Scandinavian journal of pain
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Patellofemoral pain (PFP) is a prevalent and debilitating musculoskeletal condition, considered to have a mechanical aetiology. As such, the physical impairments associated with PFP are well documented and have helped characterise different physical phenotypes. But little is known about the relationship between PFP and psychological well-being. In this study, we aimed to: (1) compare psychological profiles between groups with and without PFP; (2) compare psychological profiles and condition severity between PFP subgroups; and (3) explore relationships between psychological factors and their contribution to disability. We expected to find higher levels of psychological impairment, especially kinesiophobia and catastrophizing in the PFP group. We also expected to identify a sub-group for who worsening levels of disability correspond with worsening psychological well-being. ⋯ These findings draw attention to psychological factors to which clinicians assessing PFP should show vigilance. They also highlight psychological impairments that might be worthwhile targets in optimising PFP management.
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Observational Study
Prescription of opioids to post-operative orthopaedic patients at time of discharge from hospital: a prospective observational study.
Excessive opioid prescribing can lead to adverse consequences including stockpiling, misuse, dependency, diversion and mortality. Increased prescriptions to post-operative inpatients as part of their discharge planning may be a significant contributor. Primary aims included comparing the amount of opioids prescribed, consumed, left unused and their relationship with pain and functionality. ⋯ Changes to prescribing habits and workplace culture are required to minimise unnecessary opioid prescribing but will be challenging to implement. A multi-layered approach of electronic prescribing, opioid stewardship and targeted educational awareness programmes is recommended.
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Chronic pain is the frequent and significantly challenging complications in persons with spinal cord injury (SCI). Socio-cultural background may lead people perceive and manage pain differently. The study aims to describe the chronic pain experience and pain management of SCI persons in Nepal. ⋯ This study provides some evidence to help the team of rehabilitation professional to plan and help SCI persons with chronic pain. Based on these findings, chronic pain management intervention for SCI persons should be developed and supported continuously from hospital to home based community context of Nepal.
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The Numerical Rating Scale (NRS), Visual Analogue Scale (VAS), Verbal Rating Scale (VRS), and Faces Pain Scale-Revised (FPS-R) are valid measures of pain intensity. However, ratings on these measures may be influenced by factors other than pain intensity. The purpose of this study was to evaluate the influence of non-pain intensity factors on the pain intensity scales. ⋯ The influence of pain interference and pain unpleasantness on VRS and FPS-R, respectively should be kept in mind when selecting pain measures and interpreting the results of research studies using these scales.
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Randomized Controlled Trial Comparative Study
Low dose ketamine versus morphine for acute severe vaso occlusive pain in children: a randomized controlled trial.
Acute pain episodes associated with sickle cell disease (SCD) are very difficult to manage effectively. Opioid tolerance and side effects have been major roadblocks in our ability to provide these patients with adequate pain relief. Ketamine is cheap, widely safe, readily available drug, with analgesic effects at sub-anesthetic doses and has been used in wide range of surgeries, pediatric burns dressing change and cancer related pain however, literature concerning its use in sickle cell crises is still limited in our setting. This study aimed to establish if 1 mg/kg of intravenous ketamine is non inferior to intravenous morphine 0.1 mg/kg in severe SCD-associated pain. ⋯ Intravenous ketamine at 1 mg/kg can be a reliable alternative to morphine in the management of severe painful sickle cell crisis especially in a resource limited area where morphine is not readily available.