Articles: pain-measurement.
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Randomized Controlled Trial
Analgesic and Respiratory Depressant Effects of R-dihydroetorphine: A Pharmacokinetic-Pharmacodynamic Analysis in Healthy Male Volunteers.
There is an ongoing need for potent opioids with less adverse effects than commonly used opioids. R-dihydroetorphine is a full opioid receptor agonist with relatively high affinity at the μ-, δ- and κ-opioid receptors and low affinity at the nociception/orphanin FQ receptor. The authors quantified its antinociceptive and respiratory effects in healthy volunteers. The authors hypothesized that given its receptor profile, R-dihydroetorphine will exhibit an apparent plateau in respiratory depression, but not in antinociception. ⋯ Over the dose range studied, R-dihydroetorphine exhibited a plateau in respiratory depression, but not in analgesia. Whether these experimental advantages extrapolate to the clinical setting and whether analgesia has no plateau at higher concentrations than investigated requires further studies.
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Neonates born extremely prematurely are at high risk of acute and prolonged pain. Effective treatment requires reliable pain assessment, which is currently missing. Our study explored whether existing pain assessment tools and physiological indicators measure pain and comfort accurately in this population. ⋯ Pain measurement in clinical practice in prematurely born infants below 29 weeks remains challenging. The included behavioral and physiological indicators did not adequately distinguish between a painful situation, rest, and skin-to-skin care in premature neonates.
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Randomized Controlled Trial
Pain in persons with mild-moderate Parkinson's disease: a cross-sectional study of pain severity and associated factors.
The aims of this study were to determine pain severity in persons with mild-moderate Parkinson's disease compared with healthy age- and sex-matched controls, and identify related factors, that is, demographic, disease severity, and functioning, of pain severity in the Parkinson's disease group. A cross-sectional study design was adopted to assess pain severity in 100 persons with Parkinson's disease and 47 healthy controls. Bodily pain was assessed using item 21 of the Short Form 36, whereas pain severity was determined using the entire Short Form 36 Bodily Pain subscale (score ranging from 0 to 100). ⋯ Poorer balance performance, a shorter disease duration, and poorer health-related quality of life were independently associated with pain severity. Pain severity is higher in those living with Parkinson's disease than controls, and severity appears to be associated with disease characteristics and overall health. Further research is required to assess pain origin in Parkinson's disease with the aim of developing targeted interventions.
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Nurses play an important role in children's pain assessment and management because they spend the majority of the time with them and provide care on a 24-hour basis. However, research studies continue to report on nurses' inadequate assessment and management of children's pain, which may be partly attributed to their insufficient education in this area. ⋯ Developing a responsive program that includes expectations of beneficiaries, integrating it into existing facility training systems and delivering it through multidisciplinary collaboration, offers the benefit of securing sustainability of the educational gains.
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Randomized Controlled Trial Multicenter Study
Safety and efficacy of sphenopalatine ganglion stimulation for chronic cluster headache: a double-blind, randomised controlled trial.
Chronic cluster headache is the most disabling form of cluster headache. The mainstay of treatment is attack prevention, but the available management options have little efficacy and are associated with substantial side-effects. In this study, we aimed to assess the safety and efficacy of sphenopalatine ganglion stimulation for treatment of chronic cluster headache. ⋯ Autonomic Technologies.