Pain research & management : the journal of the Canadian Pain Society = journal de la société canadienne pour le traitement de la douleur
-
Comparative Study
Parental judgements of infant pain: importance of perceived cognitive abilities, behavioural cues and contextual cues.
Despite blatant indications, such as behavioural and contextual cues, infant pain is often undermanaged by adult caretakers. The belief that infants are limited in their abilities to comprehend the meaning of an experience or recall that experience has been used to minimize or deny the need for intervention in this vulnerable population. ⋯ Parents judged that infants undergoing a routine immunization were experiencing clinically significant levels of pain. However, despite generally acknowledging a developing trajectory for memory and understanding across the five age groups, parents did not indicate that a child's ability to remember and understand pain were essential features of their pain judgements. The results indicated that memory and understanding did not influence parental judgements of infant pain demonstrating the validity of the parents' self-assessments.
-
Recent experiments have shown that transcranial electrical stimulation significantly increases the potency and duration of the analgesic effects of opioids in humans and rats. In the present study, the influence of transcranial electrical stimulation (TCES) on the analgesic effect of remifentanil hydrochloride (HCl) in rats was determined. ⋯ TCES markedly increased the duration and analgesic potency of remifentanil HCl in rats. This effect appeared to be related to the release of enkephalins from brain structures, thus enhancing opioid analgesia.
-
Intravenous regional sympathetic block is a valued component of the pain clinician's armamentarium for the management of the complex regional pain syndrome type 1. Treatment of this multifaceted condition is multimodal, and despite a lack of convincing supporting evidence from clinical trials, the author makes the case for retaining the technique while recommending both appropriate guidance and further study.
-
To explore the attitudes of family physicians (FPs) toward the use of opioids in the management of chronic noncancer pain (CNCP) in the Calgary Health Region (CHR), Calgary, Alberta. ⋯ FPs in the CHR need to increase their comfort level toward opioids in general to adequately manage CNCP. Their lack of comfort may reflect a lack of education or fear of regulatory scrutiny.
-
To report on a long term experience in treating patients with chronic noncancer pain (CNCP). ⋯ This is a large sample of CNCP patients, most taking opioids over a long period of time. CNCP can be treated by opioids safely and with a modest effect, with improvement in functioning in some patients who are refractory to other measures. If care is taken, opioids may even be used effectively for patients with a history of chemical dependency.