Articles: pain-measurement.
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The analgesic effect of acupuncture in chronic gonarthrosis pain was studied in a placebocontrolled trial completed by 97 patients. Each patient was treated twice a week, receiving 10 acupuncture treatments in all. Before and after tee course of treatment all patients were examined by an unbiased independent examiner and the overall pain score was measured over 10 days using VAS scales; functional parameters (resilience) were measured with a modified Lysholm questionnaire. ⋯ After ten treatments the overall reduction in pain score was 47.5% in the verum group (follow-up 48.2%), and 26.1% in the placebo group (follow-up 26.1%). The results are statistically significant (P<0.05); they show that in gonarthrosis pain the analgesic effect of verum acupuncture exceeds that of placebo acupuncture. Measurement of the functional parameters according to the Lysholm score showed no significant change.
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Postoperative pain is one of the major obstacles in the prevention of complications during patient recovery. Pain and its management have gained great interest among researchers, clinicians and policy-makers. ⋯ Certain patient conditions such as length of time after surgery and ventilator status affected nurses' assessment and management of pain. Nurses' knowledge about pain assessment and management may affect patient care and outcomes.
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Comparative Study
A comparison of pain measurement characteristics of mechanical visual analogue and simple numerical rating scales.
Numerical rating scales and mechanical visual analogue scales (M-VAS) were compared for their capacity to provide ratio scale measures of experimental pain. Separate estimates of experimental pain sensation intensity and pain unpleasantness were obtained by each method, as were estimates of clinical pain. Orofacial pain patients made numerical scale and VAS ratings in response to noxious thermal stimuli (45-51 degrees C) applied for 5 sec to the forearm by a contact thermode. ⋯ Both M-VAS and numerical rating scales produced reliably different stimulus response functions for pain sensation intensity as compared to pain unpleasantness and both provided consistent measures of experimental and clinical pain intensity. Finally, both mechanical and pencil-and-paper VAS produced very similar stimulus-response functions. The ratio scale properties of M-VAS combined with its ease of administration and scoring in clinical settings offer the possibility of a simple yet powerful pain measurement technology in both research and health care settings.
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Repetitive C-fiber stimulation induces a state of facilitated processing of sensory information in the dorsal horn, while chronic nerve compression gives rise to a hyperalgesic state, characterized by spontaneous neuronal activity generated by voltage-sensitive sodium channels, as well as spinal facilitation. This study investigates the effects of systemic local anesthetic on thermal hyperalgesia evoked by chronic nerve compression and on the pain behavior responses to subcutaneous formalin. ⋯ Intravenous lidocaine acts by distinct mechanisms to diminish the hyperesthetic state induced by peripheral nerve injury and to reduce the degree of spinal sensitization induced by C-afferent fiber activation.
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A short-form of the McGill Pain Questionnaire (SF-MPQ) has been translated into Swedish. One hundred women with either fibromyalgia (FS) or rheumatoid arthritis (RA) filled out the SF-MPQ three times--the RA patients monthly while receiving their routine care, and the FS patients over 6 months while participating in an experimental treatment. Results indicated that the MPQ 15-item descriptor section was internally consistent (Cronbach's alphas .73 to .89), but lacked content validity in the RA sample. ⋯ Convergent construct validity was demonstrated by significant correlations between the SF-MPQ and other pain measurements. A principal components analysis showed that the 15-item descriptor section has three distinct factors: acute sensory, chronic sensory, and affective. We conclude that the SF-MPQ is reliable and valid for use with FS patients.