Carpal Ligament Decompression Under Local Anaesthesia: the Effect of lidocaine warming and Alkalinisation on Infiltration Pain

2004 ◽  
Vol 29 (1) ◽  
pp. 32-34 ◽  
Author(s):  
C. K. YIANNAKOPOULOS
Keyword(s):  
Visual Analogue Scale ◽  
Carpal Tunnel ◽  
Analogue Scale ◽  
Needle Insertion ◽  
Injection Pain ◽  
Significant Difference ◽  
Skin Infiltration ◽  
Group A ◽  
Vas Scores ◽  
Group B

This study investigated the effects of alkalinization and warming of lidocaine 1% on injection pain in patients undergoing carpal tunnel decompression. Sixty-four adult patients were randomly allocated into one of three groups: Group A ( n=20) received plain lidocaine 1%, Group B ( n = 22) alkalinized lidocaine and Group C ( n = 22) warmed and alkalinized lidocaine. Pain on needle insertion and on infiltration was assessed using a 100 mm Visual Analogue Scale (VAS). There was no significant difference regarding pain on needle insertion whereas significant differences were noted in reference to infiltration pain. In Groups B and C (alkalinized lidocaine) the VAS scores on skin infiltration were significantly lower than in Group A, while the pain score in Group C (alkalinized and warmed lidocaine) was significantly lower than in Group B.

scholarly journals Evaluation of Ultrasound Therapeutic Effect on Patients with Carpal Tunnel Syndrome Attending in a Tertiary Care Hospital of Bangladesh

2019 ◽  
Vol 9 (1) ◽  
pp. 70-73
Author(s):  
Nadia Siddiquee ◽  
Farzana Akonjee Mishu ◽  
Sohely Rahman ◽  
Abul Khan Ahmed Zaman
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Visual Analogue Scale ◽  
Carpal Tunnel ◽  
Analogue Scale ◽  
Ultrasound Therapy ◽  
Group A ◽  
Tunnel Syndrome ◽  
Group B ◽  
Wrist Splint

Background: Carpal tunnel syndrome is a common condition in medical practice. Ultrasound therapy is a common non-surgical treatment of carpal tunnel syndrome including other modalities like the use of antiinflammatory agents and exercise. This study was designed to evaluate the effect of ultrasound therapy for the relief of symptoms of patients with carpal tunnel syndrome. Methods: This was a randomized controlled trial. This study as conducted in Department of Physical Medicine and Rehabilitation of Bangabandhu Sheikh Mujib Medical University, Dhakaduring the period from March 2014 to August 2014to evaluate the effect of ultrasound therapy on patients of carpal tunnel syndrome. Total 110 subjects were participated in this study and they were selected randomly. The patients were divided in two groups by lottery. For group A patients treatment schedule (Ultrasound therapy+ Exercise+ Wrist splint +NSAIDs) and group B (Exercise+ Wrist splint+ NSAIDs) were applied for a period of 6 weeks. Group A were compared to group B byVisual Analog Scale after 3weeks and 6weeks of treatment.Statistical analysis of the finding was done with the help of statistical package for social science version (SPSS) 19. The student t test used to analyze the level of significance, p< 0.05. Results: This study showed mean visual analogue scale (VAS) at pretreatment (W0) in group-A was 6.42 ±1.23 and in group-B was 6.17±0.74. Group-A was 1.82±0.43 and in group-B was 3.1±0.23 in their follow up after 3 weeks (W 3). Mean Visual Analogue scale in groupA- was 1.71(±0.52) and in group-B was 2.52(±0.49) at 2nd follow up (W 6) after 6 weeks . So these result reveled that group-A is significantly better than group-B. Conclusion: This study revealed that continuous mode of US therapy with exercise, wrist splint, NSAIDs have better outcome in case of Carpal tunnel syndrome patients. Birdem Med J 2019; 9(1): 70-73

CLINICAL OUTCOME AND COST COMPARISON OF CARPAL TUNNEL WOUND CLOSURE WITH MONOCRYL® AND ETHILON®: A PROSPECTIVE STUDY

Hand Surgery ◽  
2013 ◽  
Vol 18 (02) ◽  
pp. 189-192 ◽  
Author(s):  
Anis Dosani ◽  
Sameer K. Khan ◽  
Sheila Gray ◽  
Steve Joseph ◽  
Ian A. Whittaker
Keyword(s):  
Carpal Tunnel ◽  
Wound Closure ◽  
Unit Cost ◽  
Cost Effective ◽  
Cost Comparison ◽  
Absorbable Suture ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
A Prospective Study

This prospective non-randomised two-cohort study compares the use of an absorbable suture (Poliglecrapone [Monocryl]: Group A) and a non-absorbable suture (Polyamide [Ethilon]: Group B) in wound closure after elective carpal tunnel decompression. The primary outcome was scar cosmesis as assessed by the Stonybrook Scar Evaluation Scale (SBSES); the financial cost of wound closure was compared as a secondary outocome. All fifty patients completed follow-up. At six weeks, there was no significant difference in the two groups regarding scar tenderness (p = 0.5), although residual swelling was more evident in the absorbable group (p = 0.2). The mean SBSES score at six weeks was 4.72 in Group A, and 4.8 in Group B (p = 0.3). The unit cost per closed wound of Monocryl was three times than Ethilon (p < 0.05). Ethilon is thus cost-effective without compromising the cosmetic outcome, and we recommend using this as the preferred suture for closure of carpal tunnel wounds.

scholarly journals COMPARISON BETWEEN THERAPEUTIC ULTRASOUND AND SCAR MOBILIZATION OVER PERSISTENT POSTNATAL DYSPAREUNIA

2017 ◽  
Vol 10 (9) ◽  
pp. 48
Author(s):  
Mariyam Farzana Sf ◽  
Ponmathi P ◽  
Sivakumar Pvr
Keyword(s):  
Quality Of Life ◽  
Analogue Scale ◽  
Therapeutic Ultrasound ◽  
Ultrasound Therapy ◽  
Age Group ◽  
Functional Index ◽  
Significant Difference ◽  
Group A ◽  
Group B

  Objective: Dyspareunia is known as the painful sexual intercourse. This study was conducted to compare the effectiveness between therapeutic ultrasound and scar mobilization in persistent postnatal dyspareunia.Methods: This is an experimental study. 30 subjects with superficial dyspareunia, age group between 25 and 35 years are taken in this study and 15 subjects in Group A were treated with ultrasound therapy, 15 subjects in Group B were treated with scar mobilization. Female sexual functional index questionnaire (FSFI) and visual analogue scale (VAS) were used as the outcome measure.Results: Results showed a significant difference in FSFI and VAS measurements in both the groups, but clinically Group A showed better improvement in pain and quality of life than Group B.Conclusion: There is no significant difference between ultrasound therapy and scar mobilization over the pain and quality of life in patients with persistent postnatal dyspareunia.

scholarly journals Analgesic efficacy of meloxicam with or without a buprenorphine patch in cats after ovariohysterectomy

2018 ◽  
Vol 63 (No. 6) ◽  
pp. 279-286
Author(s):  
SY Heo ◽  
SJ Kim ◽  
NS Kim
Keyword(s):  
Visual Analogue Scale ◽  
Analogue Scale ◽  
Small Sample Size ◽  
Analgesic Efficacy ◽  
Small Sample ◽  
Visual Analogue Scale Pain ◽  
Pain Scores ◽  
Analogue Scale Pain ◽  
Group A ◽  
Group B

The purpose of this prospective double blind clinical study was to evaluate the analgesic efficacy of meloxicam with/without a buprenorphine patch for pain management after ovariohysterectomy in cats. Cats were randomly divided into two groups: ten cats were treated with meloxicam s.c. after ovariohysterectomy (Group A), and eight cats were treated with s.c. meloxicam and a 20 µg/h buprenorphine transdermal patch (Group B). For patch treatment, the cat’s hair was clipped on the left side in the thoracic area. Pain scores were assessed at 0.5, 1, 2, 4, 6, 8, 24 and 30 h post-ovariohysterectomy extubation. To evaluate postoperative pain, 4A-VET pain scale and visual analogue scale pain scores were used. In addition, blood was collected from all cats to determine the cortisol levels at –2 h and at 0.5, 4, 6 and 24 h after extubation. The 4A-VET scores for Group B were significantly lower at 1, 4, 6, 8, 24 and 30 h than the scores for Group A. The visual analogue scale pain scores for Group B were significantly lower at 4, 6, 24 and 30 h than the scores for Group A. Serum cortisol concentrations were not significantly different between Groups A and B at any of the measured intervals. There was a significant positive correlation between postoperative visual analogue scale and 4A-VET pain scores in both groups. Our results should be subject to careful interpretation as the study was limited by its small sample size and by observer subjectivity.

scholarly journals EMLA Cream Prior to Insertion of Elective Epidurals

1995 ◽  
Vol 23 (3) ◽  
pp. 339-341 ◽  
Author(s):  
J. A. Elson ◽  
M. J. Paech
Keyword(s):  
Elective Caesarean Section ◽  
Needle Insertion ◽  
Patient Comfort ◽  
Epidural Needle ◽  
Double Blind Study ◽  
Double Blind ◽  
Emla Cream ◽  
Skin Infiltration ◽  
Group A ◽  
Group B

A randomized double-blind study was conducted in 83 women scheduled for elective caesarean section to determine the efficacy of EMLA and lignocaine infiltration for epidural insertion. The patients were randomly allocated to one of three groups: Group A (EM/LIG) received EMLA and intradermal and subdermal 1% lignocaine infiltration, Group B (EM/SAL) EMLA and saline while Group C (PL/LIG) received placebo cream and 1% lignocaine. Assessments using a 100 mm pain score were performed on skin infiltration and after subsequent insertion of a 16 gauge Tuohy needle into the supraspinous ligament. Skin changes under the applied cream and nursing rating of patients’ response were also noted. Statistical analyses were performed using Kruskal-Wallis and Fisher's Exact Tests. Groups were comparable for age, weight, parity and EMLA application time (interquartile range 105-150 minutes) There were significantly higher pain scores for skin infiltration in Group C (PL/LIG) (P<0.01) and for epidural needle insertion in Group B (EM/SAL) (P<0.05). We concluded that in this patient population, the application of EMLA cream for at least 90 minutes plus 1% lignocaine infiltration optimized patient comfort for epidural insertion.

scholarly journals Hematoma block for distal radius fractures – prospective, randomized comparison of two different volumes of lidocaine

2018 ◽  
Vol 46 (11) ◽  
pp. 4535-4538 ◽  
Author(s):  
Hagay Orbach ◽  
Nimrod Rozen ◽  
Barak Rinat ◽  
Guy Rubin
Keyword(s):  
Distal Radius ◽  
Analgesic Efficacy ◽  
Fracture Site ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Vas Score ◽  
Significant Difference ◽  
Group A ◽  
Vas Scores ◽  
Group B

Objective This study aimed to compare analgesic efficacy and safety of different volumes of lidocaine injected into a fracture hematoma (hematoma block [HB]) for reducing distal radius fractures. Methods Patients were randomly divided into two groups. Group A included patients in whom 10 mL of 2% lidocaine was injected into the fracture site and group B included patients in whom 20 mL of 1% lidocaine was injected. The fracture was manipulated after 15 minutes and the Visual Analogue Scale (VAS) score was recorded during manipulation. Patients were followed up for approximately 1 hour and complications were recorded. Results Twenty patients were enrolled in the study (12 women and eight men), with a mean age of 57 years (range, 32–87 years). Demographic findings were similar between the groups. The mean VAS score of group A was 5.50 ± 3.57 and that in group B was 3.09 ± 2.33, with no significant difference between the groups. Conclusion VAS scores between HB with 20 mL of 1% lidocaine and HB with 10 mL of 2% lidocaine are not significantly different. However, our study suggests that HB with 20 mL of 1% lidocaine has a better analgesic effect than HB with 10 mL of 2% lidocaine.

scholarly journals Comparative Observational Study on the Effects of Intra-articular Hominis Placenta Pharmacopuncture and Acupoint Hominis Placenta Pharmacopuncture for Knee Osteoarthritis Patients

2021 ◽  
Vol 38 (1) ◽  
pp. 60-65
Author(s):  
Yeo-bin Park ◽  
Chang Beohm Ahn ◽  
Yun-Leong Park ◽  
Ji-Won Baek ◽  
Won-Ho Kong ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Medical Records ◽  
Joint Space ◽  
Osteoarthritis Of The Knee ◽  
Analog Scale ◽  
Degenerative Osteoarthritis ◽  
Significant Difference ◽  
Group A ◽  
Vas Scores ◽  
Group B

The aim of this case report was to observe the effects of intra-articular hominis placenta pharmacopuncture (HPP). Based on the medical records patients who received intra-articular treatment or received acupoint pharmacopuncture treatment, a comparison was made. There were 35 patients who were hospitalized for degenerative osteoarthritis of the knee joint from the 1<sup>st</sup> October 2019 to 26<sup>th</sup> September 2020. There were 14 patients who were treated with HPP in the intra-articular joint space (Group A), and 14 patients who were treated with HPP at specific acupoints (Group B). The outcome effects were measured using the Korean Western Ontario and Mc (KWOMAC) the visual analog scale (VAS) before the first treatment, and after the fifth treatment. The KWOMAC (<i>p</i> < 0.001) and the VAS scores (<i>p</i> < 0.001) in Groups A and B significantly improved after treatment compared with before treatment. When comparing Group A improvement with Group B improvement using the KWOMAC there was no statistically significant difference however, when using the VAS scores, Group A treatment was statistically more effective compared with Group B (<i>p</i> = 0.002). This study indicated that HPP may be an effective treatment for knee osteoarthritis. Moreover, intra-articular HPP may be more effective than acupoint HPP for knee osteoarthritis.

scholarly journals Effect of intraarticular steroid injection in addition to physical modalities in osteoarthritis knee

2015 ◽  
Vol 23 (1) ◽  
pp. 48-54
Author(s):  
Md Jahidul Islam ◽  
MM Jalal Uddin ◽  
Md Shahadat Hossain ◽  
Md Ruhul Amin ◽  
Md Moshiur Rahman ◽  
...  
Keyword(s):  
Visual Analogue Scale ◽  
Range Of Motion ◽  
Analogue Scale ◽  
Small Sample ◽  
Therapeutic Exercise ◽  
Womac Index ◽  
Group A ◽  
Pre Treatment ◽  
Group B ◽  
Physical Modalities

Context: Osteoarthritis (OA) is the most common form of arthritis accounting for about 30% of general physician visits. Intrarticular (IA) corticosteroid injections have been used for decades in clinical practice for pain relief and control of local inflammation in OA. In the present study a combined therapy of long acting intra-articular injection in addition to physical modalities of OA knee was given to find out the functional improvement and clinical outcome of the patient. Methods: It was a prospective interventional non-randomized clinical study conducted in the Department of Physical Medicine & Rehabilitation, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from October, 2011 to March, 2012. Fifty four patients between 35 and 75 years without consideration of gender with a history of not less than three months knee pain with radiographic confirmation of primary osteoarthritis were selected purposefully. Then they were divided randomly in group A and B, having 27 patients in each group. Group A received NSAID (non steroidal anti-inflammatory drugs) i.e. aceclofenac 100mg twice daily for 10 days + omeprazol 20mg twice daily for 10 days + MWD (micro wave diathermy 20 minutes for 14 days. + therapeutic exercise + ADL (activities of daily living), while Group B received 80mg intraarticular triamcinolon acetonide injection once followed by NSAID i.e. aceclofenac 100mg twice daily for 10 days + omeprazol 20mg twice daily for 10 days + MWD 20 minutes for 14 days. + therapeutic exercise + ADL. In both groups the patients were observed for six weeks. Results: The mean of age of patients in group A and B were 52.33±9.62 years and 52.29±9.67 years respectively. In group A, 9 (33.3%) were male and 18 (66.7%) were female. In group B, 10 (37.0%) were male and 18 (63.0%) were female. Mean visual analogue scale (VAS) during pre treatment in group A and group B were 6.22±1.60 and 7.15±1.56 respectively. Mean range of motion (ROM) during pre treatment in group A and group B were 117.33±13.05 and 112.37±19.01 respectively. Mean time taken to walk 50 feet during pre treatment in group A and group B were 18.22±2.39 and 18.81±2.13 minutes respectively. Mean Western Ontario and Mc Master Universities (WOMAC) index in group A and group B were 60.85±15.86 and 67.33±16.33 minutes respectively. After treatment in both groups visual analogue scale (VAS), range of motion (ROM), time taken to walk 50 feet and Western Ontario and Mc Master Universities (WOMAC) index gradually decreased and range of motion (ROM) gradually increased, which were statistically significant. However, the study conducted with small sample size in a single centre in Dhaka city, which may not be representative for the whole country. DOI: http://dx.doi.org/10.3329/jdmc.v23i1.22694 J Dhaka Medical College, Vol. 23, No.1, April, 2014, Page 48-54

scholarly journals The Impact of Ulipristal Acetate (UPA) versus Dienogest on Pain Related to Endometriomas Evaluated with Visual Analogue Scale (VAS)

2019 ◽  
Vol 70 (4) ◽  
pp. 1500-1506
Author(s):  
Romina Marina Sima ◽  
Dragos Albu ◽  
Antoniu Cringu Ionescu ◽  
Mihai Dimitriu ◽  
Mihai Popescu ◽  
...  
Keyword(s):  
Visual Analogue Scale ◽  
Analogue Scale ◽  
Rating Scale ◽  
Randomized Study ◽  
Good Method ◽  
Numeric Rating Scale ◽  
Ulipristal Acetate ◽  
Group A ◽  
Group B ◽  
The Impact

Visual analogue scale (VAS) is a psychometric scale applied to measure subjective characteristics. The purpose of our study was to evaluate the efficiency of Ulipristal acetate (UPA) compared with Dienogest for endometriomas related pain using VAS. We performed a randomized study on women with symptomatic endometriomas. The study was realized between January 2016�December 2018. The patients were randomized in two groups: Group A- that received UPA in doses of 5 mg daily for 12�13 weeks and Group B that received 2 mg Dienogest for 12�13 weeks. Each group received de VAS (Visual Analogue Scale) questionnaire before and after treatment. 70 women wereincluded in the study with 35 patients for each group. The age the mean age was 30.20 years. For Numeric Rating Scale before treatment in the group with UPA the median value was 6 (CI= 5.26, 6.51) and for group B the median was 5 (CI= 5.13, 5.66). After treatment for group A the median value was 4 (CI= 3.58, 4.29) and for group B the median value 4 (CI= 4.23, 4.6). For FRS before treatment in the group with UPA median value was 6 (CI= 5.87, 6.58) and for the group B median was 6 (CI= 6.16, 6.57). After treatment for group A the median value was 4 (CI= 4.12, 4.73) and for group B the median value 5 (CI= 4.9, 5.06). The pain significantly improved for group A. (p[ 0.05) VAS represent a good method to evaluate the quality of pain for patients with endometriomas. The UPA and Dienogest treatment improve the VAS parameters with better results for UPA in the present study.

scholarly journals Splinting in Carpal Tunnel Syndrome: The Optimal Duration

2020 ◽  
Vol 185 (11-12) ◽  
pp. e2049-e2054
Author(s):  
Michele A Gatheridge ◽  
Elsa A Sholty ◽  
Alexander Inman ◽  
Meghan Pattillo ◽  
Frank Mindrup ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
The United States ◽  
Functional Improvement ◽  
Treatment Groups ◽  
Significant Difference ◽  
Group A ◽  
Tunnel Syndrome ◽  
Group B ◽  
Wrist Splint

Abstract Introduction The purpose of this study was to evaluate optimal neutral wrist splint duration in treatment-naive mild and mild to moderate carpal tunnel syndrome (CTS). Neutral wrist splinting is a conservative treatment for CTS; however, no clear guidelines exist for how long splinting should be prescribed for optimal outcomes. Materials and Methods In this prospective clinical trial subjects were assigned to wear a neutral wrist splint for 6 (group A) or 12 weeks (group B). Symptom and functional outcomes were assessed by questionnaire at baseline, 6 and 12 weeks. Median nerve sensory and motor latencies were recorded at baseline and 12 weeks. Pretreatment, midtreatment, and posttreatment measures were compared within and between treatment groups where applicable. This study was approved by the United States Air Force Academy institutional review board. Results A total of 30 subjects (37 hands) were randomized to 2 treatment groups. Mean symptom severity and median sensory peak latency significantly improved in both groups at 12 weeks, without a significant difference between groups. Mean functional severity significantly improved only in group A. Conclusion Neutral wrist splint for 6 weeks resulted in better clinical improvements in patients with untreated mild and mild to moderate CTS. There was no additional benefit in extending splinting 6 additional weeks. This is the first study to compare duration of wrist splint use beyond 8 weeks. A larger sample size is needed to identify the reason for lack of functional improvement in group B. Long-term follow-up of this cohort will be helpful to determine the natural history of initial wrist splint use.

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