Der Schmerz
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[Development of a screening questionnaire to predict good and poor outcome of lumbar disc surgery.].
The aims were: (1) to investigate the prognostic value of pain history, sociodemographic, psychodiagnostic and medical factors for long-term outcome after lumbar disc surgery and (2) to develop a screening checklist of reliable predictors that distinguish between good and poor outcomes. ⋯ It is possible to determine for each patient a predictor sum that is prognostic for the individual risk of a poor operation outcome.
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Introduction Buprenorphine is well known in cancer pain therapy because of the long duration of its action and high analgesic potency. Many studies exist about the intravenous and sublingual application form; however, few data are available on its use by the continuous subcutaneous route. Methods Twenty-five patients were analysed retrospectively over 956 days who has been treated with continuous subcutaneous buprenorphine for cancer-related pain. ⋯ In one case with progressive liver dysfunction, the potential risk of cumulation with buprenorphine could be controlled with this method. Conclusions Continuous subcutaneous buprenorphine with external infusors is a safe and efficient cancer pain therapy without severe side effects. Because of its ceiling effect, it is not as effective as morphine, but can be discussed as an alternative if other opioids cause incompatibility reactions.
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The series of publications is continued in which the results of a review of German pain-related psychological assessment tools are presented. The taskforce of the German Society for the Study of Pain (DGSS) describes and examines instruments assessing the qualitative aspects of how pain is experienced (part II). Part III describes and comments on methods regarding self-reporting and observation of pain behaviour. Part IV discusses the use of pain diaries and introduces different forms of diaries, focussing on the measurement of pain intensity.
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For pain therapy different methods of application are essential, because side effects or swallowing difficulties may prevent the natural oral application of analgesics. Up to now only tablets have been available for sustained-release morphine. We investigated a suspension of this drug in different pain states. ⋯ These first results show that liquid slow-release morphine suspension can provide pain relief similar to slow-release morphine tablets. Consequently, slow-release liquid morphine suspension provides a suitable alternative, especially in patients with swallowing disorders.