Articles: pain-measurement.
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Anesthesia and analgesia · May 2020
Randomized Controlled TrialGuiding Opioid Administration by 3 Different Analgesia Nociception Monitoring Indices During General Anesthesia Alters Intraoperative Sufentanil Consumption and Stress Hormone Release: A Randomized Controlled Pilot Study.
This pilot study investigated the effect of sufentanil titration by 3 different analgesia monitoring devices or clinical signs during general anesthesia. ⋯ The type of analgesia nociception monitoring affected the total amount of sufentanil administered. Lower sufentanil doses in the PPI group were associated with an increased endocrine stress response. Titration by SPI caused no opioid reduction compared to the control but was associated with a reduced endocrine stress response.
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Randomized Controlled Trial Multicenter Study Comparative Study
Subomohyoid Anterior Suprascapular Block versus Interscalene Block for Arthroscopic Shoulder Surgery: A Multicenter Randomized Trial.
Interscalene brachial plexus block, the pain relief standard for shoulder surgery, is an invasive technique associated with important complications. The subomohyoid anterior suprascapular block is a potential alternative, but evidence of its comparative analgesic effect is sparse. The authors tested the hypothesis that anterior suprascapular block is noninferior to interscalene block for improving pain control after shoulder surgery. As a secondary objective, the authors evaluated the success of superior trunk (C5-C6 dermatomes) block with suprascapular block. ⋯ The suprascapular block was noninferior to interscalene block with respect to improvement of postoperative pain control, and also for blockade of the superior trunk. These findings suggest that the suprascapular block consistently blocks the superior trunk and qualify it as an effective interscalene block alternative.
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Randomized Controlled Trial
Avoid or engage? Outcomes of graded exposure in youth with chronic pain using a sequential replicated single-case randomized design.
Pain-related fear is typically associated with avoidance behavior and pain-related disability in youth with chronic pain. Youth with elevated pain-related fear have attenuated treatment responses; thus, targeted treatment is highly warranted. Evidence supporting graded in vivo exposure treatment (GET) for adults with chronic pain is considerable, but just emerging for youth. ⋯ Improvements during GET Living was superior to the no-treatment randomized baseline period for avoidance, pain acceptance, and pain intensity, whereas fear and pain catastrophizing did not improve. All 5 outcomes emerged as significantly improved at 3- and 6-month follow-ups. The results of this replicated single-case experimental phase design support the effectiveness of graded exposure for youth with chronic pain and elevated pain-related fear avoidance.
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Randomized Controlled Trial
Offset analgesia: somatotopic endogenous pain modulation in migraine.
The complex mechanisms underlying migraine are not entirely understood. It has been suggested that descending endogenous pain modulation is an important contributing factor, although research is controversial. A frequently used method to quantify the inhibitory pain modulation system is offset analgesia (OA), defined as a disproportionally large decrease in pain perception in response to a small decrease of painful stimulation. ⋯ Statistically significant differences between the trigeminal area and the extratrigeminal area were neither observed in healthy controls nor in patients with migraine (P > 0.05). Mechanical detection, mechanical pain threshold, warm detection, and heat pain threshold showed no significant differences between groups or test sites (P > 0.05). In summary, patients with episodic migraine in the headache-free interval exhibited somatotopically specific differences in endogenous pain modulation.
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Randomized Controlled Trial Comparative Study
Analgo-Sedative Effects of Oral or Nebulized Ketamine in Preschoolers Undergoing Elective Surgery: A Comparative, Randomized, Double-Blind Study.
Premedication in children with ketamine is useful to produce mild sedation, decrease anxiety, help the child separation from parents, and provide postoperative pain relief with no or little adverse effects. ⋯ Nebulized ketamine, oral ketamine, preschooler, elective surgery.