Articles: pain-measurement.
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Randomized Controlled Trial Comparative Study Clinical Trial
Lack of effect of clonidine and pentoxifylline in short-term therapy of diabetic peripheral neuropathy.
The goal of this study was to confirm or rule out anecdotal reports of beneficial effects of clonidine and pentoxifylline in the treatment of painful diabetic peripheral neuropathy. Clonidine was administered to 16 subjects at two dosage levels (0.1 and 0.2 mg/day) and was compared to placebo in a crossover design, with each phase lasting 4 wk. ⋯ There was a significant decrease in pain score from baseline with both active drugs (P less than 0.05), but this was no better than the response to placebo (P less than 0.30 for clonidine and P less than 0.95 for pentoxifylline). This study does not demonstrate a short-term benefit of either clonidine or pentoxifylline in the treatment of peripheral neuropathy.
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Two separate studies were carried out to determine if three visual analogue scales for various feelings including pain could be marked consistently by patients, without reference to previously completed scales. Sixty patients undergoing extraction of their lower third molars had measurements of acute preoperative anxiety, expected postoperative pain and postoperative perceived pain three times in quick succession. There was no significant difference between the three measurements for any of the feelings. ⋯ Mean scores for anxiety, mood and pain relief were consistent, but mean pain scores were more variable. There was a very close correlation between any two feelings expressed on these visual analogue scales during both the initial and second visits. Litigation or social problems were not associated with increased pain scores.
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In sickle cell disease, vaso-occlusion in the small blood vessels leads to bone or joint pain which is variable in intensity and duration. An essential first step toward the development of specific treatment guidelines for such painful episodes in children and adolescents is the accurate evaluation of pain. The systematic assessment of vaso-occlusive pain is addressed through two separate studies. ⋯ In the second, data were gathered over the course of hospitalizations for uncomplicated vaso-occlusive episodes in 17 adolescent patients. Results showed that this pain experience can be quantified, that vaso-occlusive pain spans a broad range of intensity levels, and that there are a number of socioemotional factors associated with the pain experience. Further research to systematically assess the psychometric properties of pain assessment instrument is recommended.
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There is currently no classification system for chronic pain patients that has achieved consensus. The lack of a classification that is used consistently across settings has impaired advance of knowledge and treatment of chronic pain patients. Recently, an empirically derived multivariate classification system, the Multiaxial Assessment of Pain (MAP) patients, has been developed. ⋯ These data suggest that the psychosocial and behavioral responses associated with chronic pain are common to diverse samples of pain patients despite differences in demographic characteristics and medical diagnosis. The implications of these results for research and clinical practice are discussed. The potential utility of a polydiagnostic approach using more traditional medically based classifications such as proposed by the IASP (Merskey, H., Pain, Suppl. 3 (1986) S1-S225) complemented by classification based on the MAP psychosocial-behaviorally based taxonomy are examined.
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The purpose of this study was to describe various dimensions of the pain experiences of intensive care unit (ICU) patients. A purposive, primarily surgical sample of 24 ICU patients from two hospitals was interviewed after transfer from ICU. All but one patient remembered their ICU stay. ⋯ Results of this study clearly indicate that not only pain but its communication and treatment were significant problems for a substantial portion of this ICU sample. Further descriptive and experimental research of pain characteristics and treatment practices for ICU patients is urgently needed. Improvements in nursing practice that result from such research may make a substantial difference in the comfort and well-being of critically ill patients.