Articles: pain-measurement.
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Previous reports suggest that the outcome (synergism, antagonism, summation) of opioid-barbiturate interactions may depend on the depth of anesthesia. One aim of the present study was to determine whether pentobarbital, alone and in combination with morphine, blocks awakening caused by noxious stimulation in a dose-related manner: the more intense the noxious stimulation, the more pentobarbital is required to suppress the response. A second aim of the study was to determine whether the pentobarbital-morphine anesthetic interaction depends on the depth of anesthesia measured in terms of intensity of noxious stimulation required for behavioral arousal (recovery of the righting reflex). ⋯ The results suggest that the depth of anesthesia can be measured in terms of intensity of noxious stimulation required for arousal and that the outcome of barbiturate-opioid anesthetic interaction depends on the depth of anesthesia.
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Schweiz. Rundsch. Med. Prax. · Mar 1993
Review[Pain assessment and documentation in patients with tumors: theory and reality].
Each tumor patient with pain is not only entitled to a careful diagnostic workup and to effective treatment of his pain syndrome, but also to a clear and useful documentation of the course of his pain(s). This documentation ('pain evolution chart') should at least include the main location(s) of the treated pain and the varying pain intensity during the course of the day as well as at night. A respective pain documentation instrument, the St. ⋯ The 'pain evolution chart' should be a regular part of the patient's hospital chart, as it forces the patient and his care-givers to cope more constructively with the present pain syndrome. The (well instructed) patient himself is responsible for an accurate and realistic pain documentation. Such longitudinal 'pain evolution charts' are not only useful for clinical oncology practice but also for clinical pain and analgesic research.
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An increasing number of papers deal with immunological factors in headache syndromes such as migraine and cluster headache. The aim of this review is to give an overview of the factors that have been measured and to assess their reliability and relevance for the pathogenesis of these headaches. Most of the studies are handicapped by methodological problems, especially the different classifications of headaches, the lack of adequate controls and methodological problems with the measurement of certain immune parameters. ⋯ Although the immunological changes have been shown to be valid, their pathogenesis in these headaches is unclear. With the increasing recognition of the existence of a neuroimmunologic network, alterations in each system should always be considered to be associated with changes in an other. Acute or chronic pain seems to trigger immunological abnormalities.
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Comparative Study
Evaluation of the pain response by Mexican American and Anglo American women and their nurses.
This study examined the relationship between ethnicity and pain. The study addressed three major research questions. The first question asked whether there was a significant difference in Mexican American women's and Anglo American women's response to cholecystectomy pain. ⋯ Nurses evaluated the patients' pain as being less than patients did. Pearson product-moment correlations were used to examine the relationship between pain and sample characteristics of both patients and nurses. For the nurses, pain was significantly related to the patient's education, place of birth, language and religion.
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Many studies investigated patient-controlled analgesia (PCA) in the postoperative period in recovery rooms under anaesthesiologic monitoring but reports on the advantages and indications of PCA in surgical wards are scarce. The aim of this prospective study therefore was to investigate PCA as a routine technique in surgical wards. In particular we were interested in safety and in the efficacy of analgesia. ⋯ We conclude that PCA with piritramide is a safe technique when performed under routine conditions on surgical wards. However, standardized monitoring is mandatory. PCA leads to effective analgesia and consequently to greater comfort of surgical patients in the postoperative period. These conclusions hold only for patients with ASA status I-II who have undergone operations of the types listed above.