The Clinical journal of pain
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Comparative Study
Caregivers' beliefs regarding pain in children with cognitive impairment: relation between pain sensation and reaction increases with severity of impairment.
To determine whether caregivers of children with cognitive impairment (CI) have systematic beliefs regarding the pain of this special group of children and whether these beliefs are related to their general attitudes towards people with mental challenges, or their experience with, or knowledge about, children with CI . ⋯ Caregivers have a priori beliefs regarding pain in children with CI that vary with level of cognitive impairment and pain facet. These beliefs could impact children's care.
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Because of the importance of pain assessment to understanding the nature and scope of pain problems, and for testing the efficacy of pain treatments, new pain measures are frequently developed. Research that describes the development and evaluation of pain measures should include detailed information concerning the validity and reliability of the measures. However, for the findings from this research to be most useful, the consumers of this research (clinicians and researchers who use pain measures) should understand the concepts of validity and reliability, and the procedures used for evaluating these in pain assessment research. The purpose of this commentary is to provide a summary of these psychometric issues, using the study and findings of Krause and Backonja as an illustrative example of the concepts.
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Randomized Controlled Trial Comparative Study Clinical Trial
Analgesic effects and pharmacokinetics of a low dose of ketamine preoperatively administered epidurally or intravenously.
The aim of this study was to compare the analgesic effects and pharmacokinetics of epidural versus intravenous administration of low doses of ketamine. ⋯ The results suggest that epidural administration of a low dose of ketamine provides more effective analgesic effects as seen post-operatively than intravenous administration. The prolonged half-life and high plasma sustained concentration of epidural ketamine might account for the difference in analgesic effects.
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Randomized Controlled Trial Clinical Trial
Development of a neuropathic pain questionnaire.
Ongoing efforts to develop mechanisms-based assessment and treatment of chronic pain have been hindered by the lack of assessment tools differentially sensitive to various phenomena underlying different mechanisms of pain. This study describes the development of an assessment instrument intended to measure neuropathic pain based on qualities of pain as they are inferred from pain descriptors. Subjects were 528 chronic pain patients from several clinics. ⋯ The newly developed instrument, NPQ, may be used for the initial screening of neuropathic pain patients. It also has the ability to provide a quantitative measure for the descriptors important in the diagnosis and assessment of neuropathic pain. Consequently, it can be used for monitoring of neuropathic pain treatments and as an outcome measure.