Articles: pain-measurement.
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. To present the sixth in a series of articles designed to deconstruct chronic low back pain (CLBP) in older adults. This article focuses on the evaluation and management of lumbar spinal stenosis (LSS), the most common condition for which older adults undergo spinal surgery. ⋯ . Lumbar spinal stenosis exists not uncommonly in older adults with CLBP and management often can be accomplished without surgery. Treatment should address all conditions in addition to LSS contributing to pain and disability.
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Observational Study
Emergence delirium or pain after anaesthesia-how to distinguish between the two in young children: a retrospective analysis of observational studies.
Early postoperative negative behaviour in preschool children after general anaesthesia is a common problem. The distinction between emergence delirium (ED) and pain is difficult, but management differs between the two. The aim of the current analysis was to identify individual observational variables that can be used to diagnose ED and allow distinction from postoperative pain. ⋯ 'No eye contact' and 'no awareness of surroundings' identifies ED. 'Abnormal facial expression', 'crying', and 'inconsolability' indicate acute pain in children in the early postoperative period.
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Randomized Controlled Trial Multicenter Study
Pregabalin in Subjects With Painful Diabetic Peripheral Neuropathy Using an NSAID for Other Pain Conditions: A Double-Blind Crossover Study.
To evaluate pregabalin's efficacy and safety versus placebo to reduce pain in patients with diabetic peripheral neuropathy (DPN) using a concomitant nonsteroidal anti-inflammatory drug. ⋯ Pregabalin (vs. placebo) showed overall improvements in sleep, pain reduction in 1 sensitivity analysis, and was well tolerated. Potential factors that may have confounded the ability to detect a treatment difference in DPN pain reduction (high placebo response, carryover effect, short washout period, or pregabalin dose) are discussed in the context of future studies.
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Multicenter Study Controlled Clinical Trial
The Effects of Local Anesthesia Administration on Pain Experience During Interventional Spine Procedures: A Prospective Controlled Trial.
It has been postulated that local anesthetic administration may be the most painful part of interventional spine procedures. Despite this, there is a lack of evidence supporting the commonly used traditional technique of anesthetic delivery as part of these procedures. This study tested three hypotheses: 1) alternative method of local anesthesia injection is superior to the traditional method; 2) using the traditional method of injection is not superior to using no local anesthetic; and 3) treatment needle size, anesthetic injection technique, and sedation are associated with pain experienced during procedures. ⋯ The alternative method was superior (P < 0.05) to the traditional method on post procedural pain scores. Injecting local anesthetic with the traditional or alternative method was not superior to using no local anesthetic. Treatment needle size, pain at one inch of treatment needle insertion, and baseline pain were all significantly (P < 0.05) associated with overall procedural pain. Further studies are needed optimize and justify local anesthetic injections for these procedures.
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Multicenter Study Observational Study
Pain-related Sleep Disturbance - A Prospective Study with Repeated Measures.
Pain has been found to be associated with poor sleep quality, awakenings, and shorter sleep time. There is a need to understand the relationship of pain and sleep over time to adequately manage the pain disorder and its consequences. The objectives of this study were to establish the prevalence of sleep disturbance in patients with acute or persistent low back pain (LBP), to investigate the correlation between pain and sleep disturbance and to explore the influence of pain on sleep disturbance. ⋯ This study used repeated measures of both pain and sleep disturbance. The results were in line with previous research, confirming that sleep disturbance was found in the majority of patients with LBP. Pain and sleep measures were significantly correlated, and there was an increased risk of reporting sleep disturbance after experiencing LBP.