Articles: pain-measurement.
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One hundred and five patients with polyarthritis chose from 14 sensory and 5 affective pain descriptors derived from the McGill Pain Questionnaire (MPQ), and completed visual analogue scales (VAS) for overall and individual joint pain at rest and on movement. The relative frequency of sensory pain descriptor choice varied for the 4 different circumstances of pain. Over one third of patients volunteered affective words not included in the MPQ. This study suggests that conventional overall measures of pain, such as the MPQ, when used for patients with arthritis may neglect differences in pain experience perceived in individual joints and on movement.
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This paper provides an overview to the assessment and management of chronic and recurrent pain in children with chronic diseases. Relevant clinical research studies are cited, and practical guidelines are provided for the differential assessment and management issues inherent in the comprehensive care of chronic and recurrent pain in children and adolescents with hemophilia, juvenile rheumatoid arthritis, sickle cell disease, and cancer.
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Review Clinical Trial
Assessment and management of postoperative pain in children.
This paper focuses on the knowledge base about the assessment and management of postoperative pain in children. The first section deals with the nature and characteristics of postoperative pain. A description of current pain management practices with children, focusing on analgesic administration, is derived from available research literature. ⋯ Recent advances in pain assessment and measurement in all age groups, particularly with verbal children and the new self-report measures, are discussed. The latest developments in pharmacological and nonpharmacological techniques for the relief of children's postoperative pain are also described. Finally, the paper concludes with a few suggestions for pediatricians relative to their role in assisting in the search for better assessment and management techniques in the care of postoperative children.
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Visual analogue scales (VAS) for overall and individual joint pain at rest and on movement were completed by 105 patients with polyarthritis as part of a study of the relationship between overall pain and pain in individual joints. Not all subjects recorded pain on a conventional VAS although all had at least 2 painful joints on movement. At best only 25% of the variance in overall pain was explained by pain in individual joints. Our findings suggest that conventional overall measures of pain in arthritis may neglect aspects of pain experience which relate to individual joints and to pain on movement.
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A new argon laser technique was introduced to evaluate the excitability of the free nerve endings in the skin following topical application of capsaicin. Short argon laser pulses can be perceived as distinct, painful pin pricks and the pain threshold can be determined. This gives the possibility to follow changes in sensory and pain thresholds after topical application of various substances. ⋯ Capsaicin was applied to human skin once daily for 21 days, and the pain threshold was significantly increased after 10 days of application, and after 21 days the increase was found to be 260%. After termination of capsaicin treatment the thresholds were monitored for 21 days, and normalization occurred after 7 days. Argon laser stimulation is a reliable method to evaluate sensory and pain thresholds in human skin.