Articles: pain-management.
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Randomized Controlled Trial Clinical Trial
Transcutaneous electrical nerve stimulation treatment of sickle cell pain crises.
Transcutaneous electrical nerve stimulation (TENS) has been used in a variety of acute and chronic painful conditions, but has not been studied in sickle cell pain crises. We compared TENS versus placebo in a randomized, double-blind, cross-over study involving 60 trials in 4 crisis severity categories. ⋯ Patients assessments of overall treatment efficacy indicated that TENS was more frequently helpful, but there was a substantial placebo effect. Although the value of TENS in this condition was not established in this study, further trials, using varied stimulation parameters, are warranted.
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Randomized Controlled Trial Clinical Trial
Management of injection pain in children.
Researchers have come to understand a great deal about pain mechanisms, especially in the past 30 years. This understanding has spawned the development of a number of psychological pain control strategies which have been extensively assessed for use with adults. Less is known about pain control strategies in children. ⋯ Age was found to be an important determinant of the success of distraction. Furthermore, age was found to be related to amount of pain reported by children regardless of type of treatment. The results of this study support the use of music distraction in the reduction of injection pain in children.
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Randomized Controlled Trial Comparative Study Clinical Trial
Transcutaneous electrical nerve stimulation versus oral analgesic: a randomized double-blind controlled study in acute traumatic pain.
A double-blind controlled analgesic study was undertaken in outpatients suffering acute traumatic pain. One hundred patients completed the study and were randomly assigned to four treatment groups, each receiving either functioning transcutaneous electrical nerve stimulators (TENS), placebo TENS, acetaminophen with codeine and a functioning TENS, or acetaminophen with codeine and a placebo TENS. ⋯ The TENS was approximately as effective as acetaminophen (300-600 mg) with codeine (30-60 mg) but had no side effects. Transcutaneous electrical nerve stimulators have been shown to be effective in the management of acute traumatic pain and may be indicated for patients who cannot be given medications.
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Randomized Controlled Trial Comparative Study Clinical Trial
Effect of transcutaneous electrical nerve stimulation characteristics on clinical pain.
We compared the effects of four treatment variables on the pain reduction produced by transcutaneous electrical nerve stimulation and attempted to establish indications for TENS based on patient history and pain evaluation items. Treatment variables were the therapist and the three TENS stimulus characteristics--pulse width, frequency, and amplitude. We randomly assigned 192 consecutive adult patients suffering from painful conditions to one of four physical therapists and one of 12 stimulus characteristic combinations. ⋯ The amplitude effect, however, was borderline (p = .056), and subthreshold stimulation proved more effective than stimulation to tolerance (p = .05). Extensive multiple linear regression analyses failed to provide indications for TENS based on patient information and pain evaluation items. Therefore, pain remains the only indication for TENS, and we recommend subthreshold rather than higher amplitude stimulation on the initial TENS trial.
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Scand. J. Gastroenterol. · Dec 1985
Randomized Controlled Trial Clinical TrialCoeliac plexus block versus pancreaticogastrostomy for pain in chronic pancreatitis. A controlled randomized trial.
Seventeen patients with chronic pancreatitis and dilated pancreatic ducts were randomly allocated to coeliac plexus block or pancreaticogastrostomy. The number of patients with pain relief after coeliac plexus block and pancreaticogastrostomy did not differ at discharge. ⋯ Operation decreased pancreatic tissue pressure significantly. This pressure decrease is believed to explain pain relief.