Cost-efficacy of Rofecoxib versus  Acetaminophen for Preventing Pain after Ambulatory Surgery

2002 ◽  
Vol 97 (4) ◽  
pp. 931-937 ◽  
Author(s):  
Tijani Issioui ◽  
Kevin W. Klein ◽  
Paul F. White ◽  
Mehernoor F. Watcha ◽  
Gary D. Skrivanek ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Pain Management ◽  
Postoperative Pain ◽  
Confidence Interval ◽  
Analgesic Efficacy ◽  
Additional Patient ◽  
Controlled Study ◽  
Quality Of Recovery ◽  
Analgesic Medication

Background Nonsteroidal antiinflammatory drugs are commonly administered as part of a multimodal regimen for pain management in the ambulatory setting. This randomized, double-blinded, placebo-controlled study was designed to compare the analgesic effect of oral rofecoxib, a cyclooxygenase-2 inhibitor, and acetaminophen when administered alone or in combination prior to outpatient otolaryngologic surgery. Methods A total of 143 healthy outpatients undergoing elective otolaryngologic surgery were assigned to one of four study groups: group 1 = control (500 mg vitamin C); group 2 = 2 g acetaminophen; group 3 = 50 mg rofecoxib; or group 4 = 2 g acetaminophen and 50 mg rofecoxib. The first oral dose of the study medication was taken 15-45 min before surgery, and a second dose of the same medication was administered on the morning after surgery. Recovery times, side effects, and the need for rescue analgesics were recorded. Follow-up evaluations were performed at 24 and 48 h after surgery to assess postdischarge pain, analgesic requirements, nausea, and patient satisfaction with their postoperative pain management and quality of recovery. Peak pain scores and the need for rescue analgesic medication were used as the endpoints for estimating efficacy of the study drugs, while cost to achieve complete satisfaction with analgesia was used in the cost-effectiveness analysis. Results Premedication with rofecoxib (50 mg) was significantly more effective than either placebo or acetaminophen (2 g) in reducing the peak postoperative pain, the need for analgesic medication, and improving the quality of recovery and patient satisfaction. Moreover, the addition of acetaminophen failed to improve its analgesic efficacy. An expenditure for rofecoxib of 16.76 US dollars (95% confidence interval, 7.89 to 21.03 US dollars) and 30.24 US dollars (95% confidence interval, 5.25 to 54.20 US dollars) would obtain complete satisfaction with pain control in one additional patient who would not have been satisfied if placebo or acetaminophen, respectively, had been administered prior to surgery. Conclusions Rofecoxib, 50 mg administered orally, decreased postoperative pain and the need for analgesic rescue medication after otolaryngologic surgery. The addition of 2 g oral acetaminophen failed to improve its analgesic efficacy.

Comparative Efficacy of Acustimulation (ReliefBand®) versus Ondansetron (Zofran®) in Combination with Droperidol for Preventing Nausea and Vomiting

2002 ◽  
Vol 97 (5) ◽  
pp. 1075-1081 ◽  
Author(s):  
Paul F. White ◽  
Tijani Issioui ◽  
Jie Hu ◽  
Stephanie B. Jones ◽  
Jayne E. Coleman ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Plastic Surgery ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Normal Diet ◽  
Nausea And Vomiting ◽  
Controlled Study ◽  
Combination Group ◽  
Quality Of Recovery

Background Antiemetic drugs are costly, are associated with variable efficacy, and can produce unwanted side effects when used for prophylaxis against postoperative nausea and vomiting. This clinical study was designed to compare the efficacy of transcutaneous electrical acupoint stimulation using a ReliefBand to ondansetron (Zofran) when utilized alone or in combination for preventing postoperative nausea and vomiting after plastic surgery. Methods A single-center, randomized, double-blind, placebo- and sham-controlled study design was conducted to compare three prophylactic antiemetic treatment regimens in 120 outpatients undergoing plastic surgery procedures with routine low-dose droperidol prophylaxis: (1) ondansetron (n = 40), 4 mg intravenous ondansetron and a sham ReliefBand; (2) acustimulation (n = 40), 2 ml intravenous saline and an active ReliefBand; and (3) combination (n = 40), 4 mg intravenous ondansetron and an active ReliefBand. The incidences of postoperative nausea and vomiting, as well as the need for "rescue" antiemetics, were determined at specific time intervals for up to 72 h after surgery. The outcome variables assessed included recovery times, quality of recovery score, time to resumption of normal diet, and patient satisfaction with the prophylactic antiemetic therapy. Results Use of the ReliefBand in combination with ondansetron significantly reduced nausea (20 vs. 50%), vomiting (0 vs. 20%), and the need for rescue antiemetics (10 vs. 37%) compared with ondansetron alone at 24 h after surgery. Furthermore, the ability to resume a normal diet (74 vs. 35%) within 24 h after surgery was significantly improved when the ReliefBand was used to supplement ondansetron (vs. ondansetron alone). Finally, the quality of recovery (90 +/- 10 vs.70 +/- 20) and patient satisfaction (94 +/- 10 vs. 75 +/- 22) scores were significantly higher in the combination group the ondansetron group. There were no significant differences between the ReliefBand and ondansetron when administered as adjuvants to droperidol for antiemetic prophylaxis. Conclusions The ReliefBand compared favorably to ondansetron (4 mg intravenously) when used for prophylaxis against postoperative nausea and vomiting. Furthermore, the acustimulation device enhanced the antiemetic efficacy of ondansetron after plastic surgery.

scholarly journals Pain management after lung surgery

2014 ◽  
Vol 4 (1) ◽  
Author(s):  
Maria Frödin ◽  
Margareta Warrén Stomberg
Keyword(s):  
Quality Of Care ◽  
Pain Management ◽  
Postoperative Pain ◽  
Severe Pain ◽  
Postoperative Pain Management ◽  
Lung Surgery ◽  
Moderate Pain ◽  
Number Of Patients ◽  
Severe Postoperative Pain

Pain management is an integral challenge in nursing and includes the responsibility of managing patients’ pain, evaluating pain therapy and ensuring the quality of care. The aims of this study were to explore patients’ experiences of pain after lung surgery and evaluate their satisfaction with the postoperative pain management. A descriptive design was used which studied 51 participants undergoing lung surgery. The incidence of moderate postoperative pain varied from 36- 58% among the participants and severe pain from 11-26%, during their hospital stay. Thirty-nine percent had more pain than expected. After three months, 20% experienced moderate pain and 4% experienced severe pain, while after six months, 16% experienced moderate pain. The desired quality of care goal was not fully achieved. We conclude that a large number of patients experienced moderate and severe postoperative pain and more than one third had more pain than expected. However, 88% were satisfied with the pain management. The findings confirm the severity of pain experienced after lung surgery and facilitate the apparent need for the continued improvement of postoperative pain management following this procedure.

Virtual reality for pain management in advanced heart failure: A randomized controlled study

2021 ◽  
pp. 026921632110412
Author(s):  
Hunter Groninger ◽  
Diana Stewart ◽  
Julia M Fisher ◽  
Eshetu Tefera ◽  
James Cowgill ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Virtual Reality ◽  
Pain Management ◽  
Guided Imagery ◽  
Advanced Heart Failure ◽  
Controlled Study ◽  
Randomized Controlled ◽  
General Distress

Background: Hospitalized patients with advanced heart failure often experience acute and/or chronic pain. While virtual reality has been extensively studied across a wide range of clinical settings, no studies have yet evaluated potential impact on pain management on this patient population. Aim: To investigate the impact of a virtual reality experience on self-reported pain, quality-of-life, general distress, and satisfaction compared to a two-dimensional guided imagery active control. Design: Single-center prospective randomized controlled study. The primary outcome was the difference in pre- versus post-intervention self-reported pain scores on a numerical rating scale from 0 to 10. Secondary outcomes included changes in quality-of-life scores, general distress, and satisfaction with the intervention. Setting/participants: Between October 2018 and March 2020, 88 participants hospitalized with advanced heart failure were recruited from an urban tertiary academic medical center. Results: Participants experienced significant improvement in pain score after either 10 minutes of virtual reality (change from pre- to post −2.9 ± 2.6, p < 0.0001) or 10 minutes of guided imagery (change from pre- to post −1.3 ± 1.8, p = 0.0001); the virtual reality arm experienced a 1.5 unit comparatively greater reduction in pain score compared to guided imagery ( p = 0.0011). Total quality-of-life and general distress scores did not significantly change for either arm. Seventy-eight participants (89%) responded that they would be willing to use the assigned intervention again. Conclusion: Virtual reality may be an effective nonpharmacologic adjuvant pain management intervention in hospitalized patients with heart failure. Trial Registration: ClinicalTrials.gov database (NCT04572425).

The Quality Test for Postoperative Pain Management using the American Pain Society Patient Outcome Questionnaire Revisied (APS-POQ-R) version Indonesia at Mohammad Hoesin Hospital in Palembang (A study of the quality level of postoperative pain management

2020 ◽  
Vol 1 (2) ◽  
pp. 41-45
Author(s):  
Malina Resta Maria Panjaitan ◽  
Dewi Arsinta ◽  
Rose Mafiana
Keyword(s):  
Patient Outcome ◽  
Pain Management ◽  
Postoperative Pain ◽  
Emotional Experience ◽  
Postoperative Pain Management ◽  
Education Level ◽  
Quality Level ◽  
Outcome Questionnaire ◽  
Post Operative Pain

A B S T R A C TPain is an unpleasant sensory and emotional experience associated with actual orpotential tissue damage, or described in terms of such damage. APS-POQ-R (RevisedAmerican Pain Society Patient Outcome Questionnaire) is a measuring tool for assessingthe quality of postoperative pain management by exploring patient experiences andoutcomes. This research aims to assess the quality of postoperative pain managementat Mohammad Hoesin Hospital Palembang and to determine the factors that influenceit. The Cross-sectional observational analytic study was conducted toward 51respondents. Data was collected primarily by using questionnares and interview. Datawas analyzed by using chi-square. The study showed that the quality of postoperativepain management at RSUP Mohammad Hoesin General Hospital Palembang has goodquality with a total of 27 patients (52.9%). From statistical analysis there wassignificant relationship between the quality of post-operative pain management withage (p=0,037), gender (p=0,027), ethnicity (p=0,039), education level (p=0,039), andeconomic level (p=0,005). So it can be concluded that was a significant relationshipbetween the quality of post-operative pain management with age, gender, ethnicity,education level, and economic level.

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