Biomaterial Database

Modifiers of patient-controlled analgesia efficacy. II. Chronic pain. 1989

Barbarajean Magnani, and Lynn R Johnson, and Michael F Ferrante

Anesthesia Research Laboratories, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115 U.S.A. Pain Clinic, Department of Anesthesiology, Allegheny General Hospital, and Medical College of Pennsylvania, Pittsburgh, PA 15212 U.S.A. Pain Treatment Service, Department of Anesthesia, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA 02115 U.S.A.

Fifty-eight gynecologic surgical patients using patient-controlled analgesia (PCA) were given several psychological questionnaires and their pain was monitored postoperatively. Pain scores were recorded hourly on postoperative day 1. In addition, patients were asked to score retrospectively their overall pain experience while using PCA (Patient Overall Evaluation). Patients having had a history of pain for at least 6 months were considered to have 'chronic pain,' while those who had no history of chronic pain were grouped as 'acute pain' patients. Chronic pain patients spent more time in 'moderate' pain than did acute pain patients. While patients with a history of chronic pain had higher scores on the hourly pain scale compared to acute pain patients, there were no differences between the two groups on the Patient Overall Evaluation. In addition, chronic pain patients reported the same pain levels after completion of PCA as they did during its use, in contrast to acute pain patients whose retrospective pain levels were higher than during PCA use. Compared to acute pain patients, chronic pain patients had higher scores on both the Hypochondriasis and the Hysteria scales of the MMPI. A history of chronic pain may affect the use of patient-controlled analgesia since chronic pain patients may accommodate to a 'moderate' pain level which approximates their preoperative perception of pain. By contrast, acute pain patients who have no 'chronic pain experience' may self-administer pain medication so as to attain a predominately 'mild' level of pain.

UI	MeSH Term	Description	Entries
D010146	Pain	An unpleasant sensation induced by noxious stimuli which are detected by NERVE ENDINGS of NOCICEPTIVE NEURONS.	Suffering, Physical,Ache,Pain, Burning,Pain, Crushing,Pain, Migratory,Pain, Radiating,Pain, Splitting,Aches,Burning Pain,Burning Pains,Crushing Pain,Crushing Pains,Migratory Pain,Migratory Pains,Pains, Burning,Pains, Crushing,Pains, Migratory,Pains, Radiating,Pains, Splitting,Physical Suffering,Physical Sufferings,Radiating Pain,Radiating Pains,Splitting Pain,Splitting Pains,Sufferings, Physical
D010147	Pain Measurement	Scales, questionnaires, tests, and other methods used to assess pain severity and duration in patients or experimental animals to aid in diagnosis, therapy, and physiological studies.	Analgesia Tests,Analogue Pain Scale,Formalin Test,McGill Pain Questionnaire,Nociception Tests,Pain Assessment,Pain Intensity,Pain Severity,Tourniquet Pain Test,Visual Analogue Pain Scale,Analog Pain Scale,Assessment, Pain,McGill Pain Scale,Visual Analog Pain Scale,Analgesia Test,Analog Pain Scales,Analogue Pain Scales,Formalin Tests,Intensity, Pain,Measurement, Pain,Nociception Test,Pain Assessments,Pain Intensities,Pain Measurements,Pain Questionnaire, McGill,Pain Scale, Analog,Pain Scale, Analogue,Pain Scale, McGill,Pain Severities,Pain Test, Tourniquet,Questionnaire, McGill Pain,Scale, Analog Pain,Scale, Analogue Pain,Scale, McGill Pain,Severity, Pain,Test, Analgesia,Test, Formalin,Test, Nociception,Test, Tourniquet Pain,Tests, Nociception,Tourniquet Pain Tests
D010361	Patients	Individuals participating in the health care system for the purpose of receiving therapeutic, diagnostic, or preventive procedures.	Clients,Client,Patient
D011581	Psychological Tests	Standardized tests designed to measure abilities (as in intelligence, aptitude, and achievement tests) or to evaluate personality traits.	Parenting Stress Index,Trier Social Stress Test,Trier Stress Test,Psychologic Tests,Psychological Test,Test, Psychological,Tests, Psychological,Index, Parenting Stress,Psychologic Test,Stress Index, Parenting,Stress Test, Trier,Test, Psychologic,Test, Trier Stress,Trier Stress Tests
D002908	Chronic Disease	Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care (Dictionary of Health Services Management, 2d ed). For epidemiological studies chronic disease often includes HEART DISEASES; STROKE; CANCER; and diabetes (DIABETES MELLITUS, TYPE 2).	Chronic Condition,Chronic Illness,Chronically Ill,Chronic Conditions,Chronic Diseases,Chronic Illnesses,Condition, Chronic,Disease, Chronic,Illness, Chronic
D005260	Female		Females
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000208	Acute Disease	Disease having a short and relatively severe course.	Acute Diseases,Disease, Acute,Diseases, Acute
D000700	Analgesics	Compounds capable of relieving pain without the loss of CONSCIOUSNESS.	Analgesic,Anodynes,Antinociceptive Agents,Analgesic Agents,Analgesic Drugs,Agents, Analgesic,Agents, Antinociceptive,Drugs, Analgesic
D012646	Self Administration	Administration of a drug or chemical by the individual under the direction of a physician. It includes administration clinically or experimentally, by human or animal.	Administration, Self,Administrations, Self,Self Administrations