Articles: postoperative-pain.
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Clinical Trial
Cross-validation of a self-report scale for postoperative pain in school-aged children.
The present study cross-validated self-report pain scales: Verbal Rating Scale (VRS), Facial Expression Scale (FACES), Color Analogue Scale (CAS) and Poker Chip Tool (PCT) in Thai children aged 5-12 years. The concordance with observational measure, Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) was also tested. Among 100 students, test-retest reliability of all self-report measures was moderate to good (K = 0.501-0.712) and only FACES yielded acceptable face validity(IC > 0.5). ⋯ Agreement of self-report measures and CHEOPS was better in the age group 5-8 years (K = 0.417-0.826) than 9-12 years (K = 0.231-0.529). In conclusion, FACES is a valid, reliable and practical tool. Self-report measures are more in concordance with CHEOPS in the younger age group.
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To explore relationships among anxiety, anticipated pain, coping styles, postoperative pain, and patient-controlled analgesia (PCA) use among adolescent surgical patients and their parents. ⋯ Findings are interpreted as suggesting a self-fulfilling prophecy in adolescents' postoperative pain experience wherein teens who expect to have high levels of postoperative pain ultimately report more pain and use more opioid PCA medication than those who report lower levels of pain.
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Anesthesia and analgesia · Mar 2005
Perineural resiniferatoxin prevents hyperalgesia in a rat model of postoperative pain.
Resiniferatoxin (RTX) is a vanilloid agonist with a unique spectrum of activities. Vanilloids bind to the transient receptor potential ion channel subtype 1, a nonselective cation ionophore important in the integration of different noxious signals. Vanilloid agonists selectively decrease sensitivity to noxious stimuli. ⋯ Two hours after incision, the withdrawal threshold was 51 mN without and 456 mN with RTX (P < 0.0001). RTX also prevented the incision-induced decrease in struggle threshold and abolished the pain behavior associated with weight bearing. We conclude that RTX provides a type of neural blockade when postoperative pain is abolished and that nonpainful sensations and motor functions are preserved.
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Combined administration of local anesthetics and an opioid is frequently used in order to minimize the dose of each drug and to reduce adverse effects. Although fentanyl is commonly administered with local anesthetic, side effects of fentanyl increase in a dose-dependent manner. In this study, we determined the optimal dose of epidural fentanyl after gynecological surgery. ⋯ Ropivacaine alone could not provide sufficient analgesia. Although the addition of 5 microg x ml(-1) fentanyl to 0.2% ropivacaine at a rate of 5 ml x hr(-1) improved postoperative pain, side effects caused by fentanyl increased. Supplementing 2 microg x ml(-1) fentanyl provided sufficient analgesia with the least incidence of side effects.