scholarly journals Evaluation of cosmetic appearance of herniotomy wound scars in African children: Comparison of tissue glue and subcuticular suturing

2009 ◽  
Vol 42 (02) ◽  
pp. 199-203
Author(s):  
A. O. Ademuyiwa ◽  
O. A. Sowande ◽  
O. Adejuyigbe ◽  
U. E. Usang ◽  
T. I. B. Bakare ◽  
...  
Keyword(s):  
Visual Analogue Scale ◽  
Analogue Scale ◽  
Wound Closure ◽  
Plastic Surgeon ◽  
Cosmetic Outcome ◽  
Chi Square ◽  
Tissue Glue ◽  
Cosmetic Appearance ◽  
Significant Difference ◽  
Suturing Technique

ABSTRACT Aim: To evaluate the cosmetic appearance of herniotomy wound scars closed using either the tissue glue or subcuticular suturing technique. Materials and Methods: Prospective randomised control study; randomisation into tissue glue and suturing groups. Ethical clearance obtained. Cosmetic outcome were based on visual analogue scale by parents and Hollander wound evaluation scale by a Plastic Surgeon blinded to the wound closure method. Results: Fifty one wounds were evaluated, 26 in the tissue glue group and 25 in the suturing group. Parents’ evaluation using Visual Analogue scale (VAS) showed that in the suturing group, 17 parents (68%) gave a VAS of 8cm while six parents (24%) gave a score of 7cm. Two parents (8%) gave a score of 9cm. In the tissue glue group, 22 parents (84.6%) scored the scar of their children as 8 or 9cm on the VAS while four parents (15.4%) gave a score of 7cm. The median VAS was 8cm for both groups with a range of 7 to 9cm. The Chi- square test showed that the parents preferred tissue glue compared with subcuticular suturing (X2 = 7.90, P < 0.05). The Hollander Wound Evaluation Scale (HWES) used by Plastic Surgeon showed 21 herniotomy wounds (84%) had a score of 6 in the suturing group while four wounds (16%) had a score of 5. In the tissue glue group, 19 wounds (73%) had a score of 6, six wounds (23.1%) had a score of 5 and a patient (3.8%) had a score of 4. The median score is 6 for both groups. There was no statistically significant difference between both groups (X2 = 1.481, P = 0.393). Conclusion: This study has shown that the cosmetic outcome of wound closure using the tissue glue technique and subcuticular suturing technique are similar.

scholarly journals A Blinded, Randomised, Controlled Trial of Stapled Versus Tissue Glue Closure of Neck Surgery Incisions

2007 ◽  
Vol 89 (3) ◽  
pp. 242-246 ◽  
Author(s):  
DM Ridgway ◽  
F Mahmood ◽  
L Moore ◽  
D Bramley ◽  
PJ Moore
Keyword(s):  
Randomised Controlled Trial ◽  
Visual Analogue Scale ◽  
Analogue Scale ◽  
Controlled Trial ◽  
Neck Surgery ◽  
Skin Closure ◽  
Tissue Glue ◽  
Cosmetic Appearance ◽  
Randomised Controlled ◽  
Neck Mobility

INTRODUCTION Cosmetic acceptability of scar and neck mobility are important outcomes after collar line incision for neck surgery. This randomised, controlled trial compares these parameters in closures using tissue glue (Dermabond™, Ethicon, UK) and skin staples. PATIENTS AND METHODS Patients requiring a collar line incision were randomised to receiving tissue glue or staples for skin closure. Time for closure to be completed was recorded. Mobility of the neck was assessed using a visual analogue scale at 48 h and 1 week after surgery. At 6 weeks, cosmetic appearance was assessed using a linear 1–10 visual analogue scale by the patient, surgeon and an independent blinded assessor. Results were compared using appropriate statistical tests. RESULTS Glued (n = 14) and stapled (n = 15) closures were performed for hemithyroidectomy (n = 8 versus 6), sub-total thyroidectomy (n = 2 versus 4), total thyroidectomy (n = 1 versus 4) and parathyroidectomy (n = 3 versus 1). Closure with tissue glue took significantly longer than with staples (mean, 95 versus 28 s; P < 0.001). Neck mobility scores were comparable at 48 h and 1 week (mean, 4.8 versus 4.4; P = 0.552: and 2.7 versus 2.6; P = 0.886). Cosmetic appearance at 6 weeks was comparable when patient (mean, 1.7 versus 1.8; P = 0.898), surgeon (mean, 2.6 versus 2.3; P = 0.633) and independent assessment (mean, 1.4 versus 1.9; P = 0.365) was performed. CONCLUSIONS The use of glued skin closure may increase the duration of surgery but acceptable neck mobility and wound cosmesis can be achieved by the more rapid application of stapled skin closure in cervicotomy incisions.

scholarly journals The Minimum Clinically Significant Difference in Visual Analogue Scale Pain Score in a Local Emergency Setting

2009 ◽  
Vol 16 (4) ◽  
pp. 233-236 ◽  
Author(s):  
MSM Mark ◽  
TTS Au ◽  
YF Choi ◽  
TW Wong
Keyword(s):  
Visual Analogue Scale ◽  
Pain Score ◽  
Analogue Scale ◽  
Education Level ◽  
Chinese Patients ◽  
Visual Analogue Scale Pain ◽  
Emergency Setting ◽  
Significant Difference ◽  
Analogue Scale Pain ◽  
Clinically Significant

Objectives To determine whether the minimum clinically significant difference (MCSD) in visual analogue scale (VAS) pain score varies with age, gender, education level and cause of pain (trauma versus non-trauma) in Chinese patients. Methods This was a prospective descriptive study of local Chinese patients 15 years of age or older who presented with pain to the accident & emergency department. On presentation, patients were asked to indicate their current pain severity with a single mark through a standard 100–mm visual analogue scale. Then they would be offered an analgesic for pain-relief. After 30–45 minutes, the patients were asked to give a verbal categorical rating of their pain as ‘a lot better’, ‘a little better’, ‘much the same’, ‘a little worse’, or ‘much worse’ and to mark the level of pain on a VAS of the same type as used previously. The MCSD in VAS pain score was defined as the mean difference between the current and preceding scores when the subject reported ‘a little worse’ or ‘a little better’ in pain. Data were compared based on gender, age, education level, and traumatic versus non-traumatic causes of pain. Results 186 patients were enrolled in the study, yielding 77 evaluable comparisons where pain was rated as ‘a little better’ or ‘a little worse’. Overall, the MCSD in VAS pain score in the group was 17 mm (95%CI 13.6 mm to 20.6 mm). There were statistically significant differences between the MCSD in VAS pain score between genders and causes of pain (trauma versus non-trauma). Conclusions The MCSD in VAS pain scores was found to be 17 mm. There was significant differences in MCSD in VAS pain score in different genders and between trauma and non-trauma cases.

scholarly journals Comparative Evaluation of Effectiveness of Intravenous Paracetamol and Intravenous Diclofenac as Post-operative Analgesia in Laparoscopic Cholecystectomy

2018 ◽  
Vol 6 (2) ◽  
pp. 6
Author(s):  
Kalpana Kharbuja ◽  
Mahesh Sharma ◽  
Nil Raj Sharma
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Visual Analogue Scale ◽  
Analogue Scale ◽  
P Value ◽  
Anesthesia Induction ◽  
Chi Square ◽  
Rescue Analgesia ◽  
Post Operative Period ◽  
Post Operative Pain ◽  
Intravenous Paracetamol

Introduction: Though the development of minimally invasive surgery  has revolutionized the field of surgery,  post-operative pain is still a significant issue. Unlike in the past, concerns about adverse effects have limited the role of opioids in post-operative pain management. This study aims to compare the effectiveness of intravenous paracetamol and  diclofenac as postoperative analgesia in laparoscopic cholecystectomy. Methods:One hundred and twenty eight patients of American Society of Anesthesiologists (ASA) categories I and II  included in this study  were divided into two groups. Anesthesia induction and maintenance were standardized. The first group received 15mg/kg (maximum 1gm) intravenous paracetamol and the second group received 2mg/kg (maximum 75mg) intravenous diclofenac 30 minutes prior to ending of surgery. A questionnaire was responded by patients and chart was maintained by visual analogue scale. Mann Whitney U test was used to analyze quantitative data and Chi-square test for categorical data. P value <0.05 was considered statistically significant. Results:  Profiles of hemodynamic changes were almost similar in both groups with respect to heart rate and blood pressure. However, paracetamol infusion provided hemodynamic stability in post-operative period. We observed statistically significant differences  in visual analogue scale between the two groups. Most of the patients in paracetamol group had low mean pain scores in post-operative period and provided an extended analgesia compared to diclofenac. No serious postoperative complication was observed in  paracetamol group.   Conclusion: Administration of intravenous paracetamol has better and prolonged analgesic effect  with low mean pain score and less requirement for rescue analgesia compared to diclofenac.

scholarly journals Prevalence of De-Quervain’s Tenosynovitis and Its Association with Text Messaging in Collegiate Girl Students of Amritsar

2021 ◽  
Vol SP (1) ◽  
Author(s):  
Vandana ◽  
Shyamal Koley
Keyword(s):  
Visual Analogue Scale ◽  
Text Messaging ◽  
Analogue Scale ◽  
Smart Phones ◽  
Chi Square ◽  
De Quervain’S Tenosynovitis ◽  
Chi Square Test ◽  
Girl Students

Purpose: The purpose of the present study was to search the prevalence of De-Quervain’s tenosynovitis in collegiate girl students of Amritsar and its association with mobile size and text messaging per day by the students. Materials and methods: To fulfill the purpose, randomly selected 201 girl students those who used their smart phones of different sizes and for texting varied number of SMS every day, aged 18-26 years, were selected from Guru Nanak Dev University, Amritsar. The Visual Analogue Scale (VAS) was used to measure the pain in wrist. The Finkelstein test was conducted on the subjects to ascertain their De-Quervain’s tenosynovitis status. Chi-square test was applied to search any association of De-Quervain’s tenosynovitis and mobile size and SMS messaging by the students. Results: It was observed that, out of 201 girl students, 20.89% were reported Finkelstein test positive. Statistically, highly significant (p<0.001) association was found between positive Finkelstein status and the mobile size and SMS messaging per day by the collegiate girl students. Conclusion: It might be concluded that 20.89% of the girl students had De-Quervain’s tenosynovitis. Statistically highly significant association was found between positive Finkelstein status and the mobile size and SMS messaging per day by the collegiate girl students.

scholarly journals Μελέτη των παραγόντων που επηρεάζουν την εμφάνιση εξέλκωσης σε διαβητικό πόδι και σχεδιασμός εξατομικευμένου υποδήματος

2020 ◽  
Author(s):  
Αριστομένης Κοσσιώρης
Keyword(s):  
Visual Analogue Scale ◽  
Receiver Operating Characteristic ◽  
Scale Score ◽  
Visual Analogue Scale Score ◽  
Roc Curve ◽  
Analogue Scale ◽  
Operating Characteristic ◽  
Curve Analysis ◽  
Roc Curve Analysis ◽  
Chi Square

Εισαγωγή: Αν και οι ακρωτηριασμοί και οι παραμορφώσεις στα πόδια, αποτελούν παραμέτρους που έχουν μελετηθεί ως παράγοντες κινδύνου για διαβητική εξέλκωση [10,127,128], η συμπερίληψη των ποδικών ακρωτηριασμών και παραμορφώσεων σε μία ευρεία, ενιαία μεταβλητή παραμορφώσεων με αναφορά στη βαρύτητα αυτών, μπορεί να χαρακτηρίζει καλύτερα τα άτομα σε κίνδυνο για διαβητική εξέλκωση. Η διαβητική εξέλκωση μπορεί να προληφθεί εφαρμόζοντας κατάλληλες παρεμβάσεις, όπως η χρήση ειδικών υποδημάτων αποφόρτισης για ≥60% του χρόνου κατά τον οποίο βαδίζουν ή βρίσκονται σε όρθια στάση ή εκτός του κρεβατιού (≥9.6/16 ώρες) [72,76,79]. Ωστόσο, από απλούς υπολογισμούς, μόνο οι μισοί σχεδόν ασθενείς (49.5% -ενδοτεταρτομοριακό εύρος 39.0-49.5%-) των ασθενών έχουν προμηθευτεί υποδήματα πρόληψης διαβητικής εξέλκωσης μετά από σχετική σύσταση του ιατρού [74,129], όπως επίσης οι μισοί σχεδόν ασθενείς (55.7% -τυπική απόκλιση 16.9%-), από αυτούς που έχουν προμηθευτεί ειδικά υποδήματα αποφόρτισης, τα φορούν για τον ενδεδειγμένο χρόνο [72-76]. Υλικό και Μέθοδος: Σκοπός της παρούσας μελέτης ήταν η διερεύνηση της βαρύτητας των ακρωτηριαστικών και μη ακρωτηριαστικών ποδικών παραμορφώσεων ως παράγοντα κινδύνου για διαβητική εξέλκωση σε σχέση με τους άλλους καθιερωμένους στη βιβλιογραφία παράγοντες κινδύνου και η σύνδεση των ευρημάτων της διερεύνησης αυτής με τη θεωρητική υπόθεση ότι η χρήση κατάλληλων υποδημάτων από τους ασθενείς με διαβήτη τουλάχιστον για το 60% του χρόνου κατά τον οποίο βρίσκονται εκτός του κρεβατιού μπορεί να προλάβει την ανάπτυξη διαβητικών ελκών, σε δύο μελέτες στο ίδιο δείγμα ασθενών με διαβήτη με ή χωρίς ενεργά ποδικά έλκη (μελέτες 1 και 2, N=134 και 134 αντίστοιχα). Στην πρώτη μελέτη, διερευνήθηκε η βαρύτητα των ακρωτηριαστικών και μη ακρωτηριαστικών ποδικών παραμορφώσεων ως παράγοντα κινδύνου για διαβητική εξέλκωση σε σχέση με τους άλλους, καθιερωμένους στη βιβλιογραφία παράγοντες κινδύνου. Διενεργήθηκε συγχρονική και ασθενών-μαρτύρων έρευνα από τον Οκτώβριο του 2005 μέχρι τον Νοέμβριο του 2016. Για τη συλλογή των δεδομένων, χρησιμοποιήθηκε δομημένος ποσοτικός οδηγός συνέντευξης. Πραγματοποιήθηκε μονομεταβλητή λογιστική παλινδρομική ανάλυση για τους καθιερωμένους στη βιβλιογραφία παράγοντες κινδύνου, όπως επίσης για δύο εκδοχές της μεταβλητής «βαρύτητα των ακρωτηριαστικών και μη ακρωτηριαστικών ποδικών παραμορφώσεων» (με δύο και τρεις κατηγορίες βαρύτητας ποδικών παραμορφώσεων). Ακολούθως, πραγματοποιήθηκε πολυμεταβλητή λογιστική παλινδρομική ανάλυση για τρία προβλεπτικά μοντέλα και ανάλυση καμπύλης λειτουργικού χαρακτηριστικού δέκτη (receiver operating characteristic -ROC- curve analysis) για τη σύγκριση αυτών. Στη δεύτερη μελέτη, εξετάστηκαν η αρχική και συνεχιζόμενη συμμόρφωση των ασθενών με διαβητική ποδοπάθεια στη χρήση κατάλληλων υποδημάτων. Για τη συλλογή των δεδομένων, χρησιμοποιήθηκε επίσης δομημένος ποσοτικός οδηγός συνέντευξης. Για την επαγωγική στατιστική ανάλυση των δεδομένων, εφαρμόστηκαν τα τεστ Chi-square και Mann-Whitney U, όπως επίσης μονομεταβλητή λογιστική παλινδρομική ανάλυση. Αποτελέσματα: Όσον αφορά στη μελέτη 1, η μονομεταβλητή λογιστική παλινδρομική ανάλυση, αναφορικά με τις μεταβλητές που περιλαμβάνονταν στα τρία μοντέλα («1», «2» και «3») ήταν σημαντική (P≤.05) για τη διαβητική περιφερική νευροπάθεια (OR 3.80, 95% CI 1.66-8.70, P=.002), την περιφερική αρτηριοπάθεια (OR 4.14, 95% CI 1.84-9.32, P=.001), τις ακρωτηριαστικές ποδικές παραμορφώσεις (OR 2.78, 95% CI 1.04-7.45, P=.042), το ιστορικό προηγούμενης ποδικής εξέλκωσης (OR 3.79, 95% CI 1.64-8.77, P=.002) και τις μέτριες/σοβαρές ποδικές παραμορφώσεις από τη μεταβλητή «βαρύτητα των ακρωτηριαστικών και μη ακρωτηριαστικών ποδικών παραμορφώσεων» με τις δύο κατηγορίες βαρύτητας (κατηγορία αναφοράς: «καμία/ήπιες») (OR 2.78, 95% CI 1.13-6.86, P=.026). Σχετικά με την πολυμεταβλητή λογιστική παλινδρομική ανάλυση του μοντέλου 1, δεν παρήχθη καμία στατιστικά σημαντική μεταβλητή. Αναφορικά με την πολυμεταβλητή λογιστική παλινδρομική ανάλυση των μοντέλων 2 και 3, μόνο η περιφερική αρτηριοπάθεια ήταν στατιστικά σημαντική (OR 3.56, 95% CI 1.17-10.82, P=.025 και OR 3.33, 95% CI 1.10-10.08, P=.033 αντίστοιχα). Όσον αφορά στην ανάλυση καμπύλης λειτουργικού χαρακτηριστικού δέκτη, και τα δύο μοντέλα 2 και 3 είχαν μεγαλύτερες περιοχές κάτω από την ROC καμπύλη από την περιοχή του μοντέλου 1 (0.763, P<.001 και 0.754, P<.001 αντίστοιχα). Σχετικά με τη μελέτη 2, υπήρξε μια σημαντική συσχέτιση μεταξύ της παρουσίας ή απουσίας ενεργής ποδικής εξέλκωσης και του αν ή όχι οι συμμετέχοντες φορούσαν σωστά υποδήματα τη στιγμή της έρευνας (χ2(1)=4.36, P=.037). Οι ασθενείς με ενεργά ποδικά έλκη φορούσαν κατάλληλα υποδήματα σε μικρότερο ποσοστό (44.4% έναντι 78.6%) από εκείνους που δεν είχαν έλκη (τους ασθενείς σε κίνδυνο για διαβητική εξέλκωση). Η αρχικά συμμορφούμενη ομάδα είχε σημαντικά χαμηλότερο Visual Analogue Scale score αναφορικά με την ικανοποίηση από την τιμή των υποδημάτων (διάμεσος=5.0) από την ομάδα που δεν ήταν αρχικά συμμορφούμενη (διάμεσος=8.0, U=97.0, z=-2.36, P=.019, r=-0.38). Η μονομεταβλητή λογιστική παλινδρομική ανάλυση σε σχέση με την έκβαση της αρχικής συμμόρφωσης, ήταν σημαντική (P=.045) μόνο για την παράμετρο της «παρουσίας ή απουσίας ενεργής ποδικής εξέλκωσης» (OR 4.58, 95% CI 1.04-20.24) καταδεικνύοντας γραμμική σχέση μεταξύ της κατηγορικής ανεξάρτητης μεταβλητής και των λογαριθμικών λόγων των πιθανοτήτων της εξαρτημένης. Η απουσία ενεργών ποδικών εξελκώσεων είχε θετική επίδραση στη αρχική συμμόρφωση (B=1.52, SE=0.76) και ο δείκτης Nagelkerke’s R2, ο οποίος ήταν ίσος με 0.14, φανέρωσε μια σχετικά αδύναμη συσχέτιση μεταξύ της προβλεπτικής και της εξαρτημένης μεταβλητής. Το μέγεθος της υποομάδας των ασθενών σε κίνδυνο για ποδική εξέλκωση ήταν αρκετά μικρό (n=11) και συνεπώς ανεπαρκές για επαγωγική ανάλυση αναφορικά με τη συνεχιζόμενη συμμόρφωση. Συμπεράσματα: Μια ενιαία μεταβλητή για τους ακρωτηριασμούς των κάτω άκρων και τις άλλες ποδικές παραμορφώσεις με αναφορά στη βαρύτητα αυτών και ≥2 κατηγορίες κινδύνου, θα μπορούσε να είναι πιο βοηθητική στους κλινικούς για τον εντοπισμό και την ταξινόμηση των ασθενών με διαβήτη σε κίνδυνο για διαβητική εξέλκωση. Για την επαύξηση της αρχικής συμμόρφωσης και κατ’ επέκταση της συνεχιζόμενης συμμόρφωσης στη χρήση κατάλληλων υποδημάτων από τους ασθενείς με διαβήτη με ποδικά έλκη ή σε κίνδυνο για ποδική εξέλκωση, οι επαγγελματίες υγείες θα μπορούσαν αν δίνουν μεγαλύτερη έμφαση στην εκπαίδευση των ασθενών με ενεργά ποδικά έλκη, εφαρμόζοντας εντατικές εκπαιδευτικές παρεμβάσεις [70,71]. Επιπρόσθετα, θα μπορούσαν να παρέχουν στους ασθενείς πολλαπλές επιλογές κόστους αναφορικά με τα υποδήματά τους (π.χ. προτείνοντας αποτελεσματικά και οικονομικά προϊόντα) ή θα μπορούσαν να συμμετέχουν, υπό τον όρο της κατάλληλης εφαρμογής της σχετικής τεχνολογίας στα νοσοκομεία, στην διαδικασία σχεδιασμού/κατασκευής ιατροτεχνολογικών προϊόντων, όπως τα θεραπευτικά/προληπτικά υποδήματα, μειώνοντας έτσι το τελικό κόστος [109,149].

scholarly journals Comparison of Postoperative Pain between Patients who underwent Primary and Repeated Caesarean Section: A Prospective Cohort Study

2019 ◽  
Author(s):  
Guangyou Duan ◽  
Guiying Yang ◽  
Jing Peng ◽  
Zhenxin Duan ◽  
Jie Li ◽  
...  
Keyword(s):  
Cohort Study ◽  
Postoperative Pain ◽  
Visual Analogue Scale ◽  
Cesarean Section ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Analogue Scale ◽  
Visceral Pain ◽  
Significant Difference ◽  
Repeat Cesarean Section

Abstract Background: The presences of differences in post-operative pain are unclear between the primipara who underwent a primary cesarean section and multipara who underwent first repeat cesarean section. The study aimed to explore the possible difference in postoperative pain between primipara and multipara. Methods: A prospective cohort study was carried out, and only women who underwent cesarean deliveries under spinal anesthesia were included. Postoperative patient-controlled intravenous analgesia was performed for all subjects with 0.2 mg/kg hydromorphone and 4 mg/kg flurbiprofen, and the pump was programmed as 2.0 mL/h background infusion, and loading dose of 1 mL with a lockout period of 15 min. Postoperative incision and visceral pain intensity were evaluated using visual analogue scale, and inadequate analgesia was defined as visual analogue scale ≥40 during the postoperative 48 hours. Additionally, the patients’ pain statuses on postoperative week 1 and week 4 were also assessed during follow-up via telephone. Results: From January to May 2017, a total of 168 patients (67 primipara and 101 multipara) were included. The relative risk for multipara to experience inadequate analgesia on incision pain was 0.42 (95% CI: 0.25 to 0.74) compared to primipara. In patients under 30 years old, inadequate analgesia on visceral pain in the multipara was higher than that on the primipara (RR, 3.56 [1.05 to 12.04], P=0.025). There was no significant difference in the combined incidence of inadequate analgesia in both types of pain between the multipara and primipara (33.7%vs.40.2%, P=0.381). No difference was found in PCIA consumption between two groups. (111.1 ± 36.0mL vs. 110.9 ± 37.3mL, P=0.979) Additionally, a significantly higher incidence of pain at 4 weeks after the surgery was noted in the primipara compared to the multipara (62.2%vs.37.7%, P=0.011). Conclusions: Multipara who underwent first repeat cesarean section have lower risk to experience inadequate analgesia on incision pain during the first 48 hours after surgery compared to primipara. While multipara under 30 years may be more prone to experiencing postoperative inadequate analgesia on visceral pain.

scholarly journals Comparison of postoperative pain between patients who underwent primary and repeated cesarean section: a prospective cohort study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Guangyou Duan ◽  
Guiying Yang ◽  
Jing Peng ◽  
Zhenxin Duan ◽  
Jie Li ◽  
...  
Keyword(s):  
Cohort Study ◽  
Postoperative Pain ◽  
Visual Analogue Scale ◽  
Cesarean Section ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Analogue Scale ◽  
Visceral Pain ◽  
Significant Difference ◽  
Repeat Cesarean Section

Abstract Background The differences in post-operative pain are unclear between the primiparas who underwent a primary cesarean section and multiparas who underwent their first repeat cesarean section. The study aimed to explore the possible differences in postoperative pain between primiparas and multiparas. Methods A prospective cohort study was performed only including women who underwent cesarean deliveries under spinal anesthesia. Postoperative patient-controlled intravenous analgesia (PCIA) was administered to all subjects with 0.2 mg/kg hydromorphone and 4 mg/kg flurbiprofen; the pump was programmed as 2.0 mL/h background infusion with a loading dose of 1 mL and a lockout period of 15 min. Postoperative incision and visceral pain intensity were evaluated using the visual analogue scale, and inadequate analgesia was defined as a visual analogue scale score ≥ 40 during 48 h post-operation. Additionally, the patients’ pain statuses in postoperative week 1 and week 4 were also assessed during follow-up via telephone. Results From January to May 2017, a total of 168 patients (67 primiparas and 101 multiparas) were included. The relative risk for multiparas to experience inadequate analgesia on incision pain was 0.42 (95% CI: 0.25 to 0.74) compared to primiparas. In patients aged < 30 years, inadequate analgesia on visceral pain was higher in multiparas than in primiparas (RR, 3.56 [1.05 to 12.04], P = 0.025). There was no significant difference in the combined incidence of inadequate analgesia in both types of pain between the multiparas and primiparas (33.7% vs. 40.2%, P = 0.381). No difference was found in PCIA use between the two groups (111.1 ± 36.0 mL vs. 110.9 ± 37.3 mL, P = 0.979). In addition, a significantly higher incidence of pain was noted 4 weeks post-surgery in primiparas than that in multiparas (62.2% vs. 37.7%, P = 0.011). Conclusion Multiparas who underwent their first repeat cesarean section have a lower for inadequate analgesia on incision pain during the first 48 h after surgery than primiparas. Multiparas aged under 30 years may be more prone to experiencing postoperative inadequate analgesia on visceral pain. Trail Registration ClinicalTrial.gov: NCT03009955, Date registered: December 30, 2016.

The effect of distraction on pain perception during an endovenous thermal ablation procedure

2016 ◽  
Vol 31 (7) ◽  
pp. 463-470 ◽  
Author(s):  
Carina EG van Zandvoort ◽  
Irwin M Toonder ◽  
Irma AJ Stoopendaal ◽  
Cees HA Wittens
Keyword(s):  
Visual Analogue Scale ◽  
Pain Score ◽  
Thermal Ablation ◽  
Analogue Scale ◽  
Pain Perception ◽  
Visual Analogue Scale Pain ◽  
Visual Distraction ◽  
Significant Difference ◽  
Analogue Scale Pain ◽  
Endovenous Thermal Ablation

Objectives To determine whether audio and visual distraction can affect the pain perception of a patient undergoing endovenous thermal ablation under tumescent anesthesia. Methods Patients underwent an endovenous thermal ablation procedure and were randomized into two groups: non-distraction (AVD−) and with distraction (AVD+). Visual analogue scale pain score and hospital anxiety depression scale scores were used to measure outcome. The recruited patients were asked to submit an anticipated visual analogue scale pain score prior to treatment as well as the actual experienced post-operative visual analogue scale pain score. Results There was no significant difference between the AVD− and AVD+ groups post-operative pain score 2.85 (SD 1.7) versus 2.60 (SD 2.3), p = 0.68. Pain score in women with distraction (AVD+) decreased from 3.81 to 2.42. The pain score in men with distraction (AVD+) increases from 1.88 to 2.82. In the AVD− group, a significant difference was found between men and women ( p = 0.014). Disregarding gender, a significant difference was found between the anticipated pain score and the actual pain score in both the AVD− group ( p = 0.009) and AVD+ group ( p = 0.021). There was a correlation between depression and the pain score, which was not seen between pain and anxiety score. Conclusion The results suggested that audiovisual distraction has no influence on the visual analogue scale pain score during endovenous thermal ablation under tumescent anesthesia. Despite this, patients appreciate and evaluate audio and visual distraction as pleasant to extremely pleasant when applied.

scholarly journals Comparison of Four Different Pain Relief Methods during Hysterosalpingography: A Randomized Controlled Study

2015 ◽  
Vol 20 (2) ◽  
pp. 107-111 ◽  
Author(s):  
Bekir Serdar Unlu ◽  
Mehmet Yilmazer ◽  
Gulengul Koken ◽  
Dagistan Tolga Arioz ◽  
Ebru Unlu ◽  
...  
Keyword(s):  
Pain Relief ◽  
Visual Analogue Scale ◽  
Analogue Scale ◽  
Cervix Uteri ◽  
Controlled Study ◽  
Group 4 ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

BACKGROUND: Hysterosalpingography (HSG) is the most commonly used method for evaluating the anatomy and patency of the uterine cavity and fallopian tubes, and is an important tool in the evaluation of infertility. The most frequent side effect is the pain associated with the procedure.OBJECTIVES: To evaluate four analgesic methods to determine the most useful method for reducing discomfort associated with HSG.METHODS: In the present prospective study, 75 patients undergoing HSG for evaluation of infertility were randomly assigned to four groups: 550 mg of a nonsteroidal anti-inflammatory drug (NSAID) (group 1); 550 mg NSAID + paracervical block (group 2); 550 mg NSAID + paracervical analgesic cream (group 3); or 550 mg NSAID + intrauterine analgesic instillation (group 4). A visual analogue scale was used to assess the pain perception at five predefined steps.RESULTS: Instillation of the liquids used for HSG was found to be the most painful step of HSG, and this step was where the only significant difference among groups was observed. When comparing visual analogue scale scores, group 2 and group 3 reported significantly less pain than the other groups. Group 1 reported significantly higher mean ( ± SD) scores (7.2 ± 1.6) compared with groups 2 and 3 (4.7 ± 2.5 and 3.8 ± 2.4, respectively) (P<0.001). In addition, group 2 reported significantly less pain than group 4 (4.7 ± 2.5 versus 6.7 ± 1.8, respectively) (P<0.02).CONCLUSIONS: For effective pain relief during HSG, in addition to 550 mg NSAID, local application of lidocaine cream to the posterior fornix of the cervix uteri and paracervical lidocaine injection into the cervix uteri appear to be the most effective methods.

Efficacy of clindamycin in reducing pain following tonsillectomy in adults: a double-blind, randomised trial

2013 ◽  
Vol 127 (11) ◽  
pp. 1106-1110 ◽  
Author(s):  
M H Baradaranfar ◽  
V Zand ◽  
M H Dadgarnia ◽  
S Atighechi
Keyword(s):  
Visual Analogue Scale ◽  
Normal Saline ◽  
Analogue Scale ◽  
Randomised Trial ◽  
Randomised Clinical Trial ◽  
Visual Analogue Scale Pain ◽  
Double Blind ◽  
Throat Pain ◽  
Significant Difference ◽  
Post Operation

AbstractObjective:Tonsillectomy is a common operation performed in children and young adults. Pain and post-operation haemorrhage are its most common complications. This study was designed to evaluate the efficacy of topical antibiotics in reducing throat pain after tonsillectomy in adult patients.Methods:A double-blind, placebo-controlled, randomised clinical trial was conducted, enrolling 30 patients older than 18 years who were scheduled to undergo tonsillectomy. Patients were randomly assigned to receive either clindamycin or normal saline (as placebo). Throat pain severity was evaluated using a visual analogue scale.Results:All patients in both groups had experienced a reduction in pain by the seventh day after surgery. There was no statistically significant difference in the extent of visual analogue scale pain score reduction, comparing the placebo and clindamycin groups throughout the study course (p = 0.424).Conclusion:Topical clindamycin was not demonstrated to be more effective than normal saline in the reduction of throat pain following tonsillectomy in adults.

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