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Query: UMLS:C0184567 (acute pain)
 3,962 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The validity of the Cognitive Coping Strategy Inventory (CCSI; Butler et al., 1989) was tested in a prospective fashion. Subjects were randomly assigned to one of three conditions. Some were "matched" to a strategy for which they received a high CCSI score, some were "mismatched" to a strategy for which they received a low CCSI score, and some were given a choice of strategies. Those subjects using a matched strategy obtained better threshold and tolerance times on the cold pressor than subjects who used a mismatched strategy. Despite clear differences in exposure to the cold pressor these conditions did not differ from each other in self-reported levels of pain. It was concluded that the CCSI appears to be a valid and useful tool for selecting a coping strategy to help particular individuals manage acute pain. Though the CCSI is relatively easy to administer and score, the comparative costs and benefits of using it must be weighed against the somewhat more efficient approach of simply offering the subject a choice of treatments. Subjects given a choice of strategies performed as well as subjects matched to a strategy on the basis of CCSI scores.
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PMID:Matching pain coping strategies to the individual: a prospective validation of the cognitive coping strategy inventory. 148 83

The most certain symptomatic manifestation of gallstones is episodic upper abdominal pain. Characteristically, this pain is severe and located in the epigastrium and/or the right upper quadrant. The onset is relatively abrupt and often awakens the patient from sleep. The pain is steady in intensity, may radiate to the upper back, be associated with nausea and lasts for hours to up to a day. Dyspeptic symptoms of indigestion, belching, bloating, abdominal discomfort, heartburn and specific food intolerance are common in persons with gallstones, but are probably unrelated to the stones themselves and frequently persist after surgery. Many, if not most, persons with gallstones have no history of pain attacks. Persons discovered to have gallstones in the absence of typical symptoms appear to have an annual incidence of biliary pain of 2-5% during the initial years of follow-up, with perhaps a declining rate thereafter. Gallstone-related complications occur at a rate of less than 1% annually. Those whose stones are symptomatic at discovery have a more severe course, with approximately 6-10% suffering recurrent symptoms each year and 2% biliary complications. The far higher rates of symptom development reported in a few studies raise the possibility that these incidence estimates may be too low. The best predictors of future biliary pain are a history of pain at the time of diagnosis, female gender and possibly obesity. The risk of acute cholecystitis appears to be greater in those with large solitary stones, that of biliary pancreatitis in those with multiple small stones, and that of gallbladder cancer in those with large stones of any number. Drugs that inhibit the synthesis of prostaglandins may now be the treatment of choice in patients with gallstones who are suffering acute pain attacks. Persistent dyspeptic symptoms occur frequently following cholecystectomy. A prolonged history of such symptoms prior to surgery and evidence of significant psychological distress appear to be the best predictors of unsatisfactory outcome.
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PMID:Symptoms of gallstone disease. 148 6

Acute-pain syndromes are common in the elderly. They often occur in association with the degenerative diseases that are likely to affect this age-group. Diagnosis of the specific type of acute pain is made difficult by several factors, including atypical presentation and underreporting. Treatment can be complicated by the polypharmacy that is prevalent among older adults and by age-related physiologic changes. Effective management requires knowledge of the effects of various pharmacologic agents in older adults and of the health and psychosocial status of the individual patient.
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PMID:Acute pain in the elderly. 150 82

Although the Pain Sensitivity Range (PSR) has been presented as a useful parameter to measure pain in the laboratory, it has not received much attention from pain researchers. The goals of the present investigation were to analyze the reliability and stability of the PSR with the cold pressor test method. Results of our study indicate that useful data can be obtained from this parameter. The PSR is a reliable measure which has not shown any variability due to the cyclic changes in pain perception nor due to the supposedly greater pain sensitivity on the left side of the body. The authors postulate that PSR might be a good measure in laboratory research to evaluate the effectiveness of analgesic therapies, for its resemblance to the acute pain experience.
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PMID:Pain sensitivity range: a useful parameter to measure experimentally induced pain? 151 96

Adequate treatment of pain after surgery is central to the care of postoperative patients. Preventing pain or reducing its impact makes subsequent pain management easier. The establishment of 'acute pain relief services' will improve relief offered. Recent pharmacological, psychological and technical advances in this field are briefly discussed.
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PMID:Postoperative pain--an update. 156 99

Summary recommendations 1-5 and 7 should be implemented in every hospital where operations are performed on inpatients. The Acute Pain Management Guideline Panel recommends that any hospital in which abdominal or thoracic operations are routinely performed offer patients postoperative regional anesthetic, epidural or intrathecal opioids, PCA infusions, and other interventions requiring a similar level of expertise, under the supervision of an acute pain service as described in summary recommendation 6. For pain management to be effective, each hospital must designate who or which department will be responsible for all of the required activities. There are a number of alternative approaches to preventing or relieving postoperative pain, many of which can give good results if attentively applied. The following elements, however, apply to most cases and might serve as a focus for assessing the results of these guidelines: 1. Promise patients attentive analgesic care. Patients should be informed before surgery, orally and in printed format, that effective pain relief is an important part of their treatment, that talking about unrelieved pain is essential, and that health professionals will respond quickly to their reports of pain. It should be made clear to patients and families, however, that the total absence of any postoperative discomfort is normally not a realistic or even a desirable goal. 2. Chart and display assessment of pain and relief. A simple assessment of pain intensity and pain relief should be recorded on the bedside vital sign chart or a similar record that encourages easy, regular review by members of the health care team and is incorporated in the patient's permanent record. The intensity of pain should be assessed and documented at regular intervals (depending on the severity of pain) and with each new report of pain. The degree of pain relief should be determined after each pain management intervention, once a sufficient time has elapsed for the treatment to reach peak effect. A simple, valid measure of intensity and relief should be selected by each clinical unit. For children, age-appropriate measures should be used. 3. Define pain and relief levels to trigger a review. Each institution should identify pain intensity and pain relief levels that will elicit a review of the current pain therapy, documentation of the proposed modifications in treatment, and subsequent review of its efficacy. This process of treatment review and follow-up should include participation by physicians and nurses involved in the patient's care.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Acute pain management: operative or medical procedures and trauma, Part 2. Agency for Health Care Policy and Research. 158 31

Sixty-one successive patients undergoing routine cholecystectomy together with all the registered nursing staff and junior doctors working on the surgical wards in a major teaching hospital were studied by means of questionnaires. These were designed to identify beliefs and attitudes to postoperative analgesia in the hospital. The survey revealed that there is a continuing prevalence among medical and nursing staff of attitudes and practices likely to contribute to poor postoperative analgesia. Patients had low expectations of pain relief and displayed reluctance to request analgesia. Injections were generally effective when given, but dosing intervals were often too long for good analgesia. With this knowledge it has been possible to devise strategies to counteract those attitudes leading to poor analgesia and these have formed the basis of a new Acute Pain Service. It is intended to repeat this survey at 3 yearly intervals in order to monitor progress.
Pain 1992 Mar
PMID:Identification of patient, medical and nursing staff attitudes to postoperative opioid analgesia: stage 1 of a longitudinal study of postoperative analgesia. 159 53

In several diseases chronic pain is associated with long-lasting pathophysiological responses which differ strongly from those observed in acute situations. When persisting, acute pain often results in physical and psychological stress which may in turn aggravate the initial pathological state. In the present work we examined the secretory patterns of pituitary hormones related to acute stress (growth hormone (GH), prolactin (PRL) and beta-endorphin (beta-END)) in rats during the phase of Freund adjuvant-induced arthritis (AIA, a model used for chronic pain studies) when chronic pain is maximum (14 and 21 days, postinoculation (PI)). Using radio-immunoassay hormones were measured in plasma samples taken every 30 min for 7 h in free-moving rats 14 and 21 days after Freund adjuvant or vehicle injection and in control animals. The total amount of GH secretion was higher at 14 and 21 days PI in AIA rats as compared to vehicle-treated and control animals, and the pulsatility of GH secretory pattern was not modified by AIA. PRL and beta-END secretion were not significantly different in arthritic rats as compared to controls. These results show that GH, PRL and beta-END responses induced by acute stress are not observed during the AIA phase when chronic pain is maximum. Thus, in our experimental conditions, beta-END and PRL do not seem to be good plasma markers of chronic pain.(ABSTRACT TRUNCATED AT 250 WORDS)
Pain 1992 Apr
PMID:Chronic pain induces a paradoxical increase in growth hormone secretion without affecting other hormones related to acute stress in the rat. 159 79

Cancer pain represents a high-incidence problem that requires ongoing monitoring and evaluation. The recently published American Pain Society Quality Assurance Standards for Relief of Acute Pain and Cancer Pain provides an excellent basis for developing a quality assurance (QA) program in cancer pain assessment and management. These standards contain five critical areas for monitoring and evaluation related to cancer pain. The purpose of this article is to provide a useful framework for oncology nurses to develop a QA program in cancer pain assessment and management. The Oncology Nursing Society Position Paper on Cancer Pain and the American Nurses Association/Oncology Nursing Society Standards of Oncology Nursing Practice are incorporated into the framework to develop specific monitoring criteria. Practical suggestions are provided for implementing a QA program on cancer pain in a variety of oncology practice settings, using the standards of the American Pain Society.
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PMID:Implementation of the American Pain Society Quality Assurance Standards for Relief of Acute Pain and Cancer Pain in oncology nursing practice. 159 63

Deafferentation pain has been related to abnormal electrical hyperactivity in the neurons of the sensory relays in the central nervous system. This electrical activity resembles the epileptoid pattern observed in experimental epileptoid foci. With the aim of preventing this hyperactivity, rats were given long-term treatment with phenobarbital after sciatic transection and dorsal cervical rhizotomy. Daily intramuscular injections of saline solution or 5 and 10 mg/kg of phenobarbital were administered for 20 days, starting 10 days before surgery. Larger doses of phenobarbital delayed the onset and reduced the severity of autotomy. In a test of acute pain, the effect of intraperitoneal (1-16 mg) and intrathecal (100-500 micrograms) phenobarbital was studied by measuring the "tail-flick" response latency. Intraperitoneal phenobarbital did not modify acute pain, but 500 micrograms of intrathecal phenobarbital increased the threshold of pain. These results indicate that (a) phenobarbital, a drug with anticonvulsant activity, reduces deafferentation behavior in rats, and (b) intrathecal phenobarbital has an antinociceptive action in acute experimental pain.
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PMID:Antinociceptive effects of phenobarbital in "tail-flick" test and deafferentation pain. 161 67


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