The Clinical journal of pain
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This study examined the relation between marital satisfaction, psychological distress, self-reported pain, disability, and clinical findings in 63 chronic low-back pain (CLBP) patients from primary health care centers. The relation between marital satisfaction and psychological distress in their spouses was also studied. ⋯ In male CLBP patient couples, marital dissatisfaction and psychological distress were much less significantly related. This gender difference should be taken into account in the treatment of CLBP couples.
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Three cases of different types of nerve injuries following orthopedic and chest surgery are described. Recovery from these nerve injuries was prolonged and incomplete. By constant awareness of potential nerve damage during operation, it is possible to prevent such injuries.
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Clinical experience with the sphenopalatine ganglion (SPG) block combined with a review of prior studies led to conducting a retrospective evaluation of four patients with chronic pain treated with the SPG block. The review of case reports suggests the usefulness of SPG blocks in the pain management clinic.
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Of 114 patients presenting to the Pain Management Service at the Mount Sinai School of Medicine with chronic pain, 38% (N = 43) were taking one or more benzodiazepine drugs at the time of the initial assessment. The majority of patients were chronic users, with 14% (N = 6) having taken the medications for 1-2 years and 46% (N = 20) for 2 years or longer. Ninety-three percent (N = 40) of those given a benzodiazepine drug stated that it was initiated after the onset of pain. ⋯ Benzodiazepines have been reported to provide little therapeutic benefit to chronic pain patients, and may even exacerbate their symptoms. We have shown that benzodiazepine drugs are frequently prescribed for long-term use, for sleep, and in conjunction with narcotic drugs. Such use is contrary to generally accepted guidelines.
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The surgical experience is often characterized by fear, stress, and pain. Whenever an individual has to confront a painful or stressful event such as surgery, the individual's opportunity to control some aspect of the situation may actually influence the degree of pain experienced. ⋯ Regression analyses controlling for age and type of opioid revealed that the psychological measures were important predictors of pain and PCA use. Patients with higher anxiety levels and less social support had higher postoperative pain and made more frequent PCA demands.