Articles: back-pain.
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We compared the results of two multimodal back treatment programs (program A: n = 134; program B: n = 175) using pain, functional capacity, sickness absence, subjective state of health, depression, and work status as outcome variables. Whereas in program A exercise was guided by pain, in program B a "no pain, no gain" rationale was used as a basis for intensive physical training. Neither of the programs included direct attempts to influence the patient's environment (i.e., to find employment or to modify working conditions). ⋯ In contrast to some earlier results, there was no statistically significant increase in the proportion of those employed after treatment in either group. The results indicate that intensive physical exercise does not, as such, solve the problem of back disability in a country that has a highly developed social security system. More active interventions in work and work-life are needed.
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Randomized Controlled Trial Clinical Trial
Back pain after epidural anesthesia with chloroprocaine.
Chloroprocaine has been associated with severe back pain after epidural anesthesia. Factors proposed to contribute to this problem are: 1) the preservative disodium ethylenediaminetetraacetic acid (EDTA), 2) large volumes of chloroprocaine, 3) low pH of chloroprocaine, and 4) local infiltration with chloroprocaine. ⋯ Large doses (> or = 40 ml) of chloroprocaine containing EDTA resulted in a greater incidence of deep burning lumbar back pain. Using 25 ml or less of the same solution resulted in an incidence of both types 1 and 2 postepidural anesthesia back pain similar to that in the lidocaine control group.
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Comparative Study
Long-term backache after extradural or general anaesthesia for manual removal of placenta: preliminary report.
A questionnaire designed to investigate the incidence of newly acquired, long-term backache was sent to women who had previously undergone manual removal of the placenta during a 12-month period in one maternity hospital. There was a significantly greater incidence of long-term backache in patients who had extradural anaesthesia specifically for manual removal of the placenta compared with patients receiving a general anaesthetic for the same procedure. The results of this retrospective study in a small population warrant examination in a large, prospective, controlled investigation.
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La Clinica terapeutica · Feb 1993
Comparative Study[The utility of a classification scale of lumbar pain for the diagnosis of the fibromyalgia syndrome].
To help fibromyalgia syndrome's diagnosis, the authors propose the use of Back Pain Classification Scale (BPCS), verbal test for pain analysis, able to distinguish between organic and functional disease. Two-hundred patients suspected for fibromyalgia and forty controls completed the questionnaire and so it was possible correctly to distinguish patients with organic disease from those affected by fibromyalgia. The authors conclude that BPCS can represent a useful tool for fibromyalgia diagnosis.
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Int J Obstet Anesth · Jan 1993
Double-blind evaluation of patient-controlled epidural analgesia during labor.
A double-blind randomized study was designed to compare the efficacy of patient-controlled epidural analgesia (PCEA) with continuous epidural analgesia (CEA) with regards to patient satisfaction with analgesia, analgesic efficacy, and local anesthetic usage. After establishing effective epidural analgesia with 8 ml of 0.25% bupivacaine, 39 parturients were randomized to 1 of 2 groups. The CEA group received a continuous infusion of 12 ml/h of 0.125% bupivacaine. ⋯ The 2 groups also did not differ significantly in terms of patient satisfaction, pain assessment, or total drug usage. However, the PCEA group required significantly fewer supplemental doses (15%) compared with the CEA group (40%). The decreased need for supplemental doses in the PCEA group may suggest a potential advantage in consistency of analgesia and possibly decreased man-power needs.