Articles: pain-measurement.
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Every day patients arrive at Accident and Emergency (A & E) departments in pain due to a multitude of causes. As nurses working in this area, we routinely assess patients both objectively and subjectively, and this includes the intensity and descriptions of their pain and their responses to it. Anxiety and pain are closely linked and it has been shown that the use of pain assessment tools can promote nurse-patient communication, thus reducing anxiety levels, improving pain control and assisting in nursing care. This article explores the use of objective assessment of pain within the A & E setting and discusses the issues surrounding pain assessment as a whole.
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Pain has been difficult to assess because of its multidimensional nature. The primary purpose of this study was to investigate the relationship between the nurse's assessment of behavioral cues to pain and self-reports of pain made by patients using patient controlled analgesia (PCA). This descriptive-correlational study used the PACU Behavioral Pain Rating Scale (BPRS), patient's self-report, and hospital's PCA pain-rating scale to investigate pain measurement. ⋯ Significant relationships (rs = 0.56 to 0.80; P < 0.05) were found between the BPRS scores and the self-reports of pain. The relationship between the hospital's PCA pain rating scores and self-reported pain was significant only during the second assessment (rs = 0.45; P < 0.05). The BPRS consistently showed a moderate to high relationship with the patient's self-report of pain and had a stronger relationship with the patient's self-reported pain than with the hospital's pain scale.
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Methods Find Exp Clin Pharmacol · Apr 1994
Antinociceptive effects of ketamine-opioid combinations in the mouse tail flick test.
The antinociceptive activities of intraperitoneal (i.p.) ketamine in combination with subcutaneous (s.c.) morphine or fentanyl were studied using the mouse tail flick test, an acute pain model. Morphine and fentanyl exhibited dose-dependent effects, with respective ED50s (95% confidence limits) of 1.3 (1.2-1.4) mg/kg and 6.8 (6.2-7.4) mcg/kg. Ketamine (1, 5, 10 and 20 mg/kg) showed relatively weak antinociceptive effects with no apparent dose-response relationship. ⋯ Fentanyl (0.5 mcg/kg) pretreatment significantly enhanced ketamine (20 mg/kg) activity, with no apparent effect on ketamine 10 mg/kg. At 2.5 mcg/kg, fentanyl pretreatment significantly enhanced ketamine antinociception. These results suggest that ketamine may not be as effective in acute pain as opioids are, and that after systemic administration, the net effect of ketamine-opioid combination is a simple additive one.
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To determine whether physician estimates of pain severity are influenced by patient ethnicity. ⋯ Physician ability to assess pain severity does not differ for Hispanic and non-Hispanic white patients. Other explanations for a difference in analgesic practice as a function of ethnicity should be explored.
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Postoperative pain is one of the major obstacles in the prevention of complications during patient recovery. Pain and its management have gained great interest among researchers, clinicians and policy-makers. ⋯ Certain patient conditions such as length of time after surgery and ventilator status affected nurses' assessment and management of pain. Nurses' knowledge about pain assessment and management may affect patient care and outcomes.