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Comparison of pain models to detect opioid-induced hyperalgesia

Krishnan, S.; Salter, A.; Sullivan, T.; Gentgall, M.; White, J.; Rolan, P.
Fonte: Dove Medical Press Ltd Publicador: Dove Medical Press Ltd
Tipo: Artigo de Revista Científica
Publicado em //2012 EN
Relevância na Pesquisa
36.42%
OBJECTIVE: Chronic opioid therapy may be associated with hyperalgesia. Our objective was to determine if opioid-induced hyperalgesia detection sensitivity is dependent on the stimulus used to detect it. METHODS: This open design study compared the detection of hyperalgesia in opioid-dependent subjects (n = 16) and healthy control subjects (n = 16) using the following pain stimuli: cold pain, electrical stimulation, mechanical pressure, and ischemic pain. The opioid-dependent subjects were maintained on either methadone (n = 8) or buprenorphine (n = 8) for at least 3 months. None of the controls was dependent on opioids or other drugs of abuse. RESULTS: The opioid-dependent subjects were markedly more sensitive than controls to the cold pain test. Compared with the control group, the hazard ratio for ceasing the test due to intolerable pain was 7.7 (95% confidence interval [CI] 2.6–23.3) in the buprenorphine group and 4.5 (95% CI 1.7–15.6) in the methadone group, with similar data for the cold pain threshold. Of the remaining tests, there were differences only for the electrical pain threshold between treatment groups, with the geometric mean threshold in the buprenorphine group being 1.5 (95% CI 1.1–1.9)-fold higher (ie, less sensitive) than that of the controls; the geometric mean for the methadone group was 1.3 (95% CI 1.04–1.7)-fold higher than that of the controls. There were no significant differences between buprenorphine and methadone patients in test responses. Women were more sensitive to the cold pain (hazard ratio for tolerance...

The efficacy of local anaesthetic infiltrated at the incision site for post-operative pain management following abdominal surgery: an application to fast-track surgery.

Krishnan, Sumithra
Fonte: Universidade de Adelaide Publicador: Universidade de Adelaide
Tipo: Tese de Doutorado
Publicado em //2012
Relevância na Pesquisa
36.42%
Post-operative pain is the most commonly encountered and therapeutically difficult problem on a surgical ward. Pain can be a preventable outcome of surgery but its treatment is inadequate for many patients, as 30-70 % of patients continue to suffer from pain post-operatively. Current pharmacological approaches used for pain management consist mainly of opioids, which cause serious adverse effects and may increase patient morbidity and prolong recovery. Therefore, this may be reduced with appropriately delivered local anaesthesia, as a favourable adjuvant. The aim of this study was to test whether a continuous 96 hour infusion of the local anaesthetic, levobupivacaine, using a commercial infiltration device (Painbuster®, IFlow Corp, USA), delivered into the deeper muscle layers where pain fibres penetrate, can minimise or eliminate the need for opioid analgesia following laparoscopic or open abdominal surgery. The novel aspects of the study include the higher dosage of the local anaesthetic, the longer duration of infusion, and the location of the catheter in the deeper tissue layers aimed at maximising response, all as part of a fast-track surgery approach. Patients scheduled for laparoscopic or open abdominal surgery who consented into this randomised double-blinded placebo-controlled trial...

Neuro-endocrine function in older men with chronic pain : effects of chronic opioid usage.

Haylock, Clare Louise
Fonte: Universidade de Adelaide Publicador: Universidade de Adelaide
Tipo: Tese de Doutorado
Publicado em //2013
Relevância na Pesquisa
36.42%
Background: There is increasing concern regarding adverse effects of long-term opioid medication use in non-cancer pain. Chronic opioid use has been shown to affect both the hypothalamic-pituitary-adrenal (HPA) and hypothalamic-pituitary-gonadal (HPG) axes. Hormonal deficiency due to chronic opioid use might contribute to altered pain sensitivity and functional decline. This may be more pronounced in the geriatric population who has poor functional reserve. Methods: A cross sectional study was performed looking at men over the age of 65 years, who have chronic non-malignant pain. Active arm subjects were taking continuous opioid treatment (≥ 4 weeks; dose equivalence ≥ 10mg oral morphine/day); control subjects were not receiving opioid treatment. Assessments included androgen studies (dehdroepiandrosterone sulphate (DHEA-S), testosterone, sex hormone binding globulin (SHBG), follicle stimulating hormone (FSH), luteinizing hormone (LH)), waking salivary cortisol, low dose Synacthen test, neuropsychology testing, experimental cold pressor testing, cortisol testing during cold pressor testing, functional assessments (Instrumental Activities of Daily Living (IADL) Questionnaire, grip strength, and Timed Up and Go), Geriatric Depression Scale (GDS)...

Long-term follow-up in sacroiliac joint pain patients treated with radiofrequency ablative therapy

Romero,Flávio Ramalho; Vital,Roberto Bezerra; Zanini,Marco Antônio; Ducati,Luis Gustavo; Gabarra,Roberto Colichio
Fonte: Academia Brasileira de Neurologia - ABNEURO Publicador: Academia Brasileira de Neurologia - ABNEURO
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2015 EN
Relevância na Pesquisa
36.42%
Sacroiliac joint (SIJ) pain is responsible for up to 40% of all cases of lumbar back pain.Objective Report the long-term efficacy of radiofrequency denervation for sacroiliac joint pain at six, twelve and eighteen months.Method Third-two adults’ patients with sacroiliac join pain diagnosis were included for a prospective study. Primary outcome measure was pain intensity on the Numeric Rating Scale (NRS). Secondary outcome measure was Patient Global Impression of Change Scale (PGIC).Results Short-term pain relief was observed, with the mean NRS pain score decreasing from 7.7 ± 1.8 at baseline to 2.8 ± 1.2 at one month and to 3.1 ± 1.9 at six months post-procedure (p < 0.001). Long-term pain relief was sustained at twelve and eighteen months post-procedure, with NRS pain remaining at 3.4 ± 2.1 and 4.0 ± 2.7, respectively.Conclusion Radiofrequency denervation of the SIJ can significantly reduce pain in selected patients with sacroiliac syndrome.

The relationship between health-related quality of life, pain and coping strategies in juvenile idiopathic arthritis

Sawyer, M.; Whitham, J.; Roberton, D.; Taplin, J.; Varni, J.; Baghurst, P.
Fonte: Oxford Univ Press Publicador: Oxford Univ Press
Tipo: Artigo de Revista Científica
Publicado em //2004 EN
Relevância na Pesquisa
36.42%
OBJECTIVES: To investigate the relationship between health-related quality of life (HRQL), experience of pain and pain coping strategies in children with juvenile idiopathic arthritis (JIA). To compare reports describing these variables obtained from children and their parents. METHODS: Participants were 59 children aged 8 to 18 yr with JIA and their parents. Parents and children completed the PedsQLTM generic core scales and arthritis module, the visual analogue scale of the Varni–Thompson Pediatric Pain Questionnaire, and the Waldron/Varni Pediatric Pain Coping Inventory. Parents rated children's functional disability using the Childhood Health Assessment Questionnaire. RESULTS: Parents reported significantly lower scores (indicating worse HRQL) than children on five of the eight PedsQLTM scales rating children's HRQL. Parents and children reported a significant negative relationship between pain levels and the PedsQLTM scores assessing children's physical, emotional and social functioning. They also reported a significant negative relationship between scores on several pain coping scales and scores on the PedsQLTM scales. However, the pattern of these relationships varied for reports from parents and children. CONCLUSIONS: Pain intensity and pain coping strategies have a significant and independent relationship with several domains that comprise the HRQL of children with JIA. However...

Complementary and alternative therapies for pain management in labour

Smith, C.; Collins, C.; Cyna, A.; Crowther, C.
Fonte: John Wiley & Sons Publicador: John Wiley & Sons
Tipo: Artigo de Revista Científica
Publicado em //2006 EN
Relevância na Pesquisa
36.42%
BACKGROUND: Many women would like to avoid pharmacological or invasive methods of pain management in labour and this may contribute towards the popularity of complementary methods of pain management. This review examined currently available evidence supporting the use of alternative and complementary therapies for pain management in labour. OBJECTIVES: To examine the effects of complementary and alternative therapies for pain management in labour on maternal and perinatal morbidity. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (February 2006), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2006, Issue 1), MEDLINE (1966 to February 2006), EMBASE (1980 to February 2006) and CINAHL (1980 to February 2006). SELECTION CRITERIA: The inclusion criteria included published and unpublished randomised controlled trials comparing complementary and alternative therapies (but not biofeedback) with placebo, no treatment or pharmacological forms of pain management in labour. All women whether primiparous or multiparous, and in spontaneous or induced labour, in the first and second stage of labour were included. DATA COLLECTION AND ANALYSIS: Meta-analysis was performed using relative risks for dichotomous outcomes and mean differences for continuous outcomes. The outcome measures were maternal satisfaction...

The effects of positive or negative words when assessing postoperative pain

Chooi, C.; Nerlekar, R.; Raju, A.; Cyna, A.
Fonte: Australian Soc Anaesthetists Publicador: Australian Soc Anaesthetists
Tipo: Artigo de Revista Científica
Publicado em //2011 EN
Relevância na Pesquisa
36.42%
Negative or harsh words such as 'pain' and 'sting' used to describe sensations prior to potentially painful procedures have been shown to increase pain. We aimed to determine whether the reporting of pain and its severity is affected by the way it is assessed during anaesthesia follow-up after caesarean section. Following caesarean section, 232 women were randomised prior to post-anaesthesia review. Group N participants were asked questions containing the negative word 'pain, "Do you have any pain?" and then asked to rate it on a 0 to 10 point Verbal Numerical Rating Scale. Group P participants were asked questions using more positive words, "How are you feeling?" and "Are you comfortable?". Data are presented as median, interquartile range. In Group N, 63 participants (54.3%) reported pain compared with only 28 participants (24.1%) in Group P (P < 0.001). There were no significant differences between groups for Verbal Numerical Rating Scale at rest: Group N 2 (0 to 3) vs Group P 1 (0 to 4); P = 0.97, or Verbal Numerical Rating Scale with movement, Group N 5 (3 to 6) vs Group P 5 (3 to 6.3); P = 0.90. The assessment of pain after caesarean section, using more positive words, decreases its incidence but does not affect its severity when measured by pain scores. Words that focus the patient on pain during its assessment may lead some to interpret sensations as pain which they might not do otherwise. These findings may have important implications when assessing and researching postoperative pain.; C S L Chooi...

Complementary and alternative therapies for pain management in labour

Smith, C.; Collins, C.; Cyna, A.; Crowther, C.
Fonte: John Wiley & Sons Publicador: John Wiley & Sons
Tipo: Artigo de Revista Científica
Publicado em //2003 EN
Relevância na Pesquisa
36.42%
BACKGROUND: Many women would like to avoid pharmacological or invasive methods of pain management in labour and this may contribute towards the popularity of complementary methods of pain management. This review examined currently available evidence supporting the use of alternative and complementary therapies for pain management in labour. OBJECTIVES: To examine the effectiveness of complementary and alternative therapies for pain management in labour on maternal and perinatal morbidity. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group trials register (July 2002), the Cochrane Controlled Trials Register (The Cochrane Library Issue 2, 2002), MEDLINE (1966 to July 2002), EMBASE (1980 to July 2002) and CINAHL (1980 to July 2002). SELECTION CRITERIA: The inclusion criteria included published and unpublished randomised controlled trials comparing complementary and alternative therapies with placebo, no treatment or pharmacological forms of pain management in labour. All women whether primiparous or multiparous, and in spontaneous or induced labour, in the first and second stage of labour were included. DATA COLLECTION AND ANALYSIS: Meta-analysis was performed using relative risks for dichotomous outcomes and weighted mean differences for continuous outcomes. The outcome measures were maternal satisfaction...

Paracetamol/Acetaminophen (Single Administration) for Perineal Pain in the Early Postpartum Period; Cochrane Database Syst Rev

Chou, D.; Abalos, E.; Gyte, G. M.; Gulmezoglu, A. M.
Fonte: Banco Mundial Publicador: Banco Mundial
Tipo: Journal Article; Journal Article
EN
Relevância na Pesquisa
36.42%
BACKGROUND: Perineal pain is a common but poorly studied adverse outcome following childbirth. Pain may result from perineal trauma due to bruising, spontaneous tears, surgical incisions (episiotomies), or in association with operative births (ventouse or forceps assisted births). OBJECTIVES: To determine the efficacy of a single administration of paracetamol (acetaminophen) systemic drugs used in the relief of acute postpartum perineal pain SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (December 2009). SELECTION CRITERIA: Randomised controlled trials (RCTs) assessing paracetamol (acetaminophen) in a single dose compared with placebo for women with early postpartum perineal pain. We excluded quasi-RCTs and cross-over studies. DATA COLLECTION AND ANALYSIS: Two review authors assessed each paper for inclusion and extracted data. One review author reviewed the decisions and confirmed calculations for pain relief scores. MAIN RESULTS: We have included 10 studies describing two dosages of paracetamol. Of these, five studies (526 women) assessed 500 mg to 650 mg and six studies (841 women) assessed 1000 mg of paracetamol. We chose to use random-effects meta-analyses because of the heterogeneity in dosage used. Studies were from the 1970s to the early 1990s...

The effect of obesity in self-reported disability, knee pain and isokinetic quadriceps strength in knee osteoarthritis

Coriolano, Kamary
Fonte: Quens University Publicador: Quens University
Tipo: Tese de Doutorado
EN; EN
Relevância na Pesquisa
36.42%
Osteoarthritis (OA) of the knee is one of the most common musculoskeletal conditions resulting in disability. The incidence of knee OA increases with age and will likely increase further as the population becomes more obese and less physically active. Therefore, the objectives of this thesis were 1) to observe whether self-reported disability should be obtained before or after performance-based tests, 2) to assess changes in knee pain and observe whether symptoms of depression predict worsening of knee pain, quality of life (QoL) and increased need for surgery and, 3) to examine changes in quadriceps muscle strength and knee pain after isokinetic muscle testing. In the first study, disability was measured using the WOMAC scores. Results indicated that all WOMAC scores were significantly higher after as compared to before the completion of performance-based tests and a physiologic test (VO2Peak). Obese individuals with knee OA were significantly worse compared to non-obese individuals with knee OA on all WOMAC scores. In the second study, the WOMAC pain subscale and VAS pain were significantly higher after as compared to before the completion of performance-based tests. The VAS ratings captured a significant increase in pain in both groups...

CHRONIC PAIN: A COMMUNITY-BASED EXERCISE AND EDUCATION PROGRAM

THURGOOD, MARY
Fonte: Quens University Publicador: Quens University
Tipo: Tese de Doutorado Formato: 1213893 bytes; application/pdf
EN; EN
Relevância na Pesquisa
36.42%
Chronic pain affects approximately 16% to 36% of Canadian adults and is one of the most common reasons for physician visits in Canada. The effects of a self-referral community-based education/exercise program (Y-PEP) on physical function and well-being were initially evaluated in 20 individuals with chronic pain who had attended one of three Y-PEP sessions in 2007. The 10-week program incorporated chronic pain education/self-management and various exercise modalities to allow individuals with chronic pain to try different physical activities in a safe and supported environment. Questionnaires were administered pre-, post-program, and at 10-weeks follow-up and provided data on demographic information, physical activity levels, depression, pain perception, and pain catastrophizing. Maximal activity levels and adjusted activity levels increased 7% and 10% respectively at post-program, but only the adjusted activity levels remained elevated at the 10-week follow-up. No significant changes occurred in any of the other outcome measures, however, the extent to which maximal and daily activity increased was significantly correlated with greater improvements in the extent to which pain interfered with one’s life (r=0.45) and with pain catastrophizing (r=0.45). These latter two improvements were significantly associated with greater decreases in depression score (r=0.50). Overall...

THE RELATIONSHIP BETWEEN PAIN SENSITIVITY AND VASOCONGESTION DUE TO SEXUAL AROUSAL IN WOMEN WITH PROVOKED VESTIBULODYNIA

Boyer, Stéphanie Camille
Fonte: Quens University Publicador: Quens University
Tipo: Tese de Doutorado Formato: 5900788 bytes; application/pdf
EN; EN
Relevância na Pesquisa
36.42%
Women with chronic vulvar pain report reduced sexual function in comparison to non-affected women, including decreased sexual arousal. Experimentally induced sexual arousal has been examined in women with and without chronic vulvar pain, with contradictory results: some studies have found that only subjective arousal is affected in women with versus without vulvar pain, while other research has suggested that only genital responsiveness is affected in women with pain. As a result of these inconsistent findings, the role of arousal mechanisms in the causation and maintenance of provoked vestibulodynia (PVD) remains unclear. Thirty women with (n = 15) and without PVD (n = 15) were recruited to examine the relationship among physiological and subjective arousal, pain sensitivity and psychological/sexual function. Laser Doppler imaging (LDI) directly measured blood flow to the external genitals in response to an erotic film, and pain sensitivity was assessed before and after imaging. The PVD group had significantly lower blood flow than the control group during the erotic film when baseline blood flow levels were controlled; there were, however, no group differences in ratings of subjective arousal during the erotic film. Vestibular pain thresholds were significantly lower in the PVD group before and after the erotic film compared to the control group. In contrast...

The assessment and management of pain in the demented and non-demented elderly patient; Avaliação e manejo da dor em pacientes idosos com e sem demência

ANDRADE, D C; FARIA, J W V; CARAMELLI, P; ALVARENGA, L; GALHARDONI, R; SIQUEIRA, S R D; YENG, L T; TEIXEIRA, M J
Fonte: Academia Brasileira de Neurologia - ABNEURO Publicador: Academia Brasileira de Neurologia - ABNEURO
Tipo: Artigo de Revista Científica
ENG
Relevância na Pesquisa
36.42%
Persistent pain is a frequent health problem in the elderly. Its prevalence ranges from 45% to 80%. Chronic diseases, such as depression, cardiovascular disease, cancer and osteoporosis have a higher prevalence in aged individuals and increase the risk of developing chronic pain. The presence of pain is known to be associated with sleep disorders in these patients, as well as functional impairment, decreased sociability and greater use of the health system, with consequent increase in costs. Alzheimer's disease patients seem to have a normal pain discriminative capacity and they may probably have weaker emotional and affective experience of pain when compared to other types of dementia. Many patients have language deficits and thus cannot properly describe its characteristics. In more advanced cases, it becomes even difficult to determine whether pain is present or not. Therefore, the evaluation of these patients should be performed in a systematic way. There are three ways to measure the presence of pain: by direct questioning (self-report), by direct behavioral observation and by interviews with caregivers or informants. In recent years, many pain scales and questionnaires have been published and validated specifically for the elderly population. Some are specific to patients with cognitive decline...

Avaliação dos efeitos de exercicios de alongamento e uso de faixa suporte em gestantes no 3o. trimestre com lombalgia gestacional; The evaluation of the effects in lenghthening exercises and the use of strip supports in the last gestation quarter with low back pain in the pregnancy

Flavia Silva Novaes
Fonte: Biblioteca Digital da Unicamp Publicador: Biblioteca Digital da Unicamp
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 29/07/2008 PT
Relevância na Pesquisa
36.42%
No presente estudo, de abordagem quase experimental, verificou-se a evolução da dor lombar durante o período de três semanas em gestantes no último trimestre de gestação que faziam pré-natal nos Centros de Saúde (Santa Mônica, Barão Geraldo e Village) na cidade de Campinas/SP. Objetivou identificar a eficácia de duas técnicas distintas: um recebendo exercícios de alongamento e retificação da região lombar e, a outra usando faixa suporte que envolvia o quadril e a parte mais baixa do abdômen. Foi feita uma randomização formando os dois grupos. As participantes responderam um questionário que continha variáveis sobre os aspectos sócio demográficos, obstétricos e relacionadas aos hábitos. A avaliação da evolução da lombalgia gestacional com os dois tratamentos foi realizada por meio de duas escalas de dor (?carinhas? e numérica) e do registro de localização da dor. O tamanho amostral foi de 33 mulheres gestantes (16 no grupo alongamento e 17 no grupo uso de faixa), são predominantemente de baixa renda, maioria primigestas, migrantes de outras regiões do Brasil, baixo grau de instrução e capacitação profissional. Os resultados indicaram que o alívio da dor ocorreu nos dois grupos de forma semelhante. O ganho de peso foi significativo para aparecimento da dor lombar...

Limiar de dor, prevalência de fibromialgia, qualidade de vida e de sono em mulheres com endometriose= : Pain threshold, fibromyalgia prevalence, quality of life and sleep quality in women with endometriosis; Pain threshold, fibromyalgia prevalence, quality of life and sleep quality in women with endometriosis

Fabiana Roberta Nunes
Fonte: Biblioteca Digital da Unicamp Publicador: Biblioteca Digital da Unicamp
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 30/01/2014 PT
Relevância na Pesquisa
36.42%
Introdução: Mulheres com endometriose frequentemente se queixam de dor, que pode interferir na qualidade de vida e de sono. Alguns estudos mostraram maior prevalência de algumas patologias, como fibromialgia, em mulheres com endometriose. Assim, e necessário avaliar as repercussões da endometriose na vida das mulheres. Objetivo: Comparar a prevalência de fibromialgia, o limiar doloroso, a qualidade de vida e do sono em mulheres com e sem endometriose. Métodos: Participaram do estudo 257 mulheres com endometriose, confirmada cirurgicamente e histopatologicamente, e 253 sem historia ou sintomas da doença. As mulheres do grupo com endometriose foram divididas em dois subgrupos, com endometriose grau I-II (n=89), e grau III-IV (n=168), de acordo com os critérios de 1996 da American Society for Reproductive Medicine. As voluntarias responderam aos questionários: Short-form 36 (SF-36) para avaliação da qualidade de vida, Inventario do Sono para avaliar a qualidade de sono e questionário de classificação de fibromialgia de acordo com os critérios de 1990 e 2010 do American College of Rheumatology (ACR). Alem disso, foi avaliada a dor das participantes através da escala visual analógica (EVA) e as mesmas foram submetidas a exame físico para avaliação do limiar de dor em 20 diferentes pontos corporais e a presença de dor nos tender points dos critérios de fibromialgia de 1990. Para a avaliação física foi utilizado um algometro que mensurava a digitopressao realizada pela pesquisadora. O estudo foi aprovado pelo Comitê de Ética em Pesquisa da Universidade de Campinas e todas as mulheres assinaram o termo de consentimento livre e esclarecido. Resultados: Na amostra estudada...

A experiência dos trabalhadores com a dor crônica; The workers experience with chronic pain

Pollyanna Regina Pinto
Fonte: Biblioteca Digital da Unicamp Publicador: Biblioteca Digital da Unicamp
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 24/02/2012 PT
Relevância na Pesquisa
36.42%
As dores crônicas relacionadas ao trabalho (LER/DORT e lombalgias) atingem grande quantidade de trabalhadores do mercado formal e informal, causando dor, sofrimento emocional e limitação da capacidade para a execução de atividades sociais cotidianas, como as de trabalho e de lazer. Essa pesquisa qualitativa teve como objetivos: identificar e analisar a literatura relacionada à dor crônica publicada no sistema Scielo; analisar a experiência de trabalhadores atendidos no Centro de Referência em Saúde do Trabalhador de Campinas (CEREST) com a dor crônica e analisar as experiências desses trabalhadores com os grupos Consciência do Movimento do CEREST, nos quais se utiliza a técnica Klauss Vianna. Além da revisão da literatura, os demais recursos metodológicos incluíram dois estudos de caso com trabalhadores em início de tratamento no CEREST e 16 entrevistas com trabalhadores participantes dos grupos. A revisão da literatura revelou algumas limitações do modelo biomédico na compreensão e cuidado das dores crônicas. Os estudos de caso evidenciaram que as mudanças que vêm ocorrendo no mundo do trabalho, como as terceirizações e a precarização dos contratos de trabalho, têm aumentado a exploração sobre os trabalhadores...

Women's Attachment as a Predictor of Pain During Labour and Post-Delivery: a Prospective Observational Study; Vinculação da Mulher como Preditor da Dor Durante o Parto e Após o Nascimento: um Estudo Observacional Prospectivo

Costa Martins, JM; Fernandes da Silva, C; Pereira, M; Martins, H; Oliveira, C; Puga, A; Coelho, R; Tavares, J
Fonte: Centro Editor e Livreiro da Ordem dos Médicos Publicador: Centro Editor e Livreiro da Ordem dos Médicos
Tipo: Artigo de Revista Científica
Publicado em //2014 ENG
Relevância na Pesquisa
36.42%
INTRODUCTION: Labour is considered to be one of the most painful and significant experiences in a woman's life. The aim of this study was to examine whether women's attachment style is a predictor of the pain experienced throughout labour and post-delivery. MATERIAL AND METHODS:Thirty-two pregnant women were assessed during the third trimester of pregnancy and during labour. Adult attachment was assessed with the Adult Attachment Scale ' Revised. The perceived intensity of labour pain was measured using a visual analogue scale for pain in the early stage of labour, throughout labour and post-delivery. RESULTS:Women with an insecure attachment style reported more pain at 3 cm of cervical dilatation (p < 0.05), before the administration of analgesia (p < 0.01) and post-delivery (p < 0.05) than those securely attached. In multivariate models, attachment style was a significant predictor of labour pain at 3 cm of cervical dilatation and before the first administration of analgesia but not of the perceived pain post-delivery. DISCUSSION: These findings confirm that labour pain is influenced by relevant psychological factors and suggest that a woman's attachment style may be a risk factor for greater pain during labour. CONCLUSION:Future studies in the context of obstetric pain may consider the attachment style as an indicator of individual differences in the pain response during labour. This may have important implications in anaesthesiology and to promote a relevant shift in institutional practices and therapeutic procedures.

The assessment and management of pain in the demented and non-demented elderly patient

Andrade,D C; Faria,J W V; Caramelli,P; Alvarenga,L; Galhardoni,R; Siqueira,S R D; Yeng,L T; Teixeira,M J
Fonte: Academia Brasileira de Neurologia - ABNEURO Publicador: Academia Brasileira de Neurologia - ABNEURO
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2011 EN
Relevância na Pesquisa
36.42%
Persistent pain is a frequent health problem in the elderly. Its prevalence ranges from 45% to 80%. Chronic diseases, such as depression, cardiovascular disease, cancer and osteoporosis have a higher prevalence in aged individuals and increase the risk of developing chronic pain. The presence of pain is known to be associated with sleep disorders in these patients, as well as functional impairment, decreased sociability and greater use of the health system, with consequent increase in costs. Alzheimer's disease patients seem to have a normal pain discriminative capacity and they may probably have weaker emotional and affective experience of pain when compared to other types of dementia. Many patients have language deficits and thus cannot properly describe its characteristics. In more advanced cases, it becomes even difficult to determine whether pain is present or not. Therefore, the evaluation of these patients should be performed in a systematic way. There are three ways to measure the presence of pain: by direct questioning (self-report), by direct behavioral observation and by interviews with caregivers or informants. In recent years, many pain scales and questionnaires have been published and validated specifically for the elderly population. Some are specific to patients with cognitive decline...

Supporting chronic pain management across provincial and territorial health systems in Canada: Findings from two stakeholder dialogues

Wilson, Michael G; Lavis, John N; Ellen, Moriah E
Fonte: Pulsus Group Inc Publicador: Pulsus Group Inc
Tipo: Artigo de Revista Científica
EN_US
Relevância na Pesquisa
36.42%
BACKGROUND: Chronic pain is a serious health problem given its prevalence, associated disability, impact on quality of life and the costs associated with the extensive use of health care services by individuals living with it. OBJECTIVE: To summarize the research evidence and elicit health system policymakers’, stakeholders’ and researchers’ tacit knowledge and views about improving chronic pain management in Canada and engaging provincial and territorial health system decision makers in supporting comprehensive chronic pain management in Canada. METHODS: For these two topics, the global and local research evidence regarding each of the two problems were synthesized in evidence briefs. Three options were generated for addressing each problem, and implementation considerations were assessed. A stakeholder dialogue regarding each topic was convened (with 29 participants in total) and the deliberations were synthesized. RESULTS: To inform the first stakeholder dialogue, the authors found that systematic reviews supported the use of evidence-based tools for strengthening chronic pain management, including patient education, self-management supports, interventions to implement guidelines and multidisciplinary approaches to pain management. While research evidence about patient registries/treatment-monitoring systems is limited...

Patients' satisfaction with the implementation of the concept of pain as the fifth vital sign to control postoperative pain

Iuppen,Lisiane Specht; Sampaio,Fernanda Herbstrith de; Stadñik,Claudio Marcel Berdún
Fonte: Sociedade Brasileira para o Estudo da Dor Publicador: Sociedade Brasileira para o Estudo da Dor
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/03/2011 EN
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36.42%
BACKGROUND AND OBJECTIVES: There is an increasing concern of health institutions with patients' satisfaction. This study aimed at evaluating patients' satisfaction in the postoperative period of a medium-sized hospital in terms of controlling pain and implementing the concept of pain as the fifth vital sign, faced to the importance of the theme and the scarcity of prospective studies on the subject. METHOD: Open randomized clinical trial. Postoperative patients were divided in two groups. In the group with intervention, pain scales were made available to the assisting team and verbally informed when applied. For the group with no intervention, there were no pain scales. Satisfaction measurements were evaluated once a day until, at the utmost, the fifth postoperative day. RESULTS: There has been predominance of females (83.5%) and mean sample age was 36.7 years. Most surgeries were C-sections (57.1%). Patients referred pain in 75.6% of measurements and considered it from moderate to severe in 23% of measurements. As to satisfaction, most (54%) have considered pain control excellent. In comparing groups there has been no significant difference in the level of satisfaction. CONCLUSION: There has been no difference in patients' satisfaction when pain as the fifth vital sign was implemented. The study suggests that several components contribute to patients' satisfaction...