P91 Post-operative pain in neurosurgery

2019 ◽  
Vol 90 (3) ◽  
pp. e46.1-e46
Author(s):  
PM Haigh ◽  
F Al-Hatimi ◽  
H Stewart ◽  
S Rajagopal ◽  
S Khalifa ◽  
...  
Keyword(s):  
Pain Score ◽  
Spinal Surgery ◽  
Foramen Magnum ◽  
P Value ◽  
Inflammatory Agent ◽  
Pain Scores ◽  
Post Operative Period ◽  
Post Operative Pain ◽  
Significant Difference ◽  
The Mean

ObjectivesAre the analgesic guidelines for those neurosurgical operations associated with major and complex major pain consistently followed? Is there a correlation between adherence and post-operative pain?DesignPatients undergoing spinal surgery and foramen magnum decompressions were visited on the first post-operative day (D1). They provided their pain score subjectively (0=nil; 10=worst ever experienced); objectively we recorded whether they could move in/out of bed without pain limitation.Subjectsn=57 consecutive patients undergoing elective major and complex major pain neurosurgery between April and June 2018 at the NHNN, Queen Square.MethodsA proforma was completed on D1. The patients consented to take part and answered three questions. We examined what (if any) analgesics they were admitted on, and what had been prescribed to cover the post-operative period. This was compared against the appropriate guideline for that category of operation.ResultsGuidelines were only followed in 16/57 (28.1%) cases; not followed in 41/57 (71.9%). On an unpaired T-test: 2-tailed P value=0.0195. Where guidelines were followed, the mean pain score reported was: 3.75 (SD 2.72) Where not followed, the mean pain score was 5.46 (SD 2.29). So with a 95% confidence interval −3.41 to −0.29, there is a significant difference between the pain in those prescribed according to the guidelines and those that were not.ConclusionsThe pain guidelines are not routinely followed. Most commonly this was due to no prescription for a non-steroidal anti-inflammatory agent. We suggest regular sessions of education of the guidelines. Cycle 2 closed the loop of the audit. We re-reviewed adherence and pain scores and found guidelines were followed in 34% of cases, which represented a 6% improvement. On a paired two-tailed P value=0.0794. The mean pain score where guidelines were followed=3.42 (SD1.62) against a mean=4.74 (SD 1.89) where guidelines were not followed.

scholarly journals Perbedaan Efektifitas Madu dan Air Gula Terhadap Nyeri Injeksi Imunisasi Campak Bayi Usia 9-15 Bulan Puskesmas Lubuk Buaya Tahun 2019

2019 ◽  
Vol 14 (2) ◽  
pp. 26-37
Author(s):  
Dewi Susanti ◽  
Alsri Windra Doni ◽  
Rizqi Twin Desfialni Putri
Keyword(s):  
Pain Management ◽  
Sample Size ◽  
Pain Score ◽  
T Test ◽  
Injection Pain ◽  
P Value ◽  
Sugar Water ◽  
Pain Scores ◽  
Post Test ◽  
The Mean

Coverage of measles immunization in Padang city is 88.8%, while the target of achieving national measles immunization is 95%. The reason a child is not immunized is 27.5% because it is delayed at another time. Pain management of nonpharmacological immunization with honey and sugar water can increase comfort so as to avoid delaying at another time. The purpose of this study was to determine the differences in the effectiveness of honey and sugar water against the pain of measles immunization injection in infants aged 9-15 months. This type of research is a Quasi experiment with post test only design. sampling with a sample size of 32 people. Pain score data obtained from observation sheets and analyzed univariately and bivariately using an independent t test with computerization. The results of the study mean the pain score in the honey group was 1.19 while the mean pain score in the sugar water group was 1.88. After an independent t test was obtained p value = 0.038 (α <0.05) means that there is a difference in the effectiveness of honey and sugar water against the pain of measles immunization injection. The results of the study concluded that honey was more effective on measles immunization injection pain scores. The suggestion of this study was to improve the comfort of children by minimizing the pain of immunization injection using honey and sugar water.

scholarly journals COMPARATIVE EVALUATION OF POST-OPERATIVE PAIN BETWEEN CONVENTIONAL LAPAROSCOPIC CHOLECYSTECTOMY & SINGLE INCISION LAPAROSCOPIC CHOLECYSTECTOMY

2021 ◽  
Vol 5 (8) ◽  
Author(s):  
Sanjay Kumar ◽  
Ashok Kaundal ◽  
Suneet Katoch
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Pain Score ◽  
Single Incision ◽  
P Value ◽  
Conventional Laparoscopic Cholecystectomy ◽  
Conventional Laparoscopic ◽  
Post Operative Pain ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Single Incision Laparoscopic Cholecystectomy

AIM: Comparative analysis of post-operative pain between Single Incision Laparoscopic Cholecystectomy and conventional Laparoscopic Cholecystectomy. Method: Patients suffering from symptomatic cholelithasis were randomly subjected to Single Incision Laparoscopic Cholecystectomy (SILC) and conventional four ports Laparoscopic Cholecystectomy (cLC). Data analyzed included duration of surgery, post-operative pain, For assessment of post-operative pain numeric pain scale scoring system was used and pain scoring done at four hours, twelve hours and twenty-four hours post-operatively. Results: The study included fifty patients operated upon from June, 2014 to May, 2014. Twenty-five patients were subjected to SILC and rest of the twenty-five underwent cLC. Pre-operative characteristics of two groups were similar and there was no significant difference between two groups based on age, sex and Body Mass Index. Post-operative pain score was higher for cLC compared to SILC at four, twelve and twenty-four hours post-operatively. The mean pain score at four hours was 4.64 ± 1.89 for SILC versus 7.72 ± 0.84 for cLC (p-value < 0.0001). While the score at twelve and twenty-four hours were 2.96 ± 1.88 and 1.80 ± 1.44 for SILC compared to 5.08 ± 1.15 and 3.80 ± 1.11 for cLC respectively. Conclusion: SILC is superior to cLC compared to post-operative pain as per our study. Keywords: SILC, cLC, post-operative pain

scholarly journals Comparison of single shot caudal Ropivacaine and Bupivacaine in paediatric patients undergoing herniotomy

2019 ◽  
Vol 1 (2) ◽  
pp. 73-76
Author(s):  
Rishabh Ravi ◽  
Bigen Man Shakya ◽  
Anil Shrestha
Keyword(s):  
Motor Block ◽  
Complete Recovery ◽  
Pain Scale ◽  
P Value ◽  
Single Shot ◽  
Caudal Block ◽  
Post Operative Period ◽  
Post Operative Pain ◽  
The Mean ◽  
Group B

Background: Inguinal hernia repair is a common surgical procedure in children. Caudal block is an appropriate technique for the treatment of post operative pain in children undergoing herniotomy. This study compared the effects of Ropivacaine and Bupivacaine in caudal block in children undergoing herniotomy. Methodology: A total of 74 patients between 5-16 yrs undergoing herniotomy were randomized in two groups. In Group B, 0.75ml/kg of 0.25% caudal Bupivacaine was administered whereas Group R received 0.75 ml/kg of 0.25% caudal Ropivacaine. Pain score was assessed using Wong Baker pain scale in post operative period and motor power was assessed using modified Bromage scale till 6 hours. Results: The mean duration of post operative analgesia was found to be 253.51 ± 11.48 minutes in Bupivacaine and 258.1 ± 12.10 minutes in Ropivacaine group. The median duration of motor block was 180 (Q1 60- Q3 180) minutes in Bupivacaine and 30 (Q1 22.5- Q3 45) minutes in Ropivacaine group which was statistically significant. There was complete recovery of motor block by 2 hour in Ropivacaine and by 4 hour in Bupivacaine group. (p value< 0.001). Conclusion: From the current study, it is concluded that caudal Ropivacaine at 0.25% concentration and 0.75ml/ kg provides similar duration of post operative analgesia with less motor block in comparison to Bupivacaine.

scholarly journals A comparative study of coblation assissted adenotonsillectomy and cold dissection adenotonsillectomy in children

2016 ◽  
Vol 3 (1) ◽  
pp. 122 ◽  
Author(s):  
Nithya V. ◽  
Angshuman Dutta ◽  
Sabarigirish K.
Keyword(s):  
Postoperative Pain ◽  
Blood Loss ◽  
Postoperative Period ◽  
P Value ◽  
Intraoperative Blood Loss ◽  
Pain Scores ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
The Mean ◽  
Cold Dissection

<p class="abstract"><strong>Background:</strong> The aim of the present study was to compare intraoperative blood loss, operative duration and postoperative pain between coblation-assisted adenotonsillectomy and cold dissection adenotonsillectomy in children.</p><p class="abstract"><strong>Methods:</strong> A prospective, randomized, single-blind trial of pediatric patients aged 7 to 13 years undergoing adenotonsillectomy was conducted. Patients were randomized to undergo either cold dissection or coblation-assisted adenotonsillectomy. Measured intraoperative parameters included surgical duration and intraoperative blood loss. Measured postoperative parameters included a daily pain rating using the visual analog scale on the postoperative evening, postoperative day 1 and day 7. Intraoperative and postoperative measures were statistically compared between the two groups<span lang="EN-IN">.  </span></p><p class="abstract"><strong>Results:</strong> Sixty children were randomized and included in the study. 30 patients underwent cold dissection adenotonsillectomy and 30 coblation-assisted adenotonsillectomy. Mean age was 8.7 years in the coblation group and 9.1 years in the cold dissection group. Intraoperative blood loss was lower for the coblation assisted adenotonsillectomy group versus the cold dissection adenotonsillectomy group which was proved statistically (mean bleeding was 16.67 in coblation group and 58.67 in cold dissection group and p value &lt;0.0001).There was statistically no significant difference in the mean pain scores in the 2 groups in the postoperative evening and on postoperative day 1. The mean pain scores on postoperative day 7 were found to be 3.4 in the coblation group and 2.47 in the cold dissection group with a significant p value of 0.0087. The average duration of surgery in the coblation group was 55.6 minutes as against 34.1 minutes in the cold dissection group. The p- value was found to be less than 0.0001 which makes the difference statistically significant<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> This study found that the intraoperative blood loss was significantly less in Coblation adenotonsillectomy than in cold dissection adenotonsillectomy. The duration of surgery in Coblation assisted adenotonsillectomy is significantly greater than the duration of surgery in cold dissectionadenotonsillectomy. While the postoperative pain scores are similar with coblation and cold dissection adenotonsillectomy in the early postoperative period, it is significantly more with coblation in the late postoperative period<span lang="EN-IN">.</span></p>

scholarly journals ROLE OF LOCAL INFILTRATION OF INJECTION BUPIVACAINE IN REDUCING EARLY POST-OPERATIVE PAIN

2020 ◽  
Vol 11 (1) ◽  
pp. 1-8
Author(s):  
Mudassar jabeen ◽  
Fawad Zafar ◽  
Sumara Tabassam ◽  
Farhad Alam ◽  
Muhammad Sohail
Keyword(s):  
Controlled Trial ◽  
Pain Scale ◽  
Control Group ◽  
P Value ◽  
Local Infiltration ◽  
Surgical Incision ◽  
Surgical Department ◽  
Post Operative Period ◽  
Post Operative Pain ◽  
Significant Difference

ABSTRACT: BACKGROUND & OBJECTIVE: Intolerable morbidity occurs after major thoracic, orthopedic or abdominal surgeries due to post-operative pain. Inadequately controlled pain leads to patient displeasure and major morbidities like postoperative pulmonary dysfunctions and cardiac ischemic changes. Various techniques are presently used to treat this pain and opiods are the most regularly used medications by parenteral or neuraxial route. Intolerable morbidity occurs post-operatively due to inadequately controlled pain. The objective of this study was to compare the mean pain scores in patients undergoing laparotomy with and without local infiltration of injection bupivacaine at surgical incision site in post-operative period. METHODOLOGY: This randomized controlled trial was conducted at surgical department Allied hospital Faisalabad from June 2017 to December 2017.Total 80 patient were included in this study that were randomly divided into two groups using random number tables. In post-operative period, patients of both groups were given treatment as per requirement of their respective diseases. They received a baseline analgesia using Inj. Toradol (ketorolac) 30mg/1ml intravenously every 8 hours, first dose given during the surgery. The study group was additionally given 10ml Inj. Bupivacaine HCl 0.5% diluted with 10ml saline injected into the subcutaneous plane around the incision immediately after the closure of skin and time was noted. No further difference in the treatment of patients of both groups required for the purpose of this study. The patients in both groups were compared for the degree of pain experienced by them in early post-operative period. This information was collected using Numeric pain scale, 10 being worst pain and 1 meaning least appreciable pain. These assessments were done 2 and 4 hours after surgery. RESULTS: We recorded pain score 3.0+0.75 in study and 5.2+0.72 in control group, p-value was < 0.001 showing a significant difference. CONCLUSION: We concluded that there is significantly lower pain in patients infiltrated with injection bupivacaine around surgical incision in early post-operative period as compared to those who had only intravenous analgesics.

scholarly journals Comparison of post operative pain in tonsillectomy: a three year prospective study

2020 ◽  
Vol 6 (12) ◽  
pp. 2189
Author(s):  
Akshay Jain ◽  
Smruti Milan Tripathy
Keyword(s):  
Prospective Study ◽  
Pain Scale ◽  
Visual Analogue Pain Scale ◽  
Bipolar Cautery ◽  
Visual Analogue Pain ◽  
Pain Scores ◽  
Post Operative Period ◽  
Post Operative Pain ◽  
Significant Difference ◽  
Cold Dissection

<p><strong>Background:</strong> Tonsillectomy is the oldest surgery performed by otorhinolaryngologists worldwide. Through ages different techniques have been tried to improve the post surgical outcome and reduce morbidity among patients. Aim of the current study was to compare the post-operative pain among the patients undergoing tonsillectomy by cold dissection, bipolar cautery dissection and coblation dissection.</p><p><strong>Methods:</strong> 142 Patients undergoing tonsillectomy in ENT department of TMMC during the period of 3 year were included in the study. Patients were randomly distributed to undergo different techniques of tonsillectomy. The post-operative pain in patients was assessed using the pre-standardized visual analogue pain scale and results were analyzed.</p><p><strong>Results:</strong> No statistically significant difference was found among the groups undergoing tonsillectomy by cold dissection, bipolar dissection and coblator dissection as the p&gt;0.05. The immediate post-operative pain was found to be slightly higher among the group undergoing tonsillectomy by coblator dissection and the analgesics dose needed in the post-operative period remained the same for all for patients of all the three groups.</p><p><strong>Conclusions:</strong> No statistically significant difference was found in the post-operative pain scores of patients undergoing tonsillectomy by CD, BD and CBD techniques.</p>

Comparison of Intravenous Paracetamol Prophylaxis versus Placebo for Prevention of Pain with Injection Rocuronium

2021 ◽  
Vol 15 (8) ◽  
pp. 1852-1854
Author(s):  
Aneeque Alam Khan ◽  
Kiran Mehwish ◽  
Ravi Kumar ◽  
Pavan Kumar ◽  
Tahir Ali ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Placebo Group ◽  
Pain Score ◽  
Elective Surgery ◽  
Controlled Trial ◽  
P Value ◽  
Randomized Controlled ◽  
Intravenous Paracetamol ◽  
Significant Difference ◽  
The Mean

Aim: To compare the frequency of absence of pain with injection paracetamol versus placebo given before injection rocuronium in patients undergoing elective procedures Study design: Randomized Controlled Trial Place and duration of study: Dept of Anaesthesia, Civil Hospital, Karachi from 15th January to 14th July 2017. Methodology: One hundred and two patients aged 25-75 years of either gender undergoing elective surgery were enrolled. The lottery method was used to divide the patients into two equal groups. Paracetamol (5 mL, 10 mg/mL) or normal saline (5 mL) were used as pretreatment solutions. When the tourniquet was removed after 2 minutes, the rocuronium at 1% concentration was injected throughout the 10 second’s period. Patients were then advised and asked to rate their pain on the hand's dorsum using VAS. Results: Mean age of the patients was 44.11±7.75 years. Mean pain score was 1.49±1.38. Significant difference was observed in the mean pain score in between paracetamol and placebo group (p-value <0.001). Overall absence of pain was found in 49 (40.8%). Absence of pain was found to be higher 34 (69.4%) in paracetamol group as compared to placebo group (p-value <0.001). Conclusion: Frequency of absence of pain found lower in patients undergoing elective procedures with injection paracetamol versus placebo given before injection rocuronium. Keywords: Injection rocuronium, Elective procedures, Injection paracetamol, Absence of pain

Combat Application Tourniquet fares well in a chemical, biological, radiological or nuclear dress state

2020 ◽  
pp. jramc-2019-001261
Author(s):  
Alastair Beaven ◽  
E Sellon ◽  
M Ballard ◽  
P Parker
Keyword(s):  
Pain Score ◽  
Control Group ◽  
Published Data ◽  
Imaging Data ◽  
Pain Scores ◽  
British Military ◽  
Significant Difference ◽  
The Mean ◽  
Control Pain ◽  
Threat Environment

IntroductionThere is a need for a military tourniquet to control catastrophic haemorrhage in a chemical, biological, radiological or nuclear (CBRN) threat environment. No published data exist as to the efficacy of tourniquets while wearing British military CBRN individual protective equipment (IPE).Methods12 volunteers from the counter CBRN instructors’ course allowed testing on 24 legs. A Combat Application Tourniquet (C-A-T) was applied to all volunteers at the level of the midthigh. 12 legs were tested while wearing CBRN IPE (both operator and simulated casualty), and the control group of 12 legs was tested while wearing conventional combat dress state (both operator and simulated casualty). The order of leg laterality and dress state were sequenced according to a prerandomised system. Efficacy was measured via use of an ultrasound probe at the popliteal artery. Tourniquets were considered effective if arterial flow was completely occluded on ultrasound imaging. Data were collected on time to successful application, failure of tourniquets and pain scores as rated by the visual analogue scale (1–10).ResultsThere were no failures of tourniquet application in the CBRN group, and two failures (17%) in the control group. Failures were pain threshold exceeded (n=1) and tourniquet internal strap failure (n=1). The mean application time for the CBRN group was 28.5 s (SD 11.7) and 23.7 s (SD 9.8) for the conventional combat group. There was no statistically significant difference (p=0.27). The median CBRN pain score was 2.0 (IQR 2.0–3.5). The median control pain score was 4.0 (IQR 3–6). This was a statistically significant difference (p=0.002).ConclusionC-A-Ts applied to simulated casualties in CBRN IPE at the midthigh are at least as efficacious as those applied to the midthigh in a conventional combat dress state. The pain experienced was less in CBRN IPE than when in a conventional combat dress state.

scholarly journals Comparison of Visual Analog Pain Score Reported to Physician vs. Nurse, Part II

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0033
Author(s):  
Kevin Martin ◽  
Trevor McBride ◽  
Jeffrey Wake ◽  
Jeffrey Van Buren ◽  
Cuyler Dewar
Keyword(s):  
Pain Score ◽  
Nursing Staff ◽  
Patient Reported Outcome Measures ◽  
Mean Difference ◽  
Surgical Patients ◽  
Vas Score ◽  
Pain Scores ◽  
Significant Difference ◽  
Patient Reported ◽  
The Mean

Category: Ankle Introduction/Purpose: Patient reported outcome measures (PROMs) are taking a more prominent role in Orthopedics as researchers and health care networks seek to define treatment outcomes. However, interpretation and clinical applications of PROMs are still under investigation. The visual analogue scale (VAS) is considered a reliable and validated measure of acute pain. In a previous study, it was found that in surgical candidates the VAS pain score was significantly higher when reporting to the surgeon as opposed to the nurse. The aim of this current study is to examine whether this phenomenon occurs in patients that do not ultimately go on to have a surgical procedure. We hypothesize that there will be no difference in patient reporting to the surgeon versus the nursing staff. Methods: This study is a retrospective cohort of 201 consecutive non-surgical foot and ankle patients treated by a single surgeon. The patients were asked to rate their pain intensity by the nursing staff and then by the surgeon using a standard horizontal VAS 0 to 10, from “no pain” to worst pain.” Differences in reported pain levels were analyzed. Results: The mean VAS score reported to the nurse was 3.2 whereas the mean VAS score reported to the Surgeon was 4.2 (p<.001). Contrary to our hypothesis, there was a statistically significant difference in pain scores reported to the surgeon compared to the nurse. We then analyzed the mean difference of pain scores reported to surgeon and nurse for surgical versus non-surgical patients. The mean difference in VAS scores reported to physician and nurse for surgical patients was 2.87 whereas the mean difference for non-surgical patients was 1.00 (p < .001). Conclusion: The current study found statistically significant differences between VAS pain scores reported to the surgeon versus the nurse in non-surgical patients. These results support the trend found in our previous study which demonstrated discrepancies in patient pain reporting, with surgical patients reporting significantly higher pain scores to the surgeon versus the nurse. However, the mean difference between reported pain scores, to the providers, is significantly higher for surgical patients as compared to non-surgical patients. The cause of this phenomenon remains unclear, however, this study provides more information regarding patient reported VAS pain scores in an outpatient clinical setting.

Comparison of Post-Operative Pain Between Nalbuphine and Tramadol in Total Intravenous Anesthesia for Dilation and Evacuation

2021 ◽  
Vol 15 (8) ◽  
pp. 2132-2133
Author(s):  
Quratulain Yunus ◽  
Saima Abdullah ◽  
Sana Riffaat
Keyword(s):  
Pain Score ◽  
Rapid Sequence Induction ◽  
Total Intravenous Anesthesia ◽  
P Value ◽  
Intravenous Anesthesia ◽  
Post Operative Pain ◽  
Rapid Sequence ◽  
Significant Difference ◽  
Sequence Induction ◽  
Group B

Objective: Comparison of post-operative pain between nalbuphine and tramadol in total intravenous anesthesia for dilation and evacuation. Methodology: This randomized controlled trial was conducted at Fatima Memorial Medical and Dental College and Hospital, Lahore during June 2019 to September 2020. We randomly enrolled in Two Groups-A, who received intravenous injection tramadol 1.5 mg/kg after rapid sequence induction with propofol2mg/kg, succinylcholine 1-1.5mg/kg followed by LMA insertion and Group-B those receiving nalbuphine0.1mg/kg after rapid sequence induction with propofol2mg/kg, succinylcholine 1-1.5mg/kg followed by LMA insertion. Consultant anesthetist administered these drugs and evaluated pain score after 30 mins of surgery done with the help of VAS. Results: Comparison of mean pain score in both groups shows 2.28+1.13 pain on VAS in Group-A and 1.07+0.82 in Group-B, p value was 0.0001 showing a significant difference. (Table 1) Conclusion: Post-operative pain is significantly lower in nalbuphinewhen compared with tramadol in total intravenous anesthesia for dilation and evacuation. Keywords: Dilation and evacuation, postoperative pain, nalbuphine, tramadol

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