Do patients receive adequate pain control after discharge from the ED?

Studies on the effectiveness of pain management have uniformly concluded that health care providers underestimate or undertreat pain. In the emergency department (ED) in which this study was conducted, physicians receive formal didactic and bedside teaching on pain recognition and management in order to heighten the awareness of patient's need for pain control. The purpose of this study was to determine if this outpatient pain management of patients with acute, painful conditions is better than that reported in the medical literature. In this prospective study, 110 adult patients who had an acute, painful diagnosis were telephoned 48 hours after discharge from the ED and asked if they felt their pain at home was well controlled. Patient satisfaction with pain control was higher (91%) than that reported in the medical literature. Also, pain medication was provided more frequently by this study's ED (95%). Education on pain awareness and treatment is a way to improve pain management.     

痛觉测试笔的临床研究

目的通过应用痛觉测试笔测试痛觉平面,探讨其临床应用的实用性。方法选择100名志愿者观察痛觉测试笔产生刺痛感的定性描述,另500例行硬膜外阻滞的患者用针刺法和测试笔同时间同检查部位测试。结果100名志愿者认为痛觉测试笔对皮肤只引起如针刺样疼痛,每次测试产生刺痛程度一致,不产生肌肉抽搐、不放散。500例行硬膜外阻滞患者针刺法和测试笔测得的麻醉平面一致,测试笔无划痕反应。结论测试笔可替代锐器针刺法检测麻醉平面,可减少针刺法引起的皮肤损伤。     

太宁栓治疗肛裂疼痛的临床观察

目的：探讨肛裂疼痛的治疗效果及安全性。方法：将80例患者分为两组，治疗组采用黏膜保护剂太宁栓，对照组选用马应龙麝香痔疮膏。结果：治疗后太宁栓组疼痛、出血、瘙痒、水肿糜烂的减轻程度明显优于对照组（P〈0.05）。结论：太宁栓具有良好的止痛作用，临床效果明显，安全性高。     

A Management of Early CRPS I Caused by Ankle Sprain: A Case Report

Abstract:   We present a case of a 13-year-old boy who developed signs and symptoms of neuropathic pain/early Complex Regional Pain Syndrome (CRPS) Type I, formerly known as Reflex Sympathetic Dystrophy (RSD), after spraining his ankle while wrestling. Aggressive pain control, using medications and sympatholytic blocks, with physical therapy and rehabilitation, led to the resolution of his painful condition. This prevented the disease from possibly progressing to a full-blown case of CRPS I (RSD) that is very challenging to treat.     

医护人员对术后痛和术后止痛态度的调查

目的 调查了解医护人员术后痛和术后止痛的认识和态度。方法 用问卷式调查表采取面对面方式调查了本院130名医护人员。结果 ①128人（98.5%）完成答卷。②绝大多数认为应控制术后痛，但约40%不知道术后痛可致并发症。③有20%-50%的人对术后止痛有误解。④仅半数人了解术后止痛用药现状。⑤认为术后止痛应主要由外科医师和麻醉医师负责者分别占55.5%和35.9%。⑥绝大多数认为术后止痛宣传力度不够。⑦对本院术后镇痛工作评价良好。⑧非手术科室人员在某些方面不如手术科室更了解。结论 医护人员术后止痛意识较好，但仍有许多不足之处。有必要进一步加强医护人员术后止痛意识的教育。     

Postoperative analgesia: pain by choice? The influence of patient attitudes and patient education

Postoperative pain control can be unsatisfactory for a variety of reasons, including patients' attitudes towards pain treatment itself. To assess patients' expectations and their influence on postoperative analgesia, as well as the prevalence of pain following common gynaecological surgery, a prospective study was performed in 166 patients with either adbominal hysterectomy, mastectomy, laparoscopy or uterine curettage. After a first postoperative period with routine on-demand analgesia, a nurse specialised in pain treatment discussed the purposes and risks of pain treatment with the patients and cared for these patients in the second, subsequent study period. Following this discussion, 30 of 40 patients refusing analgesics in the first study period agreed to be given pain medication. In the groups with hysterectomy or mastectomy, pain control improved in the second postoperative period, even though the doses of analgesics administered were generally lower. Education of patients regarding the aims and risks of pain therapy is an essential part of pain control and can lead to an improvement of postoperative analgesia.     

两种后牙根管预备方法的临床效果比较

目的 :评估 2种后牙根管预备方法的临床效果。方法 :采用机用镍钛扩大锉 (ProFile)和手用不锈钢扩大锉 (K file)扩大后牙根管 ,并对 2组病例术后疼痛以及充填情况加以比较。结果 :发现机用镍钛扩大锉扩大后牙根管 ,具有去除根管感染物质彻底 ,根管形态保持良好 ,速度快 ,术后疼痛率较低的优点 ,但易出现断针。而手用不锈钢扩大锉扩大后牙根管速度较慢 ,术后疼痛率略高 ,但不易出现断针 ,操作上容易掌握。结论 :2种后牙根管方法都有优缺点 ,可结合起来使用。     

An inexpensive, self-assembly pressure algometer

We have developed a simple instrument for pressure algometry. It can be made easily using components found in most anaesthetic rooms. Ten students were able to make the device using written instructions. All the resulting algometers performed within 10% accuracy limits for values up to 4 kgcm⁻².