The Clinical journal of pain
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Randomized Controlled Trial
Exploration and Validation of the Behavioural Pain Measures and Physiological Pain Measures Factor Structure Extracted from the Pain Assessment Tool Item Scores for Infants Admitted to Neonatal Intensive Care.
The objective of the study was to explore and then validate the factor structure of the Pain Assessment Tool (PAT). ⋯ The PAT assesses both Behavioral Pain and Physiological Pain Measures, and these dimensions need to be considered separately when assessing pain in infants in the neonatal intensive care unit. Behavioral item scores may be insufficient for detecting pain in premature infants if used alone.
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Randomized Controlled Trial
Continuous Pectoral Nerve Block Compared with Continuous Thoracic Paravertebral Block and Intravenous Opioid Analgesia for the Postoperative Analgesic Efficacy in Patients Undergoing Modified Radical Mastectomy: A Prospective Randomized Trial.
Postoperative pain following mastectomy is often severe and pain management is necessary. We evaluated the analgesic efficacy of continuous pectoral nerve block (PEC) in comparison with that of the continuous thoracic paravertebral block (TPVB) and the intravenous opioid analgesia in patients scheduled for modified radical mastectomy (MRM). ⋯ Continuous PEC and continuous TPVB reduced the postoperative morphine consumptions as compared with the intravenous opioid analgesia in patients undergoing MRM with greater reduction in TPVB and without increased adverse effects.
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Randomized Controlled Trial
Low Back Pain Flares: How do They Differ From an Increase in Pain?
The term flare is commonly used to describe low back pain (LBP) fluctuations, but individuals with LBP consider that it does not always correspond to increased pain. This case cross-over study aimed to: (1) determine the extent to which days with a flare identified according to a multidimensional definition (self-reported flare, SRF) corresponded to days with greater than average pain (pain-defined flare, PDF) and (2) to investigate whether physical and psychosocial features differ between PDF and SRF. ⋯ These findings highlight that when individuals with LBP consider they have a flare, they do not always have greater than average pain, but have worse psychosocial features. This emphasizes that flare has broader dimensions than pain alone. Consideration of flare according to broad dimensions is important when investigating symptom fluctuations across different LBP trajectories.
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Randomized Controlled Trial
Behavioral Test (BAT-Back): Preliminary Evidence for a Successful Predictor of Treatment Outcome after Exposure Treatment for Chronic Low Back Pain.
Although several questionnaires assessing fear of movement exist, it is still a challenge to identify individuals who might benefit more from exposure for chronic pain than from other psychological approaches and vice versa. Psychological approaches to chronic pain cannot advance toward the often called-for "tailored approaches" because of limited knowledge about treatment predictors. Our aim was to evaluate the additional predictive value of avoidance behavior based on behavioral observation. ⋯ There is some preliminary evidence that pretreatment avoidance behavior might be an indicator for reduction in global disability after exposure treatments in patients experiencing disabling chronic low back pain and elevated fear avoidance. We identified preliminary cutoff scores that need further investigation.
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Randomized Controlled Trial
Impact of Early Intervention in Pain Management in Cancer Patients- A Randomised Controlled Study in a Tertiary Care Cancer Hospital.
The present study aimed to assess the role of early intervention of nerve blocks in the management of cancer pain. We also aimed to study its effect on the quality of life and the opioid requirement. ⋯ Interventional pain management has a definitive role in palliative setup for pain management. Pain relief was obtained in both groups, but the quality of pain relief was better in the intervention group with an associated reduction in the opioid requirement.