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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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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To measure the prevalence of diagnosed opioid abuse and prescription opioid use in a multistate managed care organization. ⋯ Despite a stable rate of prescription opioid use among the observed population, the prevalence of diagnosed opioid abuse is increasing, particularly in the Medicare population.
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A preliminary electronic pain assessment program known as Pain Assessment Interview Network, Clinical Advisory System (painCAS), was implemented in 2 pain centers over the course of 10 months to understand the tool's impact on opioid risk assessment documentation and clinical workflow. The program contains validated electronic versions of screeners for opioid misuse risk (SOAPP-R and Current Opioid Misuse Measure). ⋯ Implementation of an opioid risk electronic pain assessment program significantly increased the likelihood that a risk assessment would be included in the medical record, which has implications for improvement of quality of care.