The relationship between parental factors, child symptom profile, and persistent postoperative pain interference and analgesic use in children

2020 ◽  
Vol 30 (12) ◽  
pp. 1340-1347
Author(s):  
Lauren C. Siemer ◽  
Emily Foxen‐Craft ◽  
Shobha Malviya ◽  
Mark Ramirez ◽  
G. Ying Li ◽  
...  
2020 ◽  
pp. 105477382098336
Author(s):  
Ceyda Su Gündüz ◽  
Nurcan Çalişkan

This non-randomized control group intervention study was conducted to determine the effect of preoperative video based pain training on postoperative pain and analgesic use in patients undergoing total knee arthroplasty. During the study, the patients in the control ( n = 40) received routine care and the patients in the intervention group ( n = 40) received video based pain training. İt was determined that the mean postoperative pain scores of the intervention group were significantly lower and their pain management was better compared to the control group ( p < .05). The intervention group was found to use significantly less paracetamol on operation day compared to the control group ( p < .05). The intervention group was determined to benefit from non-pharmacological methods more than the control group did ( p < .05). Providing video based pain training to patients undergoing total knee arthroplasty is recommended since it reduces postoperative pain levels and increases the use of non-pharmacological pain control methods.


2010 ◽  
Vol 1 (1) ◽  
pp. 55-59 ◽  
Author(s):  
Gabriel Sandblom ◽  
Maija-Liisa Kalliomäki ◽  
Ulf Gunnarsson ◽  
Torsten Gordh

AbstractBackgroundPersistent pain after hernia repair is widely recognised as a considerable problem, although the natural course of postoperative pain is not fully understood. The aim of the present study was to explore the natural course of persistent pain after hernia repair in a population-based cohort and identify risk factors for prolonged pain duration.MethodsThe study cohort was assembled from the Swedish Hernia Register (SHR), which has compiled detailed information on more than 140 000 groin hernia repairs since 1992. All patients operated on for groin hernia in the County of Uppsala, Sweden, 1998–2004 were identified in the SHR. Those who were still alive in 2005 received the Inguinal Pain Questionnaire, a validated questionnaire with 18 items developed with the aim of assessing postherniorrhaphy pain, by mail. Reminders were sent to non-responders 5 months after the first mail. The halving time was estimated from a linear regression of the logarithmic transformation of the prevalence of pain each year after surgery. A multivariate analysis with pain persisting more than 1 month with a retrospective question regarding time to pain cessation as dependent variable was performed.ResultsAltogether 2834 repairs in 2583 patients were recorded, 162 of who had died until 2005. Of the remaining patients, 1763 (68%) responded to the questionnaire. In 6.7 years the prevalence of persistent pain had decreased by half for the item “pain right now” and in 6.8 years for the item “worst pain last week”. The corresponding figures if laparoscopic repair was excluded were 6.4 years for “pain right now” and 6.4 years for “worst pain past week”. In a multivariate analysis, low age, postoperative complication and open method of repair were found to predict an increased risk for pain persistence exceeding 1 month.ConclusionPersistent postoperative pain is a common problem following hernia surgery, although it often recedes with time. It is more protracted in young patients, following open repair and after repairs with postoperative complications. Whereas efforts to treat persistent postoperative pain, in particular neuropathic pain, are often fruitless, this group can at least rely on the hope that the pain, for some of the patients, gradually decreases with time. On the other hand, 14% still reported a pain problem 7 years after hernia surgery. We do not know the course after that.Although no mathematical model can provide a full understanding of such a complex process as the natural course of postoperative pain, assuming an exponential course may help to analyse the course the first years after surgery, enable comparisons with other studies and give a base for exploring factors that influence the duration of the postoperative pain. Halving times close to those found in our study could also be extrapolated from other studies, assuming an exponential course.


2021 ◽  
pp. rapm-2021-102953
Author(s):  
Alexandra Sideris ◽  
Michael-Alexander Malahias ◽  
George Birch ◽  
Haoyan Zhong ◽  
Valeria Rotundo ◽  
...  

BackgroundThere is growing evidence that cytokines and adipokines are associated with osteoarthritis (OA) severity, progression, and severity of associated pain. However, the cytokine response to total knee arthroplasty (TKA) and its association with persistent postoperative pain is not well understood. This study aims to describe the perioperative systemic (plasma) and local (synovial fluid) cytokine profiles of patients who do and do not develop persistent pain after TKA.MethodsPatients undergoing primary unilateral TKA for end-stage OA were prospectively enrolled. Demographic and clinical data were gathered preoperatively and postoperatively. Synovial fluid was collected pre arthrotomy and plasma was collected at multiple time points before and after surgery. Persistent postoperative pain (PPP) was defined as Numerical Rating Score≥4 at 6 months. Cytokine levels were measured using the V-Plex Human Cytokine 30-Plex Panel (Mesoscale—Rockville, Maryland, USA). Cytokine levels were compared between PPP and minimal pain groups. Given that the study outcomes are exploratory, no adjustment was performed for multiple testing.ResultsIncidence of persistent pain at 6 months post TKA was 15/162 (9.3%). Postoperative plasma levels of four cytokines were significantly different in patients who developed persistent postoperative pain: interleukin (IL)-10, IL-1β, vascular endothelial growth factor, and IL12/IL23p40. Significantly lower IL-10 levels in the prearthrotomy synovial fluid were associated with development of postoperative persistent pain.ConclusionsThis prospective cohort study described a distinct acute perioperative inflammatory response profile in patients who developed persistent post-TKA pain, characterized by significant differences in four cytokines over the first 2 postoperative days. These results support the growing evidence that the patient-specific biologic response to surgery may influence longer-term clinical outcomes after TKA.Trial registration numberClinicaltrials.gov NCT02626533.


Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Irene L Katzan ◽  
Dolora R Wisco ◽  
Brittany Lapin

Background: Self-efficacy is the belief that one is able to respond to demands of a stressful situation and it has both direct and indirect effects on health. The study objective is to investigate the amount of variance in patient-reported physical function (PF) that is explained by self-efficacy compared to clinician-reported disability and other patient-reported domains of health, and evaluate whether self-efficacy mediates the relationship between PF and other domains of health. Methods: Observational cohort study of 248 patients who were seen in a cerebrovascular clinic 3/18/20 - 7/7/20 and completed the following patient-reported outcome measures (PROMs) as part of the routine office visit: PROMIS PF, general self-efficacy, fatigue, and pain interference. Linear regression models were constructed to determine the amount of variance (adjusted R 2 ) in PROMIS PF score explained by the modified Rankin Scale (mRS) and additional PROM scores. The mRS and individual PROMs were added separately to a base model adjusted for demographic characteristics. Mediation analysis was conducted to determine the extent to which self-efficacy mediated the relationship between PF and other PROMs. Results: Mean age of study cohort was 61.5 (SD=13.5) years and 48.4% were female. The base model explained 4.5% of the variance of PF. Adding PROMIS fatigue resulted in the largest increase in the proportion of variance explained (adj R 2 = 47.7%), followed by PROMIS self-efficacy (40.7%), PROMIS pain interference (38.7%), and mRS (26.6%). Self-efficacy significantly mediated the relationship between fatigue and PF (standardized indirect effect: 0.11 (bias-corrected 95% CI: 0.05-0.18), 20.9% of total effect) and pain interference and PF (standardized indirect effect 0.10 (95% CI: 0.06-0.17), 27.1% of total effect). Conclusion: PROMIS self-efficacy explains more variance in stroke patients’ perceived physical function than their disability. This suggests that interventions to improve self-efficacy could have a significant effect on patient’s perceived health. Patients’ fatigue, despite being partially mediated by self-efficacy, was a large contributor to self-reported PF and should be included as part of an evaluation of patient’s physical health.


2018 ◽  
Vol 19 (4) ◽  
pp. 348-353
Author(s):  
Christina Kudach ◽  
Colleen Dunwoody ◽  
Susan Wesmiller

2005 ◽  
Vol 19 (5) ◽  
pp. 471-477 ◽  
Author(s):  
Sarah K. Wise ◽  
Justin C. Wise ◽  
John M. DelGaudio

Background Pain after sinonasal surgery concerns both patients and surgeons. Factors affecting sinonasal postoperative pain have not been examined extensively. Methods Using a prospective survey design, sinonasal surgery patients evaluated postoperative pain (on a scale of 0–10), pain location, and medication use. Results One hundred twenty-seven patients consented to participate. One hundred fifteen patients returned surveys, with 100 patients appropriate for analysis over the 6-day postoperative period. Pain score and medication use were evaluated with respect to sex, primary/revision case, nasal packing, and other factors. Repeated measures analysis of variance and chi-square analysis were conducted (p < 0.05). Pain ratings and analgesic use declined significantly over the postoperative period (p < 0.05). Mean pain score on postoperative day (POD) 1 was 3.61 and on POD 6 was 1.72. Mean medication use was 1.37 tablets on POD 1 and 0.55 tablets on POD 6. Additionally, a significant interaction existed, such that narcotic medication use declined from 1.91 tablets on POD 1 to 0.52 tablets on POD 6, whereas nonnarcotic medication use remained steady (p < 0.05). Periorbital pain was most frequent (46.3%), with unilateral facial pain reported least (4.1%). A significant difference existed for distribution of pain location (p < 0.05). Finally, the difference in pain rating between primary and revision procedure for women (0.65) was less than for men (1.12); this interaction was significant (p < 0.05). Conclusion Multiple patient and operative factors affect pain rating and medication use after sinonasal surgery. Generally, pain level should be low with little analgesic use postoperatively.


2015 ◽  
Vol 32 (2) ◽  
pp. 74-92 ◽  
Author(s):  
Lorna Elise Palmer ◽  
Kevin Durkin ◽  
Sinéad M. Rhodes

Explanations implicating memory in the causes and severity of checking symptoms have focused primarily on retrospective memory, and relatively little attention has been paid to prospective memory. Limited research has examined the relationship between prospective memory and executive functions. We assessed whether impairments in prospective memory and executive function predict checking symptoms in a sample of 106 adults. Checking symptoms were assessed using the Padua Inventory Washington State University Revision (PI-WSUR). All participants completed the prospective memory questionnaire (PMQ) and four computerised executive function tasks from the CANTAB, measuring inhibition, planning, attention set-shifting and working memory. Prospective memory and inhibition predicted checking symptom severity. Importantly, there were no correlations between internally cued prospective memory and inhibition or between prospective memory aiding strategies and inhibition. These variables appear to have an independent role in checking. The current findings highlight prospective memory and inhibition as key contributors to the checking symptom profile and provide the first evidence that these cognitive processes may independently contribute to checking symptoms. These findings have implications for a model in which memory performance is thought to be secondary to impairments in executive functions.


2016 ◽  
Vol 7 ◽  
Author(s):  
Rikard K. Wicksell ◽  
Marie Kanstrup ◽  
Mike K. Kemani ◽  
Linda Holmström

2021 ◽  
pp. 106002802110435
Author(s):  
Atul Dilawri ◽  
Marcia Wyman ◽  
Sneha Shah

Background Liposomal bupivacaine (LB) is increasingly being used for postoperative pain control, but there are conflicting efficacy data when compared with immediate-release bupivacaine (IRB). Objective To evaluate the comparative efficacies of LB and IRB for postoperative pain control in order to assess the formulary status of LB at our institution. Methods A single-center, retrospective, institutional review board–approved, noninferiority matched cohort study at a tertiary care academic medical center. Adult surgical patients admitted for >24 hours who received LB or IRB were included. The primary outcome was total opioid consumption within 24 hours postoperatively. Secondary outcomes included total opioid consumption within 72 hours postoperatively, nonopioid analgesic use within 24 and 72 hours postoperatively, time to rescue analgesic use, and postoperative length of stay (LOS). Results A total of 326 patients were included in the matched cohort. Median 24-hour opioid consumption was significantly lower in the IRB group compared with the LB group (81 mg [30, 153] vs 103 mg [46, 241]; P = 0.01). Patients receiving IRB compared with LB also had a decrease in total opioid consumption 72 hours postoperatively (110 mg [45, 258] vs 165 mg [68, 402]; P = 0.005) and shorter postoperative LOS (2.8 days [1.7, 4] vs 3.3 days [2, 5.1]; P < 0.001). There was no difference in time to rescue analgesic use. Conclusion and Relevance Across a variety of surgical procedures, administration of IRB compared with LB was associated with a reduction in total opioid consumption within 24 and 72 hours postoperatively and shorter LOS in adult surgical patients.


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