Pain
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A 3 x 6 factorial design with a double blind and placebo control was employed to investigate the effect of TENS treatment on pain produced by venipuncture. The three treatment groups consisted of TENS, placebo-TENS and control. Subjects were blocked into six 2-year age groups (ages: 5-17 years). ⋯ Pain intensity and affect were lowest for the TENS group and highest for the control group. The pain scores were greatest for lower age groups and lowest for higher age groups. The results of this study support the use of TENS for children's pain and the need for interventions for children's procedural pain.
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Randomized Controlled Trial Clinical Trial
Quantitative sensory examination during epidural anaesthesia and analgesia in man: effects of morphine.
In a double-blind placebo-controlled cross-over study the effects of epidural morphine (4 mg) on somatosensory functions were investigated in 10 healthy volunteers. Detection, pain detection and pain tolerance thresholds to thermal, mechanical and electrical stimuli as well as magnitude rating of short-lasting stimuli of the same modalities were monitored before and for 10 h after epidural administration of 4 mg of morphine or saline. Epidural morphine induced a naloxone-reversible (0.1 mg/kg, i.v.) increase in pain detection threshold to heat and mechanical stimuli and in pain tolerance threshold to heat, mechanical and electrical stimuli. ⋯ Segmental distribution of pruritus was reported by 7 subjects following epidural morphine which was replaced by a short-lasting burning sensation following naloxone administration. Naloxone (0.1 mg/kg) preceeded by placebo did not change somatosensory functions. These results indicate that the somatosensory effect of epidural morphine is dependent on the types of afferent fibres activated as well as on the duration and intensity of the stimulus.
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Randomized Controlled Trial Clinical Trial
The postmastectomy pain syndrome and topical capsaicin: a randomized trial.
This paper describes a randomized parallel trial of topical 0.075% capsaicin versus vehicle (placebo) in the postmastectomy pain syndrome (PMPS). The study was double-blind in design; however, this was compromised by the burning sensation induced by capsaicin. ⋯ Five of 13 patients on capsaicin were categorized as good-to-excellent responses with 8 (62%) having 50% or greater improvement. Only 1 of 10 cases had a good response to vehicle with 3 rated as 50% or better.
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Randomized Controlled Trial Comparative Study Clinical Trial
Ibuprofen plus codeine, ibuprofen, and placebo in a single- and multidose cross-over comparison for coxarthrosis pain.
The analgesic efficacy of 200 mg ibuprofen plus 30 mg codeine, 200 mg ibuprofen and placebo was investigated in a new analgesic evaluation model using single- and repeated-dose administration. The study was a double-blind randomized cross-over investigation in 26 coxarthrosis patients with persistent pain. After a washout period of at least 2 days with paracetamol available as rescue analgesic, each of the 3 treatments was administered in a total of 6 doses during 24 h. ⋯ The analgesic efficacy of ibuprofen plus codeine was significantly superior to that of ibuprofen which was, in turn, superior to that of placebo. In conclusion, analgesic efficacy was better differentiated after repeated-dose than after single-dose administration. The present study design was able to differentiate between 200 mg ibuprofen plus 30 mg codeine and 200 mg ibuprofen alone in a relatively small number of patients.
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Randomized Controlled Trial Comparative Study Clinical Trial
Facet joint injection and facet nerve block: a randomised comparison in 86 patients with chronic low back pain.
Eighty-six patients with refractory chronic low back pain were randomly assigned to receive either facet joint injection or facet nerve block, using local anaesthetic and steroid. There was no significant difference in the immediate response. ⋯ Patients who had complained of pain for more than 7 years were more likely to report good or excellent pain relief than those with a shorter history (P less than 0.005), but no other clinical feature was of value in predicting the response to infiltration. Facet joint injections and facet nerve blocks may be of equal value as diagnostic tests, but neither is a satisfactory treatment for chronic back pain.