Pain medicine : the official journal of the American Academy of Pain Medicine
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To evaluate the sensitivity and utility of the Iowa Pain Thermometer (IPT) and other selected pain intensity scales in younger and older adults using a controlled clinical pain condition. ⋯ Based on sensitivity to change, lower failure rates, higher preference evaluations, and little appreciable affects associated with cognitive impairment, the IPT was judged to be the best choice for assessing pain intensity for both age cohorts and warrants further study.
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Randomized Controlled Trial Comparative Study
Regression of sensory and motor blockade, and analgesia during continuous epidural infusion of ropivacaine and fentanyl in comparison with other local anesthetics.
To compare the regression of sensory and motor blockade, and the analgesia during continuous epidural infusion between ropivacaine and other local anesthetics. ⋯ Continuous epidural infusion of ropivacaine may induce a slower regression of sensory blockade compared with bupivacaine and lidocaine. The addition of fentanyl to ropivacaine can enhance this prolonged analgesic effect with little effect on motor blockade. Epidural infusion of ropivacaine with fentanyl provides effective pain relief, possibly because of the maintenance of sensory blockade by ropivacaine and fentanyl.
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Randomized Controlled Trial
Electronic diaries as a tool to improve pain management: is there any evidence?
Chronic pain is a common and costly syndrome which affects approximately one in three US adults. Factors such as shortened length of the medical visit, increased availability of technological approaches to care, and a more informed patient all suggest that a new paradigm is required for chronic pain management. Although much has been written about the use of electronic diaries in clinical trials, little has been presented about the use of these diaries in clinic practice and their potential for changing pain behavior. The intent of this preliminary study is to measure accessibility and usability of a software program designed for use on a personal digital assistant and to discuss how the software program may impact clinic practice and patient behavior. ⋯ This study goes beyond previous research on preference and data quality to investigate how the information provided may affect patient and physician perspectives toward pain management. Although not the initial intent of this study, findings indicate that electronic tracking may provide information which can affect management decisions. A follow-up study is ongoing to investigate these initial results. If found to be true, electronic monitoring may have broad implications for health care, policy, and improvement in quality of care for chronic pain sufferers in the future.
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Comparative Study
Pain assessment in younger and older pain patients: psychometric properties and patient preference of five commonly used measures of pain intensity.
To study the psychometric properties and preference for five different pain intensity scales (horizontal visual analog scale [VAS], vertical VAS, Box-11, Box-21, and verbal descriptor scale) across different age groups. ⋯ The numerical Box-21 scale is an excellent choice for pain intensity assessment in heterogeneous patient groups. The verbal descriptor scales may be considered when the study population consists of a majority of older persons.
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To assess perceptions of the interfering effects of chronic pain upon the frequency of eight activities of daily living, and to examine the psychosocial correlates of these perceptions. The areas assessed included social life, recreation, sleep, household chores, working at a paid job, self-care, exercise, and routine physical activities. ⋯ Although pain severity is consistently related to life task interference, several psychosocial variables make incremental contributions to the perception of pain's deleterious influence on daily task functioning.