Articles: pain-measurement.
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Randomized Controlled Trial Comparative Study Clinical Trial
What are the parameters for predictive selection of patients requiring anesthesia for extracorporeal shockwave lithotripsy?
Additional anesthesia is required to minimize the tolerable pain level in efficiently performed extracorporeal shockwave lithotripsy (ESWL) with electrohydraulic and electromagnetic sources. In order to assess optimum anesthesia for each patient undergoing a standardized ESWL protocol, pain measurement and scoring were carried out. We attempted to determine the individual type and amount of analgesia prior to treatment. ⋯ The TP and MTP levels are lower in patients requiring stronger analgesia. The determined parameters are suitable for patient preselection and individual assessment of anesthesia prior to ESWL. It may be assumed that 50% of patients administered intravenous opioids are overtreated. Routine pain measurement for patient depends on the individual pain tolerance level. A third phase of this study recruiting a large number of patients will contribute to the confirmation of these results.
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Randomized Controlled Trial Comparative Study Clinical Trial
Variation in surgical trauma and baseline pain intensity: effects on assay sensitivity of an analgesic trial.
The aims of this study were to test the hypotheses that the type of 3rd molar removal determines baseline pain and that baseline pain influences analgesic assay sensitivity. Three groups of patients were studied: (i) 100 patients that had one fully erupted maxillary 3rd molar extracted; (ii) 95 patients that had one lower impacted 3rd molar surgically removed; and (iii) 98 patients that had two ipsilateral impacted 3rd molars surgically removed. In a randomized, double-blind fashion, the patients received (every third hour, three times) either: (i) paracetamol 1g; (ii) paracetamol 1g plus codeine 60 mg; or (iii) placebo. ⋯ Analgesic effects of the active test drugs were superior to placebo. Paracetamol with and without codeine could be distinguished in patients after surgical removal of one 3rd molar. In conclusion, baseline pain was related to the degree of surgical trauma, but large inter-individual variation in baseline pain intensity reduced the ability to distinguish between paracetamol with and without codeine.
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J Pain Symptom Manage · Jul 1998
Randomized Controlled Trial Clinical TrialThe human capsaicin model of allodynia and hyperalgesia: sources of variability and methods for reduction.
Intradermal and topical application of capsaicin have been used to study mechanisms of mechanical allodynia (MA) and pinprick hyperalgesia (PPH) and the efficacy of drugs in relieving these symptoms. However, it is associated with significant inter- and intra-subject variability. In order to improve the model's sensitivity, we examined several potential sources of variability of capsaicin-evoked MA and PPH in healthy volunteers, including skin temperature fluctuations, method (intradermal vs. topical) and site (volar forearm vs. foot dorsum) of administration. ⋯ However, greater intra-subject consistency (MA: foot: r = 0.84; arm: r = 0.49; PPH: r = 0.87; r = 0.39) and significantly larger areas of MA (15.8 +/- 4.2 vs 9.1 +/- 2.5, p < 0.05) were seen with the foot. (PPH: foot: 28.9 +/- 6.7; arm: 21.6 +/- 4.2, NS). Large variability exists among subjects receiving CAP, with some developing minimal MA. However, these subjects may be screened out prior to entry, increasing the sensitivity of the model, which may be further improved by clamping the skin temperature.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jun 1998
Randomized Controlled Trial Multicenter Study Clinical Trial[Development of an observational scale for assessment of postoperative pain in infants].
In a prospective trial in 139 infants ASA classification I-II 13 observational items were scaled during the first postoperative hour (13 assessments). The items were drawn from the literature and chosen for economic purpose. Factor analyses (Principal component, Kaiser Criterion, Scree-test) were used for the elimination of useless items and for the identification of suitable ones. ⋯ There was a significant interaction between repeated measurements and the supply of Piritramide and Ketamine, but not of Midazolam. Concurrent and constructive validation were positive for both systems, using administration of Piritramide as a criterion. For clinical purpose the CHIPPS should be preferred, because it has been proven to be valid in children up to 4 years of age and because controlled data on its sensitivity, specify, reliability and validity could already be presented.
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Scand J Rehabil Med · Mar 1998
Randomized Controlled Trial Clinical TrialPressure algometry in healthy subjects: inter-examiner variability.
The purpose of this study was to estimate inter-examiner reliability of head and neck algometry. Pain perception thresholds were assessed with a mechanical pressure algometer in 21 healthy individuals. Thresholds were assessed at 13 symmetrical points on each side of the head and neck, at the deltoid muscle and at the median finger. ⋯ Inter-examiner reliability of side differences was excellent, with CR = 1.23 kg/cm2. In conclusion, manual algometry with a rather inexpensive mechanical device has a good to excellent inter-rater reliability. When studying patients, however, the possible bias introduced by different examiners should be taken into account, both regarding study design and data analysis.