Articles: pain-measurement.
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Comparative Study
Appropriate use of local anaesthetic for venous cannulation.
A departmental survey indicated that the large majority of anaesthetists believed that injection of local anaesthetic before insertion of an intravenous cannula was unnecessary if a cannula of 18 gauge or smaller was used, because injection of local anaesthetic would be more painful than insertion of the cannula. A study was undertaken to test this hypothesis. The results showed that intravenous cannulation with a cannula of 18, 20 or 22 gauge was significantly (p less than 0.006) more painful than a subcutaneous injection of 1% lignocaine. We recommend that subcutaneous injection of local anaesthetic should be considered before insertion of any size of intravenous cannula.
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Multicenter Study Clinical Trial Controlled Clinical Trial
A multi-center evaluation of the McGill Pain Questionnaire: results from more than 1700 chronic pain patients.
We argue that the conflicting results reported in previous studies examining the factor structure of the McGill Pain Questionnaire Pain Rating Index (PRI) can be explained by differences in the patient samples and statistical analyses used across studies. In an effort to clarify the factor structure of the PRI, 3 different factor models were compared using confirmatory factor analysis in 2 samples of low-back pain patients (N = 1372) and in a third sample of patients suffering from other chronic pain problems (N = 423). ⋯ Reducing the information from the 10 PRI sensory subclasses to a single subscale score may seriously limit the usefulness of the PRI. Alternate methods of using PRI data are suggested.
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This study examined the reliability and validity of a behavioral observation method for the assessment of arthritis pain in a clinical practice setting. Trained observers measured the occurrence of seven pain behaviors in a group of 61 rheumatoid arthritis patients undergoing physical examinations. ⋯ Total pain behavior scores obtained in both settings were significantly correlated with patients' self-reports of pain and with disease activity measures. Pain behavior observed during the exams was significantly associated with patients' self-reports of anxiety and depression.
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The accurate assessment of pain is essential in cancer pain treatment. As pain is a subjective experience, there is no precise method to quantitate it objectively. There are two approaches: the first is the use of laboratory techniques to measure the patient's reaction to experimental pain, such as sensory decision theory analysis. ⋯ Listening carefully to the patient's complaint is required not only for the precise assessment of pain, but also is a form of psychological treatment. Cancer pain should be relieved as soon as possible. Although WHO cancer pain relief is the first choice, nerve blocks and intraoperative radiotherapy, if indicated, must be taken into consideration in the early phase of the pain treatment.
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Pressure pain detection threshold and pressure pain tolerance threshold were measured in the temples and on the fingers in 40 healthy volunteers, equally distributed as to sex and handedness. Lower pressure pain thresholds were found over the temporal muscle than in a neighbouring temporal location without interposed myofascial tissue (p less than 0.001), indicating that nociception from myofascial tissue contributes to the pressure pain threshold. ⋯ Finally, pressure pain thresholds were lateralized in dextrals but not in sinistrals. The information that can be obtained from pressure pain detection and tolerance thresholds is discussed and examination of both threshold types is recommended in future studies.