Articles: pain.
-
Eur. J. Clin. Pharmacol. · Jan 1982
Randomized Controlled Trial Clinical TrialThe use of pain scales in assessing the efficacy of analgesics in post-operative dental pain.
Two 10 cm visual analogue scales were compared with a 0-10 point numerical rating scale and a four-point verbal descriptive scale, in assessing pain severity in twelve patients with post-operative pain following removal of an impacted lower third molar. High correlations were shown between the pain scores from the two visual analogue scales and the numerical scale, but a lower correlation was obtained when the four-point scale was compared with the other scales. Analgesic efficacy was found to be dependent on the type of scale used. The 10 cm visual analogue scale was more sensitive than other pain scales and could discriminate between small changes in pain intensity.
-
Ann Fr Anesth Reanim · Jan 1982
Case Reports Comparative Study[Intraventricular morphine analgesia. Apropos of 4 cases, 1 with self-administration].
Intractable pain in four patients enduring disseminated cancer was treated by intraventricular morphine. For all these patients, previous efficiency of opiates therapy had been assessed by a positive trial of epidural injections of morphine. The latter method had to be stopped and a switch to intraventricular morphine was motivated in three cases by a local non-tolerance to the subarachnoid catheter. ⋯ Trial times were respectively of eight days, one month, two months and seven months, with a self administration system in one case. In comparison with the epidural and lumbar intrathecal administration of morphine, the authors insist upon the quality of analgesia obtained, the absence of respiratory depression, the comfort and minimal daily quantities of morphine injected (inferior to one mg daily in three cases). Enlightened by these four cases, the authors also discuss of relative importance of the spinal and brain mechanisms involved in morphine analgesia.
-
Long-term treatment for malignant pain with morphine epidurally poses some technical problems: infection and contamination of epidural space, fixation of the epidural cannula, personal hygiene of the patient, etc. We suggest that a solution to these problems is subcutaneous tunnelling of the epidural cannula. This paper describes our technique and presents the case histories of two patients. In one case, a single epidural cannula was used for 207 days for treatment with morphine epidurally without any complication.
-
Acta Anaesthesiol Scand Suppl · Jan 1982
Pain treatment in a palliative unit or team of a university hospital.
A Palliative Care Unit and Team provides a model for delivering care, in which narcotic analgesics can be optimally effective in the treatment of cancer pain. Our rapidly expanding knowledge of pain physiology and narcotic pharmacokinetics will not benefit patients unless we design more appropriate organizational structures to implement therapy and to teach symptom control. The Palliative Care Service model, as developed at several university hospitals in Canada, is designed to assist and complement oncology departments. ⋯ Hospital organization must reflect the fact that environmental and psychosocial factors alter pain perception and response. Oral morphine is more effective when administered in a Palliative Care Unit than when it is given to patients in other settings. The Unit provides personnel skilled in analgesic titration and a supportive environment in which psychological, social and spiritual components of the pain experience can be evaluated and treated.
-
Cancer Chemother. Pharmacol. · Jan 1982
Randomized Controlled Trial Clinical TrialA double-blind controlled trial of salmon calcitonin in pain due to malignancy.
Thirty-two patients with established malignancy and associated pain participated in a randomised double-blind controlled trial. They received salmon calcitonin SC 200 UI or matching placebo 6-hourly for 48 h and were assessed by using a combination of a 20-point visual analogue scale (VAS), a 4-point physician's global pain scale, and ranking of the co-administered analgesics into 20 grades of potency. ⋯ One week after commencing therapy there was improvement or marked improvement of pain in significantly more patients in the calcitonin group (5/13) than in the placebo group (0/12) (Fisher's exact two-tailed probability test, P = 0.0484). At the end of the second week three patients in the calcitonin group were still showing marked improvement.