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

Continuous reaction times (CRTs) and subjective assessment of pain intensity (PVAS) and sedation (SVAS) were compared in 14 cancer patients during chronic oral opioid therapy (daily doses of morphine: 130-400 mg) and subsequent stable epidural opioid therapy (daily doses of morphine: 32-240 mg). CRTs were also measured in 20 healthy controls. CRT results were summarized using 10%, 50% and 90% percentiles. On the basis of these values a 'variation index' was calculated (90-10%): 50%, describing the spread of the reaction time values. No statistically significant differences were found in PVAS, SVAS and CRT before and after initiation of epidural opioid administration. Calculation of confidence limits of median differences showed absolutely no tendency towards differences in CRT between the treatments. Only 4 patients experienced both increased pain relief and less sedation on epidural opioids. Comparing CRT percentiles of the cancer patients with the controls, differences were found between the control group and the oral opioid group, the latter being statistically significantly slower in the 90% percentiles (P = 0.018) and variation indexes (P = 0.018). In conclusion, no differences were found between CRT values and VAS scores in cancer patients treated with chronic oral opioids versus epidural opioids. Therefore at this dose level of chronic opioid treatment, the advantage of epidural administration seems questionable.
Pain 1989 Oct
PMID:Pain, sedation and reaction time during long-term treatment of cancer patients with oral and epidural opioids. 281 54

The aim of the study was to investigate the influence of pain, sedation, pain medications and socio-demographics on cognitive functioning in chronic non-malignant pain patients. Chronic non-malignant pain patients (N=91) treated in a multidisciplinary pain centre were compared with age and sex matched healthy volunteers (N=64). Furthermore four subgroups of patients were examined: Group 1 (N=21) received no pain medications, group 2 (N=19) were in long-term oral opioid treatment, group 3 (N=18) were treated with antidepressants and/or anticonvulsants and group 4 (N=33) were treated with a combination of long-term oral opioids and antidepressants and/or anticonvulsants. Assessments comprised pain (PVAS) and sedation (SVAS), Continuous Reaction Time (CRT) testing for sustained attention, Finger Tapping Test (FTT) testing for psychomotor speed, Paced Auditory Serial Addition Task (PASAT) testing for information processing and working memory and Mini Mental State Examination (MMSE). CRT and FTT were impaired in the total patient sample. Treatment with opioids was associated with poorer performance of PASAT. High scores of PVAS and SVAS were associated with poor performance of PASAT and CRT, respectively. MMSE seems to be too insensitive for detecting the milder forms of cognitive impairment found in chronic non-malignant patients.
Eur J Pain 2005 Aug
PMID:Neuropsychological assessment of chronic non-malignant pain patients treated in a multidisciplinary pain centre. 1597 26