Articles: pain.
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Anasth Intensivther Notfallmed · Jun 1982
Clinical Trial Controlled Clinical Trial[Pain treatment by sub or epidural opiate administration].
Morphine and opiate analogues for pain relief were applied epidurally or intrathecally. Synthetic opioids, eg. pethidine, pentazocine or piritramide proved unsuitable with both modes of administration. Only morphine in doses as low as 2 mg reliably produced analgesia lasting from 16-24 hours. ⋯ Conversely this very side effect may advantageously be employed in patients on ventilator treatment as a method for analgesia and sedation. Lumbar epidural administration of single doses of morphine 2 mg at present is the most effective treatment both for pain following thoracotomy, laparotomy, surgery on the vertebral column, gynecological and urological procedures and pain due to trauma to the chest wall or pelvis, provided supervision in an intensive care ward guards against possible side effects. Epidural or intrathecal opiate is not suitable for the treatment of chronic or functional pain.
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Low back pain patients' responses to the McGill Pain Questionnaire (MPQ) were factor analyzed using the principal factor method and direct oblique rotation procedures. Four factors were extracted that accounted for 55% of the total variance. ⋯ The results provided positive evidence that the sensory pressure, evaluative, and affective-sensory factors that were previously identified are stable dimensions underlying the MPQ responses of low back pain patients. However, it is necessary to conduct further cross-validation studies using patients from a wide variety of treatment settings.
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J Consult Clin Psychol · Jun 1982
Comparative Study Clinical Trial Controlled Clinical TrialComparative treatment strategies and their interaction with locus of control in the reduction of postsurgical pain and anxiety.
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Comparative Study
A comparison of the McGill Pain Questionnaire in chronic and acute pain.
The McGill Pain Questionnaire (MPQ) is widely used in pain research and treatment. The internal structure of the questionnaire has been subjected to empirical investigation, with sensory and reactive factors documented. In the present study, questionnaire responses of 95 women experiencing acute (post episiotomy) pain are analyzed. ⋯ It is suggested that acute pain involves less differentiation of sensory, affective and evaluative language dimensions. Rating scales were also administered. Ratings of labor and episiotomy pain were uncorrelated indicating the importance of distinguishing between these in studying pain in the puerperium.
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Different doses of epidural morphine were studied in order to determine their effectiveness in providing postoperative pain relief after surgery of the lower extremities and their relationship to the incidence of untoward reactions. The study was carried out in a double-blind fashion using five dosages of epidural morphine (0.5, 1.0, 2.0, 4.0, and 8.0 mg) and included 60 patients. The higher doses of morphine (2.0, 4.0, and 8.0 mg) were equally effective and more effective than the lower doses (0.5 and 1.0 mg) in providing postoperative analgesia. ⋯ No statistically significant difference was found between the doses studied with regard to itching, urinary retention, and respiratory depression; the latter was evaluated in a subgroup of 20 patients. These data suggest that effective postoperative pain relief after surgery of the lower extremities can be achieved with relatively low doses of morphine sulfate and with minimal side effects. For the type of surgery studied, 2 mg morphine sulfate appeared to be the optimum dose.