Articles: pain.
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Comparative Study
Sensitivity of the McGill Pain Questionnaire to intensity and quality of laboratory pain.
Subjects completed a modified McGill Pain Questionnaire (MPQ) to describe one of two laboratory stressors (cold pressor or electrical tooth pulp stimulation) at one of two subjective intensities (pain threshold or pain tolerance). Differences in MPQ-derived scores were associated with both type of stressor and intensity level, as were patterns of frequently chosen word groups and specific words. These data support the validity of interpretations drawn from MPQ differences in clinical practice and research. In addition, the fact that the MPQ can be used in both clinical and laboratory settings suggests one way in which relevant dimensions of similarity and difference among "types" of pain may be clarified in later research.
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Chronic pain patients reported pain intensity on each of 3 pain intensity scales, the visual analog, numerical and adjectival scales, and then ranked the scales in order of perceived best communication of pain intensity. All patients were able to complete an adjectival scale but 11% were unable to complete a visual analog scale and 2% failed at a numeric scale. The intensity of the pain ratings on the 3 scales were significantly correlated and there were no reliable differences in reported intensity as a function of preference. ⋯ Patients completing all 3 scales indicated a significant preference for the adjectival scale but the basis for this preference did not appear related to sex, etiology of pain, affective variables nor selected psychological variables. These data indicate that pain scale preference does not influence pain intensity report. Nevertheless, there are some clinical situations in which a numeric scale is likely to yield a better measure of pain intensity.
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Acta Anaesthesiol Scand · Apr 1981
Randomized Controlled Trial Comparative Study Clinical TrialEpidural morphine for postoperative pain relief.
Thirty-three patients were randomly assigned to two groups to study the analgesic potency, duration of action and side effects of epidural and intramuscular morphine after hip surgery. Two milligrams of preservative-free morphine chloride in 10 ml of normal saline in the epidural space was compared to 10 mg of intramuscularly administered morphine. There was a more rapid onset of action after intramuscular morphine. ⋯ Nausea and/or vomiting was less common after epidural morphine (20% versus 55%). Pruritus or respiratory depression which have been reported previously were not encountered. However, it is recommended that preservative-free solution are used to avoid itching and that the patients are monitored, as respiratory depression may occur long after administration of epidural opiate.
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Int J Clin Pharmacol Ther Toxicol · Apr 1981
Randomized Controlled Trial Clinical TrialPropiram and codeine in episiotomy pain.
To evaluate relative efficacy, safety, and time course of analgesia, propiram fumarate (50 and 100 mg), a new narcotic agonist-antagonist, was compared with codeine sulfate (60 mg) and placebo in a clinical trial with a single peroral dose, parallel, stratified, randomized, and double-blind design involving 80 hospitalized postpartum women with medium or severe episiotomy pain. Using verbal subjective reports as index of response, patients rated pain intensity and side effects at periodic interviews for 6 h. Relative efficacy findings based on peak effects and summed pain-intensity differences suggested dose-dependent analgesia with propiram and also that 60 mg codeine lay between 50 mg propiram and placebo. ⋯ All three active drugs continued to act until the 5th or 6th h. Drowsiness was the only statistically significant side effect reported after propiram. These results suggest that single 50 or 100 mg doses of propiram were effective in episiotomy pain, induced stronger analgesia than 60 mg codeine, and took effect more rapidly.