Articles: pain.
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In the patient with advanced cancer, effective symptom control requires a multidisciplinary, multimodal approach. Considerations involved in the control of pain can serve as a model for management of other symptoms, such as anorexia and dyspnea, as well.
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Randomized Controlled Trial Comparative Study Clinical Trial
A double-blind comparison of the relative efficacy, side effects and cost of buprenorphine and morphine in patients after cardiac surgery.
The analgesic efficacy, side effects and cost of administration of regimens of intravenous buprenorphine and intravenous morphine were compared in a randomized double-blind trial performed during the first 24 h after cardiac surgery. Seven patients received buprenorphine by intermittent intravenous injection and six received morphine by continuous infusion. Both these regimens provided good analgesia for the entire 24 h period, with only mild pain at rest and moderate pain on vigorous coughing. ⋯ Buprenorphine had no narcotic code restriction and could be given by intermittent intravenous injection, whereas morphine required checking and handling as a restricted drug and administration by continuous intravenous infusion. When labour and material costs were computed, over the first 24 postoperative hours, it cost $19.76 per patient to administer morphine, but only $3.16 to administer buprenorphine. Thus the use of buprenorphine injections for the first 24 h after cardiac surgery produced pain relief and respiratory depression comparable to that produced by a morphine infusion, but with a significant cost saving in terms of labour and materials.
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The National Hospice Study of 1986 has not only revealed that hospices do a better job of meeting pain-control goals than do hospitals, but also elucidated a number of important differences in hospice and hospital care that account for this finding.
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Randomized Controlled Trial Comparative Study Clinical Trial
Effects of unilateral and bilateral auricular transcutaneous electrical nerve stimulation on cutaneous pain threshold.
This study compared the effects of unilateral and bilateral auricular transcutaneous electrical nerve stimulation on cutaneous pain threshold. Auricular acupuncture points were stimulated with low frequency, high intensity TENS for 45 seconds. Sixty healthy, adult subjects were assigned randomly to one of two treatment groups or to a control group. ⋯ Both unilateral and bilateral auricular stimulation groups exhibited a significant increase (p less than .05) in experimental pain threshold, but the control group did not. The mean change values between the unilateral and bilateral stimulation groups were not statistically different. These results suggest that both unilateral and bilateral auricular TENS can increase pain threshold.