Pain Perception Associated with Mini-Implants and Interventions for Pain Management: A Cross-Sectional Questionnaire-Based Survey

Background. Orthodontists use mini-implants temporarily as an effective mode of skeletal anchorage devices. The placement of mini-implants can cause pain and discomfort to the patients. Patients often develop swelling, and the pain could interfere with their daily activities. Practitioners tend to prescribe antibiotics and pain medication for management. Objectives. The main objectives of this study are to evaluate the pain perception and discomfort due to mini-implant placement experienced by the patient and evaluate the interventions for pain management commonly practiced among orthodontists. Materials and Methods. The study was designed as a questionnaire-based cross-sectional study. A total of 271 patients were assessed, for whom 625 mini-implants (ranging from 1.2 to 2 mm diameter and length 8-14 mm) were placed. Pain scores were assessed using the VAS and the “Faces” pain rating scale to collect data about discomfort in daily activity and function. Data was collected from 244 patients. A total of 155 orthodontists were questioned regarding the prescription of medications and the interventions for managing pain and adverse effects. Results. Average pain score among female subjects was 16.71 and among men was 13.5. The highest pain scores were recorded for palatal mini-implants with an average score of 36.29 and the least for interradicular mini-implants with an average score of 9.02. Among the subjects, 47.9% of them took analgesics, and the most commonly prescribed analgesics were paracetamol (39%). Swelling at the site is where the mini-implants were placed, and ulceration due to implants were commonly dealt with the excision of the surrounding soft tissue, composite placement, and palliative care with oral analgesic gels. Conclusion. Female subjects had more mini-implants placed, and female subjects had also given more pain scores than their male counterparts. Palatal mini-implants caused the highest pain, followed by mini-implants placed at the infrazygomatic crest and the buccal shelf region. Palatal mini-implants caused maximum discomfort during speech and eating, followed by the mini-implant in the buccal shelf and the infrazygomatic crest region that also caused difficulty in yawning and laughing. Infiltration anesthesia was commonly given for the placement of interradicular implants and extra-alveolar mini-implants. Paracetamol was the most prescribed by the orthodontists, and more than half the doctors did not regularly prescribe antibiotics.

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

Paediatrics & Child Health ◽

10.1093/pch/pxab061.022 ◽

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 > 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 < 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 < 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.

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Exploration of pain management following implementation of WHO pain guidelines

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.19646 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 19646-19646

Author(s):

S. Subongkot ◽

S. Khounnikhom ◽

N. Pratheepawanit Johns ◽

A. Sookprasert

Keyword(s):

Pain Management ◽

Pain Score ◽

Rating Scale ◽

Numeric Rating Scale ◽

Cross Sectional Study ◽

P Value ◽

Cross Sectional ◽

Daily Life Activities ◽

Naive Group ◽

Who Guideline

19646 Background: Pain is among the most common symptoms encountered in cancer patients and remains the first priority of care. Methods: This cross sectional study aimed to explore a pattern of pain management at KKU Hospital by utilizing a numeric rating scale (0–10). Cancer pain patients were categorized based on prior analgesic exposure into two groups; Naïve group, and Routine group. Treatments were defined according to WHO as 1) drug treatment relevant to pain severity, 2) analgesics being prescribed as around-the- clock and 3) analgesics used for break-through pain for patients receiving strong opioid. Results: From Dec 2005 to Jul 2006, 261 patients were enrolled. 93.1% (n=243) were in advanced stages and 88.5% (n=231) were in moderate to severe pain. This pain interfered with patient’s daily life activities mildly to moderately as each pain score increased (p-value<0.01). In Naive group (n=159), 32.7% (n=52) were given analgesics following the WHO on both days 1 and day 3 of admission whereas 40.2% (n=64) patients were not. A decreased pain score was greater (2.61, SD±1.5) in a group following the WHO on day 1. Additionally, a decreased pain score was greater (3.91, SD±1.8) in a group following the WHO on day 3 (p-value <0.0001). This pain score decreased was also clinically significant as pain score reduced more than 3 points. In Routine group (n=102), 32 (31.4%) were given analgesics following the WHO guideline on both day 1 and day 3 of admission. In contrast, 36 (35.3%) were not. A decreased pain score was greater (2.59, SD±1.8) in a routine group following the WHO on day 1. Moreover, a decreased pain score was greater (3.95, SD±1.8) in a group following the WHO on day 3. The clinical significance of pain score reduced was also found on day 3. Of the 261 evaluable patients, the pattern of analgesics usage following the WHO guideline was increased in both groups comparing to at the beginning of the study. Conclusions: The results demonstrated that patients who received pain management following the WHO guideline reported significantly lower pain intensity than those not following the WHO. No significant financial relationships to disclose.

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Perception of Pain, Attitude and Satisfaction of Pain Management among Postoperative Patients

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/45991.14457 ◽

2021 ◽

Author(s):

Uma Venkatesan ◽

Sruthi Kamal ◽

Jasmine Viswanathan

Keyword(s):

Pain Management ◽

General Surgery ◽

Pain Perception ◽

Pearson Correlation ◽

Sampling Technique ◽

Cross Sectional Study ◽

Pain Scale ◽

Postoperative Recovery ◽

Cross Sectional ◽

Urological Surgery

Introduction: Pain is considered as a fifth vital sign. Pain management and patients satisfaction with the treatment decreases early postoperative recovery. Aim: The study aim was to assess the satisfaction of pain management among postoperative patients. Materials and Methods: A cross-sectional study was used to conduct a study among 180 postoperative patients’ undergone surgeries (General surgery patients, ortho-paedic surgery and urological surgery patients) at selected hospitals, Puducherry. The purpose of the study was to associate the pain level with satisfaction. The patients were selected based on purposive sampling technique. After obtaining consent, the researcher used numerical pain scale to assess the pain perception of the patient, closed ended questionnaire to assess attitude level and modified short assessment questionnaire for patient satisfaction towards pain management. The study was analysed using Statistical Package for the Social Science (SPSS) software version 20.0. The descriptive statistics was used to assess the level of pain and attitude and inferential statistics like Pearson correlation coefficient were carried out to find the correlation between pain and satisfaction. Results: Severe pain was felt by nearly all (70%) among general surgery patients, 60% in orthopaedic surgery patients and 50% had moderate pain in urological surgery patients respectively. Regarding attitude, majority (78%, 88% and 83%) of the patients had positive attitude towards pain management in General surgery, Orthopaedic and Urology surgery patients. Most (74%) of them were satisfied with their pain management in general surgery patients, whereas in orthopaedic and urological patients, nearly all 90%, 96% of the clients were very satisfied towards pain management. Conclusion: The study concluded, optimal satisfaction toward pain management will increase quality of early postoperative recovery.

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Pain Prevalence in a Pediatric Hospital: Raising Awareness during Pain Awareness Week

Pain Research and Management ◽

10.1155/2014/737692 ◽

2014 ◽

Vol 19 (1) ◽

pp. e24-e30 ◽

Cited By ~ 29

Author(s):

Denise Harrison ◽

Cynthia Joly ◽

Christine Chretien ◽

Sarah Cochrane ◽

Jacqueline Ellis ◽

...

Keyword(s):

Pain Management ◽

Pain Assessment ◽

Management Practices ◽

Management Strategies ◽

Cross Sectional Study ◽

Infants And Children ◽

Assessment Tools ◽

Pediatric Hospital ◽

Cross Sectional ◽

Pain Scores

BACKGROUND: Despite the evidence and availability of numerous validated pain assessment tools and pain management strategies for infants and children, their use remains inconsistent in clinical practice.OBJECTIVES: To describe the prevalence of pain, pain assessment and pain management practices at a tertiary pediatric hospital in Canada.METHODS: The cross-sectional study design involved a combination of interviews with children and/or caregivers, and chart audits in five inpatient units. Information regarding pain intensity, painful procedures and pain management strategies was obtained from children and/or caregivers by interview. Patient charts were reviewed for information regarding pain assessment, pain scores, and pharmacological and nonpharmacological interventions.RESULTS: Sixty-two children (four days to 17 years of age) participated. Most children or their caregivers (n=51 [84%]) reported that pain was experienced during their hospitalization, with 40 (66%) reporting their worst pain as moderate or severe. Almost one-half reported analgesics were administered before or during their most recent painful procedure. Nineteen (32%) reported sucrose, topical anesthetics or nonpharmacological interventions were used; however, they were documented in only 17% of charts. Pain scores were documented in 34 (55%) charts in the previous 24 h. The majority of the children or their caregiver (n=44 [71%]) were satisfied with pain management at the study hospital.CONCLUSIONS: Most infants and children had experienced moderate or severe pain during their hospitalization. Analgesics were frequently used, and although nonpharmacological strategies were reported to be used, they were rarely documented. Most parents and children were satisfied with their pain management.

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Pain perception of orthodontic treatment – A cross-sectional study

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.36.2.619 ◽

2019 ◽

Vol 36 (2) ◽

Cited By ~ 2

Author(s):

Mazia Jawaid ◽

Tabassum Ahsan Qadeer ◽

Muhammad Faisal Fahim

Keyword(s):

Orthodontic Treatment ◽

Pain Perception ◽

Rating Scale ◽

Systemic Disease ◽

Cross Sectional Study ◽

Mean Value ◽

P Value ◽

Sectional Study ◽

Cross Sectional ◽

Significant Difference

Objectives: The objectives were to evaluate the intensity of pain perceived 24 hours following insertion of fixed orthodontic appliance components i-e separators, bands and brackets. Methods: This cross-sectional study conducted at a Dental College in Karachi (July 2017-March 2018) investigated the amount of pain perceived during different stages of fixed orthodontic treatment. The inclusion criteria were healthy individuals without systemic disease, age 13-26 years, fixed orthodontic treatment candidates having healthy permanent first molars. The exclusion criteria were missing permanent first molars, patients requiring brass wire separators instead of elastomeric separators and molar tubes instead of bands, ongoing or previous periodontal disease and syndromic patients. Pain intensity was assessed in ninety eight patients using a Numeric Rating scale (NRS) at baseline (T0) before insertion, and 24 hours after insertion (T1) of a component. This procedure was repeated six times, twice each for separators, bands and brackets. Scoring was done on the NRS from 0 to 10 where 0 indicated no pain and 10 indicated worst pain possible. Results: A significant difference in perceived pain was found between baseline and after 24 hours of placement of all components (P-value 0.000). Odds ratio indicated that males were at a greater risk to feel pain than females at baseline and after 24 hours of insertion of all components. Mann-Whitney U test showed that the most painful components at baseline were bands (Mean value=0.56) and after 24 hours were brackets (Mean value 6.25). Conclusions: Significant increase in pain was noted 24 hours after insertion of separators, bands and brackets. The most painful components were bands at baseline and brackets after 24 hours of insertion. There were no significant variations in pain perception based on age. However, males perceived higher pain than females both at baseline and after 24 hours. doi: https://doi.org/10.12669/pjms.36.2.619 How to cite this:Jawaid M, Qadeer TA, Fahim MF. Pain perception of orthodontic treatment – A cross-sectional study. Pak J Med Sci. 2020;36(2):---------. doi: https://doi.org/10.12669/pjms.36.2.619 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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PERBANDINGAN INTERPRETASI SKALA NYERI ANTARA NRS-VAS-WBFS OLEH PASIEN PASCA OPERASI ELEKTIF ORTHOPEDI DI RSUD Dr. SOETOMO

Care Jurnal Ilmiah Ilmu Kesehatan ◽

10.33366/jc.v8i3.1802 ◽

2020 ◽

Vol 8 (3) ◽

pp. 447

Author(s):

Ginong Pratitdya ◽

Nancy M. Rehatta ◽

Dedi Susila

Keyword(s):

Rating Scale ◽

Health Management ◽

Numeric Rating Scale ◽

Cross Sectional Study ◽

Pain Scale ◽

Primary Data ◽

Research Subjects ◽

Cross Sectional ◽

Pain Scores ◽

Significant Difference

Health management is still a challenge in health services. An instrument that can cure pain is easy, easy, with accurate interpretation and can be used by every party involved in pain management. The purpose of this study was to analyze the Numeric Rating Scale (NRS), Visual Analogue Scale (VAS), and Wong Baker Faces Scale (WBFS), which can be interpreted well by postoperative care patients. The research method used was an observational analytic study with a cross-sectional study design that analyzed the scale application (NRS, VAS, WBFS) in patients after elective orthopedic surgery at RSUD Dr. Soetomo Surabaya. This study analyzed primary data of postoperative patients which contained socio-demographic characteristics, type of anesthesia given, pain scores and patient interpretation of pain scales through special instruments. The results showed that 102 research subjects were needed. The pain scale interpretation instrument was declared valid and reliable (Cronbach Alpha> 0.60). Mean pain scores from the VAS scale (4.29), NRS (4.82) and WBFS (4.81). No significant difference was obtained NRS scale and WBFS scale (Sig> 0.05). Mean interpretation of pain scale from the VAS scale (13.62), NRS (17.14) and WBFS (21.33). There was a significant difference in the pain score of the VAS scale against the NRS scale, also the WBFS scale (Sig

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Subthreshold symptoms in bipolar disorder: Impact on quality of life

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.153 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S122-S122

Author(s):

R. Khemakhem ◽

W. Homri ◽

D. Karoui ◽

H. Belhadj ◽

L. Mouelhi ◽

...

Keyword(s):

Quality Of Life ◽

Bipolar Disorder ◽

Rating Scale ◽

Cross Sectional Study ◽

Poor Quality ◽

Average Score ◽

Young Mania ◽

Cross Sectional ◽

Sf 36

IntroductionSeveral studies have analyzed the influence of bipolar disorder (BD) related to many kinds of functioning. Even if it is obvious that patients in relapse have poor quality of live (QoL), what's about it in interictal phases with subthreshold symptoms?AimsTo study the potential relationship between QoL and subthreshold symptoms in bipolar I patients in remission.ObjectiveTo evaluate the above relationship, we hypothesized that subsyndromic BD phases can be related to worse subjectively QoL.MethodsThis was a cross-sectional study. Forty-four BD patients were enrolled. The subthreshold symptoms were evaluated by Hamilton Depression Rating Scale (HDRS) and Young Mania Rating Scale (YMRS). Patients with HDRS lower than 7 and YMSR lower than 6 were the successful applicants. Then, we run the Tunisian version of SF-36 to measure the QoL.ResultsTwenty-seven men and seventeen women with an average age of 39.3 years were selected. Age of beginning of BD was 31.5 years and patients were in relapse since 1.56 years. The HDRS's average score was 2.73. Twenty patients (45.5%) have an HDRS upper than 4. The YMRS's average score was 2.25 and twenty-nine BD's patients have a score between 1 and 6. The overall average score at SF-36 scale were 64.2 and 25% of BD patient with subthreshold symptoms had a poor QoL.ConclusionsSubsyndromic interictal phases affect the QoL of BD patients and it's necessary to introduce therapy adapted according to troubles in order to improve patient's quality of life and functioning.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Predictors of effective management of acute pain in children within a UK ambulance service: a cross-sectional study

British Paramedic Journal ◽

10.29045/14784726.2019.12.4.3.58 ◽

2019 ◽

Vol 4 (3) ◽

pp. 58-59

Author(s):

Gregory Adam Whitley ◽

Pippa Hemingway ◽

Graham Richard Law ◽

Caitlin Wilson ◽

A. Niroshan Siriwardena

Keyword(s):

Pain Management ◽

Acute Pain ◽

Rating Scale ◽

Cross Sectional Study ◽

Ambulance Service ◽

Effective Management ◽

Sectional Study ◽

Cross Sectional ◽

Second Pain ◽

Clinical Records

Introduction: Pre-hospital pain management in children is poor, with very few children in pain receiving analgesia. Without effective pain treatment, children may suffer long-term changes in stress hormone responses and pain perception and are at risk of developing posttraumatic stress disorder. We aimed to identify predictors of effective management of acute pain in children in the pre-hospital setting.Methods: A retrospective cross-sectional study using electronic clinical records from one large UK ambulance service between 1 October 2017 and 30 September 2018 was performed using multi-variable logistic regression. We included all children < 18 years suffering acute pain. Children with a Glasgow Coma Scale of < 15, no documented pain or without a second pain score were excluded. The outcome measure was effective pain management (abolition or reduction of pain by ≥ 2 out of 10 using the numeric pain rating scale, Wong and Baker FACES® scale or Face, Legs, Activity, Crying and Consolability (FLACC) scale).Results: A total of 2312 patients were included for analysis. Median (IQR) age was 13 (9‐16), 54% were male and the cause of pain was trauma in 66% of cases. Predictors of effective pain management include children who were younger (0‐5 years) compared to older (12‐17 years) (adjusted odds ratio (AOR) 1.57; 95% confidence interval (CI) 1.21‐2.03), administered analgesia (AOR 2.35; CI 1.94‐2.84), attended by a paramedic (AOR 1.39; CI 1.13‐1.70) or living in an area of medium deprivation (index of multiple deprivation (IMD) 4‐7) compared to children in an area of high deprivation (IMD 1‐3) (AOR 1.41; CI 1.10‐1.79). Child gender, type of pain, transport time and clinician experience were not significant.Conclusion: These predictors highlight disparity in effective pre-hospital management of acute pain in children. Qualitative research is needed to help explain these findings.

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EARLY RECOGNIZATION OF THE CHILDREN WITH ATTENTION DEFICIT HYPERACTIVITY DISORDER BY VANDERBILT ADHD RATING SCALE FOR TEACHERS AND PARENTS

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2019.4.12 ◽

2019 ◽

pp. 85-91

Author(s):

Dinh Duong Le ◽

Van Thang Vo ◽

Thi Mai Nguyen ◽

Thi Han Vo ◽

Huu Chau Duc Nguyen ◽

...

Keyword(s):

Attention Deficit Hyperactivity Disorder ◽

High Risk ◽

Attention Deficit ◽

Primary Schools ◽

Rating Scale ◽

Cross Sectional Study ◽

Cross Sectional ◽

Hyperactivity Disorder ◽

Teachers And Parents ◽

Key Words Adhd

Objectives: The study aims to explore the prevalence of attention deficit hyperactivity disorder and to examine the associated factors with ADHD among primary students by Vanderbilt ADHD rating scale for teacher and parents. Methods: A cross-sectional study design was conducted in 564 students who selected randomly in 4 primary schools in Hue city. Vanderbilt ADHD rating scale for parents and teachers were applied to evaluate the ADHD of children over 6 months ago. Results: The overall prevalence of children who had high risk with ADHD was 4.1% (95%CI: 2.44 - 5.72), including 4.6% and 4.8% in the rating of teachers and parents, respectively. Male was more likely to have ADHD than female (OR adj: 4.64 (95%CI: 1.53 - 14.05) and lack of closely friend (OR adj: 5.11 (95% CI: 2.13 - 12.24). Conclusion: Vanderbilt ADHD diagnosis rating scale for teachers and parents can be used to early recognization children with a high risk of ADHD. Key words: ADHD, Vanderbilt, ratings scale, teacher, parent, children

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