European journal of pain : EJP
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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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Randomized Controlled Trial Multicenter Study Clinical Trial
Systemic adenosine infusion reduces the area of tactile allodynia in neuropathic pain following peripheral nerve injury: a multi-centre, placebo-controlled study.
Systemic adenosine has been shown in earlier case reports and a small placebo-controlled study to reduce pathological sensory dysfunction such as tactile allodynia in neuropathic pain. To evaluate this further, the effects of systemic adenosine infusion (50 microg/kg/min for 60 min) on tactile sensory dysfunction and pain was evaluated in 26 patients suffering peripheral neuropathic pain characterized by dynamic tactile allodynia. A randomized, cross-over, double-blind, placebo-controlled technique was used in this multi-centre study. ⋯ The area of dynamic tactile allodynia was significantly reduced by adenosine compared with placebo (p=0.043), but spontaneous pain and tactile pain threshold were not significantly improved compared with the effects of placebo treatment. As a secondary outcome, a higher incidence of positive subjective effects on the clinical pain condition, in a few cases with long duration (several months), following adenosine treatment was found when the global effect of respective treatment was assessed (p=0.028). The results demonstrate involvement of adenosine receptor-sensitive pain mechanisms in some aspects of the sensory dysfunction often found in neuropathic pain.
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Randomized Controlled Trial Clinical Trial
Evaluation of effect of 3D video glasses on perceived pain and unpleasantness induced by restorative dental treatment.
Previous studies on modulation of anxiety, pain and unpleasantness have documented a positive effect of video glasses (I-Glasses, Virtual i-O, Seattle, USA) on the perceived pain and unpleasantness under different laboratory and clinical conditions. The aim of this study was to evaluate whether distraction induced by video glasses also had an effect on the perceived intensity of pain and unpleasantness during dental treatment. Pain and unpleasantness was evoked by the preparation (drilling) of a minor dental cavity (class I). ⋯ Differences in VAS ratings in the video and control situation were tested by Student's t-test. There was no statistically significant effect on the perceived pain (p=0.90) or unpleasantness (p=0.39), but the majority (74%) of the patients would still prefer to wear video glasses if they were to have another dental filling, and 73% had expected a positive effect of the video glasses. These findings suggest that perceived intensity of dental pain is resistant to a simple distraction technique.
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Randomized Controlled Trial Clinical Trial
Improving the quality of pain treatment by a tailored pain education programme for cancer patients in chronic pain.
Educational interventions, aiming to increase patients' knowledge and attitude regarding pain, can affect pain treatment. The purpose of this study was to evaluate the effects of a Pain Education Programme (PEP), on adequacy of pain treatment, and to describe characteristics predicting change in adequacy. The PEP consists of a multi-method approach in which patients are educated about the basic principles regarding pain, instructed how to report pain in a pain diary, how to communicate about pain, and how to contact healthcare providers. ⋯ Variables predicting an improvement in adequacy of pain treatment consisted of the PEP, the APMI score at baseline, patients' level of physical functioning, patients' level of social functioning, the extent of adherence to pain medication, patients' pain knowledge, and the amount of analgesics used. These findings suggest that quality of pain treatment in cancer patients with chronic pain can be enhanced by educating patients about pain and improving active participation in their own pain treatment. The benefit from the PEP, however, decreases slightly over time, pointing at a need for ongoing education.
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Randomized Controlled Trial Clinical Trial
Nalbuphine by PCA-pump for analgesia following hysterectomy: bolus application versus continuous infusion with bolus application.
The analgesic properties of the partial agonist-antagonist nalbuphine in the postoperative period are well known. When used for patient-controlled analgesia (PCA) the effectiveness of this substance is comparable to that of morphine or tramadol. However, the optimal programme for administration of nalbuphine in PCA-pumps has not been investigated. ⋯ Subjective rating of effectiveness by the patients was similar in both groups. The two administration settings of nalbuphine by PCA pump have shown to be equally effective in the treatment of postoperative pain following hysterectomy. However, as the total amount of nalbuphine was significantly lower in B-group, the use of this administration schedule should be encouraged.