Articles: pain.
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Physicians' attitudes toward pain in children were assessed in an attempt to explain why adults are administered more analgesics than children while in the hospital. A survey was conducted of all pediatricians, family practitioners, and surgeons in Hartford. Fifty-seven percent of the sample responded (112/195). ⋯ Many other attitudinal differences were also related to specialty. Other demographic variables (age, sex, mode of practice, and personal experience with pain) had little effect on attitudes. These findings suggest possible explanations for the discrepancy between child and adult analgesic prescribing practices.
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Clinical Trial Controlled Clinical Trial
Role of spinal noradrenergic system in transmission of pain in patients with spinal cord injury.
15 patients with deafferentation pain due to spinal cord injury were investigated for a spinal mechanism of pain transmission. Epidural morphine 5 mg in 5 ml of water had an analgesic effect in 5 patients, 3 of whom also had pain relief with epidural clonidine. ⋯ Neither epidural morphine nor clonidine was effective in the other 3 patients, 2 of whom obtained relief with epidural buprenorphine 0.3 mg in 5 ml of saline. 1 patient did not find relief with any of the injections. These data suggest that a spinal noradrenergic system may be as important as the opioid system in the transmission of pain in patients with spinal cord injury.
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Randomized Controlled Trial Clinical Trial
Double-blind evaluation of a lignocaine-prilocaine cream (EMLA) in children. Effect on the pain associated with venous cannulation.
The effect of the topical application of a lignocaine-prilocaine cream (EMLA) on the pain of venous cannulation was tested in a double-blind manner. Sixty boys and girls between the ages of 4 and 10 yr who were to undergo surgery participated in the study. No analgesic premedication was given and the venous cannulation was performed during the preparation for general anaesthesia. ⋯ The effect of EMLA in the alleviation of the pain of venous cannulation was considered significantly better than placebo by both anaesthetist (P less than 0.001) and patient (P less than 0.05) (verbal scales). One conventional pictorial scale showed a statistically significant difference (P less than 0.05), but the other, based on facial expressions, did not. Local reactions to the cream were minor and transient in both groups.
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Clinical Trial Controlled Clinical Trial
The effects of transcutaneous electrical nerve stimulation on post-cesarean pain.
The purpose of this study was to examine the effect of continuous transcutaneous electrical nerve stimulation (TENS) near the incision site on post-cesarean pain and on analgesic intake during the early postoperative period. This investigation utilised a 2-group (TENS-treated and placebo TENS-treated), single-blind experimental design. Eighteen multiparous women, each having undergone an elective cesarean delivery, participated in the study. ⋯ However, pain resulting from internal structures, i.e., deep pain, afterbirth pain (due to uterine contractions), and the somatic pain associated with decreased peristalsis (gas pains) were not amenable to TENS. No significant differences in analgesic intake were observed. The possible reasons for these findings are discussed.