Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0184567 (acute pain)
 3,962 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Subhypnotic doses of thiopentone are considered to have a hyperalgesic effect, while propofol has a hypoalgesic effect. We investigated the effect of these drugs on the nociceptive system by measuring the pain threshold to laser stimulation and the pain evoked potential (power and latency). Nineteen patients (ASA group I) participated. Twelve patients received thiopentone 0.5 mg kg-1 and propofol 0.25 mg kg-1 in random order separated by an interval of 14 h, and seven patients received saline. Immediately after the injection of both agents, the pain threshold was increased significantly (P less than 0.001) and the amplitude of the evoked potential was reduced significantly (P less than 0.05), while the latency of the evoked potential remained constant. It is concluded that, in subhypnotic doses, both thiopentone and propofol decrease the acute pain evoked by argon laser stimulation.
 ...
PMID:Subhypnotic doses of thiopentone and propofol cause analgesia to experimentally induced acute pain. 188 13

A fundamental challenge in the medical community is to manage postoperative/acute pain both effectively and adequately. The stress response cycle must be incorporated and adverse physiological effects, resulting complications, and prolonged hospital stays must be documented. The inadequacies of traditional method of pain management are compared with new technology using patient-controlled analgesia and epidural opioids. Setting up an acute pain service and training, and certification of the nurses, who are managed by the Anesthesia Department, are described. This type of program is best coordinated by the PACU. The value of marketing this service to physicians and the community will reap immeasurable rewards.
 ...
PMID:Acute pain service in a community hospital. 183 31

A cross-sectional evaluation of 117 people who sustained acute back injuries was undertaken within 15 days of the first report of the pain. The subjects showed no discal or neural signs and had not experienced previous episodes of back or neck pain. All subjects were given a structured interview and filled in a series of psychological evaluation instruments. Results show acute pain reactions to be comparable to those seen in chronic pain groups. The predominant emotion is one of frustration rather than anxiety or depression and considerable behavioural disruption is evident from this early point. The extent to which these data undermine the model of gradual evolution of chronic back pain problems is discussed.
 ...
PMID:Acute back pain: a psychological analysis. 183 35

Based on accumulating evidence, an important shift in the nonsurgical treatment paradigm for low back pain is underway. This shift is away from prolonged rest and passive therapy toward earlier patient activation and greater use of exercise therapy. The patient's best interest is often served by encouraging an early return to work and by avoiding adversarial legal proceedings. Patients should be reassured about the good prognosis of acute pain, and the alarming terminology of "injury" or "ruptured disc" should be avoided. Intervention to avoid sedentariness, smoking, and obesity probably offers important therapeutic and preventive opportunities. When surgery is indicated, the patient should have a major role in decision making after being provided an accurate view of risks and benefits of surgical intervention. Surgery should generally be reserved for those cases for which a benefit of surgery has been clearly established, avoiding the liberalization of indications to include imaging findings alone, persistent pain alone, or the failure of other treatments in the absence of clear surgical indications.
 ...
PMID:Nonsurgical care of low back pain. 184 Mar 91

Cost of treatment of pain in 1687 hospital and 400 ambulatory cancer patients was calculated. The average cost of medication for acute pain in a hospital was 1.41 roubles per conventional patient whereas for chronic pain in a polyclinic--4.31 roubles. The overall expenses were 82.55 and 18.81 roubles per conventional patient, respectively. Those expenses were formed by the cost of drugs (1.71% and 22.91%, respectively), salary (deductions included) for medical (36.92% and 61.24%) and other staff (37% and 5.8%), wear and tear (0.61% and 0.21%) and running costs (23.76% and 8.84%, respectively).
 ...
PMID:[Economic aspects of the treatment of acute and chronic pain syndromes in cancer patients in hospitals and outpatient clinics]. 184 41

Cutaneous stimulation has had a long history as a method of pain control. While there is general agreement that modern techniques such as electrical stimulation and massage often provide relief from acute pain and may in some cases significantly affect chronic pain, the mechanism by which these techniques affect pain remains unclear. Significant attention has been focused on the effects of stimulation on the autonomic nervous system (ANS) along with the increasing evidence of important ANS modulation of nociceptive activity throughout the pain pathway. However, inconsistent results on the presence and direction of ANS changes from cutaneous stimulation characterize the recent literature. The present study investigated a nonelectrical cutaneous stimulation device, the Dermapoints Massageroller, as well as an active placebo massage. The results indicate that the Dermapoints Massageroller has both general effects associated with simple skin stimulation (such as increased skin temperature), as well as specific effects from increased stimulation by the toothed design of the roller. These specific effects include decreased muscle tension (at least for some muscle sites) and increased sympathetic activation. The results are consistent with a model of activation of Pacinian receptors as a possible mechanism for the antinociceptive properties of cutaneous stimulation.
 ...
PMID:Autonomic and skeletal muscle responses to nonelectrical cutaneous stimulation. 185 67

Patient controlled analgesia (PCA) is a drug delivery system aimed to control acute pain using negative feedback technology in a closed loop system in which the patient plays an active role. It overcomes the inadequacies of traditional analgesic protocols due to marked differences in pharmacokinetic and dynamy of analgesis between patients. Moreover, doctors and nurses frequently underprescribe opioids in patients with severe pain for fear of dangerous side-effects. A safe and effective delivery of these drugs on patient demand can be achieved using various delivery systems, modes and dosing parameters. Most devices provide both demand dosing, where a constant predetermined dose is self administered, and constant rate infusion plus demand dosing, where the minimum administration rate is determined by the doctor, but can be supplemented by patient demand. Morphine sulphate remains the drug most commonly used in PCA therapy, but meperidine hydrochloride, alfentanil, nalbuphine and buprenorphine are also sometimes administered. The doctor determines the incremental dose per demand, the lockout interval, and the maximum dose per time unit, possibly also the loading dose and the minimum dose rate when a continuous flow is used. PCA provides improved analgesia, which is immediate and independent of nurse availability. This technique decreases opioid requirements, and the required total amounts are lowered. PCA gives patients both behavioural and decisional control. They can titrate the analgesic dose in such a way as to balance pain relief with the degree of side-effects, the patient is willing to tolerate. Patients often choose less than the available total dose of analgesic. The risks consists in the usual opioid side-effects, mainly respiratory depression. These may be due to mechanical problems, machine failure, or user incidents (misprogramming, or miscalculation of doses). Standards help to ensure consistent care and avoid errors that can occur even with handwritten orders. The principles of demand analgesia are now being investigated using other agents, such as local anaesthetics, and other routes of administration, mainly epidural injection. In most patients, even in children, PCA can replace intramuscular injections, which are the standard route for opioid administration. Today PCA and spinal opioids are the two main methods of analgesia for postoperative pain management.
 ...
PMID:[Patient-controlled analgesia]. 185 55

Acute and chronic pain are different clinical entities. Acute pain is provoked by a specific disease or injury, serves a useful biologic purpose, is associated with skeletal muscle spasm and sympathetic nervous system activation, and is self-limited. Chronic pain, in contrast, may be considered a disease state. It is pain that outlasts the normal time of healing, if associated with a disease or injury. Chronic pain may arise from psychological states, serves no biologic purpose, and has no recognizable end-point. Both acute and chronic pain are an enormous problem in the United States, costing 650 million lost workdays and $65 billion a year. The therapy of acute pain is aimed at treating the underlying cause and interrupting the nociceptive signals. The therapy of chronic pain must rely on a multidisciplinary approach and should involve more than one therapeutic modality.
 ...
PMID:The difference between acute and chronic pain. 187 58

The use of epidural morphine for postoperative analgesia outside of intensive care units remains controversial. In this report our anesthesiology-based acute pain service documents experience with 1,106 consecutive postoperative patients treated with epidural morphine on regular surgical wards. This experience involved 4,343 total patient days of care and 11,089 individual epidural morphine injections. On a 0-10 verbal analog scale, patient-reported median pain scores at rest and with coughing or ambulation were 1 (inter-quartile range 3) and 4 (interquartile range 4), respectively. The incidence of side effects requiring medication were as follows: pruritus 24%, nausea 29%, and respiratory depression 0.2%. There were no deaths, neurologic injuries, or infections associated with the technique. Migration of epidural catheters into the subarachnoid space and into epidural veins each occurred twice. Overall, 1,051 of the 1,106 patients (95%) experienced none of the following problems: catheter obstruction, premature dislodgement, painful injections, catheter migration, infection, or respiratory depression. We conclude that postoperative pain can be safely and effectively treated with epidural morphine on surgical wards.
 ...
PMID:Postoperative epidural morphine is safe on surgical wards. 172 29

Based upon a tripartite theoretical model of pain, the Pain Rating Index (PRI) of the McGill Pain Questionnaire (MPQ) continues to be one of the most frequently used instruments to measure clinical pain. Although a number of exploratory factor analytic studies have failed to consistently support the theoretical structure of the instrument, one previous confirmatory factor analytic study of chronic pain did statistically support the a priori model. Because it has been suggested that acute pain may not involve the same dimensions as chronic pain, this study provided a direct test of the theoretical structure of the MPQ through multi-sample confirmatory factor analysis (CFA) using data provided by women experiencing pain during labor (n = 185) and women experiencing acute postoperative pain (n = 192). Results of the LISREL CFA analysis indicated that the a priori, 3-factor, oblique model originally proposed by Melzack provided the most parsimonious representation of the data across the 2 samples of acute pain.
Pain 1991 Jul
PMID:Confirming the theoretical structure of the McGill Pain Questionnaire in acute clinical pain. 189 8


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>