口服葡萄糖缓解新生儿疼痛的临床研究

目的:探讨口服葡萄糖缓解新生儿疼痛的临床有效性及可行性.方法:我院新生儿病房住院患儿70例随机分为观察组和对照组各35例.观察组喂食25%葡萄糖水2 mL,用注射器于30 s内滴入口中,5 min后进行足跟采血,对照组在足跟采血操作过程中不给予任何缓解疼痛的干预措施.选用新生儿疼痛量表(Neonatal infant ...     

芬太尼骨架型透皮贴剂治疗晚期肺癌中重度疼痛疗效观察

目的 观察芬太尼骨架型透皮贴剂(多瑞吉)治疗晚期肺癌中、重度疼痛的疗效.方法 42例晚期肺癌患者,治疗前均为中、重度疼痛,给予多瑞吉镇痛治疗,每24小时评定疼痛强度、生活质量、不良反应.结果 疼痛完全缓解12例(28.6%),明显缓解27例(64.3%),总有效率92.9%,患者生活质量明显改善,不良反应发生率低,主要为恶心、呕吐、嗜睡、便秘等.结论 多瑞吉治疗晚期肺癌中、重度疼痛效果良好. Abstract： Objective To observe the the efficacy of fentanyl patches (duragesic) in the treatment of advanced lung cancer with moderate to severe pain.Methods Forty-two cases of advanced lung cancer before treatment were of moderate to severe pain,who were given duragesic analgesic treatment.To assessed pain intensity, quality of life and adverse reactions every 24 hours.Results The pain complete relief in 12 cases (28.6%), 27 cases were obvious relief (64.3%). The total effective rate was 92.9%. Patients with significant improvement in the quality of life, a lower incidence of adverse reactions, mainly include nausea, vomiting, drowsiness and constipation.Conclusions Durogesic in the treatment of advanced lung cancer with moderate to severe pain has good efficacy.     

提高无痛肌肉注射效果的体会

目的消除患者对肌内注射恐惧的心理而达到无痛效果。方法选择2008年5～8月在我院肌内注射的患者5840例（均为成年人）列为观察对象,其中2940人次为新法选位及操作组,即选择合适部位,掌握进针、拔针技巧等。2900人为传统定位,即＂十字法＂及常规操作组的＂两快一慢＂,即进针快,拔针快,推药慢。结果新法选位及操作组肌内注射比传统法及常规操作组的肌内注射无痛注射率显著提高。结论注射部位的选择、进针拔针技巧、进针角度、针力和掌握好注射快慢对无痛注射至关重要。     

中药穴位贴敷治疗慢性胃痛临床护理观察

目的:观察中药穴位贴敷对慢性胃痛患者临床疗效及副作用。方法:应用随机双盲法将210名慢性胃痛患者均分为三组,观察组1(组1)、观察组2(组2)、对照组,各组间年龄、性别、胃痛原因以及病程均无显著性差异(P>0.05),基础治疗包括:制酸、保护胃黏膜以及抗幽门螺旋杆菌等治疗,各组在基础治疗的基础上,组1采用胃痛贴贴敷中脘穴,组2则在胃痛贴的基础上加用口服止痛药,对照组采用止痛药物治疗,观察各组患者胃痛症状缓解或者消失的时间、程度以及口干、面红、心动过速、小便不出等副作用,患者依从性以及治疗组患者有无局部皮肤损伤,疗程均为7天。结果:观察组疗效显著优于对照组(P<0.01),组1未见副作用显著优于其他两组(P<0.01),组1患者依从性优于其他两组(P<0.01),组2与对照组比较,均出现副作用,观察组局部皮肤无明显损伤。结论:中药穴位贴敷治疗慢性胃痛疗效确切,无明显副作用,患者依从性好。     

Tuning the gain of somato-sympathetic reflexes by stimulation of the thoracic spine in humans

In animals, somatic stimulation of the limbs can evoke sympathetic reflexes of supraspinal origin. In addition, spinal reflexes can be elicited by stimulation of somatic tissues of the trunk. However, limited evidence is available concerning the specific modulation of sympathetic reflexes by afferents from the thoracic spine. This has also been largely overlooked in healthy humans. The aim of the present study was to determine whether tonic noxious heat (NH) applied to the skin over T3–T5 could segmentally increase supraspinal sympathetic reflexes (skin conductance responses – SCRs) induced by phasic electrical stimulation of the sural nerve. In addition, the effect of spinal manipulation (SM) on SCR amplitude and SCR amplification by NH was investigated. During the control session, palmar and plantar SCR amplitude was stable, showing no significant modulation. During NH and SM, however, palmar SCR amplitude was respectively increased and decreased in comparison to baseline, leading to a robust difference in SCR amplitude between the 2 conditions (p < 0.001). Moreover, these changes were also significantly and marginally different compared to the control session (p = 0.041 and p = 0.053, respectively). Interestingly, when applied immediately before NH, SM had a preventive effect on palmar SCR amplification induced by NH. In sharp contrast, changes in plantar SCRs were not significantly different between sessions (p = 0.42). Altogether, these results indicate that somatic stimulation of the thoracic spine may modulate somato-sympathetic reflexes segmentally in conscious, healthy volunteers.     

Ethnic differences in cardiovascular-somatosensory interactions and in the central processing of noxious stimuli

Ethnic differences in central sensitization of pain processing and stress-relevant endogenous pain regulatory mechanisms were examined. Forty-four African Americans (AAs; 50% women) and 44 non-Hispanic Whites (nHWs; 50% women) matched for socioeconomic status, were tested for pain responses to the temporal summation of heat pulses and ischemic and cold pain. Resting and stress blood pressure (BP) and norepinephrine (NE) were assessed. AAs had heightened pain responses to all 3 pain tasks relative to nHWs. In nHWs, higher BP and NE were related to reduced pain. In AAs, there was no relationship between BP and pain, but higher NE was related to increased pain. This study provides evidence for ethnic differences in centrally mediated pain and extends prior research demonstrating ethnic differences in endogenous pain regulatory mechanisms. These results have implications for understanding biobehavioral factors contributing to ethnic disparities in clinical pain.     

Mood and Attitude Predict Pain Outcomes Following Arthroscopic Knee Surgery

Background  Decreased pain represents a clinically important outcome following arthroscopic knee surgery. However, little is known about preoperative mood and attitudinal factors and their potential relationship with pain outcomes. Purpose  This prospective, longitudinal study investigated the influence of preoperative depression, stress, and optimism on pain severity and interference with functioning, controlling for relevant demographic and clinical factors 1 year postoperatively. Methods  Participants (N = 180, mean age = 48.2 years) completed scales assessing pain severity and interference both preoperatively and postoperatively. Demographics, depression, stress, optimism, and body mass index were assessed preoperatively. Physicians assessed extent of knee osteoarthritis during surgery. Results  Hierarchical regression analyses controlling for relevant demographic and clinical variables revealed that optimism and stress were significant predictors of pain severity at 1 year but not pain interference. Extent of osteoarthritis predicted pain interference. Conclusions  These findings support that optimism and stress are important predictors of patient-rated pain severity. They do not, however, predict the extent to which pain interferes with daily functioning.