Articles: pain.
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The evaluation of cancer pain remains a problematic clinical problem, not only due to the subjective and multidimensional nature of pain per se, but also because of its specific characteristics. Cancer pain has an insidious onset, often involves many sites, and is frequently multicausal. Tools have been developed to quantify pain, the most commonly used being the verbal rating scale (VRS), the visual analogue scale (VAS), and the McGill Pain Questionnaire (MPO). ⋯ In addition, the words within a given category are considered to be equidistant, the number of words in each category are unequal, and the number of categories evaluating a given dimension are not taken into account when calculating the total pain rating index. A further issue in assessing pain, other than the choice of a valid and reliable tool, is the frequency with which pain evaluations should be repeated. To date no studies have addressed this problem.(ABSTRACT TRUNCATED AT 250 WORDS)
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Patient-controlled analgesia (PCA) provides improved titration of analgesic drugs, thereby minimizing individual pharmacokinetic and pharmacodynamic differences. Patient-controlled analgesia decreases patient anxiety resulting from delays in receiving pain-relieving medication and from the slow onset of analgesic action when these drugs are administered either intramuscularly or in the extradural space. ⋯ The potential for overdose can be minimized if small bolus doses are used with a mandatory lockout interval between successive doses. Finally, studies of the cost-effectiveness of PCA therapy are important if this therapeutic approach is to achieve more widespread acceptance.
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Acta psychiatrica Belgica · Jan 1988
ReviewHysteria, depression and the nosological problem of chronic pain.
In this article the nosological relevance of hysteria and depression for somatically unexplained chronic pain is critically discussed. Despite many clinical controversies and methodological problems, it is concluded from the available literature that both concepts merit a place in the psychiatric nosology of chronic pain. Nevertheless, more research is needed to further clarify the complex relationships between hysteria, depression and pain, and to more exactly determine the relative importance of hysterical and depressive features in chronic pain patients.