Pain practice : the official journal of World Institute of Pain
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Comparative Study Observational Study
The Comparison of Two Analgesic Regimes after Ambulatory Surgery: An Observational Study.
Over the past 15 years, the number of ambulatory surgical procedures worldwide has increased continuously. Studies show that 30% to 40% of the patients experience moderate-to-severe pain in the first 48 hours. The objective of this observational study is to compare the percentage of moderate-to-severe pain, side effects, and the use of escape medication of two different analgesic regimes after ambulatory surgery. ⋯ A total of 375 patients participated in the study, of which 99 in the tramadol group and 138 in the combination tablet tramadol/paracetamol group. The percentage of patients with moderate-to-severe postoperative pain was 25% to 40%. In both the groups, an equal percentage of patients experienced moderate-to-severe postoperative pain. Both analgesic regimes have a comparable analgesic effectiveness with each with its own specific advantages and disadvantages. On the first day after surgery, patients with the tramadol/paracetamol regime experienced more side effects (drowsiness and nausea) were less therapy compliant, but needed a smaller amount of escape medication than the patients from the tramadol group.
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Neuropathic pain is a serious chronic condition strongly affecting quality of life, which can be relieved but cannot be cured. Apart from symptomatic management, treatment should focus on the underlying disorder. The estimated prevalence is at least 1% to 5% of the general population. ⋯ Ancillary investigations may include EMG and computerized tomography/magnetic resonance imaging scans, depending on the localization of the suspected lesion. A limited number of agents, primarily directed at symptom control, are currently approved for use in neuropathic pain. A mechanism-based approach to pharmacological intervention supports the use of polypharmacy in neuropathic pain.
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The cold pressor task (CPT) was originally developed as a clinically indicative cardiovascular test, and quantifies vascular response and pulse excitability when a subject's hand is immersed into ice water. Since the test procedure results in a gradually increasing cold pain, the CPT has been widely used as a nociceptive stimulus in experimental studies on adults and children. ⋯ Consistent with previous findings, regression analysis reveals that age is significantly associated with pain tolerance. The CPT procedure shows excellent 2 week test-retest stability to assess pain threshold and pain tolerance within a student population.
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Clinical Trial
Percutaneous Nerve Stimulation in Chronic Neuropathic Pain Patients due to Spinal Cord Injury: A Pilot Study.
The long-term prognosis for neuropathic pain resolution following spinal cord injury (SCI) is often poor. In many SCI patients, neuropathic pain continues or even worsens over time. Thus, new treatment approaches are needed. We conducted a pilot study to evaluate the feasibility and effect of percutaneous (electrical) nerve stimulation (P(E)NS) in SCI patients with chronic neuropathic pain. ⋯ P(E)NS is feasible as an intervention in SCI patients and might have a positive effect on pain reduction in a part of this patient group.
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Pain is a subjective experience influenced by multiple factors, and tremendous variety within individuals is present. To evaluate emotional state of pain, catastrophizing score can be used. This study investigated pain catastrophizing ratings in association with experimental pain perception. ⋯ Even small increments in pain catastrophizing score can influence pain perception to deep and tonic stimulations. Catatrophizing may partly explain the variability found in experimental pain studies.