The Relationship between the Visual Analog Pain Intensity and Pain Relief Scale Changes during Analgesic Drug Studies in Chronic Pain Patients 

Abstract

The relationship between visual analog pain intensity and pain relief scores changed systematically during both analgesic drug studies. The authors hypothesize that patients' interpretation of the pain relief scale had changed during the studies and therefore suggest using the pain intensity scale to quantify analgesic drug action over time.

ORIGINAL RESEARCH–CLINICAL SCIENCE: Reducing wound pain in venous leg ulcers with Biatain Ibu: A randomized, controlled double‐blind clinical investigation on the performance and safety

“…The minimum leg ulcer pain score accepted for inclusion was moderate on a five-point Verbal Rating Scale (VRS) (none, slight, moderate, lots, complete). Exclusion criteria were: (1) painful ulcers that had been resistant to analgesic treatment over the past 6 months or more, (2) pregnant or lactating women, (3) clinical infection including erysipelas and cellulitis, (4) local infection or bacterial imbalance within or surrounding the study ulcer, (5) vasculitis, (6) allergy or other contraindication to ibuprofen or other related analgesics (nonsteroidal anti-inflammatory agents), (7) a history of asthma, rhinitis, or urticaria, (8) diabetes, (9) the use of unscheduled additional pain medication for 3 days before study admission (regular concomitant pain medication was acceptable for inclusion), (10) concomitant treatment with systemic antibiotics other than nitrofurantoin, (11) concomitant treatment with systemic corticosteroids (more than 10 mg/day of prednisolone or equivalent), (12) treatment with other immunosuppressant or cancer chemotherapeutic agents within 1 month before inclusion, (13) concomitant participation in other studies, and (14) previous participation in this study.…”

“…11 Pain relief was regarded as a retrospective view of the treatment efficiency and a high score was associated with high treatment efficacy. 12,13 Pain intensity was measured on a validated 11-point Numeric Box Scale (NBS) from 0 to 10 with ''0'' as no pain and ''10'' as the worst imaginable pain. 11 Patients rated pain at dressing change (NBS) immediately after removal of the dressing and cleansing of the wound at the visits on days 2 and 5 and on days 45 and 47.…”

Rational Opioid Dosing in the Elderly: Dose and Dosing Interval When Initiating Opioid Therapy

“…In addition, robust PK–PD data relating to the contribution of active metabolites to opioid analgesia and side effects during maintenance therapy would allow the performance of similar simulations to determine the effects of organ dysfunction on maintenance dosing regimens. Part of the challenge in obtaining these data is that clinically attractive analgesic effect measures (i.e., pain‐rating scores or change in pain intensity) are not easily translatable from one clinical study to another because of the large interindividual variability in these scales 21 , 22 . Good biomarkers of clinical effect (e.g., pupillary miosis, experimental pain stimuli, electroencephalographic changes) can provide robust information that may even allow modification of a library of PK–PD models for opioid tolerance, opioid‐induced hyperalgesia, or the addition of other, non‐opioid analgesics.…”

A Randomized Controlled Trial of the Effects of a Combination of Static and Dynamic Magnetic Fields on Carpal Tunnel Syndrome

“… The VAS [28] is a self‐report estimate of pain symptoms measured on an 11‐point Likert scale (0 = absent, 10 = worst pain). Participants were asked to rate their pain three times daily and at the same time to represent mean daily pain.…”