scholarly journals Endoscopic Treatment of Piriformis Syndrome Results in a Significant Improvement in Pain Visual Analog Scale Scores

Author(s):  
Frédérique Vanermen ◽  
Jan Van Melkebeek
1999 ◽  
Vol 90 (3) ◽  
pp. 734-739 ◽  
Author(s):  
Gabriela R. Lauretti ◽  
Raquel de Oliveira ◽  
Marlene P. Reis ◽  
Anita L. Mattos ◽  
Newton L. Pereira

Background Sufentanil is a potent but short-acting spinal analgesic used to manage perioperative pain. This study evaluated the influence of transdermal nitroglycerine on the analgesic action of spinal sufentanil in patients undergoing orthopedic surgery. Methods Fifty-six patients were randomized to one of four groups. Patients were premedicated with 0.05-0.1 mg/kg intravenous midazolam and received 15 mg bupivacaine plus 2 ml of the test drug intrathecally (saline or 10 microg sufentanil). Twenty to 30 min after the spinal puncture, a transdermal patch of either 5 mg nitroglycerin or placebo was applied. The control group received spinal saline and transdermal placebo. The sufentanil group received spinal sufentanil and transdermal placebo. The nitroglycerin group received spinal saline and transdermal nitroglycerine patch. Finally, the sufentanil-nitroglycerin group received spinal sufentanil and transdermal nitroglycerine. Pain and adverse effects were evaluated using a 10-cm visual analog scale. Results The time to first rescue analgesic medication was longer for the sufentanil-nitroglycerin group (785+/-483 min) compared with the other groups (P<0.005). The time to first rescue analgesics was also longer for the sufentanil group compared with the control group (P<0.05). The sufentanil-nitroglycerin group group required less rescue analgesics in 24 h compared with the other groups (P<0.02) and had lesser 24-h pain visual analog scale scores compared with the control group (P<0.005), although these scores were similar to the sufentanil and nitroglycerin groups (P>0.05). The incidence of perioperative adverse effects was similar among groups (P>0.05). Conclusions Transdermal nitroglycerine alone (5 mg/day), a nitric oxide generator, did not result in postoperative analgesia itself, but it prolonged the analgesic effect of spinal sufentanil (10 microg) and provided 13 h of effective postoperative analgesia after knee surgery.


1999 ◽  
Vol 89 (6) ◽  
pp. 1517 ◽  
Author(s):  
Paul S. Myles ◽  
Sally Troedel ◽  
Michael Boquest ◽  
Mark Reeves

Author(s):  
Merav Ben Natan ◽  
Yaniv Steinfeld ◽  
Sara Badash ◽  
Galina Shmilov ◽  
Milena Abramov ◽  
...  

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0037
Author(s):  
Hyun-woo Park ◽  
Ho-seong Jang ◽  
Jae Wan Suh ◽  
Sunghyun Kim

Category: Midfoot/Forefoot Introduction/Purpose: To compare the outcomes of fixation methods for osteosynthesis of a type II symptomatic accessory navicular between screw and tension band wiring. Methods: Forty-four patients (mean age, 29.2 years; range, 13–54 years; 21 males and 23 females) who had undergone operative treatment after failed conservative treatment were chosen for the study between 2007 and 2014. The patients were divided into two groups by the method of osteosynthesis: group 1 (screw) and group 2 (tension band wiring). Pre and postoperative evaluations were performed, using the midfoot scale from the American Orthopaedic Foot & Ankle Society (AOFAS), a visual analog scale, time to return to social activities, and plain radiography. Results: The AOFAS midfoot and visual analog scale scores of both groups were improved at the last postoperative follow-up. The time to return to social activities was 12.3 weeks in the screw group and 11.9 weeks in the tension band wiring group (p = 0.394). A broken screw was observed in one case in the screw group and a broken k-wire was detected in two cases in the tension band wiring group. Nonunion was observed in two cases in each group. Conclusion: The tension band wiring technique could be another treatment choice of osteosynthesis for fixation of the accessory navicular bone.


2011 ◽  
Vol 101 (3) ◽  
pp. 223-230 ◽  
Author(s):  
Stephen L. Barrett ◽  
Jim Maxka ◽  
Jamie N. Mieras ◽  
Kimbal E. Cooper

Background: Lidocaine injection for local anesthesia is a common podiatric medical procedure. We tested the hypothesis that injection of bacteriostatic saline solution containing 0.9% benzyl alcohol before the lidocaine infiltration can reduce the burning caused by lidocaine injection. Methods: This double-blind prospective trial involved 45 participants who each received four injections in two areas of the dorsum of the foot and rated the perceived pain on a visual analog scale. The order of the injections was designed to disguise the control and intervention arms of the study. Results: The sensation of the lidocaine injection after the injection of saline was reduced significantly (P = .028). The percentage of lidocaine injections with visual analog scale scores of 0 increased by 36% after preinjection with bacteriostatic saline solution containing 0.9% benzyl alcohol. Conclusions: The fact that 40% of the intervention visual analog scale pain scores for lidocaine injections were 0 suggests that a near painless lidocaine injection technique is an achievable goal and that the present technique is a simple and inexpensive method of reducing the pain of lidocaine injections. (J Am Podiatr Med Assoc 101(3): 223–230, 2011)


2003 ◽  
Vol 23 (5) ◽  
pp. 414-421 ◽  
Author(s):  
Joseph M. Mrus ◽  
Michael S. Yi ◽  
Kenneth A. Freedberg ◽  
Albert W. Wu ◽  
Robert Zackin ◽  
...  

2009 ◽  
Vol 99 (2) ◽  
pp. 129-134 ◽  
Author(s):  
Hugo R. Perez ◽  
Joshua Roberts

Background: Lesser metatarsal overload may lead to pathologic conditions ranging from plantar metatarsophalangeal joint pain to dislocation. The flexor tendon sheath lies directly plantar to the joint. The increased pressure associated with lesser metatarsal overload may lead to synovitis and pain of the flexor tendon sheath. Methods: Fifteen consecutive patients with lesser metatarsal overload had visual analog scale scores determined at three metatarsophalangeal joint areas to determine the source of pain. The patients underwent seven maneuvers to determine the pain scale score: single-leg heel raise and palpation of the second and third metatarsophalangeal joints on the plantar proximal, plantar distal, and dorsal aspects. The patients were then injected with 0.5 mL of lidocaine, 2%, into the second and third flexor tendon sheaths, and the maneuvers were repeated. Results: Before the injection, the second metatarsophalangeal joint had a significantly greater visual analog scale score plantar than dorsal (6.9 and 2.6, P ≤ .01). The flexor tendon sheath injection significantly improved all seven pain scale scores. Conclusions: Patients with lesser metatarsal overload experienced significantly greater visual analog scale pain scores on the plantar than the dorsal aspect of the second metatarsophalangeal joint. The scores significantly improved after diagnostic injection in the flexor tendon sheaths. The flexor tendon sheaths are probably involved in patients with primarily plantar pain. (J Am Podiatr Med Assoc 99(2): 129–134, 2009)


Sign in / Sign up

Export Citation Format

Share Document