Using mode and maximum values from the Numeric Rating Scale when evaluating postoperative pain management and recovery

2012 ◽  
pp. no-no
Author(s):  
Kerstin Eriksson ◽  
Lotta Wikström ◽  
Marianne Lindblad-Fridh ◽  
Anders Broström
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Rating Scale ◽  
Postoperative Pain Management ◽  
Numeric Rating Scale ◽  
Numeric Rating

scholarly journals Effectiveness of Ketoprofen Suppositoria as Preemptive Analgesia for Postoperative Pain in Patients Undergoing Elective Surgery with General Anesthesia

2020 ◽  
Vol 2 (1) ◽  
pp. 20
Author(s):  
Lupi Lestari ◽  
Elizeus Hanindito ◽  
Arie Utariani
Keyword(s):  
Pain Management ◽  
Side Effects ◽  
Postoperative Pain ◽  
General Anesthesia ◽  
Rating Scale ◽  
Postoperative Pain Management ◽  
Numeric Rating Scale ◽  
Preemptive Analgesia ◽  
Acute Postoperative Pain ◽  
Numeric Rating

Introduction: Effective postoperative pain management provides improved patient comfort and satisfaction, earlier mobilization, fewer pulmonary and cardiac complications, reduced risk deep vein thrombosis, fast recovery, and reduced cost of care. Preemptive analgesia, initiated before the surgical procedure to prevent pain in the early postoperative period, has the potential to be more effective than a similar analgesic treatment initiated after surgery. As a part of multimodal analgesia, the use of NSAIDs should always be considered for acute postoperative pain management. NSAIDs can be used preoperatively as a part of the preemptive regimen and for postoperative pain control to increase the efficacy of opioids and reduce its side effects. Material and Method: This research was experimental research with a case-control design of the study. The samples separated into two groups, the first group got ketoprofen suppository before the induction, and the second group didn’t get the ketoprofen suppository The intensity of pain measured with the Numeric Rating Scale (NRS) or Wong-Baker Faces Pain Scale was the variable studied at different postoperative times (30 min, 60 min, 120 min, 2-6 hours, 6-12 hours). The total amount of rescue analgesics (fentanyl) and side effects were other variables of this study. Result and Discussion: The result is ketoprofen suppository as preemptive analgesia administrations can reduce postoperative pain. Numeric Rating Scale was significantly lower in the ketoprofen group compared to the control group (p < 0,05) at 30 min, 60 min, 230 min, 2-6 hours, 6-12 hours. The number of postoperative analgesics needed in the recovery room was significant differences among both groups (p < 0,05). Conclusion: Preemptive analgesia in patients who underwent an operation with general anesthesia with ketoprofen suppository was effectively in blocking noxious stimuli and central sensitization, with subsequent prevention of acute postoperative pain.

scholarly journals Pain Level of Postoperative Orthopedic Patients at Dr. Soetomo General Hospital

2019 ◽  
Vol 1 (1) ◽  
pp. 19
Author(s):  
David Wicaksono ◽  
Lilik Herawati ◽  
Herdy Sulistyono
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Rating Scale ◽  
Postoperative Pain Management ◽  
Medical Personnel ◽  
Numeric Rating Scale ◽  
Individual Factors ◽  
Pain Level ◽  
Post Surgery ◽  
Significant Difference

Introduction: Postoperative pain is the most undesirable consequence of the surgery. If it is not managed properly, it can lead to a long healing. However, assessment and treatment of postoperative pain in surgical wards still have not received attention. Differences in patient’s pain level after surgery and after being transferred to the surgical ward is very important in monitoring the effectiveness postoperative pain management. Objective: This study was conducted to determine the overview of pain level experienced by patients following orthopedic surgery and to know the individual factors that can affect the patient's pain level. Method and Material: This research was observational analytic with 43 orthopedic postoperative patients as a sample. The Patients’ pain level were measured by the Numeric Rating Scale (NRS) at one hour after surgery and 24 hours after surgery. Result and Discussion: The Pain level one hour after surgery varied between pain level 0 as much as 53% to pain level 8 as much as 4.7%. The results of measurements of pain 24 hours after surgery only 23.3% of the patients who did not complain of pain, and there was a patient who experienced pain level 10. The results of the statistical calculation, the difference between the level of pain one hour and 24 hours post-surgery obtained value of p=0.037 (p<0.05). Conclusion: There was a significant difference between the pain level at one hour and 24 hours post-surgery. It might be due to the process of peripheral and central sensitization in patients with delayed pain management. It also may be influenced by individual factors as well as medical personnel.

scholarly journals Postoperative Pain Management among Registered Nurses in a Vietnamese Hospital

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Phuong Hoang Vu ◽  
Duc Viet Tran ◽  
Yen Thi Le ◽  
Ha Thi Thu Do ◽  
Sao Thi Vu ◽  
...  
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Registered Nurses ◽  
Management Practices ◽  
Rating Scale ◽  
Management Practice ◽  
Postoperative Pain Management ◽  
Numeric Rating Scale ◽  
Assessment Tools ◽  
Urban Hospital

This study examined the postoperative pain management practices among registered nurses in an urban hospital in Vietnam. Data of 90 nurses about postoperative pain management practices and pain management at the department were collected. Results indicated that 83.3% of nurses reported that they regularly assessed the degree of pain for postoperative patients. Only 32.2% used assessment tools such as the numeric rating scale to measure pain. Experience in pain management and having guidelines in the department were associated with a higher score in pain management practice. Findings suggested that facilitating the use of pain instruments and developing pain management guidelines should be prioritized.

CYP2D6 Basic Genotyping of Patients with Chronic Pain Receiving Tramadol or Codeine. A Study in a Greek Cohort

Pain Medicine ◽  
2020 ◽  
Vol 21 (11) ◽  
pp. 3199-3204 ◽  
Author(s):  
Chrysanthi Batistaki ◽  
Eleni Chrona ◽  
Andreas Kostroglou ◽  
Georgia Kostopanagiotou ◽  
Maria Gazouli
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Adverse Effects ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
Cyp2d6 Genotype ◽  
Chronic Pain Patients ◽  
Reduction Of Pain ◽  
Pain Patients ◽  
Numeric Rating

Abstract Objective To assess CYP2D6 genotype prevalence in chronic pain patients treated with tramadol or codeine. Design Prospective cohort study. Setting General hospital, pain management unit. Subjects Patients with chronic pain, treated with codeine or tramadol. Methods Patients’ pain was assessed at baseline (numeric rating scale [NRS]; 0–10). Prescription of codeine or tramadol was selected randomly. The assessment of patients’ response to the drug in terms of pain relief and adverse effects was performed after 24 hours. Reduction of pain intensity of &gt;50% or an NRS &lt;4 was considered a positive response. Patients’ blood samples were collected during the first visit. Genotyping for the common variants CYP2D6 *2, *3, *4, *5, *6, *9, *10, *14, and *17 was performed, and alleles not carrying any polymorphic allele were classified as CYP2D6*1 (wild-type [wt]). Results Seventy-six consecutive patients were studied (20 males, 56 females), aged 21–85 years. Thirty-four received tramadol and 42 codeine. The main genotypes of CYP2D6 identified were the wt/wt (35.5%), the *4/wt (17.1%), and the *6/wt (10.5%). Adverse effects were common, especially in carriers of *9/*9, *5/*5, *5/*4, and *10/*10, as well as in variants including the 4 allele (*4/*1 [38.4%] and *4/*4 [42.8%]). Conclusions Genotyping can facilitate personalized pain management with opioids, as specific alleles are related to decreased efficacy and adverse effects.

Regional anaesthesia for postoperative pain management after liver resection

2012 ◽  
Vol 19 (3) ◽  
pp. 126-129
Author(s):  
Darius Trepenaitis ◽  
Tadas Česnaitis ◽  
Andrius Macas
Keyword(s):  
Pain Management ◽  
Liver Resection ◽  
Postoperative Pain ◽  
Adverse Effects ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Postoperative Pain Management ◽  
Control Group ◽  
Wound Infiltration ◽  
Adequate Treatment

Background. Pain is the most common complication in the postoperative period. If adequate treatment is not taken, it can transform to chronic pain. Postoperative pain brings a lot of social, psychological and financial problems for patients and their families. Materials and methods. This prospective study included 30 patients after laparatomic liver resection operation. Patients were randomly assign­ ed to Infiltrated or Control groups. An infiltration of 40 ml levobupivacaine 0.25% solution to the operation cut edges was performed to the Infiltrated group. The pain was evaluated using the numerical rating scale after 2, 5, 12, 24, 48 hours and 1 month after the operation. Our aim was to determine the effect of local anesthesia in the operation wound. The total usage of morphine and any side effects were registered. Results. A statistically significant reduction in pain was observed in the Infiltrated group in all evaluation periods. Opioids usage was higher in the Control group almost by 4 times and adverse effects were 9 to 1 compared to the Infiltrated group. Conclusions. Surgical wound infiltration with local anesthetic for postoperative pain management after liver resection operations has a positive effect on postoperative pain reduction and leads to lesser usage of opioid analgetics. As a result, there is a less chance of opioids induced adverse effects.

scholarly journals Epidural administration of ketamine or fentanyl with bupivacaine for postoperative analgesia – A comparative study

2014 ◽  
Vol 22 (1) ◽  
pp. 21-25
Author(s):  
Abdullah Al Maruf ◽  
Iqbal Hosain Chowdhury ◽  
Kazi Ashkar Lateef ◽  
Manzoorul Haq Laskar ◽  
Md Mustafa Kamal
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Postoperative Analgesia ◽  
Rating Scale ◽  
Postoperative Pain Management ◽  
Epidural Administration ◽  
Group A ◽  
Group B ◽  
Post Operative Nausea ◽  
Inguinal Surgery

The purpose of the study was to compare the analgesic effectiveness of epidural administration of ketamine mixed bupivacaine with fentanyl mixed bupivacaine in the management of postoperative pain. This prospective study was carried out in CMH, Bogra in one calendar year from July 2004 to June 2005. For postoperative pain management 100 patients of both sex, age ranging between 20 to 50 years, ASA physical status I and II scheduled for lower abdominal, pelvic and inguinal surgery were included in the study. All patients were divided into two groups. Epidural catheter was inserted in each patient through space between L3 to L2. Surgery was done under epidural anaesthesia in both groups. In group A (n=50) surgery was done with 0.5% bupivacaine and fentanyl (bupivacaine 1.5 ml/segment + fentanyl 2?g/ml). In group B (n=50) surgery was done with 0.5% bupivacaine and ketamine (bupivacaine 1.5ml/segment + ketamine 0.3mg/kg body weight). Epidural analgesia was continued in postoperative ward with 6 ml 0.25% bupivacaine + fentanyl 2?g/ml in group A and with 6 ml 0.25% bupivacaine + ketamine 0.3mg/kg bodyweight in group B, 4 hourly for 24 hours. The efficacy of analgesia was assessed by using Visual Analogue Scale (VAS) and Verbal Rating Scale (VRS). Mean VAS and mean VRS were less than 3 in both groups, which proved adequate postoperative analgesia. Differences of mean VAS and mean VRS between two groups were statistically not significant. Haemodynamic parameters, respiration and oxygenation were within normal range in both groups. Postoperative complications, like inadequate analgesia, post operative nausea and vomiting (PONV), headache and vertigo were less in both groups. It was observed that epidural administration of both bupivacaine mixed with ketamine and bupivacaine mixed with fentanyl found safe, effective and tolerable for postoperative pain management. DOI: http://dx.doi.org/10.3329/jbsa.v22i1.18097 Journal of BSA, 2009; 22(1): 21-25

scholarly journals Evaluasi Kepatuhan Pelaksanaan Standar Prosedur Operasional Manajemen Nyeri pada Pasien Luka Bakar di RSUP Dr. Hasan Sadikin Bandung

2019 ◽  
Vol 7 (2) ◽  
pp. 92-99
Author(s):  
Yudhanarko Yudhanarko ◽  
Suwarman Suwarman ◽  
Ricky Aditya
Keyword(s):  
Pain Management ◽  
General Hospital ◽  
Pain Assessment ◽  
Rating Scale ◽  
Emotional Experience ◽  
Numeric Rating Scale ◽  
Pain Scale ◽  
Standard Operating ◽  
Numeric Rating

Nyeri didefinisikan sebagai pengalaman sensorik dan emosional yang tidak menyenangkan terkait dengan kerusakan jaringan aktual atau potensial. Manajemen nyeri pada luka bakar merupakan bagian yang tidak terpisahkan dari terapi luka bakar. Nyeri pada luka bakar merupakan nyeri akut, penanganan yang tidak baik akan menyebabkan komplikasi, salah satunya nyeri kronik. Rumah Sakit Umum Pusat (RSUP) Dr. Hasan Sadikin Bandung telah membuat Standar Prosedur Operasional (SPO) manajemen nyeri yang berguna untuk meningkatkan kepatuhan dalam pelaksanaan manajemen nyeri. Penelitian ini bertujuan mengevaluasi kesesuaian teknik pengkajian, tindak lanjut dan evaluasi ulang nyeri pada pasien luka bakar dengan SPO manajemen nyeri. Penelitian menggunakan metode deskriptif observasional retrospektif terhadap 99 rekam medis pasien luka bakar yang memenuhi kriteria inklusi di RSUP Dr. Hasan Sadikin Bandung pada tahun 2018. Hasil penelitian didapatkankan bahwa pengkajian nyeri yang dilakukan sesuai dengan SPO menggunakan numeric rating scale atau Wong Baker faces pain scale ditemukan pada 99 pasien (100%). Tindak lanjut hasil pengkajian nyeri luka bakar yang dilakukan sesuai dengan SPO sebanyak 71 pasien (72%). Evaluasi ulang setelah tindak lanjut pengkajian nyeri yang sesuai SPO pada 93 pasien (94%). Simpulan, pengkajian nyeri di RSUP Dr. Hasan Sadikin Bandung sudah sesuai dengan SPO manajemen nyeri, namun tindak lanjut dan evaluasi ulang pada nyeri luka bakar belum sesuai dengan SPO manajemen nyeri.Evaluation of Compliance to Standard Operating Procedures for Pain Management in Patients with Burns in Dr. Hasan Sadikin General Hospital BandungPain is defined as an unpleasant sensory and emotional experience related to actual or potential tissue damage. Pain management for burns is an integral part of burn therapy. Pain in burns is an acute pain and poor management will lead to health complications including chronic pain. Dr. Hasan Sadikin General Hospital Bandung has made a standard operating procedure (SOP) for pain management to improve compliance to pain management standard. This study aimed to evaluate the compliance to the standards in assessment techniques, follow-up, and re-evaluation of pain in patients with burn according to the applicable pain management SOP. This was a retrospective descriptive observational study on 99 medical records of burn patients who met the inclusion criteria in Dr. Hasan Sadikin General Hospital Bandung in 2018. The results of the study revealed that the pain assessment for these patient was carried out according to the SOP which refers to the use of a numeric rating scale or Wong Baker face pain scale in 99 patients (100%). In the follow-up, 71 were performed according to the SOP (72%) while the re-evaluation was performed in compliance with the SOP in 93 patients (94%). In conclusion, pain assessment in Dr. Hasan Sadikin General Hospital Bandung is performed in accordance with SOP on pain management but not all patients receive follow-up and re-evaluation of burn pain in accordance with the SOP on pain management. 

Pain after Cardiac Surgery

2006 ◽  
Vol 105 (4) ◽  
pp. 794-800 ◽  
Author(s):  
Pasi Lahtinen ◽  
Hannu Kokki ◽  
Markku Hynynen
Keyword(s):  
Cardiac Surgery ◽  
Postoperative Pain ◽  
Scale Score ◽  
Severe Pain ◽  
Rating Scale ◽  
Artery Bypass ◽  
Numeric Rating Scale ◽  
Persistent Pain ◽  
Numeric Rating Scale Score ◽  
Numeric Rating

Background Persistent chest pain may originate from cardiac surgery. Conflicting results have been reported on the incidence of persistent poststernotomy pain with considerable discrepancies between the retrospective reports and the one prospective study conducted to assess this pain. Therefore, the authors conducted a follow-up survey for the first 12 months after cardiac surgery in 213 patients who had a sternotomy. Methods The authors performed a prospective inquiry of acute and chronic poststernotomy pain both before and after cardiac surgery. Two hundred thirteen coronary artery bypass patients received a questionnaire preoperatively, 4 days postoperatively, and 1, 3, 6, and 12 months postoperatively. All patients were asked about their expectations, their preferences, and the location and intensity of postoperative pain. Results The return rates for the postal questionnaires were 203 (95%) and 186 (87%) after 1 and 12 months, respectively. Patients experienced more pain postoperatively at rest than they had expected to preoperatively. At rest, the worst actual postoperative pain was 6 (0-10), and the worst expected pain as assessed preoperatively was 5 (0-10) (P = 0.013). The worst reported postoperative pain was severe (numeric rating scale score 7-10) in 49% at rest, in 78% during coughing, and in 62% of patients on movement. One year after the operation, 26 patients (14%) reported mild chronic poststernotomy pain at rest, 1 patient (1%) had moderate pain, and 3 patients (2%) had severe pain. Upon movement, persistent pain was even more common: 45 patients (24%) had mild, 5 patients (3%) had moderate, and 7 patients (4%) had severe pain. Patients who experienced moderate to severe acute postoperative pain also reported any chronic poststernotomy pain (numeric rating scale score 1-10) more frequently. Conclusions Although common, the incidence of persistent pain after sternotomy was lower than previously reported. Also, reassuringly, 1 year after surgery this pain was mostly mild in nature both at rest and on movement.

scholarly journals Postoperative Drip-Infusion of Remifentanil Reduces Postoperative Pain—A Retrospective Observative Study

2021 ◽  
Vol 18 (17) ◽  
pp. 9225
Author(s):  
Yi-Hsuan Huang ◽  
Meei-Shyuan Lee ◽  
Yao-Tsung Lin ◽  
Nian-Cih Huang ◽  
Jing Kao ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Adverse Effects ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
Intravenous Anesthesia ◽  
Anesthetic Care ◽  
Drip Infusion ◽  
Pain Scores ◽  
Unpleasant Experience ◽  
Numeric Rating

Development of remifentanil-induced hyperalgesia (RIH) postoperatively is an unpleasant experience that requires further treatment. This study assessed the effects of gradual withdrawal combined with drip infusion of remifentanil on postoperative pain and the requirement for rescue analgesics. A total of 559 patients receiving total intravenous anesthesia with propofol and remifentanil were enrolled. All patients either underwent gradual withdrawal of remifentanil (GWR) or gradual withdrawal combined with drip infusion (GWDR) with a dose of 1 mcg·kg−1 for 30 min after extubation. The numeric rating scale (NRS) and the requirement of rescue analgesics were assessed. The requirement for rescue analgesics was significantly lower in the GWDR group than in the GWR group (13.2% vs. 35.7%; p < 0.001). At the post-anesthetic care unit (PACU), patients in the GWDR group had a lower NRS pain score (p < 0.001). In addition, in the postoperative 2nd hour, patients in the GWDR group had a significantly lower NRS than the GWR group (beta, −0.31; p = 0.003). No remifentanil-related adverse effects were observed. We found that gradual withdrawal combined with drip infusion of remifentanil required less rescue analgesics and reduced pain scores. The new way of remifentanil administration may be effective to prevent RIH.

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