Articles: pain-measurement.
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J. Neurosci. Methods · May 2019
Comparative StudyLong term reliability of nociceptive withdrawal reflex thresholds.
The nociceptive withdrawal reflex (NWR) is a polysynaptic spinal reflex protecting the body from harmful stimuli. Two different methods to assess its' threshold (NWR-T) have been part of clinical trials concerning the evaluation of the nociceptive system in the human body. NWR-T's are gathered by stimulation at the sole of the foot and over the sural pathway. Consequently, EMG analyzes the muscle activity over the biceps femoris and tibialis anterior muscle. Past studies favor stimulation at the sole of the foot. ⋯ The NWR-T upholds reliable measurements over a longer period of time and seems to be a stable measure for pain condition. Reliability estimations, EMG recordings, and subject's rating show stimulation at the sole of the foot could be the better choice.
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Multicenter Study
Chest pain score: a novel and practical approach to angina pectoris. A diagnostic accuracy study.
The chest pain classifications that are currently in use are based on studies that are several decades old. Various studies have indicated that these classifications are not sufficient for determining the origin of chest pain without additional diagnostic tests or tools. We describe a new chest pain scoring system that examines the relationship between chest pain and ischemic heart disease (IHD). ⋯ We developed a pre-test chest pain score that uses a digital scoring system to assess whether or not the pain was caused by IHD. This scoring system can be applied easily and swiftly by healthcare professionals and can prevent the confusion that is caused by other classification and scoring systems.
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Reg Anesth Pain Med · May 2019
Preoperative frailty and its association with postsurgical pain in an older patient cohort.
Chronic postsurgical pain in patients over 65 negatively impacts recovery, quality of life and physical functioning. In the community setting, chronic pain has been shown to be related to frailty, a syndrome more commonly seen in older adults and characterized by limited physiologic reserve and ability to withstand stressors. While frailty is an important preoperative risk factor for poor surgical outcomes in older adults, the relationship between frailty and postsurgical pain in this population has not been investigated. We hypothesized that preoperative frailty would be associated with greater odds of postsurgical chronic pain. ⋯ Although future studies are needed to establish a causal relationship between preoperative frailty and postsurgical pain, our findings suggest that older patients should have preoperative frailty assessments and frail older adults may need additional resources to improve postsurgical pain outcomes.
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Intravenous lidocaine and dexmedetomidine treatments have been proposed as methods for inhibiting cough. We compared the efficacy of intravenous lidocaine and dexmedetomidine treatments on inhibiting cough during the tracheal extubation period after thyroid surgery. ⋯ Compared with intravenous infusions of normal saline, both lidocaine and dexmedetomidine had equal effectiveness in attenuating cough and hemodynamic changes during the tracheal extubation period after thyroid surgery, and both of these treatments were able to reduce the volume of postoperative bleeding and provide better analgesic effect after surgery. But intravenous infusions of dexmedetomidine resulted in bradycardia and delayed the time to awareness when compared with lidocaine and normal saline.
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Reg Anesth Pain Med · May 2019
Randomized Controlled TrialImpact of patient choice for different postcesarean delivery analgesic protocols on opioid consumption: a randomized prospective clinical trial.
Choice of postcesarean delivery analgesic protocol may improve pain experience and reduce analgesic requirements. ⋯ Having a choice compared with no choice routine care did not reduce oxycodone requirements or pain scores. However, women have insight into their analgesic needs; women offered a choice and who chose the higher dose analgesic protocol required more oxycodone, and women who chose the lower dose protocol required less oxycodone. Despite providing additional analgesic (six times more intrathecal morphine plus gabapentin in high dose vs low dose protocols), we still did not equalize postcesarean oxycodone requirement differences between groups.