Articles: pain-clinics.
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Until recently the measurement of pain in cognitively impaired patients represented a neglected field in the diagnostics and treatment of pain. Investigations indicate a prevalence of pain in nursing home residents of between 45 % and 80 %. ⋯ The Doloshort scale is a well suited measurement instrument for the evaluation of pain in cognitively impaired patients. Because of the short form only simple instructions are necessary and it has a high acceptance with users.
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Clinical rheumatology · Aug 2015
Is it necessary to strictly diagnose fibromyalgia syndrome in patients with chronic widespread pain?
The applicability of the American College of Rheumatology (ACR) 1990 and 2010 criteria for the diagnosis of fibromyalgia syndrome (FMS) was determined in 284 patients with chronic widespread pain (CWP) including those with regional and systemic painful disorders. On the basis of initial evaluation, patients were classified into three groups. Group 1, those without any comorbid disease (N = 105), group 2, those having regional non-inflammatory painful disorders (N = 104), and group 3, those with a diagnosis of an inflammatory rheumatic disease (N = 75). ⋯ The findings of the study support the suggestion that FMS is just a continuum of CWP, rather than a distinct diagnostic entity. As treatment of FMS is usually identical with that of CWP, strict diagnosis of FMS will provide little or no significance from the viewpoint of clinical practice. We suggest that future research should be directed toward classification of CWP to provide guidance to clinicians in selecting effective therapies.
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Acta Anaesthesiol Scand · Aug 2015
ReviewCan the dopaminergic-related effects of general anesthetics be linked to mechanisms involved in drug abuse and addiction?
General anesthetics (GA) are well known for the ability to induce a state of reversible loss of consciousness and unresponsiveness to painful stimuli. However, evidence from animal models and clinical studies show that GA exposure may induce behavioral changes beyond acute effects. Most research and concerns are focused on changes in cognition and memory. ⋯ A review of available evidence strongly suggests that there may be a link between the effects of GA on the brain and substance abuse, partly explained by their influence on the dopaminergic system.
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Acta Anaesthesiol Scand · Aug 2015
Randomized Controlled TrialNaloxone added to bupivacaine or bupivacaine-fentanyl prolongs motor and sensory block during supraclavicular brachial plexus blockade: a randomized clinical trial.
In this study, the effect of naloxone on duration of supraclavicular brachial plexus block was evaluated. It was hypothesized that naloxone can increase the duration of neural blockade. ⋯ Addition of naloxone to bupivacaine in supraclavicular brachial plexus block prolonged the duration of the neural blockade.
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Fear, anxiety, and emotional upset are common experiences for hospitalized children. To identify and treat children's emotional reactions, health care professionals must be able to differentiate emotional reactions from pain and other symptoms. Clinical assessment of emotions requires the use of valid and reliable instruments in acute care settings. ⋯ Internal consistency was better supported for the recalled unpleasant experience (α = 0.77) than for the pleasant experience (α = 0.60). Results supported construct and concurrent validity and beginning internal consistency reliability for the ERC in an acute care setting. Further research is required to establish feasibility of repeated use with ill children.