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Journal Cover British Journal of Pain
  [13 followers]  Follow
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 2049-4637 - ISSN (Online) 2049-4645
   Published by Sage Publications Homepage  [842 journals]
  • Editorial
    • Authors: Cox; F.
      Pages: 65 - 65
      PubDate: 2016-04-01T02:22:35-07:00
      DOI: 10.1177/2049463716638575
      Issue No: Vol. 10, No. 2 (2016)
  • The French Syrette of morphine for administration to combat casualties
    • Authors: Pasquier, P; Bazin, S, Petit, L.
      Pages: 66 - 66
      PubDate: 2016-04-01T02:22:35-07:00
      DOI: 10.1177/2049463715622958
      Issue No: Vol. 10, No. 2 (2016)
  • Intrathecal drug delivery for the management of pain and spasticity in
           adults: an executive summary of the British Pain Societys recommendations
           for best clinical practice
    • Authors: Duarte, R; Raphael, J, Eldabe, S.
      Pages: 67 - 69
      Abstract: This article provides a summary of the updated British Pain Society Guidance on Intrathecal Drug Delivery for the management of pain and spasticity in adults. We aim to highlight the areas of the guidance that have been updated and to provide a concise summary.
      PubDate: 2016-04-01T02:22:35-07:00
      DOI: 10.1177/2049463715587747
      Issue No: Vol. 10, No. 2 (2016)
  • Perceptions of phantom limb pain in lower limb amputees and its effect on
           quality of life: a qualitative study
    • Authors: Trevelyan, E. G; Turner, W. A, Robinson, N.
      Pages: 70 - 77
      Abstract: Background: Phantom limb pain (PLP) is a prevalent complication post-amputation. Currently, qualitative literature exploring the experience of PLP in amputees is sparse, and little is known about whether the educational needs of amputees are being met. Objectives: To explore lower limb amputees’ descriptive lived experiences of PLP, to understand how PLP affects quality of life and to determine whether amputees feel they are provided with adequate information about PLP. Methods: A qualitative descriptive approach, situated under the constructivist paradigm was taken, consisting of cross-sectional semi-structured interviews. A purposive sample of 15 lower limb amputees, 1–3 months post-surgery with past or current experience of PLP were interviewed once about their experience of PLP. Interviews were audio-recorded, transcribed verbatim and analysed using Framework Analysis. Interviews were conducted while participants were inpatients at an amputee rehabilitation unit in London. Results: Six key themes were identified during analysis, of which three were related to PLP and are reported on in this article (real and physical phantoms, living with a phantom and being informed). PLP had numerous painful qualities. The phantom felt real, with kinetic and kinaesthetic properties. PLP had multiple meanings to amputees, was considered a reminder of circumstances and could affect quality of life. Information provided about PLP was inadequate. Conclusion: PLP can be a severe and annoying experience acting as a reminder of amputees’ circumstances. Information provided about PLP is inadequate, with some amputees still perceiving PLP as mental and imaginary. Education about PLP and awareness and accessibility to non-pharmacological interventions needs to be improved.
      PubDate: 2016-04-01T02:22:35-07:00
      DOI: 10.1177/2049463715590884
      Issue No: Vol. 10, No. 2 (2016)
  • 'Pseudofailure of spinal cord stimulation for neuropathic pain following a
           new severe noxious stimulus: learning points from a case series of failed
           spinal cord stimulation for complex regional pain syndrome and failed back
           surgery syndrome
    • Authors: Muquit, S; Moussa, A. A, Basu, S.
      Pages: 78 - 83
      Abstract: Failure of spinal cord stimulation (SCS) may be due to hardware problems, migration of electrodes and, in the long-term, plasticity in the spinal cord with habituation to the stimulation current. We describe a series of seven patients who experienced acute therapeutic loss of SCS effects following an acute nociceptive event unrelated to primary pathology. There were no hardware problems. We called this ‘Pseudofailure’, as the effective stimulation returned in all patients following a period off stimulation or reprogramming. This phenomenon has not been reported previously in the literature. Over a 4-year period, we managed seven patients with this feature: four had received SCS for complex regional pain syndrome and three for failed back surgery syndrome. In all seven cases, there was cessation of the pain relief afforded by SCS following an acute painful event: four patients had trauma, two patients had domestic electric shock and one patient suffered shingles (varicella zoster infection). We excluded hardware-related problems in all cases. In two patients, SCS effects could be regained by an initial attempt at reprogramming. In the remaining five cases reprogramming was unsuccessful, and stimulation was switched off for several months before recommencing, when we discovered a return of good therapeutic effect. We conclude that SCS may seem to fail following a separate strong nociceptive stimulus. Stimulation may be regained with reprogramming or following a period with stimulation switched off. We would, therefore, advise against removal of SCS hardware in the first instance.
      PubDate: 2016-04-01T02:22:35-07:00
      DOI: 10.1177/2049463715622795
      Issue No: Vol. 10, No. 2 (2016)
  • Patient compliance with postoperative analgesia after day case surgery: a
           multisite observational study of patients in North East London
    • Authors: Fahmy, N; Siah, J, Umo-Etuk, J.
      Pages: 84 - 89
      Abstract: Background: Pain is the commonest reason for delayed discharge and readmission post day surgery with up to 45% of patients reported to suffer moderate-to-severe post-surgical pain 24 hours after discharge. The importance of post-surgical pain management extends beyond the acute phase when one considers that all chronic post-surgical pain was once acute. Although much focus is given to perioperative analgesia, a patient’s pain management once discharged can be overlooked, whilst at this time the patient’s pain management is within their own hands. Methods: We conducted this multisite observational study of adult patients undergoing day case surgery. After obtaining patient consent data was collected on the operation, intra- and postoperative analgesia administered and discharge analgesia prescribed. Patients were then contacted at home by telephone 48 hours after discharge and asked about their postoperative pain and analgesia requirements. Results: Of 150 patients consented for the enrolment, we were able to obtain postoperative analgesia data on 100. A total of 68% of patients reported pain following discharge with 26% reporting severe pain, defined as a pain score of >=7. A total 68% of patients were prescribed and dispensed analgesia, and of those, 83% were compliant with their analgesia. Thus, we conclude that in this patient group, the incidence of postoperative pain was not due to lack of patient compliance, but inadequate analgesia prescription. Discussion: We recognise that our data reflect a patient population in North East London but suggest that the results may still be relevant to a wider patient group across the United Kingdom as the incidence of postoperative pain in our study was similar to published figures. Better patient satisfaction with postoperative analgesia may be obtained with more patient- and surgery-specific analgesic prescription.
      PubDate: 2016-04-01T02:22:35-07:00
      DOI: 10.1177/2049463715627286
      Issue No: Vol. 10, No. 2 (2016)
  • 'Simplicity radiofrequency neurotomy of sacroiliac joint: a real life
           1-year follow-up UK data
    • Authors: Anjana Reddy, V. S; Sharma, C, Chang, K.-Y, Mehta, V.
      Pages: 90 - 99
      Abstract: Background: Sacroiliac joint (SIJ) pain is considered to be the third most common cause of low back pain with the prevalence of 13–25% in all low back pain patients. Its diagnosis and treatment remain a challenge with the poor evidence base for interventional procedures. Patients with SIJ pain experience a low quality of life, worse than some of the chronic health conditions. Simplicity radiofrequency (RF) neurotomy is a novel technique which tackles some of the problems faced by conventional RF neurotomy and may offer better results in managing pain arising from SIJ. Aim: The purpose of this retrospective review of practice was to look into the effectiveness of Simplicity RF neurotomy in terms of pain relief, quality of health improvement in patients suffering from SIJ pain and complications associated with the procedure. Methodology: Retrospective review of the patients undergoing Simplicity RF neurotomy at a tertiary hospital (April 2012 to June 2013). Pain scores and responses to SF (Short Form) 12 questionnaire before and at 12 months after treatment were compared using the Wilcoxon signed-rank test. Results: Out of 26 patients, 16 were considered for analysis. There was statistically significant reduction in both mean pain score (Numerical Rating Scale, NRS from 8.8 pre-intervention to 4.3 post-intervention) and median pain score (NRS from 9 pre-intervention to 5 post-intervention) with a p-value of
      PubDate: 2016-04-01T02:22:35-07:00
      DOI: 10.1177/2049463715627287
      Issue No: Vol. 10, No. 2 (2016)
  • Understanding factors that facilitate the inclusion of pain education in
           undergraduate curricula: Perspectives from a UK survey
    • Authors: Carr, E. C; Briggs, E. V, Briggs, M, Allcock, N, Black, P, Jones, D.
      Pages: 100 - 107
      Abstract: Background: Studies in Europe, North America and Australasia suggest that one in five adults suffer from pain. There is increasing recognition that pain, particularly chronic pain, represents a global health burden. Many studies, including two national surveys exploring the content of undergraduate curricula for pain education, identify that documented pain education in curricula was limited and fragmentary. Methods: The study design used a questionnaire which included an open text comment box for respondents to add ‘further comments’ as part of larger study previously published. The sample consisted of 19 UK universities that offered 108 undergraduate programmes in the following: dentistry, medicine, midwifery, nursing (adult, child, learning disabilities and mental health branches), occupational therapy (OT), pharmacy, physiotherapy and veterinary science. An inductive content analysis was performed, and the data were managed using NVivo 10 software for data management. Results: A total of 57 participants across seven disciplines (dentistry, medicine, midwifery, nursing, pharmacy, physiotherapy and OT) completed the open text comment box (none were received from veterinary science). Analysis revealed two major themes of successes and challenges. Successes included expansion (extending coverage and/or increased student access), multidimensional curriculum content and diversity of teaching methods. Challenges included difficulties in identifying where pain is taught in the curriculum, biomedical versus biopsychosocial definitions of pain, perceived importance, time, resources and staff knowledge, and finally a diffusion of responsibility for pain education. Conclusion: This study identifies new insights of the factors attributed to successful implementation of pain education in undergraduate education. Many of the challenges previously reported were also identified. This is one of the first studies to identify a broad range of approaches, for pain education, that could be deemed as ‘successful’ across a range of health disciplines.
      PubDate: 2016-04-01T02:22:35-07:00
      DOI: 10.1177/2049463716634377
      Issue No: Vol. 10, No. 2 (2016)
  • Does preoperative psychological status of patients affect postoperative
           pain' A prospective study from the Caribbean
    • Authors: Bradshaw, P; Hariharan, S, Chen, D.
      Pages: 108 - 115
      Abstract: Objectives: Patients with high anxiety states in the preoperative period often have more intense postoperative pain, despite adequate pain control during the intraoperative period. This study aimed to determine the relationship between the preoperative psychological status and the pain experienced postoperatively in a sample of Caribbean patients. Design and methods: A prospective study was conducted in elective surgical adult patients at a teaching hospital in the Caribbean. Patients’ preoperative psychological status was assessed using Hospital Anxiety and Depression Scale (HADS), and a preoperative ‘expected’ pain score was recorded. Postoperatively, ‘observed’ pain scores at 4 and 24 hours and the maximum pain score during 24 hours were recorded. Demographic data and clinical details including data regarding postoperative analgesia were collected. Expected and observed pain scores were compared between patients with and without anxiety and depression. Results: A total of 304 patients were enrolled. The overall prevalence of anxiety and depression was 43% and 27%, respectively, based on the HADS scores. There were significant associations between the postoperative pain scores and factors such as preoperative anxiety and depression (HADS) scores, preoperative expected pain scores, patient educational level, presence of preoperative pain and surgical duration. Age, gender, ethnicity and type of anaesthesia did not impact postoperative pain scores. Conclusion: The presence of preoperative anxiety and depression as indicated by HADS score may significantly influence postoperative pain. Other factors such as educational level, presence of preoperative pain and surgical duration may also impact postoperative pain. Some of these factors may be modifiable and must be addressed in the preoperative period.
      PubDate: 2016-04-01T02:22:35-07:00
      DOI: 10.1177/2049463716635680
      Issue No: Vol. 10, No. 2 (2016)
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
Tel: +00 44 (0)131 4513762
Fax: +00 44 (0)131 4513327
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