Articles: pain.
-
Review Meta Analysis Comparative Study
Systematic review of randomized controlled trials of nonpharmacological interventions for fibromyalgia.
Little is known of the effectiveness of nonpharmacological interventions for fibromyalgia syndrome (FMS). The authors therefore carried out a systematic review from 1980 to May 2000 of randomized controlled trials (RCTs) of nonpharmacological interventions for FMS. ⋯ The varying combinations of interventions studied in the RCTs and the wide range of outcome measures used make it hard to form conclusions across studies. Strong evidence did not emerge in respect to any single intervention, though preliminary support of moderate strength existed for aerobic exercise. There is a need for larger, more methodologically rigorous RCTs in this area.
-
Review Meta Analysis
Effectiveness of acute postoperative pain management: I. Evidence from published data.
This review examines the evidence from published data concerning the incidence of moderate-severe and of severe pain after major surgery, with three analgesic techniques; intramuscular (i.m.) analgesia, patient controlled analgesia (PCA), and epidural analgesia. ⋯ These results suggest that the UK Audit Commission (1997) proposed standards of care might be unachievable using current analgesic techniques. The data may be useful in setting standards of care for Acute Pain Services.
-
Meta Analysis
Reducing venipuncture and intravenous insertion pain with eutectic mixture of local anesthetic: a meta-analysis.
The eutectic mixture of local anesthetics (EMLA), by producing dermal anesthesia through contact with intact skin, has become a major indication for the reduction of pain experienced during venipuncture (VE) and intravenous (IV) insertion. ⋯ EMLA cream can significantly decrease VE and IV insertion pain in 85% of the population.
-
J Pain Symptom Manage · Feb 2002
Meta AnalysisCombination analgesic efficacy: individual patient data meta-analysis of single-dose oral tramadol plus acetaminophen in acute postoperative pain.
The primary aims of this study were to assess the analgesic efficacy and adverse effects of single-dose oral tramadol plus acetaminophen in acute postoperative pain and to use meta-analysis to demonstrate the efficacy of the combination drug compared with its components. Individual patient data from seven randomized, double blind, placebo controlled trials of tramadol plus acetaminophen were supplied for analysis by the R. W. ⋯ Adverse effects were similar for the combination drugs and the opioid component alone. Common adverse effects were dizziness, drowsiness, nausea, vomiting, and headache. In sum, this meta-analysis demonstrated analgesic superiority of the combination drug over its components, without additional toxicity.
-
"He slept less and less; they gave him opium and began to inject morphine. But this did not relieve him. The dull pain he experienced in the half asleep condition at first only relieved him as a change, but then it became as bad, or even more agonizing, than the open pain."--Tolstoy, The Death of Ivan Ilyitch. ⋯ Those who work in chronic pain are unfortunately only too aware of the problems that such pains can cause. One of the hallmarks of neuropathic pain is poor or incomplete relief with opioids. As with so many things in medicine, there is nothing novel in this realization, as the Tolstoy quotation shows.