Articles: pain-measurement.
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In the first part of this article (NJI, August, 1998), the author defined 'Pain' and dwelt on Pain Characteristics, Pain Components, Pain Theories and some Factors Affecting Pain. In this concluding part she describes other factors and goes on to deal with the issues regarding assessment of the pain experience and the aspect of precention of intensification of pain and the Nurses' role in providing pain relief.
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How to measure pain is a great challenge to those who desire to control adequately such a complex experience. Standardized instruments that take into consideration the patient's own account, have been developed in order to make such a task easier. In this article we carry out a revision of the instruments used mostly for measuring postoperative pain, and we point out some of the advantages and disadvantages. We emphasize the need for specific research focusing on the measurement of surgical pain, taking into consideration the multiple dimensions of a painful experience.
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Am J Hosp Palliat Care · Jan 1998
ReviewCancer pain management: newer perspectives on opioids and episodic pain.
Cancer pain is significantly undertreated, but the current armamentarium of opioids and other analgesics are such that no cancer patient should be in pain. The guidelines for the treatment of cancer pain suggest that a long-acting, preferably oral, opioid be administered around the clock for persistent baseline pain, along with a short-acting oral opioid for episodes of breakthrough pain. Morphine is the gold standard for ATC opioid treatment, and OTFC is emerging as a potent agent for the management of breakthrough pain. The careful assessment and management of persistent cancer pain and breakthrough pain will help realize the goal of optimal pain management for all cancer patients.
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The assessment of postoperative pain and analgesic efficacy is essential as pain levels and morphine requirements are not predictable. Self-assessment with unidimensional methods (such as the visual analogue pain scale, the numerical rating scale and the verbal rating scale) is the rule for adults and children more than 5 years of age. The former is a validated method and the most accurate and reproducible scale. ⋯ Finally, morphine consumption with PCA is also an indirect pain assessment method. Postoperative pain should be assessed several times a day in every patient, starting in the recovery room and prolonged during hospital stay. Pain should be measured at rest and in dynamic conditions by the medical and paramedical team.
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Pain assessment is essential for effective pain management. Development of structured pain assessment and documentation of the child's pain history is vital. ⋯ Pain management requires multiprofessional commitment and involvement. The role of the acute pain service is a vital element within a Children's Trust.