Agreement between children's, nurses’ and parents’ pain intensity reports is stronger before than after analgesic consumption: results from a post-operative study

2022 ◽  
pp. 104176
Author(s):  
Dafna Zontag ◽  
Pora Kuperman ◽  
Liat Honigman ◽  
Roi Treister
Keyword(s):  
Pain Intensity ◽  
Analgesic Consumption

scholarly journals Pain and discomfort during the first week of rapid maxillary expansion (RME) using two different RME appliances: A randomized controlled trial

2016 ◽  
Vol 87 (3) ◽  
pp. 391-396 ◽  
Author(s):  
Ingalill Feldmann ◽  
Farhan Bazargani
Keyword(s):  
Pain Intensity ◽  
Rapid Maxillary Expansion ◽  
Maxillary Expansion ◽  
Analgesic Consumption ◽  
Function Impairment ◽  
Group A ◽  
Jaw Function ◽  
Group B ◽  
Median Pain ◽  
Hyrax Appliance

ABSTRACT Objectives: To evaluate and compare perceived pain intensity, discomfort, and jaw function impairment during the first week with tooth-borne or tooth-bone–borne rapid maxillary expansion (RME) appliances. Materials and Methods: Fifty-four patients (28 girls and 26 boys) with a mean age of 9.8 years (SD 1.28 years) were randomized into two groups. Group A received a conventional hyrax appliance and group B a hybrid hyrax appliance anchored on mini-implants in the anterior palate. Questionnaires were used to assess pain intensity, discomfort, analgesic consumption, and jaw function impairment on the first and fourth days after RME appliance insertion. Results: Fifty patients answered both questionnaires. Overall median pain on the first day in treatment was 13.0 (range 0–82) and 3.5 (0–78) for groups A and B, respectively, with no significant differences in pain, discomfort, analgesic consumption, or functional jaw impairment between groups. Overall median pain on the fourth day was 9.0 (0–90) and 2.0 (0–71) for groups A and B, respectively, with no significant differences between groups. There were also no significant differences in pain levels within group A, while group B scored significantly lower concerning pain from molars and incisors and tensions from the jaw on day 4 than on the first day in treatment. There was a significant positive correlation between age and pain and discomfort on the fourth day in treatment. No correlations were found between sex and pain and discomfort, analgesic consumption, and jaw function impairment. Conclusions: Both tooth-borne and tooth-bone–borne RME were generally well tolerated by the patients during the first week of treatment.

Preemptive Analgesia: Intraperitoneal Local Anesthetic in Laparoscopic Cholecystectomy

1996 ◽  
Vol 85 (1) ◽  
pp. 11-20 ◽  
Author(s):  
Alberto Pasqualucci ◽  
Verena De Angelis ◽  
Riccardo Contardo ◽  
Francesca Colo ◽  
Giovanni Terrosu ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Blood Glucose ◽  
Postoperative Pain ◽  
Pain Intensity ◽  
Local Anesthetic ◽  
Preemptive Analgesia ◽  
Placebo Control ◽  
Analgesic Consumption ◽  
Surgery Group ◽  
Before And After

Background A controversy exists over the effectiveness and clinical value of preemptive analgesia. Additional studies are needed to define the optimum intensity, duration, and timing of analgesia relative to incision and surgery. Methods One hundred twenty patients undergoing laparoscopic cholecystectomy under general anesthesia plus topical peritoneal local anesthetic or saline were studied. Local anesthetic (0.5% bupivacaine with epinephrine) or placebo solutions were given as follows: immediately after the creation of a pneumoperitoneum (blocking before surgery), and at the end of the operation (blocking after surgery). Patients were randomly assigned to one of four groups of 30 patients each. Group A (placebo) received 20 ml 0.9% saline both before and after surgery, group B received 20 ml 0.9% saline before surgery and 20 ml local anesthetic after surgery, group C received 20 ml local anesthetic both before and after surgery, group P received 20 ml local anesthetic before and 20 ml 0.9% saline after surgery. Pain was assessed using a visual analog scale and a verbal rating scale at 0, 4, 8, 12, and 24 h after surgery. Metabolic endocrine responses (blood glucose and cortisol concentrations) and analgesic requirements also were investigated. Results Pain intensity (visual analog and verbal rating scales) and analgesic requirements were significantly less in the group receiving bupivacaine after surgery compared to placebo. However, in the groups receiving bupivacaine before surgery, both pain intensity and analgesic consumption were less than in the group receiving bupivacaine only after surgery. Blood glucose and cortisol concentrations 3 h after surgery were significantly less in groups receiving bupivacaine before surgery. Conclusions The results indicate that intraperitoneal local anesthetic blockade administered before or after surgery preempts postoperative pain relative to an untreated placebo-control condition. However, the timing of administration is also important in that postoperative pain intensity and analgesic consumption are both lower among patients treated with local anesthetic before versus after surgery.

scholarly journals Pain Intensity and Discomfort Following Surgical Placement of Orthodontic Anchoring Units and Premolar Extraction

2007 ◽  
Vol 77 (4) ◽  
pp. 578-585 ◽  
Author(s):  
Ingalill Feldmann ◽  
Thomas List ◽  
Hartmut Feldmann ◽  
Lars Bondemark
Keyword(s):  
Pain Intensity ◽  
Daily Activities ◽  
Short Term ◽  
Premolar Extraction ◽  
Analgesic Consumption ◽  
Anchorage System ◽  
Perceived Pain ◽  
Adolescent Patients ◽  
Group A ◽  
Group B

Abstract Objective: To evaluate and compare perceived pain intensity and discomfort between the placement of two different orthodontic anchoring units designed for osseointegration and premolar extraction in adolescent patients. Materials and Methods: A total of 120 adolescent patients (60 girls and 60 boys) were recruited and randomized into three groups. Group A underwent installation of an onplant, group B installation of an Orthosystem implant, and group C premolar extraction. Pain intensity and discomfort, analgesic consumption, limitations in daily activities, and functional jaw impairment were evaluated the first evening and one week after the intervention. Results: Pain intensity following surgical installation of an onplant was comparable to the pain intensity experienced after premolar extraction, but there was significantly less pain after surgical installation of an Orthosystem implant compared to installation of an onplant (P = .002) or premolar extraction (P = .007). The protective, vacuum-formed stent caused great discomfort, even more discomfort than the surgical sites following installation of the onplant or the Orthosystem implant. Conclusion: The Orthosystem implant was better tolerated than the onplant in terms of pain intensity, discomfort, and analgesic consumption and was, therefore, the anchorage system of choice in a short-term perspective.

588 Peripheral Nerve Blocks in Procedural Care for Burn Injuries Less Than 10% Total Burn Surface Area: A Retrospective Chart Review.

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S145-S146
Author(s):  
Kimberly Maynell ◽  
Khattiya Chharath ◽  
Thanh Tran ◽  
Loryn Taylor ◽  
David J Smith
Keyword(s):  
Pain Management ◽  
Pain Intensity ◽  
Hospital Discharge ◽  
Burn Injuries ◽  
Burn Patients ◽  
Nerve Blocks ◽  
Peripheral Nerve Blocks ◽  
Burn Care ◽  
Analgesic Consumption ◽  
Significant Difference

Abstract Introduction Pain control remains one of the major challenges in management of burn patients. Pain associated with procedural and post-procedural burn care such as excision and grafting, postoperative dressing changes, and postoperative physical therapies often requires patients to be on intravenous and oral analgesics leading to potential long-term dependence after hospital discharge. Peripheral nerve blocks (PNB) use for perioperative pain management in burn patients may present an alternative pain management modality to help decrease analgesic consumption and shorten length of stay following procedural care. Our hypothesis was tested by evaluating the outcomes from implementation of PNB with ultrasound guided catheter placement for burn procedural care in patients with ≤ 10% total burn surface area (TBSA) requiring excision and grafting. Methods After IRB approval, we retrospectively collected demographics, medical history, pain intensity (rated as “No Pain” [NRS=0], “Minor Pain” [NRS 1 to 3], “Moderate Pain” [NRS 4 to 6], “Severe Pain” [NRS 7 to 10]), postoperative analgesic consumption and time to hospital discharge of patients who underwent autografting procedures for burn injuries ≤ 10% TBSA from October 1, 2019 to December 31, 2019 (the start of our implementation of PNB for procedural burn care). Data was analyzed using chi square/Fisher exact test for categorical variables and t-test for continuous variables. Results Our preliminary data included 20 patients (10 patients had PNB) with average age of 53 years, 60% males and average TBSA of 4.8%. Patients in both PNB and non-PNB groups had unremarkable medical histories and scald and flame as mechanism of burns. There was no significant difference in TBSA (5.3% TBSA in PNB and 4.8% TBSA in non-PNB). Pain intensity before autografting procedure for both groups were reported as moderate to severe and managed with fentanyl, morphine, oxycodone, along with ibuprofen and acetaminophen. There was no significant difference in postoperative pain intensity and opioid consumptions; however, postoperative acetaminophen consumption was less in PNB group compared to non-PNB group (2762±3646 mg vs 3932±7511 mg, respectively), although not statistically significant. There was no significant difference between time from surgery to first physical therapy session; however, time to hospital discharge was shorter in PNB group compared to non-PNB group (5.7±1 days vs 10.5±9 days, respectively), although not statistically significant. Conclusions This evaluation shows a trend in reduction of inpatient postoperative analgesic consumption as well as time to hospital discharge with the use of PNB, although a bigger sample size is needed for further assessment.

scholarly journals Magnesium Sulfate Enables Patient Immobilization during Moderate Block and Ameliorates the Pain and Analgesic Requirements in Spine Surgery, Which Can Not Be Achieved with Opioid-Only Protocol: A Randomized Double-Blind Placebo-Controlled Study

2021 ◽  
Vol 10 (19) ◽  
pp. 4289
Author(s):  
Hye-Min Sohn ◽  
Bo-Young Kim ◽  
Yu-Kyung Bae ◽  
Won-Seok Seo ◽  
Young-Tae Jeon
Keyword(s):  
Pain Intensity ◽  
Magnesium Sulfate ◽  
Spine Surgery ◽  
Neuromuscular Blocking ◽  
Controlled Study ◽  
Neurophysiological Monitoring ◽  
Control Group ◽  
Intravenous Anesthesia ◽  
Double Blind ◽  
Analgesic Consumption

Spine surgery is painful despite the balanced techniques including intraoperative and postoperative opioids use. We investigated the effect of intraoperative magnesium sulfate (MgSO4) on acute pain intensity, analgesic consumption and intraoperative neurophysiological monitoring (IOM) during spine surgery. Seventy-two patients were randomly allocated to two groups: the Mg group or the control group. The pain intensity was significantly alleviated in the Mg group at 24 h (3.2 ± 1.7 vs. 4.4 ± 1.8, p = 0.009) and 48 h (3.0 ± 1.2 vs. 3.8 ± 1.6, p = 0.018) after surgery compared to the control group. Total opioid consumption was reduced by 30% in the Mg group during the same period (p = 0.024 and 0.038, respectively). Patients in the Mg group required less additional doses of rocuronium (0 vs. 6 doses, p = 0.025). Adequate IOM recordings were successfully obtained for all patients, and abnormal IOM results denoting warning criteria (amplitude decrement >50%) were similar. Total intravenous anesthesia with MgSO4 combined with opioid-based conventional pain control enables intraoperative patient immobilization without the need for additional neuromuscular blocking drugs and reduces pain intensity and analgesic requirements for 48 h after spine surgery, which is not achieved with only opioid-based protocol.

Efficacy of Methylprednisolone on Pain, Fatigue, and Appetite Loss in Patients With Advanced Cancer Using Opioids: A Randomized, Placebo-Controlled, Double-Blind Trial

2014 ◽  
Vol 32 (29) ◽  
pp. 3221-3228 ◽  
Author(s):  
Ørnulf Paulsen ◽  
Pål Klepstad ◽  
Jan Henrik Rosland ◽  
Nina Aass ◽  
Eva Albert ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Pain Intensity ◽  
Rating Scale ◽  
Oral Morphine ◽  
Life Questionnaire ◽  
Appetite Loss ◽  
Patients With Cancer ◽  
Analgesic Consumption ◽  
Average Pain Intensity ◽  
Average Pain

Purpose Corticosteroids are frequently used in cancer pain management despite limited evidence. This study compares the analgesic efficacy of corticosteroid therapy with placebo. Patients and Methods Adult patients with cancer receiving opioids with average pain intensity ≥ 4 (numeric rating scale [NRS], 0 to 10) in the last 24 hours were eligible. Patients were randomly assigned to methylprednisolone (MP) 16 mg twice daily or placebo (PL) for 7 days. Primary outcome was average pain intensity measured at day 7 (NRS, 0 to 10); secondary outcomes were analgesic consumption (oral morphine equivalents), fatigue and appetite loss (European Organisation for Research and Treatment of Cancer–Quality of Life Questionnaire C30, 0 to 100), and patient satisfaction (NRS, 0 to 10). Results A total of 592 patients were screened; 50 were randomly assigned, and 47 were analyzed. Baseline opioid level was 269.9 mg in the MP arm and 160.4 mg in the PL arm. At day-7 evaluation, there was no difference between the groups in pain intensity (MP, 3.60 v PL, 3.68; P = .88) or relative analgesic consumption (MP, 1.19 v PL, 1.20; P = .95). Clinically and statistically significant improvements were found in fatigue (−17 v 3 points; P .003), appetite loss (−24 v 2 points; P = .003), and patient satisfaction (5.4 v 2.0 points; P = .001) in favor of the MP compared with the PL group, respectively. There were no differences in adverse effects between the groups. Conclusion MP 32 mg daily did not provide additional analgesia in patients with cancer receiving opioids, but it improved fatigue, appetite loss, and patient satisfaction. Clinical benefit beyond a short-term effect must be examined in a future study.

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