scholarly journals Noradrenaline, Serotonin, GABA, and Glycine in Cerebrospinal Fluid during Labor Pain: A Cross-Sectional Prospective Study

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Pornpan Chalermkitpanit ◽  
Atikun Thonnagith ◽  
Phatthanaphol Engsusophon ◽  
Somrat Charuluxananan ◽  
Sittisak Honsawek
Keyword(s):  
Cerebrospinal Fluid ◽  
Rating Scale ◽  
Visceral Pain ◽  
Numerical Rating Scale ◽  
Labor Pain ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Gamma Aminobutyric Acid ◽  
Cross Sectional ◽  
Pain Scores

Background and Aims. The inhibitory pathways that play a role in spinal modulation include local interneurons and descending control. Clinical data regarding the role of these pathways in acute pain is lacking. Accordingly, the aim of this study was to evaluate cerebrospinal fluid (CSF) levels of noradrenaline, serotonin, gamma-aminobutyric acid (GABA), and glycine in parturients with labor pain compared to those without labor pain.Methods. One hundred term uncomplicated pregnant women receiving spinal anesthesia for cesarean section were enrolled in this prospective cross-sectional study. CSF noradrenaline, serotonin, GABA, and glycine levels were analyzed by enzyme-linked immunosorbent assay. Labor pain score was assessed by numerical rating scale.Results. Median CSF serotonin concentration in parturients with labor pain was significantly lower than in those without pain (p<0.001). Median CSF glycine level in the labor pain group was significantly higher than in the control group (p<0.001). There were no significant differences in median CSF level of noradrenaline or GABA between parturients with and without labor pain. Subsequent analysis showed labor pain scores to be negatively correlated with CSF serotonin (r=-0.217,p=0.04) but positively correlated with CSF glycine (r=0.415,p<0.001).Conclusion. CSF serotonin and glycine were significantly correlated with labor pain scores. These findings suggest that the serotonergic and glycinergic systems may play a role in spinal modulation of visceral pain.

scholarly journals THE EFFECT OF ACUPRESSURE AND EFFLEURAGE ON PAIN RELIEF IN THE ACTIVE PHASE OF THE FIRST STAGE OF LABOR IN THE COMMUNITY HEALTH CENTER OF KAWUNGANTEN, CILACAP, INDONESIA

2017 ◽  
Vol 3 (5) ◽  
pp. 508-514
Author(s):  
Yuli Sya’baniah Khomsah ◽  
Agus Suwandono ◽  
Ida Ariyanti
Keyword(s):  
Community Health ◽  
Health Center ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Community Health Center ◽  
Active Phase ◽  
Labor Pain ◽  
Control Group ◽  
P Value ◽  
First Stage Of Labor

Background: Pain during pregnancy and childbirth is a physiological process, but it leads to discomfort without pain management. Acupressure and effleurage are considered to be effective in reducing labor pain.Objective: To examine the effect of acupressure and effleurage in reducing pain during in the active phase of the first stage of labor in the community health center of Kawunganten, Cilacap regency.Methods: This was a quasi-experimental study with pretest-posttest control group design. There were 33 respondents recruited using simple random sampling. Numerical rating scale was used to measure labor pain. Data were analyzed using one way anova, Post hoc anova and repeated anova for normal data distribution. Kruskal Wallis was also used for non-normal data distribution.Results: There was a statistically significant mean difference of pain scale before and after given acupressure and effleurage (p-value <0.05). However, acupressure treatment had a greater effect  in reducing pain compared with effleurage.Conclusion: Acupressure and efflurage had a significant effect in reducing pain in mothers in the active phase of the first stage of labor. The results of this study are expected to enrich and contribute to the development of science in the field of health promotion, and  serve as an additional input for midwives in order to carry out the care of mother during labor.

scholarly journals LAVENDER (LAVANDULA ANGUSTIFOLIA) AROMATHERAPY AS AN ALTERNATIVE TREATMENT IN REDUCING PAIN IN PRIMIPAROUS MOTHERS IN THE ACTIVE FIRST STAGE OF LABOR

2017 ◽  
Vol 3 (4) ◽  
pp. 420-425
Author(s):  
Hilda Yani Karo Karo ◽  
Noor Pramono ◽  
Sri Wahyuni ◽  
Imam Djamaluddin Mashoedi ◽  
Leny Latifah
Keyword(s):  
Community Health Centers ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Pain Scale ◽  
Labor Pain ◽  
Control Group ◽  
P Value ◽  
Lavandula Angustifolia ◽  
Numerical Rating ◽  
And Control

Background: Labor and childbirth is an extremely painful process. Aromatherapy is considered as one of the nonpharmacological methods to reduce labor pain.Objective: To determine the effect of Lavender (Lavandula Angustifolia) aromatherapy on the level of pain in primipara in the first stage of labor.Methods: A quasy-experimental research with pretest and posttest design with control group conducted between October until November 2016. Forthy respondents selected using consecutive sampling, which 20 assigned in each group. a Numerical Rating Scale (NRS) pain scale was used. Paired and independent t-test were used for data analyses.Results: The results showed that the p-value of labor pain after intervention was 0.000 (<0.05), which indicated that there was statistically mean difference of labor pain between intervention (6.10) and control group (4.05) in primipara in the first active stage of labor.Conclusion: The women in the lavender aromatherapy group reported lower intensity of labor pain. The intervention study could be practiced in the community health centers for pregnant women in order for them to apply this healing method.

EFEK AROMA EKSTRAK MELATI TERHADAP PENGURANGAN NYERI PERSALINAN KALA I FASE AKTIF PADA PARTURIENT

2017 ◽  
Vol 11 (4) ◽  
pp. 323
Author(s):  
Nike Sari Oktavia
Keyword(s):  
Essential Oil ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Active Phase ◽  
Labor Pain ◽  
Reflex Response ◽  
Control Group ◽  
Birth Process ◽  
Quasi Experimental ◽  
And Control

<p><em>Labor pain arising from physical and psychological reflex response of from the pain that experienced by the patient. Jasmine essential oil is proven to nervous exhoustion, reduce pain, emotional distress, reduce anxiety, energy, and euphoria that everything that is needed by a mother while facing the birth process. Purpose of this study was to determine whether the jasmine essnstial oil can be used to reduce the pain of the active phase on first stage of parturient. This study used a quasi-experimental method, the sampel was 48 people inpartu who are in the active phase of the first stage of labor. Study subjects were devided into 2 groups; jasmine essential oil (n = 24) and control (n = 24). Pain assessed twice in each group with a numerical rating scale (NRS), that when the woman is in the active phase before inhalation the smell of jasmine essential oil and at the end of the first stage after inhalation the smell. Test statistical analysis using Wilcoxon Signed Ranks test and Mann Whitney test.  The result is; in jasmine essential oil group the median 6 with a range  4-9 decreased to 4 (3-9), while controls had increased pain intensity with a median value of 4.5 (2-10) to 9 (4 -10). There are difference between pain assesment I and II in both groups p = 0.000 (p &lt;0,05). Comparison between jasmine essential oil  group and control group p = 0.000 (p &lt;0,05). </em><em><br />      </em></p><p><strong><em>Keyword: Jasmine essential oil, labor pain</em></strong><strong><em></em></strong></p>

Comparison of Analgesic Effect of Levobupivacaine with Dexmedetomidine and Levobupivacaine for Scalp Block before Supratentorial Craniotomy: A Randomized Controlled Trial

2020 ◽  
Vol 103 (10) ◽  
pp. 1028-1035
Keyword(s):  
Postoperative Pain ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Control Group ◽  
Study Group ◽  
Analgesic Requirement ◽  
Supratentorial Craniotomy ◽  
Numerical Rating ◽  
Fentanyl Consumption ◽  
Scalp Block

Background: Craniotomy causes acute and chronic pain. Uncontrolled postoperative pain may lead to adverse events. Perioperative scalp nerves block is not only effective in reducing intraoperative hemodynamic response, but it also reduces postoperative pain and postoperative analgesia requirement. Objective: To compare the benefits of adding dexmedetomidine to levobupivacaine in scalp nerves block before craniotomy for the duration of analgesia in supratentorial craniotomy. Materials and Methods: After approval by the Committee for Research, 50 supratentorial craniotomy patients were randomized into two groups. The control group received 30 mL scalp nerves block with 0.25% levobupivacaine with adrenaline 1:200,000, whereas the study group received 30 mL scalp nerves block with 0.25% levobupivacaine with adrenaline 1:200,000 plus dexmedetomidine 1 mcg/kg. The primary outcome was the time to first analgesic requirement postoperatively. The secondary outcomes included intraoperative fentanyl consumption, verbal numerical rating scale, tramadol consumption, and complications during the first 24 hours postoperatively. Results: Patients in the study group had significantly increase time to the first analgesic requirement in postoperative period and reduced intraoperative fentanyl consumption. The median time to first analgesic requirement was 555 (360 to 1,035) minutes in the study group versus 405 (300 to 520) minutes in the control group (p=0.023). Intraoperative fentanyl consumption 125 (75 to 175) mcg in the study group was significantly lower than 200 (150 to 250) mcg in the control group (p=0.02). The verbal numerical rating scale at 1, 4, 8, 12 and 24 hours postoperatively, tramadol consumption, and complications during the first 24 hours postoperatively were not statistically significant different. Conclusion: Preoperative scalp nerves block with 0.25% levobupivacaine with adrenaline (1:200,000) with dexmedetomidine 1 mcg/kg significantly increased the time to first analgesic requirement and reduced intraoperative fentanyl consumption compared to 0.25% levobupivacaine with adrenaline (1:200,000) without perioperative complications. Keywords: Scalp block, Dexmedetomidine, Post-craniotomy analgesia, Supratentorial tumor, Levobupivacaine

scholarly journals Ultrasound-guided superficial cervical plexus block for analgesia in patients undergoing craniotomy via suboccipital retrosigmoid approach: study protocol of a randomised controlled trial

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e034003
Author(s):  
Kun Peng ◽  
Min Zeng ◽  
Jia Dong ◽  
Xiang Yan ◽  
Dexiang Wang ◽  
...  
Keyword(s):  
Nerve Block ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Controlled Trial ◽  
Control Group ◽  
Cervical Plexus ◽  
Ethics Review ◽  
Superficial Cervical Plexus Block ◽  
Cervical Plexus Block ◽  
Plexus Block

IntroductionScalp nerve block has been proven to be an alternative choice to opioids in multimodal analgesia. However, for the infratentorial space-occupying craniotomy, especially the suboccipital retrosigmoid craniotomy, scalp nerve block is insufficient.Methods and analysisThe study is a prospective, single-centre, randomised, paralleled-group controlled trial. Patients scheduled to receive elective suboccipital retrosigmoid craniotomy will be randomly assigned to the superficial cervical plexus block group or the control group. After anaesthesia induction, superficial cervical plexus nerve block will be performed under the guidance of ultrasound. The primary outcome is the cumulative consumption of sufentanil by the patient-controlled intravenous analgesia pump within 24 hours after surgery. Secondary outcomes include the cumulative consumption of sufentanil at other four time points and numerical rating scale pain severity score.Ethics and disseminationThe protocol (version number: 2.0, 10 April 2019) has been approved by the Ethics Review Committee of China Registered Clinical Trials (Ethics Review No. ChiECRCT-20190047). The findings of this study will be disseminated in peer-reviewed journals and at scientific conferences.Trial registration numberNCT04036812

High revision rates with the metal-on-metal Motec carpometacarpal joint prosthesis

2015 ◽  
Vol 41 (3) ◽  
pp. 322-327 ◽  
Author(s):  
J. K. Thillemann ◽  
T. M. Thillemann ◽  
B. Munk ◽  
K. Krøner
Keyword(s):  
Rating Scale ◽  
Revision Rate ◽  
Numerical Rating Scale ◽  
Elevated Serum ◽  
Consecutive Series ◽  
Dash Score ◽  
Level Of Evidence ◽  
Pain Scores ◽  
Thumb Carpometacarpal

We retrospectively evaluated a consecutive series of 42 Motec thumb carpometacarpal total joint arthroplasties. The primary endpoint was revision with implant removal and trapeziectomy. At follow-up the disability of the arm shoulder and hand (DASH) score, pain on numerical rating scale at rest and with activity and serum chrome and cobalt concentrations were assessed for both unrevised and revised patients. At a mean follow-up of 26 months, 17 patients had been revised. The 2 year cumulative revision rate was 42% (95% CI, 28–60%). The DASH score and pain scores at rest and with activity were comparable between the patients whose thumbs remained unrevised and those revised. Patients with elevated serum chrome and cobalt levels had significantly higher DASH and pain scores, but elevated levels were not associated with revision. The revision rate in this study is unacceptably high. However, pain and DASH scores after revision are acceptable and comparable with patients with non-revised implants. Level of evidence: IV

scholarly journals Analgesic Effects of Preincision Ketamine on Postspinal Caesarean Delivery in Uganda’s Tertiary Hospital: A Randomized Clinical Trial

2017 ◽  
Vol 2017 ◽  
pp. 1-6
Author(s):  
Richard Mwase ◽  
Tonny Stone Luggya ◽  
John Mark Kasumba ◽  
Humphrey Wanzira ◽  
Andrew Kintu ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Rating Scale ◽  
Breakthrough Pain ◽  
Numerical Rating Scale ◽  
Postoperative Pain Management ◽  
Mulago Hospital ◽  
Clinical Trial Registry ◽  
Analgesic Effects ◽  
Pain Scores ◽  
Intravenous Ketamine

Background. Good postoperative analgesic management improves maternal satisfaction and care of the neonate. Postoperative pain management is a challenge in Mulago Hospital, yet ketamine is accessible and has proven benefit. We determined ketamine’s postoperative analgesic effects.Materials and Methods. We did an RCT among consenting parturients that were randomized to receive either intravenous ketamine (0.25 mg/kg) or placebo after spinal anesthetic. Pain was assessed every 30 mins up to 24 hours postoperatively using the numerical rating scale. The first complaint of pain requiring treatment was noted as “time to first breakthrough pain.”Results. We screened 100 patients and recruited 88 that were randomized into two arms of 44 patients that received either ketamine or placebo. Ketamine group had 30-minute longer time to first breakthrough pain and lower 24-hour pain scores. Postoperative diclofenac consumption was lesser in the ketamine group compared to placebo and Kaplan-Meier graphs showed a higher probability of experiencing breakthrough pain earlier in the placebo group.Conclusion. Preincision intravenous ketamine (0.25 mg/kg) offered 30-minute prolongation to postoperative analgesia requirement with reduced 24-hour pain scores. We recommend larger studies to explore this benefit. This trial is registered with Pan African Clinical Trial Registry numberPACTR201404000807178.

28 Assessment of Pain and Provision of Non-Pharmacologic Analgesia to Children by Prehospital Providers in Southwestern Ontario: A Cross-Sectional Study

2021 ◽  
Vol 26 (Supplement_1) ◽  
pp. e21-e21
Author(s):  
Karina Burke ◽  
Branka Vujcic ◽  
Jonathan Hamilton ◽  
Charlotte Mace ◽  
John Teefy ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Rating Scale ◽  
A Priori ◽  
Numeric Rating Scale ◽  
Cross Sectional Study ◽  
Subject Area ◽  
Stepwise Logistic Regression ◽  
Tertiary Referral Centre ◽  
Cross Sectional ◽  
Pain Scores

Abstract Primary Subject area Emergency Medicine - Paediatric Background There is abundant evidence that provision of pharmacologic analgesia by prehospital providers to children is suboptimal. Most paediatric calls are performed by primary care paramedics (PCPs) who are unable to administer pharmacologic analgesia to children but can administer non-pharmacologic therapies. Objectives Our objective was to describe the provision of non-pharmacologic analgesia to children by prehospital providers. Design/Methods We reviewed all ambulance call reports (ACRs) of children 0-17 years with acutely painful conditions (headache, abdominal pain, injury, head/ears/eyes/nose/throat pain, and back pain) who were transported to a paediatric tertiary referral centre serving a catchment of &gt; 1 million from 2017-2019. Data collection was recorded by two blinded assessors using a study-specific Excel™ sheet. The primary outcome was the proportion of children offered non-pharmacologic analgesia. We performed a stepwise logistic regression on the primary outcome using covariates defined a priori: age, sex, visible deformity, type of crew, complaint, pain score, call time, and prior analgesia. Results All 11,084 ACRs from January 1, 2017 to December 31, 2019 were reviewed. The sample included 5887/11084 (53.1%) males, ranging from 1 month to 17 years, with a mean (SD) age of 10.5 (5.6) years. Calls involved mainly PCPs [8576/11084 (77.4%)]. Non-trauma-related musculoskeletal injuries were most common, comprising 2743/11,084 (24.7%) of calls. Pain scores were documented in 6947/11084 (62.7%) of calls. The verbal numeric rating scale (0-10) was used in 5022/6947 (72.3%) of calls, with a mean (SD) score of 5.2 (3.2). Non-pharmacologic analgesia was provided in 2926/11084 (26.4%) of calls, most commonly splint (1115/2926, 38.1%) and ice (931/2926, 31.8%). Pharmacologic analgesia was provided in 458/11084 (4.1%) of calls. In the multivariate model, mild (OR: 3.2; 95% CI 2.3-4.4; p &lt; 0 .001) and moderate pain (OR: 1.7; 95% CI 1.3-2.2) (versus no pain) were significant predictors of non-pharmacologic analgesia, whereas visible deformity (OR: 0.5; 95% CI 0.3-0.6; p &lt; 0 .001) was a significant negative predictor. Conclusion The provision of non-pharmacologic analgesia to children in Southwestern Ontario by prehospital providers is suboptimal, despite moderate to severe pain. There is a clear need for education surrounding approaches to non-pharmacologic analgesia in children among prehospital providers.

scholarly journals Effectiveness of Neck Myofascial Release Techniques and Exercise Therapy on Pain Intensity and Disability in Patients with Chronic Tension-Type Headache

2016 ◽  
Vol 9 (6) ◽  
pp. 47
Author(s):  
Mohammad Hosseinifar ◽  
Razieh Bazghandi ◽  
Zahra Azimi ◽  
Bahareh Khodadadi Bohlouli
Keyword(s):  
Pain Intensity ◽  
Exercise Therapy ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Tension Type Headache ◽  
Control Group ◽  
Myofascial Release ◽  
Headache Intensity ◽  
Headache Disability ◽  
Type Headache

PURPOSE: Tension type headache (TTH) is one of the most prevalent types of headache. TTH is classified as episodic if it occurs on less than 15 days a month and as chronic if it occurs more often. Tension, anxiety and depression are some etiological factors for TTH which leads to work efficiency reduction. Today the interest in non-pharmacological methods is increasing; massage is one of these approaches which has no side effects. Aim of this study was to investigate the effects of neck Myofascial Release (MFR) techniques and exercise therapy on pain intensity and disability in patients with chronic tension-type headache.METHODS: This randomized clinical trial study was investigated on 30 females suffering from TTH. Participants were randomly assigned into two equal groups (n=15). The MFR group received neck MFR massage and exercise therapy four times a week for 3 weeks, each session lasting 45 minutes. Control group had no intervention. Outcomes were headache intensity and disability measured by numerical rating scale (NRS) and headache disability index (HDI), respectively. Data was analysed through independent and pair t-test.RESULTS: Between group comparison showed significant improvement of headache intensity and disability rate in MFR group (p<0.05) than control group (p=0.000).DISCUSSION: This study provides evidences that MFR technique and exercise therapy have significant effect on patients with TTH.

Acupuncture for Low Back Pain in Pregnancy – a Prospective, Quasi- Randomised, Controlled Study

2004 ◽  
Vol 22 (2) ◽  
pp. 60-67 ◽  
Author(s):  
João Bosco Guerreiro da Silva ◽  
Mary Uchiyama Nakamura ◽  
José Antonio Cordeiro ◽  
Luiz Kulay
Keyword(s):  
Pelvic Pain ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Real Life ◽  
Acupuncture Group ◽  
Controlled Study ◽  
Control Group ◽  
Study Group ◽  
Low Back ◽  
Average Pain

This study was undertaken to investigate the effects of acupuncture in low back and pelvic pain during pregnancy under real life conditions, as compared with patients undergoing conventional treatment alone. A total of 61 conventionally treated pregnant women were allocated randomly into two groups to be treated or not by acupuncture. Twenty-seven patients formed the study group and 34 the control group. They reported the severity of pain using a Numerical Rating Scale from 0 to 10, and their capacity to perform general activities, to work, and to walk. We also assessed the use of analgesic drugs. Women were followed up for eight weeks and interviewed five times, at two-week intervals. All women completed the study. In the study group the average pain during the study period showed a larger reduction (4.8 points) than the control group (−0.3 points) (P<0.0001). Average pain scores decreased by at least 50% over time in 21 (78%) patients in the acupuncture group and in five (15%) patients in the control group (P<0.0001). Maximum pain and pain at the moment of interview were also less in the acupuncture group compared with the control group. The capacity to perform general activities, to work and to walk was improved significantly more in the study group than in the control group (P<0.05). The use of paracetamol was lower in the acupuncture group (P<0.01). These results indicate that acupuncture seems to alleviate low back and pelvic pain during pregnancy, as well as to increase the capacity for some physical activities and to diminish the need for drugs, which is a great advantage during this period.

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