Pain
-
Randomized Controlled Trial Clinical Trial
Central post-stroke pain--a controlled trial of amitriptyline and carbamazepine.
A double-blind, 3-phase, cross-over, placebo-controlled trial of the pain-relieving effect of amitriptyline and carbamazepine was carried out in 15 patients with central post-stroke pain (CPSP) but without signs of depression. Treatment was given, in randomized order, for periods of 4 weeks, separated by 1 week wash-out. The final doses were 75 and 800 mg/day, respectively, for amitriptyline and carbamazepine. ⋯ No final dose reduction was necessary. Carbamazepine caused more side effects and the final dose had to be reduced in 4 patients. However, only 1 patient had to be taken off medication, on day 25, due to drug interaction.
-
Randomized Controlled Trial Clinical Trial
Biofeedback of somatosensory event-related potentials: can individual pain sensations be modified by biofeedback-induced self-control of event-related potentials?
This study investigates the effects of biofeedback based upon event-related brain potentials evoked by nociceptive electrical stimuli. In a visual and monetary feedback paradigm, 10 subjects received positive feedback within one training session when systematically showing two different behavior patterns: one pattern correlated with a decrease (down-training) and one with an increase (up-training) of the peak-to-peak size of the N150-P260 complex, respectively. ⋯ Furthermore, the individual pain report measured with a visual analogue scale was altered in accordance with the biofeedback-induced behavioral modifications. A decrease in subjective pain report was achieved after down-training while an increase was observed after the up-training.
-
Randomized Controlled Trial Clinical Trial
A double-blind comparison between epidural morphine and epidural clonidine in patients with chronic non-cancer pain.
In a randomised double-blind study of 20 patients with chronic pain, epidural morphine 5 mg in 5 ml of saline was compared with epidural clonidine 150 micrograms in 5 ml of saline. Thirteen patients had a clinical and radiological diagnosis of arachnoiditis, 6 had low back pain and 1 had post-operative scar pain. There were 18 females and 2 males with an average age of 52 years, range 22-76 years. ⋯ Clonidine was associated with sedation and a fall in blood pressure of greater than 20 mm Hg in all patients, 1 patient required ephedrine to treat hypotension. Twelve patients had pruritus, 7 nausea and 2 vomiting following the morphine. Statistically there was no difference found between morphine and clonidine for short-term (3 h) analgesia in these patients.(ABSTRACT TRUNCATED AT 250 WORDS)
-
Randomized Controlled Trial Clinical Trial
Regional sympathetic blockade in primary fibromyalgia.
Twenty-eight patients with primary fibromyalgia participated in the study. Eight patients received a stellate ganglion blockade with bupivacaine, and 14 days later an intravenous regional sympathetic blockade with guanethidine. The remaining patients served as controls and were randomly allocated to receive either a sham (placebo) injection with physiologic saline superficial to the stellate ganglion (n = 10) or bupivacaine intramuscularly (n = 10). ⋯ The guanethidine blockade reduced the number of TePs, but had no effect on rest pain. The reduction in pain and TePs produced by a sympathetic blockade may be due to an improvement in microcirculation. Sympathetic activity may, in some patients, contribute to the pathogenesis of primary fibromyalgia.
-
Randomized Controlled Trial Clinical Trial
The efficacy of hypnosis- and relaxation-induced analgesia on two dimensions of pain for cold pressor and electrical tooth pulp stimulation.
This study evaluated the efficacy of hypnosis- and relaxation-induced suggestions for analgesia for reducing the strength and unpleasantness dimensions of pain evoked by noxious tooth pulp stimulation and by cold pressor stimulation. The Tellegen Absorption Questionnaire was used to assess hypnotic susceptibility for 28 subjects in order to match treatment groups according to sex and susceptibility scores. Tooth pulp stimulation consisted of a 1 sec train of 1 msec pulses at a frequency of 100 Hz, applied at 20 sec intervals to the central incisor. ⋯ Tooth pulp and cold pressor stimulation represent qualitatively different stimuli with respect to both the type of nerves activated and the mode of stimulus application. Discrete, randomly presented levels of noxious electrical stimulation to the teeth activate predominantly small fibers and produce brief pain sensations that vary unpredictably in intensity. In contrast, continuous cold stimulation to the forearm activates a variety of nociceptive and non-nociceptive fibers and produces progressive cold and pain sensations with a predictable increase in intensity from cold sensations to paresthesia and severe pain.