Articles: low-back-pain.
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Ortop Traumatol Rehabil · Dec 2003
Morphine or bupivacaine in controlling postoperative pain in patients subjected to knee joint arthroscopy.
Background. We investigated the efficacy of intra - articular bupivacaine with morphine administration after knee joint arthroscopy.
Material and methods. The present study compared intra- arthicular bupivacaine with intra-arthricular morphine for postoperative analgesia in 56 patients (21 women, 35 men) (age 20-70, mean 39.8) undergoing knee joint arthroscopy.
Intraoperatively, the patients received anaesthesia spinaly (0.5 % Marcaine spinal ASTRA) and immediately following surgery received 10 ml intra-arthricular injection consisting either of 0.5 % bupivacaine (group I), 5 mg morphine + 0.9 % saline (group II). ⋯ Intra-arthricular administration of each solution was well toleratede and non side effects were noted.
There was non significant difference among the two groups in monitored parameters. The mean time of postoperative analgesia was 185,7 +/- 25.3 min for bupivacaine group and 390.3 +/- 35,4 min for morphine group.
Total amount proefferalgan supplamentation was the highest in group I.
Conclusions. Postoperative intra- arthricular injections of bupivacaine and morphine for patients undergoing knee joint arthroscopy can provide a safe and effective analgesia and therefore shound be recommended and widely implamented into the clinical use as a standard procedure. -
Randomized Controlled Trial Clinical Trial
Importance of the back-café concept to rehabilitation after lumbar spinal fusion: a randomized clinical study with a 2-year follow-up.
A prospective, randomized, clinical study with a 2-year follow-up. ⋯ The patients in the back-café group were significantly better at accomplishing a succession of daily tasks compared with the video and training groups 2 years after lumbar spinal fusion. At the 2-year follow-up the training group had a significant pain problem compared with the video and back-café groups. The video group had significantly more treatment demands outside the hospital system. This study demonstrates the relevance of the inclusion of coping schemes and questions the role of intensive exercises in a rehabilitation program for spinal fusion patients.
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Randomized Controlled Trial Comparative Study Clinical Trial
The association between anger expression and chronic pain intensity: evidence for partial mediation by endogenous opioid dysfunction.
Recent work suggests that an expressive anger management style (anger-out) is associated with elevated acute pain sensitivity due to endogenous opioid antinociceptive dysfunction. We tested the hypothesis that this opioid dysfunction mediates the previously reported positive association between anger-out and chronic pain intensity. To assess endogenous opioid antinociception in the laboratory, 71 subjects with chronic low back pain received opioid blockade (8 mg naloxone i.v.) or placebo in counterbalanced order in separate sessions. ⋯ Inclusion of blockade effects in the first step of the regression resulted in a decrease from 7 to 3% in chronic pain variance accounted for by anger-out. Opioid dysfunction did not mediate the positive association between anger-in and chronic pain. These results provide preliminary support for the hypothesis that the positive association between anger expression and chronic pain intensity is mediated by opioid antinociceptive system dysfunction.
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To determine the relationships between low back pain (LBP) frequency and intensity and self-reported and performance-based physical function in a large cohort of well-functioning older adults. ⋯ Among well-functioning community-dwelling older adults, LBP frequency/intensity was associated with perceived difficulty in performing important functional tasks, but not with observed physical performance. The demonstrated dose-response relationship between pain frequency/intensity and self-reported task performance difficulty underscores the importance of clinical efforts to treat pain without necessarily eradicating it. Additional work is needed to determine whether back pain is associated with a risk for progressive functional decline and loss of independence in older adults and whether therapeutic interventions can ameliorate decline and, therefore, preserve independence.
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Anesthesiol Clin North America · Dec 2003
ReviewSpecial techniques in pain management: lysis of adhesions.
Low back pain, with or without radicular symptoms, is a common medical condition. It can cause mild to severe suffering, high health costs, and disability. ⋯ The less fortunate group of patients who do not improve despite conservative and mildly interventional therapy, find themselves in search of a more effective treatment. To enhance treatment outcome, an understanding of the pathophysiology of the underlying pain and the design of target-specific treatment modalities is important.