Pain
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A method to measure cutaneous hyperalgesia to thermal stimulation in unrestrained animals is described. The testing paradigm uses an automated detection of the behavioral end-point; repeated testing does not contribute to the development of the observed hyperalgesia. ⋯ Both the thermal method and the Randall-Selitto mechanical method detected dose-related hyperalgesia and its blockade by either morphine or indomethacin. However, the thermal method showed greater bioassay sensitivity and allowed for the measurement of other behavioral parameters in addition to the nociceptive threshold.
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The reflex sympathetic dystrophy syndrome (RSDS) consists of a triad of pain, edema and sympathetic dysfunction of an extremity following trauma, peripheral nerve injury or central nervous system disorder. Reflex sympathetic dystrophy syndrome is a difficult and costly pain syndrome to treat. One of the difficulties in evaluating treatment efficacy is the objectification and quantification of patient findings. ⋯ Skin temperature was not predictive of changes in joint pain score, AROM, limb volume or subjective pain measures. However, there was internal consistency between volumetric and AROM measures and joint pain indices. This protocol is recommended for use in therapeutic trials for the treatment of the RSDS.
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Epidural administration of opiates as a long-term treatment of cancer pain, even for out-patients, is now well established. Most reports describe intermittent injections given several times a day, which may have technical and personal disadvantages. ⋯ This report describes 16 patients who were treated with epidural opiates delivered by plastic infusion pumps. Pain relief was effective, the equipment was inexpensive and home treatment was easily accomplished.
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Recordings were made from dorsal horn neurones in the spinal cord and trigeminal nucleus caudalis of intact anaesthetized rats. These rats had been rendered polyarthritic by s.c. injection of Mycobacterium butyricum suspended in oil into the base of the tail. The experiments were carried out during the acute phase of the illness (3-4 weeks post inoculation) during which hyperalgesia occurred. ⋯ The activity of non-noxious neurones was never modified by any heterotopically applied stimuli. By contrast, all convergent neurones were inhibited by heterotopic stimuli, noxious (52 degrees C, pinch) or non-noxious (light and mild pressure), applied to inflamed areas. While the inhibition triggered by noxious stimuli was reminiscent of that observed in healthy rats, the inhibition triggered by non-noxious mechanical stimuli was related to the inflammatory state of the part of the body stimulated, the most sensitive areas being the hind paws.(ABSTRACT TRUNCATED AT 400 WORDS)
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Research on the assessment and management of pain in infants and children has increased dramatically, with the consequence that a wide variety of behavioral, physiological, and psychological methods are now available for measuring pediatric pain. Although the criteria for a pain measure for children are identical to those required for any measuring instrument, special problems exist in pediatric pain measurement because the influence of developmental factors, previous pain experience, and parental attitudes on children's perceptions and expressions of pain is not known. This article reviews the recent advances in the measurement of pain in children, with special emphasis on the methods that satisfy the criteria for reliability and validity, the methods that can be used to assess multiple dimensions of pain, and the methods that may be appropriate for assessing all types of acute, recurrent, and chronic pediatric pain.