European journal of pain : EJP
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Meta Analysis
Efficacy of spinal cord stimulation: 10 years of experience in a pain centre in Belgium.
Spinal cord stimulation is a minimally invasive mode of treatment in the management of certain forms of chronic pain that do not respond to conventional pain therapy. Several authors have reported encouraging findings with this technique. Over a 10-year period in a single centre, 254 patients were subjected to a trial period of spinal cord stimulation with an externalized pulse generator. ⋯ The aim of this study was to evaluate the efficacy of an implanted spinal cord stimulation system in terms of pain relief and quality of life and to assess the accuracy of the patient selection criteria. The results of this study demonstrate a high success rate as evaluated by the patients' own assessments--68% of the patients rated the result of the treatment as excellent to good after an average follow-up of almost 4 years. The resumption of work by 31% of patients who had been working before the onset of pain supports these positive findings.
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Randomized Controlled Trial Clinical Trial
Investigating the effects of anxiety sensitivity and coping on the perception of cold pressor pain in healthy women.
Research indicates that anxiety sensitivity may be related to the negative experience of pain, especially amongst women. Further evidence with chronic pain patients indicates that anxiety sensitivity may result in avoidance pain-coping strategies. However, this effect has not yet been experimentally investigated in healthy groups. ⋯ The pain coping instruction manipulation was found to moderate pain experience, in that the avoidance strategy resulted in higher pain ratings compared to when instructed to focus. Finally, high anxiety sensitive women reported greater pain when instructed to avoid rather than focus on cold pressor pain. These results are discussed in light of previous research and future directions for pain management.
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China is a large country with a huge population. It is estimated that 1.8 million patients suffer initially from cancer and 1.4 million patients die from it each year in Mainland China. Cancer ranks as the primary reason for death among the common diseases in cities and the second in rural areas. ⋯ As a result, the three-step analgesic ladder of the World Health Organization (WHO) has been gradually accepted by medical personnel and patients. Although pain management has been improved since the WHO's strategy of the three-step approach was implemented in China, variations still exist in different regions of the Mainland. Currently the three main aspects of work on pain measurement are going to be undertaken including (1) continuous support from government policy; (2) consistent education and training; and (3) better availability of drugs for medical use throughout the whole country.
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The aim of this investigation was to determine current opioid use in the Philippines and the reasons why its use is very low. We surveyed 314 doctors in Metro Manila to determine their specialty, possession of narcotics license, and knowledge of opioid use beyond the terminal stage. We found that the majority of respondents possess a narcotics licence. ⋯ Fentanyl has a 7 gram usage versus a 100 gram INCB allocation. We conclude that actual opioid use in the Philippines is minimal. However, the correlation between survey results and actual usage indicates a strong awareness of the usefulness of opioids but hesitancy in opioid prescription.
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Clinical Trial
Computer-controlled pneumatic pressure algometry--a new technique for quantitative sensory testing.
Hand-held pressure algometry usually assesses pressure-pain detection thresholds and provides little information on pressure-pain stimulus-response function. In this article, a cuff pressure algometry for advanced pressure-pain function evaluation is proposed. The experimental set-up consisted of a pneumatic tourniquet cuff, a computer-controlled air compressor and an electronic visual analogue scale (VAS) for constant pain intensity rating. ⋯ There was a direct correlation between the number of compressions, the compression rate and pain thresholds. The cuff algometry technique is appropriate for pressure-pain stimulus-response studies. Cuff algometry allowed quantification of psychophysical response to the change of stimulus configuration.