Der Schmerz
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Parental reactions to their child's pain can comprise cognitive-affective and behavioral responses. Dysfunctional responses like parental catastrophizing may lead to an aggravation of the child's pain. ⋯ The results offer a basis to grade parental catastrophizing, so that risk-groups can be identified.
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Case Reports
[Postherpetic neuralgia of the left trigeminus nerve V1 : Successful therapy with capsaicin 8% patch].
A 68-year-old patient suffered from postzoster neuralgia with severe pain of the left trigeminal nerve V1. Despite medication with gabapentin 1800 mg/d, oxacarbazepine 600 mg, tapentadol 500 mg/d, amitriptyline 20 mg as well as ambroxol 20% ointment and lidocaine patch topically, the pain reached an intensity of 8-10 on the numeric rating scale (NRS). Wearing a CPAP (continuous positive airway pressure) mask at night to treat a sleep apnea was impossible or the mask was leaking under lidocaine patch, only topical ambroxol 20% brought a certain pain relief. ⋯ Six weeks after application, the average pain during the day was only NRS 3/10 despite a considerable reduction in oral medication. Three months after the second treatment, the patient was almost pain-free during the day. Topical capsaicin 8% patch is, in our opinion, also safe and successful to use on the face with appropriate experience of the user.
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Review
[Pain therapy for children and adolescents with hemophilia : Recommendations by an expert panel].
Children and adolescents with severe hemophilia commonly suffer from acute and chronic pain as a consequence of hemophilia-related bleeding. Intervention-related pain also plays a major role. Despite its high prevalence in this patient group, hemophilia-related pain is not always adequately addressed and sufficiently treated. ⋯ Pain management in children with hemophilia needs improvement. Children with hemophilia are at risk of developing chronic pain and of suffering traumatization due to insufficient pain management. Pain therapy can be challenging in these children as both their age and the underlying disease limit the options in particular in pain medication. The expert panel developed recommendations to improve pain management in children with hemophilia.
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There is neither a "gold standard" nor commonly approved therapy goals in postoperative pain therapy. In a multi-center study, more than 80% of all patients treated stated that they suffered from postoperative pain. Moreover, patients evaluated the pain therapy as significantly worse than other medical or nursing practices. Therefore, there is a need for optimization in therapy for acute pain. ⋯ The maximum pain values declared by the patients significantly decreased after the introduction of the "pain standard." The satisfaction with pain therapy significantly increased for the patients and for the providers. The reported minimum pain values of the patients did not change significantly. The costs of pain medicine slightly increased. In general, there was a positive effect of introducing a "pain standard" for patients and providers.
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Opioid dependence is a chronic mental disease with multifactorial etiology. The neurobiological theory of addiction focuses on the manipulation of the dopaminergic reward system as a basic property of substances with addictive potential including opioids. With regular opioid intake, the manipulation of the reward system results in a cognitive bias towards drug-related stimuli. ⋯ These biological factors are independent of the legal status of the individual opioid. Genetics also significantly influence the etiology. However, the assignment of this genetic influence is difficult because not only basic biological functions, but also personality traits and mental illnesses are genetically determined.