Hyperalgesia in opioid-managed chronic pain and opioid-dependent patients.

Unlabelled: This observational study aimed to determine whether pain sensitivity in patients with noncancer chronic pain, taking either methadone or morphine, is similar to patients maintained on methadone for dependence therapy, compared with a control group. Nociceptive thresholds were measured on a single occasion with von Frey hairs, electrical stimulation, and cold pressor tests. In all subjects receiving methadone or morphine, nociceptive testing occurred just before a scheduled dose.

Out-patient cognitive-behavioural therapy with amitriptyline for chronic non-malignant pain: a comparative study with 6-month follow-up.

A study was carried out in a multidisciplinary pain clinic with the purpose of comparing the effectiveness of outpatient cognitive-behavioural therapy (CBT) with amitriptyline (AMI) to that of supportive therapy with AMI. The treatments were given weekly over 8 weeks. Global and continuous outcome measures were used.

Description of a mechanistic approach to pain management in advanced cancer. Preliminary report.

A mechanistic approach to advanced cancer pain management is proposed, based on the clinically perceived anatomical and pathophysiological mechanisms of pain generation. It is an extension of the World Health Organisation (WHO) analgesic ladder in which severity of pain is the principal determinant of analgesic choice. The mechanistic categories are: superficial somatic, deep somatic, visceral and neurogenic (mixed or pure, i.

Identification of patient, medical and nursing staff attitudes to postoperative opioid analgesia: stage 1 of a longitudinal study of postoperative analgesia.

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.