Articles: pain.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Using distraction to reduce reported pain, fear, and behavioral distress in children and adolescents: a multisite study.
Distraction during painful procedures has been shown to be effective in previous studies, yet this simple intervention is not used routinely. This study examined the effectiveness and feasibility of distraction in reducing behavioral distress, pain, and fear during venipuncture or intravenous insertion. ⋯ Failure of the distraction intervention to reach statistical significance in this study is puzzling, given anecdotal reports of clinical efficacy. Methodological issues may have obscured actual differences between experimental and control groups.
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Multicenter Study Clinical Trial
A drug use evaluation of selected opioid and nonopioid analgesics in the nursing facility setting.
To determine the medical conditions for which selected analgesics are most frequently prescribed in nursing facilities (NFs), describe the use of pharmacologic and nonpharmacologic pain therapies, and determine the frequency and quality of pain assessment in NF residents. ⋯ The findings show a lack of adequate pain assessments, little use of nonpharmacologic interventions, and inappropriate use of analgesic medication. The small percentage of residents with chronic pain assessed objectively suggests the difficulty of monitoring pain progression in NFs. The prescribing of analgesic for most residents (with propoxyphene used most often, long-acting opioids used infrequently, and frequent prn use) was inconsistent with recommended pain therapy in older people and attests to the urgent need to educate NF practitioners on the appropriate use of analgesics.
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J. Diabetes Complicat. · Mar 2000
Randomized Controlled Trial Multicenter Study Clinical TrialMaintenance of the long-term effectiveness of tramadol in treatment of the pain of diabetic neuropathy.
The objective of this study was to evaluate the efficacy and safety of tramadol in a 6-month open extension following a 6-week double-blind randomized trial. ⋯ Tramadol provides long-term relief of the pain of diabetic neuropathy.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Comparing three patient-controlled analgesia methods.
Among 301 patients randomly assigned to use one of three methods for patient-controlled analgesia (PCA), no statistically significant differences were found for self-reported pain or acceptability of PCA method. Methods yielded differences in on-demand bolus analgesia use and number of symptoms.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Postoperative pain management and recovery after remifentanil-based anaesthesia with isoflurane or propofol for major abdominal surgery. Remifentanil Study Group.
We have assessed if recovery times after morphine or fentanyl, given before terminating remifentanil anaesthesia with isoflurane or propofol, are compromised. We studied patients undergoing elective, major abdominal surgery, allocated randomly to receive remifentanil and isoflurane (n = 277) or remifentanil and propofol (n = 274) anaesthesia. ⋯ Recovery was rapid and at an Aldrete score > or = 9 (median 12-15 min), 42-51% of patients reported none or mild pain. However, 26-35% of patients reported severe pain and > 90% required a second dose of opioid within 21-27 min after anaesthesia.