The Clinical journal of pain
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infants and young children are often unable to verbalize pain or advocate for themselves which may increase their risk for poor pain assessment and management. Although patient-controlled analgesia (PCA) has been shown to be safe, effective, and superior to intermittent opioid dosing, infants and young children are not able to operate PCA independently. Allowing a parent or nurse to operate the PCA for the child [parent/nurse-controlled analgesia (PNCA)] may be an option for these children. However, the use of PNCA has been heavily scrutinized and more evidence of safety is needed to support this practice. ⋯ diligent monitoring and education are crucial to ensure safety. Untoward side effects adverse events and pain scores suggest PNCA may be an effective method of pain control for this patient population.
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single nucleotide polymorphisms (SNPs) in the genes for catecholamine-O-methyltransferase (COMT), μ-opioid receptor and GTP cyclohydrolase (GCH1) have been linked to acute and chronic pain states. COMT polymorphisms are associated with experimental pain sensitivity and a chronic pain state. No such association has been identified perioperatively. We carried out a prospective observational clinical trial to examine associations between these parameters and the development of postoperative pain in patients undergoing third molar (M3) extraction. ⋯ we report an early demonstration of a COMT SNP association with a clinically meaningful pain outcome after elective surgery.
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pain is one of the most prevalent symptoms in patients with advanced cancer and, according to anecdotal reports, perhaps the most feared. Surprisingly, fear of pain has been the subject of little research within cancer care. The literature on chronic noncancer pain, however, suggests that fear of pain contributes to limitations in function in populations with diverse chronic illness. Little is known about the extent to which such findings might generalize from patients with chronic noncancer pain to those with chronic cancer pain. Therefore, this research examined the extent to which fear of pain is associated with limitations in function in patients with advanced cancer and also compared patients with chronic cancer and noncancer pain. ⋯ the findings emphasize the importance of psychological dimensions of pain in patients with advanced cancer, as well as the similarities and differences between the 2 groups of patients suffering from chronic pain.
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Review Meta Analysis
The association between chronic low back pain and sleep: a systematic review.
chronic low back pain (CLBP) adversely affects many quality of life components, and is reported to impair sleep. The aim of this review was to determine the association between CLBP and sleep. ⋯ many dimensions of sleep are adversely associated with CLBP. Management strategies for CLBP need to address these to maximize quality of life in this patient cohort.
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Multicenter Study
Clinical Investigation of Pain-related Fear and Pain Catastrophizing for Patients With Low Back Pain.
to investigate select psychometric properties of fear-avoidance model measures commonly used to assess pain-related fear and catastrophizing in clinical studies of low back pain. ⋯ these analyses suggest clinical assessment of the Fear-Avoidance Model of Musculoskeletal Pain likely captures 3 factors including PCS, beliefs about work, and beliefs about physical activity. The FABQ-PA and PCS can be recommended for clinical use because of their unique associations with pain intensity and disability. The FABQ-W may only be appropriate for those interested in assessing work specific beliefs.