Articles: pain.
-
Randomized Controlled Trial Clinical Trial
Labor room and laboratory: clinical validation of the cold pressor as a means of testing preparation for childbirth strategies.
Annually, numerous couples prepare for childbirth through Lamaze childbirth education classes. Research on various portions of the Lamaze method has used the cold pressor as an analogue for labor. In this experiment, pregnant women who had attended either (a) Lamaze classes which taught pain control methods (n = 22), or (b) Red Cross parenting classes which did not teach pain control methods (n = 7), and students who received either (c) brief Lamaze training (n = 10), or (d) no training (n = 10), were tested on the cold pressor. ⋯ Post hoc analyses showed that women who managed labor pain well performed better on the cold pressor task than women who did not manage labor pain well. This experiment established some limits for applying analogue results to childbirth. Moreover, it showed that women who attended Lamaze classes received less medication during labor than women who attended Red Cross classes; however, it was not clear whether this difference was due to the Lamaze classes per se, or to other uncontrolled variables.
-
J Bone Joint Surg Am · Jan 1982
Case ReportsLong-term pain control by direct peripheral-nerve stimulation.
In 1970, we began implanting electrodes for prolonged stimulation of injured peripheral nerves to reduce chronic pain. Thirty-eight peripheral nerves in thirty-five patients have been stimulated with electrodes for a period ranging from four to nine years. Nineteen electrode systems were implanted in the upper extremity (eleven on the median nerve, six on the ulnar nerve, one on the median and ulnar nerves, and one on the median and radial nerves), with successful relief of pain in 52..6 per cent of the patients. ⋯ We speculate that the stress of weight-bearing and the anatomical position of the posterior tibial nerve may partially account for this rate of failure. Use of the electrode-implant systems required careful preoperative assessment by an experienced team, meticulous technique, and a mechanical system that tolerates stress. The location and characteristics of the lesion affect the response to electrical stimulation.
-
Eur. J. Clin. Pharmacol. · Jan 1982
Randomized Controlled Trial Clinical TrialThe use of pain scales in assessing the efficacy of analgesics in post-operative dental pain.
Two 10 cm visual analogue scales were compared with a 0-10 point numerical rating scale and a four-point verbal descriptive scale, in assessing pain severity in twelve patients with post-operative pain following removal of an impacted lower third molar. High correlations were shown between the pain scores from the two visual analogue scales and the numerical scale, but a lower correlation was obtained when the four-point scale was compared with the other scales. Analgesic efficacy was found to be dependent on the type of scale used. The 10 cm visual analogue scale was more sensitive than other pain scales and could discriminate between small changes in pain intensity.
-
Ann Fr Anesth Reanim · Jan 1982
Case Reports Comparative Study[Intraventricular morphine analgesia. Apropos of 4 cases, 1 with self-administration].
Intractable pain in four patients enduring disseminated cancer was treated by intraventricular morphine. For all these patients, previous efficiency of opiates therapy had been assessed by a positive trial of epidural injections of morphine. The latter method had to be stopped and a switch to intraventricular morphine was motivated in three cases by a local non-tolerance to the subarachnoid catheter. ⋯ Trial times were respectively of eight days, one month, two months and seven months, with a self administration system in one case. In comparison with the epidural and lumbar intrathecal administration of morphine, the authors insist upon the quality of analgesia obtained, the absence of respiratory depression, the comfort and minimal daily quantities of morphine injected (inferior to one mg daily in three cases). Enlightened by these four cases, the authors also discuss of relative importance of the spinal and brain mechanisms involved in morphine analgesia.