Articles: pain-measurement.
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Observational Study
Endogenous Pain Facilitation Rather Than Inhibition Differs Between People with Chronic Fatigue Syndrome, Multiple Sclerosis, and Controls: An Observational Study.
Commonalities in the core symptoms of fatigue and cognitive dysfunction experienced by chronic fatigue syndrome (CFS, also known as ME) and multiple sclerosis (MS) patients have been described. Many CFS and MS patients also experience chronic pain, which has been attributed to central sensitization in both groups of patients. However, the characteristics of pain in CFS and MS patients have not been compared. ⋯ We found differences in the characteristics of pain symptoms reported by patients with CFS and patients with MS, which suggest different underlying mechanisms. Specifically, overactive endogenous pain facilitation was characteristic of pain in patients with CFS but not in patients with MS, suggesting a greater role for central sensitization in CFS.
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The term complex regional pain syndrome (CRPS) describes a variety of painful conditions, which typically occur distally on an extremity following an initiating event. Characteristically CRPS exceeds the expected clinical course in both magnitude and duration. Clinical manifestations of CRPS include sensory, vasomotor, sudomotor, motor and trophic disorders. ⋯ Essential differential diagnoses in the early phase include infections, neurological compression and inflammatory conditions. Although benign courses have been reported, many patients develop a chronic condition with persisting complaints even after 1 year. Therapy is based on a variety of pharmacological, interventional, physiotherapeutic, occupational and psychiatric treatment options.
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Postoperative pain after total knee arthroplasty (TKA) can be burdensome. Multiple methods of pain control have been used, including adductor canal block (ACB) and multimodal periarticular analgesia (MPA). These two techniques have been studied have proven to be efficacious separately. The purpose of this study was to compare: (1) lengths of stay (LOS), (2) pain level, (3) discharge status, and (4) opioid use in TKA patients who received ACB alone vs patients who received ACB and MPA. ⋯ There was no significant difference in LOS, pain levels, discharge status, and opiate requirements between the 2 groups. ACB alone may be as effective as combined ACB and MPA in TKA patients for postoperative pain control. Larger prospective studies are needed to verify these findings and to improve generalization.
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Z Evid Fortbild Qual Gesundhwes · May 2017
[Standardised pain assessment in cognitively impaired nursing home residents: Comparing the use of assessment tools in dementia care units and in integrated care units].
A large number of nursing home residents with cognitive impairments (CI) suffer from chronic pain, which is also discussed as a reason for challenging behavior. To assess pain in people with severe CI, the use of an observational pain instrument is recommended; for people without or with mild CI the gold standard is a self-rating instrument. It is unknown whether in German nursing homes pain assessment in residents with severe CI is actually conducted using observational instruments and which instruments are used. Because of different resident structure we assume that in dementia care units observational pain instruments are more often used than in integrated care units. The aim of this study was to investigate the conduction of pain assessments and the instruments used in both types of care units. ⋯ Especially in integrated units, a defined and consented method of pain assessment is important because of the differences in their residents' cognitive and verbal abilities. Appropriate education may help to improve this process.