Change In Pain Scores (change + in_pain_score)

Distribution by Scientific Domains


Selected Abstracts


Ibuprofen Provides Analgesia Equivalent to Acetaminophen,Codeine in the Treatment of Acute Pain in Children with Extremity Injuries: A Randomized Clinical Trial

ACADEMIC EMERGENCY MEDICINE, Issue 8 2009
Janet H. Friday MD
Abstract Objectives:, This study compared the analgesic effectiveness of acetaminophen,codeine with that of ibuprofen for children with acute traumatic extremity pain, with the hypothesis that the two medications would demonstrate equivalent reduction in pain scores in an emergency department (ED) setting. Methods:, This was a randomized, double-blinded equivalence trial. Pediatric ED patients 5 to 17 years of age with acute traumatic extremity pain received acetaminophen,codeine (1 mg/kg as codeine, maximum 60 mg) or ibuprofen (10 mg/kg, maximum 400 mg). The patients provided Color Analog Scale (CAS) pain scores at baseline and at 20, 40, and 60 minutes after medication administration. The primary outcome measured was the difference in changes in pain score at 40 minutes, compared to a previously described minimal clinically significant change in pain score of 2 cm. The difference was defined as (change in ibuprofen CAS score from baseline) , (change in acetaminophen,codeine CAS score from baseline); negative values thus favor the ibuprofen group. Additional outcomes included need for rescue medication and adverse effects. Results:, The 32 acetaminophen,codeine and the 34 ibuprofen recipients in our convenience sample had indistinguishable pain scores at baseline. The intergroup differences in pain score change at 20 minutes (,0.6, 95% confidence interval [CI] = ,1.5 to 0.3), 40 minutes (,0.4, 95% CI = ,1.4 to 0.6), and 60 minutes (0.2, 95% CI = ,0.8 to 1.2) were all less than 2 cm. Adverse effects were minimal: vomiting (one patient after acetaminophen,codeine), nausea (one patient after ibuprofen), and pruritus (one after acetaminophen,codeine). The three patients in each group who received rescue medications all had radiographically demonstrated fractures or dislocations. Conclusions:, This study found similar performance of acetaminophen,codeine and ibuprofen in analgesic effectiveness among ED patients aged 5,17 years with acute traumatic extremity pain. Both drugs provided measurable analgesia. Patients tolerated them well, with few treatment failures and minimal adverse effects. [source]


Extracorporeal shock wave therapy for lateral epicondylitis,a double blind randomized controlled trial

JOURNAL OF ORTHOPAEDIC RESEARCH, Issue 5 2002
C. A. Speed
Abstract Extracorporeal shock wave therapy (ESWT) is an increasingly popular therapeutic approach to the treatment of a number of soft tissue complaints. Whilst benefit has been demonstrated in calcific tendinitis, evidence is lacking for benefit in the management of non-calcific rotator cuff disorders. Aims: To perform a double-blind placebo controlled trial of moderate dose ESWT in chronic lateral epicondylitis. Methods: Adults with lateral epicondylitis were randomised to receive either active treatment (1500 pulses ESWT at 0.12 mJ/mm2) or sham therapy, monthly for three months. All were assessed before each treatment and one month after completion of therapy. Outcome measures consisted of visual analogue scores for pain in the day and at night. Results: Seventy-five subjects participated and there were no significant differences between the two groups at baseline. The mean duration of symptoms was 15.9 and 12 months in the ESWT and sham groups, respectively. Both groups showed significant improvements from two months. No significant difference existed between the groups with respect to the degrees of change in pain scores over the study period. In the ESWT group the mean (SD, range) pain score was 73.4 (14.5, 38,99) at baseline and 47.9 (31.4, 3,100) at three months. In the sham group the mean (SD, range) pain score was 67.2 (21.7, 12,100) at baseline and 51.5 (32.5, 3,100) at three months. At three months, 50% improvement from baseline was noted in 35% of the ESWT group and 34% of the sham group with respect to pain. Conclusions: There appears to be a significant placebo effect of moderate dose ESWT in subjects with lateral epicondylitis but there is no evidence of added benefit of treatment when compared to sham therapy. 2002 Orthopaedic Research Society. Published by Elsevier Science Ltd. All rights reserved. [source]


Randomized Double-blind Placebo Controlled Crossover Study of Acetaminophen, Ibuprofen, Acetaminophen/Hydrocodone, and Placebo for the Relief of Pain From a Standard Painful Stimulus

ACADEMIC EMERGENCY MEDICINE, Issue 9 2009
James R. Miner MD
Abstract Objectives:, The objective was to compare subjects' change in perceived acute pain from an identical painful stimulus after receiving three separate, commonly used pain medications and placebo. Methods:, This was an institutional review board,approved, randomized, double-blind crossover study of healthy human volunteers. Subjects received 1000 mg of acetaminophen, 800 mg of ibuprofen, the combination of 650 mg of acetaminophen with 10 mg of hydrocodone, or placebo (800 mg of lactose) in a randomized order over four separate occasions each 1 week apart. Prior to receiving the drug on each study day, subjects placed their nondominant hand in a bath of 0C water for 45 seconds. The bath was divided into two sections; the larger was the reservoir of cooled water monitored at 0C, and the other half was filled from constant overflow. Water drained from the overflow section into the cooling unit and was then pumped up into the base of the reservoir through a diffusion grid. Subjects completed a 100-mm visual analog scale (VAS) representing perceived pain during the exposure. The cold water exposure and VAS were repeated 1 hour after receiving the study drug, and then subjects were observed for side effects for 4 hours. Data were compared using descriptive statistics, 95% confidence intervals (CIs), and repeated-measures analysis of variance (ANOVA). Results:, Twenty-five subjects were enrolled. The mean VAS preexposure was 56.9 mm (15.1 mm; range = 5 to 92 mm). The mean decrease in VAS after receiving the study drug for acetaminophen was 10.2% (95% CI = ,1.4 to 20.4), for ibuprofen was ,6.6% (95% CI = ,16.5 to 3.20), for acetaminophen/hydrocodone was 9.5% (95% CI = 1.4 to 20.4), and for placebo was ,6.9% (95% CI = ,15.2 to 1.4). The range in change in pain scores for all agents was ,91.3% to 57.6%. Mild side effects (nausea, dizziness, or somnolence) were reported in 11 subjects (44%) after receiving acetaminophen/hydrocodone; no other side effects were reported. Conclusions:, There was a wide range of changes in pain scores from this identical painful stimulus after receiving the study medications. Acetaminophen and acetaminophen/hydrocodone resulted in a similar decrease in pain (10.2 and 9.5%), while ibuprofen and placebo had a similar lack of effect (,6.6 and ,6.9%). Forty-four percent of subjects receiving acetaminophen/hydrocodone reported mild side effects; no other side effects were seen. In this noninflammatory pain model, the VAS is not able to distinguish differences in pain relief between acetaminophen and acetaminophen/hydrocodone or ibuprofen and placebo. [source]


Ibuprofen Provides Analgesia Equivalent to Acetaminophen,Codeine in the Treatment of Acute Pain in Children with Extremity Injuries: A Randomized Clinical Trial

ACADEMIC EMERGENCY MEDICINE, Issue 8 2009
Janet H. Friday MD
Abstract Objectives:, This study compared the analgesic effectiveness of acetaminophen,codeine with that of ibuprofen for children with acute traumatic extremity pain, with the hypothesis that the two medications would demonstrate equivalent reduction in pain scores in an emergency department (ED) setting. Methods:, This was a randomized, double-blinded equivalence trial. Pediatric ED patients 5 to 17 years of age with acute traumatic extremity pain received acetaminophen,codeine (1 mg/kg as codeine, maximum 60 mg) or ibuprofen (10 mg/kg, maximum 400 mg). The patients provided Color Analog Scale (CAS) pain scores at baseline and at 20, 40, and 60 minutes after medication administration. The primary outcome measured was the difference in changes in pain score at 40 minutes, compared to a previously described minimal clinically significant change in pain score of 2 cm. The difference was defined as (change in ibuprofen CAS score from baseline) , (change in acetaminophen,codeine CAS score from baseline); negative values thus favor the ibuprofen group. Additional outcomes included need for rescue medication and adverse effects. Results:, The 32 acetaminophen,codeine and the 34 ibuprofen recipients in our convenience sample had indistinguishable pain scores at baseline. The intergroup differences in pain score change at 20 minutes (,0.6, 95% confidence interval [CI] = ,1.5 to 0.3), 40 minutes (,0.4, 95% CI = ,1.4 to 0.6), and 60 minutes (0.2, 95% CI = ,0.8 to 1.2) were all less than 2 cm. Adverse effects were minimal: vomiting (one patient after acetaminophen,codeine), nausea (one patient after ibuprofen), and pruritus (one after acetaminophen,codeine). The three patients in each group who received rescue medications all had radiographically demonstrated fractures or dislocations. Conclusions:, This study found similar performance of acetaminophen,codeine and ibuprofen in analgesic effectiveness among ED patients aged 5,17 years with acute traumatic extremity pain. Both drugs provided measurable analgesia. Patients tolerated them well, with few treatment failures and minimal adverse effects. [source]


Randomized Double-blind Placebo Controlled Crossover Study of Acetaminophen, Ibuprofen, Acetaminophen/Hydrocodone, and Placebo for the Relief of Pain From a Standard Painful Stimulus

ACADEMIC EMERGENCY MEDICINE, Issue 9 2009
James R. Miner MD
Abstract Objectives:, The objective was to compare subjects' change in perceived acute pain from an identical painful stimulus after receiving three separate, commonly used pain medications and placebo. Methods:, This was an institutional review board,approved, randomized, double-blind crossover study of healthy human volunteers. Subjects received 1000 mg of acetaminophen, 800 mg of ibuprofen, the combination of 650 mg of acetaminophen with 10 mg of hydrocodone, or placebo (800 mg of lactose) in a randomized order over four separate occasions each 1 week apart. Prior to receiving the drug on each study day, subjects placed their nondominant hand in a bath of 0C water for 45 seconds. The bath was divided into two sections; the larger was the reservoir of cooled water monitored at 0C, and the other half was filled from constant overflow. Water drained from the overflow section into the cooling unit and was then pumped up into the base of the reservoir through a diffusion grid. Subjects completed a 100-mm visual analog scale (VAS) representing perceived pain during the exposure. The cold water exposure and VAS were repeated 1 hour after receiving the study drug, and then subjects were observed for side effects for 4 hours. Data were compared using descriptive statistics, 95% confidence intervals (CIs), and repeated-measures analysis of variance (ANOVA). Results:, Twenty-five subjects were enrolled. The mean VAS preexposure was 56.9 mm (15.1 mm; range = 5 to 92 mm). The mean decrease in VAS after receiving the study drug for acetaminophen was 10.2% (95% CI = ,1.4 to 20.4), for ibuprofen was ,6.6% (95% CI = ,16.5 to 3.20), for acetaminophen/hydrocodone was 9.5% (95% CI = 1.4 to 20.4), and for placebo was ,6.9% (95% CI = ,15.2 to 1.4). The range in change in pain scores for all agents was ,91.3% to 57.6%. Mild side effects (nausea, dizziness, or somnolence) were reported in 11 subjects (44%) after receiving acetaminophen/hydrocodone; no other side effects were reported. Conclusions:, There was a wide range of changes in pain scores from this identical painful stimulus after receiving the study medications. Acetaminophen and acetaminophen/hydrocodone resulted in a similar decrease in pain (10.2 and 9.5%), while ibuprofen and placebo had a similar lack of effect (,6.6 and ,6.9%). Forty-four percent of subjects receiving acetaminophen/hydrocodone reported mild side effects; no other side effects were seen. In this noninflammatory pain model, the VAS is not able to distinguish differences in pain relief between acetaminophen and acetaminophen/hydrocodone or ibuprofen and placebo. [source]


Posterior tibial nerve stimulation in patients with intractable interstitial cystitis

BJU INTERNATIONAL, Issue 1 2004
Jimao Zhao
OBJECTIVE To evaluate the efficacy of intermittent percutaneous posterior tibial nerve stimulation (PPTNS) in patients with refractory interstitial cystitis. PATIENTS AND METHODS One man and 13 women (mean age 58.3 years) with suprapubic or perineal pain were enrolled in a prospective open study, in which they had 10 weekly sessions of PPTNS. Their mean duration of symptoms was 8.3 years. All patients were previously diagnosed as having interstitial cystitis according to the National Institute of Diabetes and Digestive and Kidney Diseases criteria. The response to the treatment were assessed using voiding diary, visual analogue scale diary for a pain index, and the Interstitial Cystitis Problem Index (ICPI), O'Leary/Sant Interstitial Cystitis Symptom Index (ICSI) and the 36-item short-form health survey (SF-36) quality-of-life questionnaire. RESULTS Of the 14 patients, 13 completed the 10 weeks of treatment with no complications; 12 continued treatment for a short period after the study. There were no statistically significant changes in pain scores, voiding frequency and volumes, or in the ICPI, ICSI and SF-36 scores. However, there was an improvement in some patients, with one having complete resolution of the pain. CONCLUSION Intermittent PPTNS in patients with refractory interstitial cystitis has no significant clinical effect over 10 weeks of treatment. [source]