The Clinical journal of pain
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Randomized Controlled Trial Multicenter Study
Making pain assessment more accessible to children and parents: can greater involvement improve the quality of care?
To determine whether nursing and parental pain assessment documentation and analgesia administration increased with the use of a temporary tattoo of a pain intensity scale (TTPS) compared with a paper version of the pain scale (PPS). To document any adverse skin reactions from the use of the TTPS and to assess the feasibility and acceptability of the PPS and TTPS for use as postoperative pain assessment tools in the home and clinical setting. ⋯ The TTPS is a new method to engage children in pain assessment, which may have positive effects on the quality of postoperative pain assessment and management in hospital and home settings. Larger trials are needed to determine the effectiveness of the TTPS across all pediatric settings and for children with nonsurgical and also surgical pain. The findings from these pilot trials provide useful information for design and power estimation for further research in inpatient and home settings.
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Randomized Controlled Trial
Thermal and visceral hypersensitivity in irritable bowel syndrome patients with and without fibromyalgia.
Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder characterized by both visceral and somatic hyperalgesia, producing a similar effect seen with the central hypersensitivity mechanism in fibromyalgia (FM). ⋯ FM+IBS patients show greater thermal hypersensitivity compared with IBS patients. However, IBS patients exhibit higher pain ratings to rectal distension compared with FM+IBS patients. This data suggests that regions of primary and secondary hyperalgesia are dependent on the primary pain complaint.
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Clinical Trial
Long-term use of controlled-release oxycodone for noncancer pain: results of a 3-year registry study.
To evaluate the outcomes associated with the use of controlled-release (CR) oxycodone for up to 3 years in the treatment of noncancer pain. ⋯ These registry data demonstrate that a subgroup of patients with noncancer pain experienced prolonged relief with tolerable side effects and modest need for dose escalation during long-term therapy with CR oxycodone.
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Comparative Study
Psychiatric history and psychologic adjustment as risk factors for aberrant drug-related behavior among patients with chronic pain.
To investigate the role of psychiatric history and psychologic adjustment on aberrant drug-related behavior among patients prescribed opioids for noncancer pain. ⋯ Psychiatric factors, such as a history of mood disorder, psychologic problems, and psychosocial stressors, may place patients at risk for misuse of prescription opioids. Future studies to elucidate the risk of medication misuse and aberrant drug behavior among this patient population are needed.
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We describe a case of spontaneous complex regional pain syndrome developing first in the left arm and 2 years later in the right foot of a 14-year-old girl. Physical examination showed abnormalities in tactile and thermal sensitivity. ⋯ We suggest that the observed electrophysiologic alterations could result from a temporary dysfunction of attentional systems, which are assumed to contribute greatly to the LEPs vertex complex. Further studies are needed to test this hypothesis.