Articles: pain-management.
-
In spite of the many possible methods of pain control in the burned child satisfactory pain management may still be a problem, at times formidable. The most fruitful approach would seem to be frequent assessment of pain in the individual patient with a readiness to try alternative or additional measures when relief seems inadequate. In this way the most effective analgesic agent(s), route(s), and frequency of administration, as well as nonpharmacologic methods, can be determined for each child. ⋯ Nevertheless, careful observation of physiologic signs such as heart rate and blood pressure, facial expressions, body movement and position, and the quality of an infant's cries may in sum be sufficient to evaluate the intensity of pain. Monitoring of analgesic plasma levels to ascertain that they are within the ranges established for good analgesia and even determination of beta-endorphin blood levels may also aid in judging the adequacy of analgesia. By tailoring pain management methods to the needs of each child it may be possible to keep pain at acceptable levels in victims of burn injury.
-
Even though hypnosis is a very old form of therapy, a number of points still need to be made clear. We do know, however, that endorphins are not involved in the pain control process and that hypnosis effects and placebos are quite different. ⋯ The use is more limited in the case of acute pain, because the developments in modern anaesthesia preclude the use of hypnosis in the fields of surgery and dentistry. On the other hand, hypnosis can be helpful for patients suffering from burns, cancer pain, or other chronic pain.
-
A retrospective study of 30 patients who met the clinical criteria for saphenous nerve entrapment at the adductor canal is described. Patients experienced symptoms, usually anterior knee pain, for an average of 36 +/- 7 months. Each patient received an average of 1.9 +/- 0.4 saphenous nerve blocks at the adductor canal during treatment. ⋯ Age, medications taken, number of blocks performed, and length of followup were unrelated to outcome. Length of symptoms did significantly correlate with final pain level (r = 0.39, P less than 0.05). The diagnosis of this syndrome, description of the saphenous nerve block at the adductor canal, and the possible etiology are presented.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Randomized trial of Codetron for pain control in osteoarthritis of the hip/knee.
Patients suffering from pain due to osteoarthritis of the hip and knee participated in a double-blind placebo controlled trial using daily Codetron home care units for 6 weeks over the tibial, saphenous, popliteal and sciatic nerves, and tender points. Seventy-four percent of patients in the real Codetron (Group A) and 28% of the patients in sham Codetron (Group B) improved their pain level more than 25% as measured by visual analogue scale. ⋯ Other functional parameters proved to be insensitive to change in this study. This is highly suggestive of beneficial effect of nonhabituating Codetron as a complementary modality in the therapy of chronic pain conditions such as osteoarthritis.
-
Over a 3 1/2-year period, a series of 20 chronic pain patients with back pain and with documented organic difficulties were treated by means of implanted spinal cord stimulation. Short-term treatment outcome was found to be significantly related to diagnosis, with single nerve root injury and mononeuropathy patients having better treatment outcomes than arachnoiditis patients with multiply injured nerve roots. Outcome was not related to the psychological evaluation, or age, sex, number of previous pain surgeries, pain location, the Minnesota Multiphasic Personality Inventory, or the Pain Assessment Index. Implications for patient selection are discussed.