Comparison of Frenotomy Techniques for the Treatment of Ankyloglossia in Children: A Systematic Review

2020 ◽  
Vol 163 (3) ◽  
pp. 428-443
Author(s):  
Usman Khan ◽  
Jake MacPherson ◽  
Michael Bezuhly ◽  
Paul Hong
Keyword(s):  
Rating Scale ◽  
Pediatric Population ◽  
Meta Analysis ◽  
Numeric Rating Scale ◽  
Assessment Tools ◽  
Future Research ◽  
Randomized Controlled ◽  
Comprehensive Search ◽  
High Level ◽  
Numeric Rating

Objective To compare the effectiveness of conventional (CF), laser (LF), and Z-plasty (ZF) frenotomies for the treatment of ankyloglossia in the pediatric population. Data Sources A comprehensive search of PUBMED, EMBASE, and COCHRANE databases was performed. Review Methods Relevant articles were independently assessed by 2 reviewers according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Results Thirty-five articles assessing CF (27 articles), LF (4 articles), ZF (3 articles), and/or rhomboid plasty frenotomy (1 article) were included. A high level of outcome heterogeneity prevented pooling of data. All 7 randomized controlled trials (RCTs) were of low quality. Both CF (5 articles with 589 patients) and LF (2 articles with 78 patients) were independently shown to reduce maternal nipple pain on a visual analog or numeric rating scale. There were reports of improvement with breastfeeding outcomes as assessed on validated assessment tools for 88% (7/8) of CF articles (588 patients) and 2 LF articles (78 patients). ZF improved breastfeeding outcomes on subjective maternal reports (1 article with 18 infants) only. One RCT with a high risk of bias concluded greater speech articulation improvements with ZF compared to CF. Only minor adverse events were reported for all frenotomy techniques. Conclusions Current literature does not demonstrate a clear advantage for one frenotomy technique when managing children with ankyloglossia. Recommendations for future research are provided to overcome the methodological shortcomings in the literature. We conclude that all frenotomy techniques are safe and effective for treating symptomatic ankyloglossia.

scholarly journals A prospective randomized controlled trial to study the effect of preoperative and intraoperative magnesium over postoperative ileus and postoperative pain in major non–laparoscopic abdominal surgeries

2019 ◽  
Vol 6 (9) ◽  
pp. 3182
Author(s):  
A. R. Vishal Varma Bathina ◽  
Rama Krishna Peetani ◽  
Viswa Teja Vaitla
Keyword(s):  
Postoperative Pain ◽  
Total Dose ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
Controlled Study ◽  
Control Group ◽  
Anesthetic Care ◽  
Analgesic Consumption ◽  
Randomized Controlled ◽  
Numeric Rating

Background: The objective of the study were postoperative pain on 1st postoperative hour and 2, 4, 12, 24th postoperative hour as per numeric rating scale (NRS); total dose of postoperative analgesic consumption; postoperatively time of first appearance of bowed sounds; postoperatively time of first passage of flatus.Methods: A randomized controlled study will be performed. Patients of ASA 1 and 2, scheduled for major abdominal (GI) surgery, were divided into magnesium group and control group. Serum magnesium levels are estimated in both groups. Magnesium group receives 40 mg/kg of magnesium sulfate in 100 cc NS 30 minutes before the induction* as Intravenous drip, followed by 10 mg/kg/hr during the intraoperative hours. Control group receives the same volume of isotonic saline solution. Intra-operative hemodynamic parameters are evaluated constantly by recording pulse rate, blood pressure and Spo2. Further, post- operative analgesic will be ensured by epidural top-up using bupivacaine and tramadol when patients complaints of pain or when monitored with numeric rating scale (NRS). Postoperative patient pain is going to be evaluated in post-anesthetic care unit (PACU)/ SICU by numeral rating scale (NRS) during 1st hour, 2nd hour, 4th hour, 12th hour and 1 day, total dose of post-operative analgesic consumption will be recorded.Results: Of the 60 patients studied, 30 belong to magnesium group for which pre-operative and intraoperative intravenous magnesium (cases). Remaining 30 were given equal amounts of preoperative and intraoperative normal saline given (controls).Conclusions: The results of present study suggests that pre and intra operative. Magnesium as an adjunct to epidural analgesia reduces postoperative pain pre-operative and intra operative IV mg reduces post-operative ileus duration.

Foot Massage Menurunkan Nyeri Post Operasi Sectio Caesarea Pada Post Partum

2020 ◽  
Vol 6 (2) ◽  
pp. 164-170
Author(s):  
Dewi Nurlaela Sari ◽  
Aay Rumhaeni
Keyword(s):  
Daily Living ◽  
Rating Scale ◽  
Post Partum ◽  
Numeric Rating Scale ◽  
Sectio Caesarea ◽  
P Value ◽  
Test Design ◽  
Purposive Sampling ◽  
Post Test ◽  
Numeric Rating

ABSTRAK Sectio caesarea merupakan tindakan alternatif dalam proses persalinan untuk menyelamatkan ibu dan janin. Ibu Bersalin dengan operasi sectio caesarea dilakukan pembedahan pada dinding abdomen dan dinding rahim. Dampak yang paling sering muncul dirasakan oleh postpartum dengan post operasi sectio caesarea adalah  nyeri. Nyeri akan berdampak pada bounding attachment terganggu, mobilisasi terbatas, Activity Daily Living (ADL) terganggu serta berpengaruh  terhadap Inisiasi Menyusui Dini (IMD). Asuhan yang diberikan terbatas pada terapi farmakologi dibandingkan  non farmakologi. Foot massage adalah salah satu terapi non farmakologi yang dapat membantu menutup gerbang di posterior horns dari sumsum tulang belakang dan memblokir bagian dari nyeri ke sistem saraf pusat. Tujuan penelitian ini untuk mengetahui pengaruh foot massage terhadap skala nyeri pada klien post operasi sectio caesarea di RS AMC. Penelitian ini merupakan penelitian pre eksperimen dengan pendekatan one group pre test post test design. Jumlah sampel yang digunakan berjumlah 27 orang dengan menggunakan teknik purposive sampling. Instrumen yang digunakan adalah Numeric Rating Scale (NRS) dan prosedur kerja foot massage. Responden dilakukan foot massage selama 20 menit selama 2 hari. Data di analisis dengan menggunakan uji wilcoxon. Hasil penelitian menunjukkan lebih dari setengah klien post operasi sectio caesarea berada di skala nyeri 6 sebelum dilakukan foot massage dan hampir setengah memiliki skala nyeri 3 sesudah dilakukan foot massage dan didapatkan nilai p value = 0.000, sehingga disimpulkan ada pengaruh foot massage terhadap skala nyeri pada klien post operasi sectio caesarea. Diharapkan rumah sakit dapat menjadikan foot massage sebagai salah satu alternatif manajemen non farmakologi dalam penanganan nyeri.   Kata kunci: Foot Massage; Post Partum; Nyeri; Sectio Caesarea      

Efektivitas pencucian luka menggunakan daun jambu biji terhadap tingkat malodor klien luka kaki diabetik

2019 ◽  
Vol 8 (2) ◽  
pp. 152
Author(s):  
Adi Antoni ◽  
Yanna Wari Harahap
Keyword(s):  
Diabetic Foot ◽  
Rating Scale ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Numeric Rating Scale ◽  
P Value ◽  
Consecutive Sampling ◽  
Guava Leaves ◽  
Guava Leaf ◽  
Numeric Rating

Abstrak   Latar belakang: Diabetes mellitus (DM) merupakan penyakit kronik dan menjadi masalah global. Salah satu komplikasi yang ditimbulkan dari DM adalah luka kaki diabetic. Langkah awal dalam perawatan luka kaki diabetic adalah mencuci luka. Tujuan penelitian ini adalah mengetahui keefektifan dari rebusan daun jambu biji sebagai cairan pencuci luka terhadap tingkat malodor pada luka kaki diabetic. Metode: Desain penelitian yang digunakan adalah quasy experiment dengan rancangan one group pretests-posttest only. Teknik sampling yang digunakan adalah consecutive sampling dengan jumlah sampel 16 orang. Kriteria sampel yang digunakan adalah klien luka kaki diabetic, tingkat malodor 1-10 dengan NRS. Alat ukur yang digunakan adalah Numeric Rating Scale (NRS). Analisa data yang digunakan dalam penelitian ini menggunakan uji paired t test. Hasil: tingkat malodor sebelum intervensi pencucuan luka menggunakan rebusan daun jambu biji rata-rata sebesar 4.40 dan sesudah intervensi sebesart 2.44 dengan p value < 0.001. Selisih tingkat malodor antara sebelum dan sesudah intervensi sebesar 1.96. Hasil penelitian ini menunjukkan bahwa daun jambu dapat digunakan sebagai cairan pencuci luka dalam mengatasi tingkat malodor pada luka kaki diabetik. Kesimpulan : daun jambu biji dapat digunakan sebagai cairan pencuci luka pada luka kaki diabetic. Perawat diharapkan dapat memanfaatkan daun jambu biji sebagai salah satu alternatif dalam pencucian luka kronik khususnya luka kaki diabetik.   Kata kunci: Daun Jambu Biji, Tingkat Malodor, Luka Kaki Diabetik   Abstract   Background: Diabetes mellitus (DM) is a chronic disease and a global problem. One of the complications that arise from DM is diabetic foot ulcer. The first step in treating diabetic foot ulcer is washing the wound. The purpose of this study was to determine the effectiveness of guava leaf decoction as a washing fluid for malodor levels in diabetic foot ulcer. Method: The research design used was quasy experiment with one group pretests-posttest only design. The sampling technique used was consecutive sampling with a sample of 16 people. Sample criteria used were diabetic foot ulcer clients, malodor level 1-10 with NRS. The measuring instrument used is the Numeric Rating Scale (NRS). Analysis of the data used in this study used paired t test. Results: the level of malodor before intervening in wound washing using guava leaf decoctions on average was 4.40 and after the intervention was 2.44 with p value <0.001. The difference in the level of malodor between before and after the intervention was 1.96. The results of this study indicate that guava leaves can be used as a washing fluid in dealing with malodor levels in diabetic foot ulcer. Conclusion: Guava leaves can be used as a washing fluid for diabetic foot wounds. Nurses are expected to be able to use guava leaves as an alternative in washing chronic wounds, especially diabetic foot injuries.   Key words: Guava Leaf, Malodor Level, Diabetic foot ulcer.

scholarly journals RCT on the effectiveness of the intraligamentary anesthesia and inferior alveolar nerve block on pain during dental treatment

2021 ◽  
Author(s):  
Bahaa R. Youssef ◽  
Andreas Söhnel ◽  
Alexander Welk ◽  
Mohamed H. Abudrya ◽  
Mohamed Baider ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Nerve Block ◽  
Rating Scale ◽  
Dental Treatment ◽  
Inferior Alveolar Nerve ◽  
Numeric Rating Scale ◽  
Inferior Alveolar Nerve Block ◽  
Posterior Teeth ◽  
Mandibular Posterior Teeth ◽  
Numeric Rating

Abstract Objective To compare the effectiveness and complications of intraligamentary anesthesia (ILA) with conventional inferior alveolar nerve block (IANB) during injection and dental treatment of mandibular posterior teeth. Materials and methods In this randomized, prospective clinical trial, 72 patients (39 males, 33 females), scheduled for dental treatment of mandibular posterior teeth, were randomly allocated to ILA group (n = 35) received ILA injection or IANB group (n = 37) received the conventional IANB. Our primary outcome was to assess pain and stress (discomfort) during the injection and dental treatment, using the numeric rating scale (NRS) from 0 to 10 (0 = no pain, 10= the worst pain imaginable), whereas recording 24-h postoperative complications was our secondary outcomes. Results Patients in ILA group reported significantly less pain during injection when compared with IANB group (p = 0.03), while pain during dental treatment was similar in both groups (p = 0.2). Patients in both groups also reported similar law values of discomfort during treatment (p = 0.7). Although no signs of nerve contact or any other postoperative complications were observed, five patients in IANB group (none in ILA group) reported temporary irritations. Conclusion This study showed equivalent effectiveness of both intraligamentary anesthesia and conventional inferior alveolar nerve block, for pain control during routine dental treatment of mandibular posterior teeth. Nevertheless, ILA showed significantly less pain during injection. No major postoperative complications in both groups were observed. Clinical relevance ILA could be considered as an effective alternative for routine dental treatment. Trial registration NCT04563351

scholarly journals Prevalence of Psychological Distress and Its Risk Factors in Patients with Primary Bone and Soft Tissue Tumors

Healthcare ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 566
Author(s):  
Masato Ise ◽  
Eiji Nakata ◽  
Yoshimi Katayama ◽  
Masanori Hamada ◽  
Toshiyuki Kunisada ◽  
...  
Keyword(s):  
Risk Factors ◽  
Psychological Distress ◽  
Soft Tissue ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
Soft Tissue Tumors ◽  
Number Of Patients ◽  
Primary Bone ◽  
Associated Risk Factors ◽  
Numeric Rating

Psychological distress is common in patients with soft tissue and bone tumors. We first investigated its frequency and the associated risk factors in patients with pre-operative bone and soft tissue tumors. Participants included 298 patients with bone and soft tissue tumors who underwent surgery in our institution between 2015 and 2020. Psychological distress was evaluated by the Distress and Impact Thermometer (DIT) that consists of two types of questions (questions about the severity of the patient’s distress (DIT-D) and its impact (DIT-I)). We used a cut-off point of 4 on the DIT-D and 3 on the DIT-I for screening patients with psychological distress. We therefore investigated: (1) the prevalence of psychological distress as assessed with DIT or distress thermometer (DT), which can be decided by DIT-D ≥ 4, (2) what are the risk factors for the prevalence of psychological distress, and (3) what is the number of patients who consulted a psychiatrist for psychological distress in patients with pre-operative bone and soft tissue tumors. With DIT and DT, we identified 64 patients (21%) and 95 patients (32%), respectively, with psychological distress. Multivariate logistic regression revealed that older age, sex (female), malignancy (malignant or intermediate tumor), a lower Barthel Index, and higher numeric rating scale were risk factors for psychological distress. Two patients (3%) consulted a psychiatrist after surgery. In conclusion, careful attention to psychological distress is needed, especially for female patients, older patients, and those with malignant soft or bone tissue tumors who have more than moderate pain.

Frequency, severity, and impact on daily life of delayed and intercycle chemotherapy-induced nausea, vomiting, and retching

2021 ◽  
pp. 030089162199043
Author(s):  
Silvia Gonella ◽  
Dino S. Di Massimo ◽  
Marinella Mistrangelo ◽  
Gianmauro Numico ◽  
Paola Berchialla ◽  
...  
Keyword(s):  
Rating Scale ◽  
Daily Life ◽  
Numeric Rating Scale ◽  
Cross Sectional Study ◽  
Common Side Effect ◽  
Cross Sectional ◽  
Chemotherapy Administration ◽  
Effect Of Treatment ◽  
Numeric Rating ◽  
Observation Period

Introduction: Chemotherapy-induced nausea, vomiting, and retching (CINVR) remains a common side effect of treatment. Most previous studies have focused on vomiting control; nausea and retching have been less explored. This study aimed at describing the incidence, severity, and impact on daily life (IDL) of CINVR in the acute (0–24 hours), delayed (>24–120 hours), and overall (0–120 hours) postchemotherapy periods and beyond 120 hours (until next chemotherapy administration); and the pharmacologic and nonpharmacologic strategies adopted by patients to relieve symptoms. Methods: This was a single-center, cross-sectional study of 60 patients undergoing chemotherapy. Participants reported the frequency, severity, and IDL of CINVR from the day of chemotherapy administration up to 120 hours thereafter and nausea and vomiting that occurred beyond 120 hours, as well as pharmacologic and nonpharmacologic remedies used. Results: Forty-seven (78.3%, 95% confidence interval [CI] 66.4–86.9), 37 (61.7%, 95% CI 49.0–72.9), and 35 (58.3%, 95% CI 45.7–69.9) patients reported no nausea (Numeric Rating Scale ⩽1), vomiting, or retching in the acute, delayed, and overall periods, respectively. Nausea was more frequent, more severe, and had a greater IDL than did vomiting and retching across the overall observation period; beyond 120 hours, 11 (18.3%, 95% CI 10.6–29.9) patients reported nausea and none reported vomiting, with a median IDL of 1/10 (interquartile range: 0.75–5.00; 95% CI 0–7.6). Metoclopramide (n = 57 administrations), dexamethasone (n = 28), eating small servings of food (n = 13), and aloe (n = 11) were the most commonly used rescue therapies. Conclusions: Future studies should set hard outcomes, such as the absence of any symptoms, as a primary end point, and these should be assessed across and beyond the 120-hour period.

scholarly journals A prospective cohort register-based study of chronic postsurgical pain and long-term use of pain medication after otorhinolaryngological surgery

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Nina Graf ◽  
Katharina Geißler ◽  
Winfried Meißner ◽  
Orlando Guntinas-Lichius
Keyword(s):  
Rating Scale ◽  
Numeric Rating Scale ◽  
Postsurgical Pain ◽  
Average Pain Intensity ◽  
Chronic Postsurgical Pain ◽  
Average Pain ◽  
Patients At Risk ◽  
Perioperative Assessment ◽  
Numeric Rating

AbstractData on chronic postsurgical pain (CPSP) after otorhinolaryngological surgery are sparse. Adult in-patients treated in 2017 were included into the prospective PAIN OUT registry. Patients’ pain on the first postoperative day (D1), after six months (M6) and 12 months (M12) were evaluated. Determining factor for CPSP was an average pain intensity ≥ 3 (numeric rating scale 0–10) at M6. Risk factors associated with CPSP were evaluated by univariate and multivariate analyses. 10% of 191 included patients (60% male, median age: 52 years; maximal pain at D1: 3.5 ± 2.7), had CPSP. Average pain at M6 was 0.1 ± 0.5 for patients without CPSP and 4.2 ± 1.2 with CPSP. Average pain with CPSP still was 3.7 ± 1.1 at M12. Higher ASA status (Odds ratio [OR] = 4.052; 95% confidence interval [CI] = 1.453–11.189; p = 0.007), and higher minimal pain at D1 (OR = 1.721; CI = 1.189–2.492; p = 0.004) were independent predictors of CPSP at M6. Minimal pain at D1 (OR = 1.443; CI = 1.008–2.064; p = 0.045) and maximal pain at M6 (OR = 1.665; CI = 1.340–2.069; p < 0.001) were independent predictors for CPSP at M12. CPSP is an important issue after otorhinolaryngological surgery. Better instrument for perioperative assessment should be defined to identify patients at risk for CPSP.

scholarly journals Measuring Pain Impact Versus Pain Severity Using a Numeric Rating Scale

2011 ◽  
Vol 27 (5) ◽  
pp. 555-560 ◽  
Author(s):  
Liana Fraenkel ◽  
Paul Falzer ◽  
Terri Fried ◽  
Minna Kohler ◽  
Ellen Peters ◽  
...  
Keyword(s):  
Rating Scale ◽  
Numeric Rating Scale ◽  
Pain Severity ◽  
Numeric Rating
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