Articles: pain-measurement.
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Randomized Controlled Trial Comparative Study Clinical Trial
[Initial results of the reliability and validity of a German-language scale for the quantitative measurement of postoperative pain in young children].
In a previous study it was proved impossible to evaluate the validity of a system modified according to McGrath et al. for measuring postoperative pain in children. Three reasons were postulated for this result. The analgesics used did not modulate the pain in such a manner that the statistical analysis was effective; or the postoperative pain had an acute onset or fluctuated and the regular observations did not allow detection of the pain peaks; or the system used did not measure pain. ⋯ RESULTS. A replication verified the results of the previous study: the factor analysis resulted in a one-factorial solution. Of the 8 items (wakefulness, wake-up reactions, crying, position of the trunk, position of the legs, verbal communications on being asked about pain, special defense against stimuli) only 4 had a sufficiently substantial load on all measurements (crying, facial expression, position of the trunk and position of the legs). (ABSTRACT TRUNCATED AT 400 WORDS)
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In the first part of this report a methodology is described which allows an objective and specific exploration of experimental pain in man by using some electrophysiological features of cutaneous reflexes. This method can be summarized as follows: in normal and trained volunteers, we studied simultaneously the recruitment curves of the nociceptive flexion reflex of a knee-flexor muscle (biceps femoris muscle) and that of pain sensation elicited by electrical stimulation of the ipsilateral sural nerve at the ankle. In this procedure, we found that the reflex threshold (Tr) was closely related to that of pain threshold (Tp) around a similar value (10 mA). ⋯ On the other hand, data also show that the spinal level is one of the main important sites of the mechanisms of morphine-induced analgesia since this drug is found to strongly depress selectively the nociceptive transmission directly at the spinal level. Finally, this method is applied for investigating the nociceptive reactions in patients affected either with a pathological lack of pain sensation or, by contrast, in patients complaining of acute or chronic pain from various origins. Since the nociceptive flexion reflex can be considered as a specific and objective physiological correlate of a pain sensation, it can be successfully employed as a useful tool for investigating some aspects of the human nociceptive reactions in both experimental and pathological situations.
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Acta Anaesthesiol Scand · Nov 1990
Pressure pain thresholds in volunteers and herniorrhaphy patients.
Pressure algometry is a method to estimate pressure pain sensitivity in tissues. The aim of the present study was to evaluate the reproducibility of pressure pain thresholds (PPT) in the abdominal integument and to evaluate the use of pressure algometry as a measure of wound tenderness following surgery. PPT was determined in 20 healthy volunteers on two separate examinations, and in 14 patients at the incisional site before and following inguinal herniotomy. ⋯ In surgical patients a significant decrease in PPT was observed following operation. Morphine 0.07 mg/kg caused a slight but significant increase in PPT. Pressure algometry may be useful to study nociceptive mechanisms and the dynamics of wound pain in surgical patients.
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Two separate studies were carried out to determine if three visual analogue scales for various feelings including pain could be marked consistently by patients, without reference to previously completed scales. Sixty patients undergoing extraction of their lower third molars had measurements of acute preoperative anxiety, expected postoperative pain and postoperative perceived pain three times in quick succession. There was no significant difference between the three measurements for any of the feelings. ⋯ Mean scores for anxiety, mood and pain relief were consistent, but mean pain scores were more variable. There was a very close correlation between any two feelings expressed on these visual analogue scales during both the initial and second visits. Litigation or social problems were not associated with increased pain scores.
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In sickle cell disease, vaso-occlusion in the small blood vessels leads to bone or joint pain which is variable in intensity and duration. An essential first step toward the development of specific treatment guidelines for such painful episodes in children and adolescents is the accurate evaluation of pain. The systematic assessment of vaso-occlusive pain is addressed through two separate studies. ⋯ In the second, data were gathered over the course of hospitalizations for uncomplicated vaso-occlusive episodes in 17 adolescent patients. Results showed that this pain experience can be quantified, that vaso-occlusive pain spans a broad range of intensity levels, and that there are a number of socioemotional factors associated with the pain experience. Further research to systematically assess the psychometric properties of pain assessment instrument is recommended.