8-10), 46% had constant pain, 54% had intermittent pain. 59% had suffered with pain for two to 15 years, 21% had been diagnosed with depression because of their pain, 61% were less able or unable to work outside the home, 19% had lost their job and 13% had changed jobs because of their pain. 60% visited their doctor about their pain 2-9 times in the last six months. Only 2% were currently treated by a pain management specialist. One-third of the chronic pain sufferers were currently not being treated. Two-thirds used non-medication treatments, e.g,. massage (30%), physical therapy (21%), acupuncture (13%). Almost half were taking non-prescription analgesics; 'over the counter' (OTC) NSAIDs (55%), paracetamol (43%), weak opioids (13%). Two-thirds were taking prescription medicines: NSAIDs (44%), weak opioids (23%), paracetamol (18%), COX-2 inhibitors (1-36%), and strong opioids (5%). Forty percent had inadequate management of their pain. Interesting differences between countries were observed, possibly reflecting differences in cultural background and local traditions in managing chronic pain. ⋯ Chronic pain of moderate to severe intensity occurs in 19% of adult Europeans, seriously affecting the quality of their social and working lives. Very few were managed by pain specialists and nearly half received inadequate pain management. Although differences were observed between the 16 countries, we have documented that chronic pain is a major health care problem in Europe that needs to be taken more seriously.