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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Children with cancer experience a great deal of anxiety concerning their treatment and invasive tests such as bone marrow aspirations (BMAs) and lumbar punctures (LPs). Responses of pain, fear, and anxiety are well documented and may cause regression, developmental delay, sleeping and eating problems, nausea and vomiting, nightmares, and depression. Diagnostic and treatment procedures need not cause such adverse effects if sufficient pharmacological sedation, analgesia, and anesthesia are used. However, studies show that inappropriate interventions such as underdosing and limited use of medications occur because of certain myths, beliefs, and lack of pharmacological knowledge on the part of health professionals. Studies that specifically address premedication for painful procedures in children with cancer have shown that only a small percentage of children receive premedications and that there is no clear consensus or standard for either drugs or dosages. The issue of premedicating children before procedures remains controversial and deserves further investigation. This study explored the attitudes and perceptions of oncology physicians and nurses concerning medicating children before procedures. Findings showed that most pediatric oncology specialists medicate their patients before invasive procedures and that the most common premedications used are Versed; Demerol, Phenergan, Thorazine; chloral hydrate; Ativan; fentanyl; Demerol; and Xylocaine. Most pediatric oncology specialists believe that premedication is necessary for children for BMAs and LPs.
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PMID:Premedicating children for painful invasive procedures. 149 58

The cause of postanesthesia shaking (PS) is unknown. PS develops spontaneously and unpredictably in up to 67% of patients emerging from general anesthesia, and it continues for minutes to hours when not treated with medications or radiant heat lamps. The purposes of this study were to (1) examine whether butorphanol tartrate (Stadol; Anaquest, Madison, WI/Bristol-Meyers Squibb, Evansville, IN), meperidine (Demerol; Winthrop, NY, NY), and morphine are differentially effective in suppressing PS, (2) compare PS suppression by sex, and (3) determine time to PS development. PS, measured on a 0 to 3 visual scale, developed in 120 of 533 patients (23%). Medication treatment was initiated for 66 of 120 patients by PACU nurses following standard policies and procedures for intravenous doses of 1 mg butorphanol (n = 12), 15 to 30 mg meperidine (n = 18; n = 23), or 2 to 4 mg morphine (n = 13). Treatment effect was measured in units on a 0 to 2 visual scale. By t test, butorphanol is more effective within 2 minutes than meperidine for suppressing shaking alone (P less than .02) or shaking among patients also complaining of pain (P less than .02). Morphine does not relieve shaking. The chi 2 test indicates women suppress PS more rapidly than men (P less than .01), and PS develops within 5 minutes of PACU arrival (P less than .001). Findings suggest that butorphanol is an alternative PS treatment to meperidine, since it relieves shaking within 2 to 5 minutes without producing nausea, vomiting, or recurrence of shaking.
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PMID:Butorphanol tartrate (Stadol) relieves postanesthesia shaking more effectively than meperidine (Demerol) or morphine. 157

Previous studies have shown that electroanalgesia is an effective method of reducing postoperative pain in patients who have urologic surgery. All prior studies of postperative transcutaneous electrical nerve stimulation (TENS) have employed TENS stimulators which were designed for the control of chronic pain. Disadvantages to the use of standard TENS stimulators in postoperative patients include the high cost of the devices and their operative complexity which make it difficult for staff and patients to use them. FasTENS is a lightweight, relatively inexpensive disposable TENS stimulator which has been designed specifically for use in postoperative patients. We evaluated the effectiveness of FasTENS in patients who had implantation of an inflatable penile prosthesis, radical retropubic prostatectomy, or radical nephrectomy. Patients treated with FasTENS used 60 percent less pain medication (P less than 0.001) and made 61 percent fewer requests for Demerol injections (P less than 0.001) than did control patients who were not treated with postoperative electroanalgesia. FasTENS was most effective in patients who had radical prostatectomy or penile prosthetic surgery. FasTENS was not cost-effective or practical in patients who had radical nephrectomy.
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PMID:Clinical evaluation of FasTENS, an inexpensive, disposable transcutaneous electrical nerve stimulator designed specifically for postoperative electroanalgesia. 249 33

This prospective study assessed 54 consecutive arthroscopically assisted ACL reconstructions for the amount of postoperative pain relief provided by cold therapy, using the Hot/Ice Thermal Blanket. Twenty-six randomly selected patients undergoing this procedure were compared to a control group consisting of 28 patients having the identical procedure in which the Hot/Ice unit was not used postoperatively. The initial ACL injury in both groups was sports related with the exception of three patients whose injury occurred while on the job. The Hot/Ice Thermal Blanket consists of two rubber pads (blankets) connected by a hose to the main cooling unit. The pads were applied to either side of the operated knee in the operative suite. The pads received fluid which was circulated from the main unit. The temperature of the fluid was set at 50 degrees in the recovery room and the unit was run continuously until the time of discharge, which was approximately 4 days. Hot/Ice patients required 53% less injectable Demerol and 67% less oral Vistaril than patients in the control group. Hot/Ice patients had made the conversion from injectable to oral pain medication an average of 1.2 days sooner than did their non-Hot/Ice counterparts. There was no appreciable difference in length of hospital stay. Physical therapy and nursing records documented a greater percentage of compliant patients in the Hot/Ice group. According to these records the Hot/Ice patients were more helpful in self-assistance, were out of bed and ambulating in the halls more quickly, and did their range of motion exercises with greater ease.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The effects of cold therapy in the postoperative management of pain in patients undergoing anterior cruciate ligament reconstruction. 272 84

Using an analogued labor pain procedure, the efficacy of combinations of five cognitive and one pharmacologic approach to pain management was examined. Nulliparous undergraduates (N = 120) were randomly assigned to 1 of 12 groups. Cognitive groups included: systematic desensitization (SYS DENS); sensory description (SEN DESC); sensory transformation (ST); modeling (M); and relaxation (R); combined groups: SYS DENS, SEN DESC, and ST; SEN DESC, ST, and R; SEN DESC, R, ST, and Demerol. Pharmacologic groups included expected Demerol, did not expect Demerol, placebo, and no treatment control. Subjects assigned to a cognitive group received two 1-hour training sessions 1 week apart. Remaining subjects were given the assigned pharmacologic treatment one-half hour prior to the exposure to the painful stimulus. Assessment of the cognitive and pharmacologic approaches were made in a 1-hour session involving twenty 80-second exposures to a laboratory pain stimulus patterned to resemble labor contractions. Dependent variables included self-reported pain, blood pressure, frontalis electromyograph, heart rate, and respiratory rate. Significant treatment by trials and treatment effects were found for self-reported pain. No other effects achieved statistical significance.
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PMID:Effects of cognitive and pharmacologic strategies on analogued labor pain. 287 39

Transcutaneous electrical nerve stimulation (TENS) was employed to reduce postoperative pain in 40 patients who had either radical nephrectomy, radical prostatectomy, or implantation of an inflatable penile prosthesis. These patients used 68 per cent less pain medication and made 84 per cent fewer requests for meperidine hydrochloride (Demerol) injections than did 40 control patients who had similar surgical procedures. The TENS units were easy to use, and there were no complications to electroanalgesia. The TENS program also was costeffective. TENS provided a simple, safe method of reducing postoperative pain in the three surgical procedures tested. Electroanalgesia may have application in other types of urologic surgery, and TENS should be particularly useful in patients who have outpatient surgery.
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PMID:Electroanalgesia in urologic surgery. 349 62

This study provides a comparison of two clinical regimens for controlling pain in children for the first 48 h after orthopedic surgery: oral morphine, every 4 h, and injected meperidine (Demerol), every 3-4 h pro re nata. Using Visual Analogue Scale, 25 children between the ages of 7 and 17 years of age, who were randomly divided into two groups, rated the severity of their pain every 1-3 h from 8 a.m. to 8 p.m. Each child's parents and attending nurse also rated the child's pain. The morphine group had a significantly higher number of pain-free children on both day 1 and day 2.
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PMID:Oral morphine versus injected meperidine (Demerol) for pain relief in children after orthopedic surgery. 379 16

Although the hazards of using Demerol for pain management is well documented, physicians at a 350-bed tertiary-care center in the upper midwest continued to follow the antiquated practice of ordering intramuscular Demerol and Vistaril to manage pain for patients with acute pancreatitis. Their reasoning was based on early evidence that Demerol, unlike morphine, does not cause biliary-tract spasms resulting in epigastric or right upper quadrant pain. In an effort to change practice patterns, a multidisciplinary team was formed to study the efficacy of using Transdermal Therapeutic System (TTS) fentanyl to manage pain in this patient population. Thirty-two subjects were enrolled in a double-blind, placebo-controlled study to evaluate the efficacy of using TTS fentanyl with intramuscular Demerol for breakthrough pain in comparison to using a placebo system and intramuscular Demerol. There was no statistically significant difference in self-reported pain intensity between the control and experimental groups on the first day of hospitalization. This finding would be expected because serum fentanyl concentrations rise gradually during the first 12 to 14 hours after application of the TTS fentanyl and plateau at 24 hours. There was a statistically significant difference between groups at 36 hours (exact p <.0154) and 45 hours (exact p <.0132) after application of the TTS fentanyl. This is probably because of greater serum fentanyl concentrations observed during the 36- to 48-hour period after application of TTS fentanyl. Although not statistically significant, trends in the data revealed that the experimental group had lower self-reported pain intensity scores than the control group throughout the course of hospitalization. Even though the experimental group had significantly more previous hospitalizations for acute pancreatitis and a higher pain intensity score on admission, this group had a significantly shorter length of stay in the hospital c2 (1, N = 31) = 4.3706 p <.05. There was no statistically significant difference between the two groups for self-reported satisfaction with pain management.
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PMID:Transdermal fentanyl for the management of acute pancreatitis pain. 1199 27

Relief of pain and safety of mother and child are fundamentals in obstetrical analgesia. Elimination of those drugs which are ineffective or dangerous is the best guide to proper medication. Morphine, codeine, or similar opium derivatives should be avoided as they depress fetal respiration. Barbiturates have the same fault, despite their popularity. Demerol in small dosage is safe and effective. Scopolamine yields excellent results with safety. Magnesium sulfate potentiates and reinforces the action of scopolamine and involves no danger. This combination of drugs may be used by any competent general practitioner in the home or hospital.
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PMID:An evaluation of obstetrical analgesia. 1312 11

Musculoskeletal injuries secondary to seizures are well documented and have a variable incidence. Meperidine (Demerol [Abbott, Abbott Park, IL]) has been used for many years in the postoperative setting for pain control; however, in high doses, it has been associated with seizure. We report the case of patient who experienced a tonic-clonic seizure 5 days after hip revision surgery, resulting in dissociation of the socket from the acetabulum with an associated acetabular fracture. In this patient, meperidine administered for patient-controlled analgesia within recommended range caused the seizure.
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PMID:Meperidine-induced seizure after revision hip arthroplasty. 1580 67


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