European journal of pain : EJP
-
Randomized Controlled Trial
Validation of the PAC-SYM questionnaire for opioid-induced constipation in patients with chronic low back pain.
The Patient Assessment of Constipation Symptoms (PAC-SYM) questionnaire is a 12-item self-report instrument divided into abdominal, rectal and stool domains. ⋯ PAC-SYM is a reliable, valid and responsive measure of the presence and severity of opioid-induced constipation symptoms.
-
Psychosocial factors have been implicated in the pain experience during childbirth, which can have both short- and long-term consequences on the mother's health and her relationship with her infant. The present study evaluated important demographic, social, and psychological factors as predictors of multiple dimensions of labor pain among 35 mothers during childbirth. ⋯ These data replicate previous research that has demonstrated the significant impact of AS on pain responding in other areas (e.g., chronic pain) and extend knowledge in this literature to demonstrate the important role that AS serves among women and their experience of labor pain. Clinical implications are highlighted and discussed.
-
While opioids in increasing doses may produce adverse effects, the same adverse effects may be associated with poor pain control. Moreover, in the clinical setting symptomatic treatment and illness may balance the outcome of opioid titration. Some adverse effects may tend to disappear continuing the treatment in a long-term period. ⋯ The effects reported were often due to multiple causes. A rapid decrease in pain intensity induced by rapid opioid titration does not produce changes in weakness, nausea and vomiting, appetite. While constipation appears the most relevant problem, resistant to common symptomatic treatment, drowsiness initially produced by acute opioid dose increase and the achievement of pain relief, tends to spontaneously decrease, probably as the result of late tolerance. Improved well-being may be the late positive effect of pain relief, also influenced by the setting of home care.
-
To review the clinical and cost-effectiveness of spinal cord stimulation (SCS) in the management of patients with complex regional pain syndrome (CRPS) and identify the potential predictors of SCS outcome. ⋯ SCS appears to be an effective therapy in the management of patients with CRPS type I (Level A evidence) and type II (Level D evidence). Moreover, there is evidence to demonstrate that SCS is a cost-effective treatment for CRPS type I.
-
Classification of patients with chronic whiplash associated disorders (WAD) into homogenous subgroups is an important objective in order to tailor interventions and to control for subgroup differences when evaluating treatment outcome. ⋯ These results support the presence of different subgroups among patients with whiplash associated disorders. This classification can be seen as a complement to a classification based on medical condition.