Articles: pain-measurement.
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The objective was to investigate the relationship between pain relief scores produced by placebo and by active interventions in randomised controlled trials (RCTs). Individual patient categorical pain relief scores from 5 placebo-controlled single-dose parallel-group RCTs in acute postoperative pain were used to calculate the percentage of the maximum possible pain relief score (%maxTOTPAR) for the different treatments. One hundred and thirty of the 525 patients in the 5 trials had a placebo. ⋯ In double-blind, randomised parallel-group studies of high quality placebo scores should not vary. Despite these conditions being met the placebo scores did vary. The previous explanation, of a relationship between the mean placebo scores and the mean scores for the active treatments was not supported.
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Clinical Trial
Concerning the homology of painful experiences and pain descriptors: a multidimensional scaling analysis.
How is the sensory (or other) experience of pain related to the words used to describe such experiences? Answering this question would not only improve our general understanding of the relationship between the experience of pain and the report of pain, but also would allow one to quantify inaccuracies or idiosyncracies in this regard. A continuous multidimensional scaling model was used to examine the similarity between noxious electrocutaneous stimuli and the words used to describe them. If these two types of stimulus objects were homologous, one would expect that physical and verbal stimuli with the same meaning would be scaled with similar values along a single dimension; if not, the two types of stimuli would be scaled at opposite poles of a dimension which distinguished between them. ⋯ A single dimension in the group stimulus space scaled both physical and verbal stimulus objects from least to greatest intensity. Since this (or any higher) dimension failed to segregate verbal from physical stimuli, the words appear to be homologous with experience. While conclusions are limited to these specific stimuli, results suggest that the INDSCAL model offers a valuable method for exploring the relationship between pain report and pain experience.
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Randomized Controlled Trial Clinical Trial
A new method of recording somatosensory evoked potentials by randomized electrical tooth stimulation with 6 levels of intensity.
Dental somatosensory evoked potentials (SEPs) corresponding to the stimulus intensity levels were recorded at 6 different levels of intensity presented in a randomized order. The relationships between the amplitude of the late SEP component with latency between 150 and 300 msec and each stimulus intensity level were also compared in conditions of randomized intensity and constant intensity. The amplitude of the late component increased significantly with the increased stimulus intensity both in the randomized and constant intensity stimulation. ⋯ The latency of the late positive component significantly increased with the randomized stimulation with a 3-sec ISI. This phenomenon might be attributable to the psychological contamination. SEP recording in the randomized dental stimulation with a 1-sec ISI may have applications in neuropharmacological research or physiological research on pain and evaluation of the effects of analgesics, anesthetics, acupuncture and transcutaneous electrical nerve stimulation (TENS).
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Cues that 46 pediatric nurses with a BS in Nursing reported as key to their pain assessments of 88 videotaped infants, ages 0 to 12 months, are identified. Frequencies with which these cues were used for infants of different ages and the relationships between key cues and assessed levels of pain are described. Greater pain was strongly associated with tears, stiff posture, guarding, and fisting. ⋯ Internurse variability in cue use was sizable. Most of the often-used cues had weak or no association with assessed pain level. Only consolability, pain cry, grimace, and stiff posture were frequently used and correlated > .51 with assessed level of pain.
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Neonatal network : NN · Feb 1996
Increasing staff nurse awareness of postoperative pain management in the NICU.
Infants must have effective pain management in the postoperative period. A Level III NICU evaluated its current practice and identified barriers to effective pain management. ⋯ This included developing a pain management team, testing and implementing an objective postoperative pain tool, employing a new flow sheet that incorporates the pain tool, offering multidisciplinary educational activities, and involving nurses in research. These actions have broken down the barrier to effective postoperative pain management and provided direction for a new standard of care.