Intravenous Butorphanol, Meperidine, and Their Combination Relieve Pain and Distress in Women in Labor

2005 ◽  
Vol 102 (5) ◽  
pp. 1008-1013 ◽  
Author(s):  
Kenneth E. Nelson ◽  
James C. Eisenach
Keyword(s):  
Pain Relief ◽  
Pain Intensity ◽  
Drug Administration ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Therapeutic Benefit ◽  
Kappa Opioid Receptor ◽  
Numerical Rating ◽  
Effective Pain Relief ◽  
Descriptive Scale

Background Systemic opioids are commonly administered during labor, but their efficacy has been recently questioned. In addition, laboratory and clinical studies provide a strong rationale for combining mu- and kappa-opioid receptor agonists for analgesia. The authors therefore studied, using validated intensity and affective scales and definitions of effective pain relief, the efficacy of intravenous meperidine, butorphanol, and their combination for labor analgesia. Methods Healthy women with singleton term pregnancy requesting analgesia during active labor were studied. Women were randomly assigned to receive 50 mg meperidine, 1 mg butorphanol, or 25 mg meperidine plus 0.5 mg butorphanol (n = 15/group). Pain intensity was assessed using a 0-10 numerical rating scale, and affective magnitude was assessed using a ratiometric descriptive scale before drug administration and between the sixth and seventh uterine contractions after drug administration. Results All three treatments reduced pain intensity equally. Butorphanol alone did not reduce pain affective magnitude, whereas the other treatments did. There was a significant correlation between reduction in pain intensity and affective magnitude in all groups, with greater reductions in affective magnitude than intensity. Overall, 29% of women exhibited clinically meaningful pain relief, with no difference among groups. Groups did not differ in incidence of opioid-induced adverse effects. Conclusions These doses of meperidine and butorphanol do reduce pain intensity and affective magnitude, although a minority of patients achieve meaningful pain relief as defined in multiple patient populations, including laboring women. Combination of these drugs did not improve their therapeutic benefit.

scholarly journals Pain Relief Scale Is More Highly Correlated with Numerical Rating Scale than with Visual Analogue Scale in Chronic Pain Patients

2015 ◽  
Vol 2;18 (2;3) ◽  
pp. E195-E200
Author(s):  
Sang Sik Choi
Keyword(s):  
Pain Relief ◽  
Visual Analogue Scale ◽  
Pain Intensity ◽  
Analogue Scale ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Visual Analogue Scale Pain ◽  
Raw Data ◽  
Key Words Pain ◽  
Numerical Rating

The pain relief scale (PRS) is a method that measures the magnitude of change in pain intensity after treatment. The present study aimed to evaluate the correlation between PRS and changes in pain determined by the visual analogue scale (VAS) and numerical rating scale (NRS), to confirm the evidence supporting the use of PRS. Sixty patients with chronic spinal pain that had a VAS and NRS recorded during an initial examination were enrolled in the study. One week later, the patients received an epidural nerve block, then VAS, NRS, and PRS assessments were performed. Differences between VAS and NRS were compared to the PRS and scatter plots and correlation coefficient were generated. The differences and magnitude of decrease in the VAS and NRS raw data were converted to percentile values, and compared to the PRS. Both VAS and NRS values exhibited strong correlations (> 0.8) with PRS. Further, the differences between the VAS-PRS R (0.859) and NRS-PRS R (0.915) were statistically significant, (P = 0.0259). Compared to PRS, the VAS and NRS percentile scores exhibited higher correlation coefficients than scores based on the raw data differences. Furthermore, even when converted to a percentile, the NRS%-PRS R (0.968) was higher than the VAS%-PRS R (0.904), P = 0.0001. The results indicated that using the PRS together with NRS in pain assessment increased the objectivity of the assessment compared to using only VAS or NRS, and may have offset the limitations of VAS or NRS alone. Key words: Pain relief scale, numerical rating scale, visual analogue scale, pain measurement, pain intensity measurement, pain intensity scale

Comparing the efficacy of nebulized morphine with intravenous morphine in traumatic musculoskeletal pain management

2020 ◽  
Vol 8 (1) ◽  
pp. 21-21
Author(s):  
Mani Mofidi ◽  
Ali Dashti ◽  
Mahdi Rezai ◽  
Niloufar Ghodrati ◽  
Hoorolnesa Ameli ◽  
...  
Keyword(s):  
Pain Management ◽  
Pain Relief ◽  
Musculoskeletal Pain ◽  
Normal Saline ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Vital Signs ◽  
Categorical Variables ◽  
Intravenous Morphine ◽  
Numerical Rating

Introduction: This study was designed to compare the effectiveness of intravenous morphine with nebulized morphine in pain relief of patients referring to the emergency setting with traumatic musculoskeletal pain. Methods: This randomized, placebo-controlled and double-blind clinical study evaluated 160 patients 18 to 65 years of age with acute traumatic pain, who attended the emergency department during 2019. Subjects were assessed with Numerical Rating Scale based on inclusion and exclusion criteria and randomly divided into two groups. In one group, 80 patients received IV morphine (0.1 mg/kg+5 mL normal saline) plus an equivalent volume of IV placebo. In the second group, 80 patients received nebulized morphine (0.2 mg/kg+5 mL normal saline) plus nebulized placebo. Pain score was monitored in all patients with Numerical Rating Scale before and after intervention at baseline, 15, 30, 45, and 60-minute intervals. Patients’ vital signs and possible adverse events were evaluated in each observation time points. Finally, all participants were assessed for their satisfaction with pain management. Data were analyzed using repeated measure analysis for continuous variables and Binomial test for categorical variables Results: There was no significant difference between the demographic characteristics of patients in study groups. Pain relief between the two groups was similar during the observation (0, 15, 30, 45, 60 min) (P>0.05). There were no changes in vital signs between two groups, although the nebulized group had lower systolic blood pressure at the time-point of 15 minutes after the treatment initiation (P=0.03). Conclusion: Although Nebulized morphine has similar efficacy in comparison with IV route, nebulization might be considered as the clinically efficacious route of morphine administration with minimal side effects, providing optimal pain relief in patients.

scholarly journals Effect of warm footbath with vibration on arteriovenous fistula puncture-related pain in hemodialysis patients

2017 ◽  
Vol 5 (2) ◽  
pp. 631
Author(s):  
Zahra Abbas Ali Madadi ◽  
Jalil Azimian ◽  
Farzaneh Falahatpishe ◽  
Mahmoud Alipour Heidari
Keyword(s):  
Pain Intensity ◽  
Arteriovenous Fistula ◽  
Rating Scale ◽  
Control Method ◽  
Numerical Rating Scale ◽  
Simple Random Sampling ◽  
Hemodialysis Patients ◽  
Numerical Rating ◽  
Rating Scale Data ◽  
Frequent Hemodialysis

Background: Pain and stress of hemodialysis are experienced by more than 50% of patients who are suffering from renal disease; hence decreasing a part of these adverse effects can be effective on individual’s long term coping with hemodialysis. The current study was done to determine the effect of warm footbath with vibration on arteriovenous fistula puncture-related pain in hemodialysis patients.Methods: This clinical trial was conducted on 31 hemodialysis patients in 2014. The patients were selected by simple random sampling method and placed in one group. First, the pain intensity of all patients was measured in the six frequent hemodialysis sessions without any intervention (control method). After two weeks, the intervention of warm footbath with vibration was done on all patients and the pain intensity was measured for six frequent hemodialysis sessions (intervention method). The patients were received 40±2 °C footbath with vibration by foot massage spa machine for ten minutes; then, fistula needles were placed and the pain intensity was assessed by using a numerical rating scale. Data were analyzed by ANOVA and T test.Results: The study group had contained 20 males (64.5%), 11 females (35.5%), with an average age of 44.16±14.85 and a range of 18 to 65 years old, which shows that the pain intensity of the warm footbath with vibration method was lower than the control method (P< 0.05).Conclusions: Warm footbath with vibration can be used as an effective palliative method to reduce pain of hemodialysis patients.

What is the clinical relevance of the Numerical rating scale for pain?

2018 ◽  
Author(s):  
Felicia Cox
Keyword(s):  
Chronic Pain ◽  
Pain Intensity ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Clinical Importance ◽  
Patient Global Impression ◽  
Numerical Rating ◽  
Group A ◽  
Clinically Significant ◽  
Global Impression Of Change

The landmark paper discussed in this chapter is ‘Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale’, published by Farrar et al. in 2001. The numerical rating scale is now the standard instrument used in chronic pain studies to measure pain intensity. Farrar et al. determined the changes in pain intensity that were clinically significant for studies of chronic pain while measuring the patient’s global impression of change. The paper used pooled data from ten recent studies of pregabalin in 2,724 subjects. The authors reported a consistent relationship between pain intensity and patient global impression of change, regardless of study, disease type, age, sex, study result, or treatment group. A reduction of approximately two points on the numerical rating scale, or of 30% in the global impression of change of pain intensity, represented a clinically important difference.

scholarly journals Jaw Exercise Therapy and Psychoeducation to Reduce Oral Parafunctional Activities for the Management of Persistent Dentoalveolar Pain

2018 ◽  
Vol 2018 ◽  
pp. 1-7
Author(s):  
Izumi Makino ◽  
Young-Chang Arai ◽  
Shuichi Aono ◽  
Masayuki Inoue ◽  
Hiroki Sakurai ◽  
...  
Keyword(s):  
Standard Deviation ◽  
Combination Therapy ◽  
Pain Intensity ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
End Of Treatment ◽  
Before And After ◽  
Numerical Rating ◽  
Therapy Treatment ◽  
Nonpharmacological Treatments

Objective. To retrospectively analyze the effects of our original combination therapy treatment on patients with nonodontogenic persistent dentoalveolar pain. Methods. Twenty-one patients suffering from persistent dentoalveolar pain (nineteen females and two males; mean age ± standard deviation: 55.7 ± 19.6 years) participated in this study. They were treated with a therapy combination of jaw exercise and psychoeducation to reduce oral parafunctional activities every month. The intensity of pain in these subjects was evaluated using a numerical rating scale (NRS) before and after treatment. Results. The NRSs at the baseline ranged from 5 to 10 (median, 8), from 0 to 10 (median, 2) at one month after treatment, from 0 to 10 (median, 1) at three months after treatment, and from 0 to 10 (median, 0) at the end of treatment. Pain intensity after treatment improved significantly. Conclusion. There was a significant reduction in pain after our combination of therapies as nonpharmacological treatments, and therefore this treatment could be useful in the management of NPDP patients.

Agreement Between Verbal and Electronic Versions of the Numerical Rating Scale (NRS-11) when Used to Assess Pain Intensity in Adolescents

2015 ◽  
Vol 31 (3) ◽  
pp. 229-234 ◽  
Author(s):  
Elena Castarlenas ◽  
Elisabet Sánchez-Rodríguez ◽  
Rocío de la Vega ◽  
Roman Roset ◽  
Jordi Miró
Keyword(s):  
Pain Intensity ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Numerical Rating

On the electronic measurement of pain intensity: Can we use different pain intensity scales interchangeably?

2016 ◽  
Vol 22 (13) ◽  
pp. 1658-1667 ◽  
Author(s):  
Elisabet Sánchez-Rodríguez ◽  
Elena Castarlenas ◽  
Rocío de la Vega ◽  
Roman Roset ◽  
Jordi Miró
Keyword(s):  
Visual Analogue Scale ◽  
Pain Intensity ◽  
Analogue Scale ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Pain Scale ◽  
Maximum Intensity ◽  
Bland Altman Method ◽  
Numerical Rating ◽  
Electronic Measurement

The objective of this work was to study the agreement between four pain intensity scales when administered electronically: the Numerical Rating Scale-11, the Faces Pain Scale-Revised, the Visual Analogue Scale and the Coloured Analogue Scale. In all, 180 schoolchildren between 12 and 19 years old participated in the study. They had to report the maximum intensity of their most frequent pain using the electronic versions of the four scales. Agreement was calculated using the Bland–Altman method. Results show that the electronic versions of Numerical Rating Scale-11, Coloured Analogue Scale and Visual Analogue Scale can be used interchangeably.

scholarly journals Effect of Premedication with Anti-inflammatory Drugs on Post-Endodontic Pain: A Randomized Clinical Trial

2018 ◽  
Vol 29 (3) ◽  
pp. 254-260 ◽  
Author(s):  
Adrian Camargo Amaral Jorge-Araújo ◽  
Marcelo Carlos Bortoluzzi ◽  
Flares Baratto-Filho ◽  
Fábio André Santos ◽  
Márcia Thaís Pochapski
Keyword(s):  
Pain Intensity ◽  
Rescue Medication ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Secondary Outcome ◽  
Chi Square ◽  
Significant Difference ◽  
Numerical Rating ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Abstract In spite of advances in root canal therapy and better knowledge of pulpal and periapical inflammation, up 40% of endodontic patients report varying degrees of pain. The aim of this present study was to compare the effect of single preoperative dose of ibuprofen or dexamethasone on post-endodontic pain. Sixty volunteers were divided into three groups (n=20 per group): PL, placebo; IB, 400 mg of ibuprofen; and DE, 8 mg of dexamethasone. The primary outcome was the post-endodontic pain intensity measured with a numerical rating scale (4, 8, 12, 24, and 48 h). Secondary outcomes included number of anesthetic cartridges used and consumption of rescue medication. Data were analyzed by one-way ANOVA, chi-square and Kruskal-Wallis tests. There was no significant difference among groups (p>0.05) considering the pain intensity. Only 37% of IB group patients and 28% of DE group patients used some rescue medication. On the other hand, 74% of PL group patients mentioned the consumption of rescue medication; PL group had a statistically significant difference (p<0.05) in comparison with IB and DE groups. The number of anesthetic cartridges used had no statistically significant difference among the groups (p>0.05). Significant differences were not found in the reduction of pain intensity and the number of anesthetic cartridges used. Considering the consumption of rescue medication (secondary outcome), preoperative administration of Ibuprofen or dexamethasone reduces post-endodontic pain and discomfort in comparison with a placebo. Premedication with anti-inflammatory drugs drugs could be contributed to control of the post-endodontic pain, mainly in patients more sensible for pain.

scholarly journals Measuring Pain Intensity in Elderly Patients

2021 ◽  
Vol 1 (2) ◽  
pp. 77-81
Author(s):  
Sasikaan Nimmaanrat
Keyword(s):  
Pain Intensity ◽  
Vital Sign ◽  
Pain Measurement ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Pain Scale ◽  
Measurement Tool ◽  
Measurement Tools ◽  
Aging Populations ◽  
Numerical Rating

Pain intensity is considered as the fifth vital sign. However, it is the only vital sign which is subjective, with there being many pain measurement tools for adults to rate their level of pain. Additionally, there is an increasing number of aging populations throughout the world, and pain measurement in this group of people is challenging as geriatrics have both physical and cognitive impairment. The most frequently utilized pain measurement tools are; the Visual Analogue Scale (VAS), Verbal Rating Scale (VRS), Numerical Rating Scale (NRS); and faces scales [Faces Pain Scale (FPS) and Faces Pain Scale-Revised (FPS-R) are the faces scales studied most often] tend to be valid for measuring pain severity in cognitively intact elderly. When problems arise, the VAS is the pain measurement tool found to have more difficulties (including higher rates of failure) than the other tools. In elderly with cognitive deficits, fewer difficulties tend to occur as the tools become simpler, with the most valid and useful tools in the following order: the FPS/FPS-R, the VRS, the 0-10 NRS, and the VAS. Furthermore, simpler pain measurement tools tend to be favored over more complicated tools. Keywords: aging; elderly; geriatrics; older; pain measurement; pain measurement tools

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