European journal of pain : EJP
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Surveys show consistently that pain is not treated well. Improvement depends on knowing which treatments are the most effective. We used systematic review to compare the relative efficacy of two common analgesics, ibuprofen and diclofenac, in post-operative pain. ⋯ Both drugs worked well. Choosing between them is an issue of dose, safety and cost. Copyright 1998 European Federation of Chapters of the International Association for the Study of Pain.
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The extent of surgical trauma was related to postoperative pain intensity in a previous study. However, more extensive surgical procedures with higher baseline pain intensity did not appear to influence the ability to document the additive analgesic effect of codeine when given with paracetamol, partly due to large interindividual variation in baseline pain intensity. The aim of the present study was to attempt to improve upside assay sensitivity in this dental pain model by: (1) selecting patients with high baseline pain intensity; and (2) closer supervision of outpatients>> drug intake and compliance with protocol. ⋯ More pain relief was revealed when codeine 60 mg was added to paracetamol 1000 mg on the following measures of effect: change of pain intensity with time (p<0.05, Mann-Whitney), sum of pain intensities (p=0.019), pain intensity difference (p
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Low back pain patients (n=142) on sick leave for at least 8 weeks were given a multi-modal cognitive behavioural treatment program (MMCBT) that lasted for 4 weeks. Before treatment, all patients were tested with a comprehensive test battery. The outcome at 12-month follow-up was predictable from the pretest, but only when combining medical and psychological data. ⋯ Non-returners in the control group lacked energy, trained less regularly, worked in occupations that gave an almost constant load on the back, and did not expect to be back to work in the course of a couple of weeks. It seems to be important to develop further diagnostic tools to identify those who might benefit from extensive or specific treatments. Copyright 1998 European Federation of Chapters of the International Association for the Study of Pain.
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Temporal summation of pain is suggested to be an important factor during various clinical conditions. Controversies exist as to whether temporal summation exists for Adeltafibre-mediated first pain. The aim of the present human experimental study was to investigate the importance of stimulus configuration (intensity, inter-pulse interval, location) for temporal summation of radiant (laser)- and contact-heat-induced pain. ⋯ Taking the latency from stimulation to perception into consideration, we were able to differentiate and find summation of first (Adeltafibre-mediated) and second pain (C fibre-mediated). Summation of first pain was more pronounced for high (38 degrees C) than for low (30-32 degrees C) baseline temperature. Copyright 1998 European Federation of Chapters of the International Association for the Study of Pain.
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The formalin test is a well-established model for assessing nociceptive processes and analgesic drug effects. Previous studies have provided statistical validation of optimal procedures for conducting and scoring the rat formalin test. In the mouse model, formalin concentration has been subjected to validation studies. ⋯ Multiple regression analyses defined the optimal second-phase formalin response in outbred, Swiss-Webster mice as 15-35 min post formalin injection, and revealed that the second-phase response is best characterized by the cumulative time spent biting/licking the injected paw. Finally, paw physiological measures provided convergent evidence of nociceptive and antinociceptive processes in the mouse formalin test. Copyright 1998European Federation of Chapters of the International Association for the Study of Pain.