Intranasal Ketorolac for Acute Pain in Adult Emergency Department Patients

2021 ◽  
pp. 019394592110303
Author(s):  
Elizabeth Gaul ◽  
Tracy Barbour ◽  
Amy S. Nowacki ◽  
Sharon E. Mace
Keyword(s):  
Emergency Department ◽  
Side Effects ◽  
Pain Relief ◽  
Acute Pain ◽  
Rating Scale ◽  
Rapid Onset ◽  
Numeric Rating Scale ◽  
Needlestick Injury ◽  
Interquartile Range ◽  
Numeric Rating

Pain is a common complaint in the emergency department. An alternative to opioids is desirable. Oral medications are not feasible with gastrointestinal disorders or NPO. Intravenous medications require skill and time. Intravenous/intramuscular medications are painful with potential needlestick injury. Intranasal medications have rapid onset, easy administration, do not need skilled providers, and no risk of needlestick injury. A total of 28 adults with acute pain (numeric rating scale ≥ 4) received intranasal ketorolac. Numeric rating scale decreased in all: 32% complete pain relief, median (interquartile range) decrease −5 (−6.8 to −4) ( p < .001). Pain relief onset was median [interquartile range] 5 (2.3, 15.0) min. Vital signs remained normal. There were no nasal mucosal changes, no complications. Minor side effects, mostly nasal burning, in 43%, resolved within 5 min. Patients and nurses were satisfied with intranasal ketorolac, and would use it again. Intranasal ketorolac had a rapid onset, was effective, safe, well tolerated with minor side effects that resolved quickly.

scholarly journals A comparison of pain registration by Visual Analog Scale and Numeric Rating Scale – a cross-sectional study of primary triage registration

2020 ◽  
Author(s):  
Jofrid Kollltveit ◽  
Malin Osaland ◽  
Marianne Reimers ◽  
Magnus Berle
Keyword(s):  
Emergency Department ◽  
Visual Analog Scale ◽  
Rating Scale ◽  
Emergency Admission ◽  
Numeric Rating Scale ◽  
University Hospital ◽  
Analog Scale ◽  
Cross Sectional ◽  
Significant Difference ◽  
Numeric Rating

BackgroundPain is a subjective sensation; self-reporting is important for quantifying pain intensity. There are several different validated tools for this, such as Visual Analog Scale and Numeric Rating Scale. In the clinic, these terms are often used as equivalent. The objective of this study was to examine correlation and agreement between the pain registration tools in triage in an emergency department.Materials and MethodsThe study was performed in the Department of Emergency Medicine at Haukeland University Hospital in the period June-August 2019. We registered the pain score with two tools in 200 unselected patients in emergency admission with pain. In addition, we registrered gender, age, triage and general department affiliation.ResultsWe found a strong correlation between the pain registration tools by Spearmans correlation test (rho=0,930, p<0,001). There were no significant difference between the pain registration tools within the subgroups. Bland-Altman analysis show agreement between the two pain registration tools.ConclusionsIn an Emergency Department triage is it acceptable to use Visual Analog Scale and Numeric Rating Scale as equivalent, as long as the correct terminology is used.

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.

The influence of chief complaint on opioid use in the emergency department

2006 ◽  
Vol 2 (4) ◽  
pp. 228 ◽  
Author(s):  
Kathleen Puntillo, RN, DNSc, FAAN ◽  
Martha Neighbor, MD ◽  
Garrett K. Chan, APRN, BC, PhD ◽  
Roxanne Garbez, RN, MS, ACNP
Keyword(s):  
Emergency Department ◽  
Rating Scale ◽  
Patient Discharge ◽  
Numeric Rating Scale ◽  
Opioid Use ◽  
Pain Scores ◽  
Patient Pain ◽  
Nurses And Physicians ◽  
Time Of Admission ◽  
Numeric Rating

The aim of this study was to explore factors influencing emergency department (ED) clinicians’ use of opioids in treating selected patients. Patients who either received or did not receive opioids in the ED, as well as their nurses and physicians, were interviewed before patient discharge. We found that the decrease in patients’ mean (SD) pain intensity from the time of admission to the ED (7.3 ± 2.4 on a 0 to 10 numeric rating scale) to discharge (5.0 ± 2.9) was statistically significant (t93 = 8.4, p < 0.001, 95 percent CI = 1.7, 2.8) for all groups except those with trauma-related pain. The factor that most frequently led physicians of patients with abdominal pain and nurses in general to administer no opioids was that the patient was “not in that much pain.” However, the patients in question had self-reported pain scores that indicated moderate pain. Our findings lead us to conclude that clinicians inaccurately infer severity of patient pain. This in turn can influence the prescription of opioids and the patient’s decrease in pain.

scholarly journals A Case Report of Abdominal Pain Relief in a Patient with Metastatic Colorectal Cancer Treated with Korean Medicine

2021 ◽  
Vol 42 (4) ◽  
pp. 687-694
Author(s):  
Mi-jung Yoon ◽  
Na-yeon Kim ◽  
Hong-sik Choi ◽  
Seung-mo Kim ◽  
Kyung-soon Kim
Keyword(s):  
Colorectal Cancer ◽  
Abdominal Pain ◽  
Case Report ◽  
Pain Relief ◽  
Herbal Medicine ◽  
Cancer Patients ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
Korean Medicine ◽  
Numeric Rating

Objectives: The aim of this case report is to present abdominal pain relief in a patient diagnosed with colorectal cancer with several organ metastases.Methods: The patient was treated with herbal medicine, acupuncture, and moxibustion. The effect of the treatment was measured by a numeric rating scale (NRS).Results: The NRS of the patient’s abdominal pain was reduced after Korean medicine treatment.Conclusions: This case report suggests that Korean medicine may be effective for treating abdominal pain in cancer patients. However, additional study is needed to confirm interactions between Korean medicine and the control of abdominal pain.

scholarly journals Validation of a New “Objective Pain Score” Vs. “Numeric Rating Scale” For the Evaluation of Acute Pain: A Comparative Study

2016 ◽  
Vol 6 (1) ◽  
Author(s):  
Manish Tandon ◽  
Anshuman Singh ◽  
Vandana Saluja ◽  
Mandeep Dhankhar ◽  
Chandra Kant Pandey ◽  
...  
Keyword(s):  
Comparative Study ◽  
Pain Score ◽  
Acute Pain ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
Numeric Rating

Pain Relief Effect of Cryotherapy in Parturients

2016 ◽  
Vol 6 (3) ◽  
pp. 149-156
Author(s):  
Octavio M. C. Vargens ◽  
Sonia Nunes ◽  
Lolita D. da Silva ◽  
Jane M. Progianti
Keyword(s):  
Pain Relief ◽  
Rating Scale ◽  
Intervention Group ◽  
Numeric Rating Scale ◽  
Cervical Dilation ◽  
Prospective Data ◽  
Thoracolumbar Region ◽  
Single Intervention ◽  
Pilot Intervention ◽  
Numeric Rating

INTRODUCTION: Pain in childbirth and strategies for relieving it have been a subject of interest to researchers for many years. The use of cold (cryotherapy), as a pain relief technique generally, is quite well known and studied. However, few studies have addressed the use of cryotherapy as a strategy for relieving the pain of childbirth.OBJECTIVE: To evaluate the effects of cryotherapy in relieving childbirth pain.METHOD: Pilot intervention study using prospective data in a single intervention group, the outcome being the pain relief in women in labor. The sample comprised 36 parturients at the Hospital Maternidade Carmela Dutra, Rio de Janeiro, Brazil. Cryotherapy was applied to the parturients’ thoracolumbar region at cervical dilation of 5, 7, and/or 9 cm, using an icepack belt. In all, 48 applications were made. The responses regarding the action of cryotherapy on pain were recorded on a specific form. The Numeric Rating Scale (NRS) was used. Following a form, the parturients’ behavior during the application of cryotherapy was also observed.RESULTS: It was found that 91.67% (outcome) of the women reported pain relief and better conditions in which to experience childbirth. The behavior of 75% of the women in labor was calm and participatory; some slept (5.56%), others took short naps (19.44%).CONCLUSION: Cryotherapy proved effective in relieving pain in childbirth. Because characteristically, cryotherapy does not interfere in the physiological process of childbirth, it can be used in care for women in labor.

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