Pain
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Randomized Controlled Trial Clinical Trial
The cold pressor test in children: methodological aspects and the analgesic effect of intraoral sucrose.
To determine whether intraoral sucrose has analgesic-like effects in pre-pubertal children and to explore the utility of an ethical and viable laboratory test of nociceptive stimulation in this age group, 8-11-year-olds (n = 42) underwent the cold pressor test (CPT) at 10 degrees C on each of 2 successive days, while holding either 24% sucrose or water in their months. Outcome measures used were threshold (time at which the arm first started to hurt), tolerance (when children removed their arms because they could not stand it any more) and visual analogue scale (VAS) ratings of the intensity of sensation. To ensure validity of the data obtained in this age group, some responses were rejected according to established decision rules and blind to group assignment. ⋯ Inability to perform adequately on the VAS also occurred, but was not related to age. Holding sucrose in the mouth was associated with a significant 35% prolongation of the children's threshold times relative to water, but there was no detectable effect on tolerance and intensity ratings. It is concluded that the analgesic properties of intraoral sucrose, seen previously in human newborns and rat pups, may also be present in pre-pubertal children.(ABSTRACT TRUNCATED AT 250 WORDS)
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Randomized Controlled Trial Comparative Study Clinical Trial
Low-dose intra-articular morphine analgesia in day case knee arthroscopy: a randomized double-blinded prospective study.
The aim of this study was to demonstrate the effect of intra-articular morphine following knee arthroscopy performed in infiltration analgesia. Fifty-two healthy patients were randomized to receive either 1 mg of morphine or placebo. The pain was assessed 2, 4, 8 and 24 h after the procedure by (1) a VAS scale and (2) the amount of acetaminophen consumed. ⋯ Stratifying data in therapeutic versus diagnostic arthroscopy indicated additional effect of morphine in patients undergoing therapy (P < 0.1), an aspect supporting the hypothesis of peripherally administered morphine as a potential suppressor of the substance P-mediated cytokine cascade and the peripheral leukocyte activity. Intra-articular morphine (1 mg) after knee arthroscopy offers efficient analgesia lasting more than 24 h. The method is devoid of side effects and deserves wider recognition.