Articles: pain-measurement.
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Appropriate pain measurement relies on the use of valid, reliable tools. The aim of this study was to determine and compare the psychometric properties of 3 self-reported pain scales commonly used in the pediatric emergency department (ED). The inclusion criteria were children aged 6 to 17 years presenting to the ED with a musculoskeletal injury and self-reported pain scores ≥30 mm on the mechanical Visual Analogue Scale (VAS). ⋯ Intraclass correlation coefficient and coefficient of repeatability estimates suggested acceptable reliability for the 3 scales at, respectively, 0.79 and ±2.29 (VAS), 0.82 and ±2.07 (CAS), and 0.76 and ±2.82 (FPS-R). The scales demonstrated good psychometric properties for children with acute pain in the ED. The VAS and CAS showed a strong convergent validity, whereas FPS-R was not in agreement with the other scales.
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The pursuit of a physiological indicator of noxious stimulation is desirable as it has the potential to provide mechanistic information regarding acute pain and may ultimately improve pain management strategies. Currently, there are no specific neurophysiological markers of pain to evaluate treatments. Recent attempts to identify neural correlates of pain have focused on different neuroimaging modalities. The purpose of this review is to discuss common neuroimaging techniques and findings thus far.
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Research on labor pain currently uses standard scores such as numerical scales as clinical outcomes, but no clear guidelines for such an assessment have appeared since a review published in 1998. We aimed to describe and estimate the quality of the methods used to assess and analyze such outcomes in a systematic review of 215 comparative studies published since then in 27 influential journals. ⋯ This review points out the need for a better standardization of the methods in this field of research.
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Observational Study
Evaluation of the analgesia nociception index for monitoring intraoperative analgesia in children.
Intraoperative analgesia is still administered without guidance. Anaesthetists decide upon dosing on the basis of mean population opioid pharmacological studies and in response to variations in haemodynamic status. However, those techniques have been shown to be imprecise. We assessed the diagnostic value of monitoring the analgesia nociception index (ANI) to detect surgical stimulation in children. ⋯ ANI has diagnostic value for detecting surgical stimuli in children.
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Observational Study
Postoperative Changes in Moderate to Severe Nonspecific Low Back Pain After Cervical Myelopathy Surgery.
Cervical myelopathy patients sometimes experience concurrent nonspecific moderate to severe low back pain (msLBP). However, postoperative changes in msLBP after cervical myelopathy surgery have rarely been reported. Awareness of postoperative changes in msLBP may be helpful in consultation. Therefore, the objective of this study was to examine postoperative changes in msLBP. ⋯ Although the exact pathophysiology was not demonstrated, cervical myelopathy surgery may directly and indirectly improve msLBP.