ISSN:0749-8047    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Despite advances in the understanding of pain mechanisms and innovative strategies to assess pain patients, there continues to be a substantial proportion of patients who do not appear to benefit from treatment interventions available. One possible explanation for these results is the tendency to treat chronic pain patients as a homogeneous group with generic treatments—adherence to “patient and treatment uniformity myths.” Following from the traditional medical model, several attempts have been made to identify specific subgroups of patients exclusively on the basis of physical factors. In addition, a number of studies have attempted to empirically identify subgroups of pain patients using standard psychiatric assessment instruments (e.g.. MMPI, SCL-90) and. recently, cognitive measures and measures of pain behaviors. These different approaches and the assessment instruments used are reviewed, and the limitations are described. Alternative strategies to classify subgroups of pain patients based on combinations of physical, psychosocial, and behavioral measures (i.e.. multiaxial strategies) are presented. The efforts to classify homogeneous subgroups of chronic pain patients are reviewed, and the potential utility of customizing therapeutic interventions to patient characteristics is discussed.

ISSN:0749-8047    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

This study examined profiles of self-reported depressive symptoms in chronic pain patients (n - 51), family practice outpatients (n - 52), and controls (n - 53) who were receiving neither psychological nor medical treatment and were pain free. Subjects in the three groups were matched for age and sex. The short form of the Multiscore Depression Inventory (SMDI) was used. Chronic pain and family practice groups had similar SMDI profiles, with significant elevations on Low Energy. Pessimism. Sad Mood, and Low Self-Esteem subscales compared with controls. Although both groups of medical patients were depressed compared with control subjects, their SMDI profiles were different from those previously reported for psychiatric inpatients with a diagnosis of depression.

ISSN:0749-8047    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Forty-six pain clinic patients (British) were compared with 143 nonclinical subjects (Canadian) on a variety of demographic and illness variables. A subset of 43 nonclinical subjects was further compared with the 46 pain clinic patients for depression and illness behaviour. Both groups were well matched for age, sex, and marital status. The nonclinical group was better educated and had higher incomes. The nonclinical group was significantly more socially active. Low back pain, joint pain, and head and chest pain were commonly reported by both groups. Nearly 75% of subjects in both groups were aware of the diagnosis for their pain condition. On Beck Depression Inventory both groups scored in the nondepressed range. On the Illness Behaviour Questionnaire the pain clinic group scored significantly higher on disease conviction. somatization, and denial than did the nonclinical sample.

ISSN:0749-8047    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

We studied 31 patients with acute herpes zoster (AHZ) 28 days' duration. Clinical characteristics (pain, allodynia. course of disease) and somatosensory perception thresholds (thermal discrimination, hot pain, and vibration) of the affected dermatome and the contralateral homologous area were assessed. Touch-evoked allodynia was found in 17 (55%) and dysesthesia in a further 5 (16%). Thermal and vibration perception thresholds demonstrated significant elevations when compared to the contralateral side. Thermal threshold abnormalities were significantly associated with the prevalence of postherpetic neuralgia (PHN) at 3 months. The effect of nerve blockade was less favorable on allodynia than spontaneous pain. The results of possible pathophysiological mechanisms are discussed.

ISSN:0749-8047    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

From 1984 to 1989. 112 patients with typical drug-refractory trigeminal neuralgia were treated by retrogasserian glycerol injection. The present study assesses results and complications after a mean follow-up period of 3.5 years (range 0.1–5.5 years). One hundred and three of 112 patients (91.9%) showed complete pain relief 1 month postoperatively, and at the end of follow-up 80 patients (71.4%) were still enjoying complete pain relief (recurrence rate 20.5%). Abnormal facial sensations were noted in 49 patients, the most common complication being mild hypoesthesia (32% of patients), while paresthesia occurred in 19% of cases and dysesthesia in 3%. The corneal reflex was absent in 3% of patients and reduced in 5%. None of the patients developed anesthesia dolorosa, permanent masseter weakness, neuroparalytic keratitis, or diplopia.

ISSN:0749-8047    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Patients (n - 120) undergoing major orthopedic (e.g.. total hip replacement). urologic (e.g.. radical prostatectomy), or gynecologic (e.g.. total abdominal hysterectomy) procedures were randomly assigned to receive either morphine or oxymorphone postoperatively using a patient-controlled analgesic (PCA) delivery system. The opioid analgesic was administered either intravenously (IV-PCA) or subcutaneously (SQ-PCA) during the 72-h study period. Oxymorphone. 0.6? /Mp 0.42 mg/h (0–24 h). 0.53 /Mp 0.35 mg/h (24–48 h),'and 0.42 /Mp 0.31 mg/h (48–72 h), was as effective as morphine. 2.2 /Mp 1.6 mg/h (0–24 h), 1.6 /Mp 1.2 mg/h (24–48 h), and 1.2 /Mp 1.1 mg/h (48–72 h), in providing postoperative pain relief (mean values /Mp SD). Although the average opioid dosage requirements were 10 to 28/X% higher with SQ-PCA. it is an acceptable alternative to conventional IV-PCA for pain control after major surgical procedures. Postoperative analgesia scores and patient satisfaction were similar in all four PCA treatment groups. Thus. SQ-PCA with either o.xymorphone or morphine represents a clinically acceptable alternative to IV-PCA in the treatment of postoperative pain.

ISSN:0749-8047    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Those in professions treating pain must prepare to justify the cost-effectiveness of the treatments they supply. Attempts have been made to define cost-effectiveness. Is it the lowest possible cost? The return of the patient to work and other daily activities? Pain clinics must develop good working relationships with business providers; establish credibility: plan, communicate, evaluate results scientifically; and educate the public.

ISSN:0749-8047    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

A review of Social Security Disability Income (SSDI), listed impairments (Section 1.05) for axial pain, the application process, appeals process, and the importance and impact of the treating physician's role in Social Security disability determination is discussed. The authors summarize the major types of disability programs and the present impairment rating systems, and present recent research in the complicated area of chronic pain and illness behavior that may alter the present system. They give recommendations that may aid the treating physician to prepare the patient's application for Social Security Disability Income.

ISSN:0749-8047    

出版商:OVID    

年代:1990

数据来源: OVID

ISSN:0749-8047    

出版商:OVID    

年代:1990

数据来源: OVID