Articles: pain-measurement.
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Clin. Pharmacol. Ther. · Aug 1992
Randomized Controlled Trial Comparative Study Clinical TrialA new method for rate of analgesic onset: two doses of intravenous morphine compared with placebo.
A new method of frequent early pain assessments for 1 hour only was used to determine time of onset of analgesia after intravenous administration of 10 mg morphine, 5 mg morphine, or placebo in a double-blind study; 79 patients were randomized if they required parenteral analgesia in the early postoperative period. Pain intensity was determined by a four-point categoric verbal rating scale and on a verbal ordinal scale from 0 to 100 (0 = no pain, 100 = worst pain imaginable) during the first hour after analgesic administration. The onset time of analgesia, assessed by 50% of patients achieving 25% reduction from their baseline pain assessment, was significantly faster for 10 mg morphine compared with 5 mg morphine (p = 0.02) and placebo (p less than 0.01). More familiar analgesic efficacy measures, including the sum of pain intensity differences and time to next analgesic dose, similarly showed the superiority of 10 mg morphine to placebo in the first hour, confirming sensitivity according to the conventional paradigm.
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Acta Derm. Venereol. · Aug 1992
The analgesic effect of EMLA cream on facial skin. Quantitative evaluation using argon laser stimulation.
The hypoalgesic effect of EMLA cream (Eutectic Mixture of Local Anesthetics) applied for 5, 15, and 30 min on facial skin was evaluated. Hypoalgesia was assessed by changes in pain thresholds to brief argon laser stimuli 0, 2, 5, 10, 15, 20, 25, 30, 45, and 60 min after removal of EMLA cream. The local cutaneous vascular changes induced by EMLA cream was evaluated by Erythema Index determined by reflectance spectroscopy and by laser Doppler blood flowmetry. ⋯ This great variability should be considered when EMLA cream is used for facial application in the clinic. Differences in local blood flow probably contribute to the variability. Application of EMLA cream for 5 and 15 min did not change erythema of the skin, while 30 min of application caused minor blanching.
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We have developed a new method for the collection and analysis of pain drawings, as part of a computer-controlled, patient-interactive system for use with implanted neurological stimulators. The system has been tested in 44 patients with permanently implanted spinal cord stimulators for the relief of chronic, intractable pain. Patients interact directly with the system, using a graphics tablet, to enter pain drawings and corresponding outlines of their perceptions of stimulation paresthesias, for different stimulating pulse parameters and electrode geometries. ⋯ One particular configuration (cathode(s) flanked by anode(s) above and below) is significantly better, by this measure, than all the alternatives. This is consistent with prior clinical observations that this configuration is favored by patients whose systems have been adjusted by conventional, manual methods. Pain drawing' entry and analysis by a computerized, patient-interactive system has been useful in this specialized setting and may have broader applications.
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Randomized Controlled Trial Comparative Study Clinical Trial
Pain comparison of unbuffered versus buffered lidocaine in local wound infiltration.
The purpose of this study was to compare the pain of infiltration between unbuffered lidocaine and buffered lidocaine in a traumatic laceration. Solutions of unbuffered 1% lidocaine and buffered 1% lidocaine were randomly assigned to Site I or Site II of a single laceration for each subject, with the patient serving as self-control. ⋯ It was also found that Site I was preferred more often than Site II regardless of which medication was used. The conclusion is that buffered lidocaine is preferred over unbuffered lidocaine and that the order of injection is an important factor in trials that involve multiple sequential injections in the same patient.
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Comparative Study
Comparative study of the validity of four French McGill Pain Questionnaire (MPQ) versions.
Four different French versions of the McGill Pain Questionnaire (MPQ) have been published: 3 are MPQ translations in Canadian French and 1 (QDSA) is an MPQ reconstruction in (France) French. The aim of our work was to study the validity of these available questionnaires for use in France. The validity was evaluated by 44 French physicians. ⋯ The validity of the newly developed French MPQ was equal but not better than the QDSA. A 15-item short MPQ-QDSA version was also developed. For studies with patients from France, it is recommended that the QDSA or the short MPQ-QDSA versions be used.