Aspects of long-term evaluation of pain unit treatment program for patients with chronic intractable benign pain syndrome: treatment outcome.
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Biomedical subjects
Publications and source records attributed to D C Agnew.
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An analysis of the language of pain complaints, employing categories of descriptors, was used to determine if chronic pain of either psychiatric of organic origin might be depicted in terms specific for the disease. The complaints of 128 patients with chronic pain were studied for characteristic patterns. Patients with pain of organic etiology used sensory-thermal (e.g., hot, burning) words more frequently than those with pain of psychiatric origin. Female patients with pain attributed to anxiety used sensor-temporal words (e.g., throbbing) more frequently than those with other psychiatric diagnoses. There was also a statistically significant preponderance of pain on the left when the groups of patients with physical and psychological illness were combined.
Phenytoin was given in full dosage to eight patients with thalamic pain and two others with intractable pain resistant to other forms of treatment. Serum levels were monitored and correlated with dosage levels. Three patients improved markedly, two improved only minimally, two were unchanged, and three were worse. Those patients who had improved noted return of original pain on stopping phenytoin. The results indicate the need for a further study of the drug in thalamic and other chronic pain states.
The authors present the concept that a multi-disciplinary interdepartmental pain center should include: 1) an initial out-patient pain clinic, 2) an inpatient pain service for diagnosis of pain problems and treatment of patients with intractable pain, including pain from cancer, 3) a psychotherapeutically-oriented chronic benign Pain Unit, 4) facilities for clinical and basic pain research, and 5) affiliations for an adequate teaching program.
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