scholarly journals The Linearity of the Visual Analogue Scale in Patients with Severe Acute Pain

2005 ◽  
Vol 33 (1) ◽  
pp. 54-58 ◽  
Author(s):  
P. S. Myles ◽  
N. Urquhart

The visual analogue scale (VAS) is a standard measurement tool in pain research and clinical practice, and has been shown to have linear scale properties for mild to moderate pain. Our aim was to evaluate the scaling properties of the VAS in subjects with severe acute pain. After Ethics Committee approval we studied 22 patients and asked them to rate the severity of their pain on a 100 mm VAS at the initial assessment (VAS1), and again after administration of analgesic medication. The subject was asked to nominate when they considered their pain intensity had halved, and at this time they were asked to rate this on a second VAS (VAS0.5). When the subject had received satisfactory relief of their pain, they were asked to describe how much their pain had been relieved and were then asked to rate their final pain state using a third VAS (VASfinal). The mean (SD) scores were VAS1 84 (14) (range 56–100), VAS0.5 42 (13) and VASfinal 21 (16). The mean (95% CI) for VASratio was 0.51 (0.45–0.57). The mean (SD) patients’ estimate of pain relief was 77 (21)% from that of baseline, with a mean (SD) VASfinal 0.26 (0.20), 95% CI 0.17–0.38. The correlation of the patients’ estimate of pain relief with the VASfinal was r=0.89, rho=0.87, both P<0.001. The VAS is a linear scale in subjects with severe acute pain. Changes in the VAS score represent a relative change in the magnitude of pain sensation.

2003 ◽  
Vol 18 (4) ◽  
pp. 353-358 ◽  
Author(s):  
Bill A. Lord ◽  
Brian Parsell

AbstractIntroduction:The aim of this study was to use a visual analogue scale (VAS) to measure the adequacy of prehospital pain management. Patients reported pain severity at two points in time during treatment and transport by ambulance paramedics. The change in pain score was compared with a benchmark reduction of 20 mm that has been shown to correspond with the minimum clinically significant change in pain perception reported by patients.Methods:This prospective, observational study used a VA S to record pain severity among patients reporting pain who were transported to a hospital by paramedics. Patients used a VAS to score pain severity during the initial patient assessment process (T0), and again at the hospital of destination (Tend). This study reports the mean changes in the scores, and the percentage of cases for whom the difference between T0and Tend in the study population achieved or exceeded the 20 mm benchmark. A survey also was administered to paramedics who participated in this study in order to identify attitudes, values, and beliefs relating to the measurement of pain.Results:A total of 262 patients were enrolled in this study. The mean value for thereduction in VAS (T0-Tend) was 18.2±23.9 mm [±SD] (Median = 14.0mm, 95% confidence interval (CI) = 15.3–21.1 mm). One hundred and thirty-four patients (51.1%) did not receive analgesia (either morphine sulfate or methoxyflurane). The mean initial (T0) pain score for the no-analgesia group was 54.5 ±24.7 mm [±SD], with the mean value for the change in VAS (T0-Tend) = 10.6 mm (median = 5 mm, 95% CI = 6.4–14.8 mm). Fo rty-six patients (17.6%) recorded some deterioration in their pain score at Tend (T0-Tend<0 mm). Survey results identified attitudes that may affect paramedics' pain management practice.Conclusion:The results suggest that inadequate analgesia is an issue in this study setting. Effective analgesia requires formal protocols or guidelines supported by effective analgesic therapies along with education that addresses attitudes that may inhibit pain assessment or management by paramedics. Regular audits form part of clinical quality assurance programs that assess analgesic practice. However, such auditsmust have access to data obtained from patient self-reporting of pain using a valid and reliable pain measurement tool.


1995 ◽  
Vol 73 (4) ◽  
pp. 517-530 ◽  
Author(s):  
Anne Raben ◽  
ANNA TAGLIABUE ◽  
Arne Astrup

Although subjective appetite scores are widely used, studies on the reproducibility of this method are scarce. In the present study nine healthy, normal weight, young men recorded their subjective appetite sensations before and during 5 h after two different test meals A and B. The subjects tested each meal twice and in randomized order. Visual analogue scale (VAS) scores, 10 cm in length, were used to assess hunger, satiety, fullness, prospective food consumption and palatability of the meals. Plasma glucose and lactate concentrations were determined concomitantly. The repeatability was investigated for fasting values, Δ-mean 5 h and mean 5 h values, Δ-peak/nadir and peak/nadir values. Although the profiles of the postprandial responses were similar, the coefficients of repeatability (CR = 2SD) on the mean differences were large, ranging from 2·86 to 5.24 cm for fasting scores, 1·36 to 1·88 cm for mean scores, 2·98 to 5·42 cm for Δ-mean scores, and 3·16 to 6·44 cm for peak and Δ-peak scores. For palatability ratings the CK values varied more, ranging from 2·38 (taste) to 8·70 cm (aftertaste). Part of the difference in satiety ratings could be explained by the differences in palatability ratings. However, the low reproducibility may also be caused by a conditioned satiation or hunger due to the subjects' prior experience of the meals and therefore not just be a reflection of random noise. It is likely, however, that the variation in appetite ratings is due both to methodological day-to-day variation and to biological day-to-day variation in subjective appetite sensations.


2021 ◽  
Vol 103-B (6) ◽  
pp. 1155-1159
Author(s):  
Khodamorad Jamshidi ◽  
Farshad Zandrahimi ◽  
Abolfazl Bagherifard ◽  
Fatemeh Mohammadi ◽  
Alireza Mirzaei

Aim There is insufficient evidence to support bony reconstruction of the pubis after a type III internal hemipelvectomy (resection of all or part of the pubis). In this study, we compared surgical complications, postoperative pain, and functional outcome in a series of patients who had undergone a type III internal hemipelvectomy with or without bony reconstruction. Methods In a retrospective cohort study, 32 patients who had undergone a type III hemipelvectomy with or without allograft reconstruction (n = 15 and n = 17, respectively) were reviewed. The mean follow-up was 6.7 years (SD 3.8) for patients in the reconstruction group and 6.1 years (SD 4.0) for patients in the non-reconstruction group. Functional outcome was evaluated using the Musculoskeletal Tumor Society (MSTS) scoring system and the level of postoperative pain with a visual analogue scale (VAS). Results The mean MSTS score of the patients was significantly better in patients after reconstruction (26 (SD 1.7) vs 22.7 (SD 2.0); p < 0.001). The mean visual analogue scale score for pain was significantly less in the reconstruction group (2.1 (SD 2) vs 4.2 (SD 2.2); p = 0.016). One infection occurred in each group. Bladder herniation occurred in three patients (17.6%) in the non-reconstruction group but none in the reconstruction group. Five patients (29.4%) in the non-reconstruction group and one (7%) in the reconstruction group had a limp. Graft displacement occurred in two patients in the reconstruction group. Conclusion We recommend reconstruction of the bony defect after a type III hemipelvectomy: it gives a better functional result, less postoperative pain, and fewer late surgical complications. Cite this article: Bone Joint J 2021;103-B(6):1155–1159.


2020 ◽  
Vol 7 (3) ◽  
pp. 154
Author(s):  
Amanda Machado Antonio ◽  
Thaina Cristina Vieira Gaspardi ◽  
Evelyn Regina Couto ◽  
Gustavo Constantino De Campos ◽  
João Batista De Miranda ◽  
...  

<p class="abstract"><strong>Background:</strong> The objectives of the study was to evaluate the efficacy of dry needling inactivation of trigger points in acute pain relief and function improvement in patients with severe knee osteoarthritis.</p><p class="abstract"><strong>Methods:</strong> Thirty participants choose between dry needling or static stretching. It was analyzed the immediate effects of a single dry needling intervention, compared to a control group that received static stretching. Outcomes of the study was timed up and go test; visual analogue scale and brief pain inventory.</p><p class="abstract"><strong>Results:</strong> The group treated with dry needling had a better result on the visual analogue scale and on the brief pain inventory scale. There was no difference in time up and go performance in relation to the control group. The muscle group with the highest prevalence of trigger points was the thigh adductors (83.3%), despite valgus or varus frontal plane misalignment of the limb.</p><p class="abstract"><strong>Conclusions: </strong>The inactivation of trigger points by dry needling in patients with acute pain due to severe osteoarthritis of the knees obtained better relief compared to static stretching of the musculature.</p>


2020 ◽  
Vol 24 (3) ◽  
Author(s):  
RIAZ-UR- REHMAN ◽  
MUHAMMAD NAWAZ KHAN ◽  
ATTIYA NASIR SIDDIQUE ◽  
AKBAR JAMAL

Objective:  The aim of conducting this study was to evaluate the outcome of a Micro vascular Decompression procedure for the definitive treatment of Trigeminal Neuralgia in our setup. Material and Methods:  This observational prospective study was carried out in Neurosurgery unit Hayatabad Medical Complex, Peshawar. A total of 50 patients operated for micro vascular decompression surgeries were enrolled in the study, both genders and any age were in inclusion criteria. Patients previously operated for trigeminal neuralgia were excluded from the study. Post operatively all patients were followed for 1year to calculate the outcome in terms of pain control using visual analogue score (VAS). Immediate pain relief during the first post-operative week and trigeminal neuralgia pain at 1 year post op were recorded and  graded into three categories based on Visual Analogue Scale (VAS) such as Excellent: 0-2 , Good: 3-6, Fail/Poor: 7 – 10. Results:  50 patients fulfilled the inclusion criteria. 22 were male & 28 were female with an age range from 42-78 years. Average duration of disease was 5 years. In 30 patients, clinically v2-v3 were predominantly involved, in remaining 14 patient v1-v2 were involved & only in 6 patients all three branches were involved. Among all operated 50 patients 18(36%) had excellent pain relief, 26 (52%) had good pain relief & 6 (12%) had fail/poor pain relief. Conclusion:  From this data it was concluded that micro vascular decompression is an effective surgical procedure in relieving pain of trigeminal neuralgia in patients who are refractive to medical treatment.


2019 ◽  
Vol 30 (6) ◽  
pp. 1349-1355 ◽  
Author(s):  
Mercedes Molero-Senosiaín ◽  
Laura Morales-Fernández ◽  
Federico Saenz-Francés ◽  
Julian García-Feijoo ◽  
Jose María Martínez-de-la-Casa

Objectives: To analyze the reproducibility of the new iC100 rebound tonometer, to compare its results with the applanation tonometry and iCare PRO and to evaluate the preference between them. Materials and methods: For the study of reproducibility, 15 eyes of 15 healthy Caucasian subjects were included. Three measurements were taken each day in three separate sessions. For the comparative study, 150 eyes of 150 Caucasian subjects were included (75 normal subjects and 75 patients with glaucoma). Three consecutive measurements were collected with each tonometer, randomizing the order of use. The discomfort caused by each tonometer was evaluated using the visual analogue scale. Results: No statistically significant differences were detected between sessions. In the comparison between tonometers, the measurements with iC100 were statistically lower than those of Perkins (−1.35 ± 0.417, p = 0.004) and that iCare PRO (−1.41 ± 0.417, p = 0.002). The difference between PRO and Perkins was not statistically significant ( p = 0.990). The mean time of measurement (in seconds) with iC100 was significantly lower than with Perkins (6.74 ± 1.46 vs 15.53 ± 2.01, p < 0.001) and that PRO (6.74 ± 1.46 vs 11.53 ± 1.85, p < 0.001). Visual analogue scale score with iC100 was lower than Perkins (1.33 ± 0.99 vs 1.73 ± 1.10, p < 0.05). In total, 61.7% preferred iC100 against Perkins. Conclusion: The reproducibility of this instrument has been proven good. iC100 underestimates intraocular pressure compared to applanation tonometry at normal values and tends to overestimate it in high intraocular pressure values. Most of the subjects preferred iC100 tonometer.


2020 ◽  
Vol 134 (2) ◽  
pp. 145-149
Author(s):  
M Casale ◽  
A Costantino ◽  
L Sabatino ◽  
A Luchena ◽  
A Moffa ◽  
...  

AbstractObjectiveThis paper aims to report our experience with a minimally invasive surgical procedure for the treatment of chronic rhinosinusitis with nasal polyps, performed in a day-surgery setting under local anaesthesia.MethodsA retrospective study of 30 patients with chronic rhinosinusitis with nasal polyps was conducted. Sino-Nasal Outcome Test 22 and modified Lund–Kennedy scores were collected. Intra- and post-operative pain was evaluated using a 10-point visual analogue scale.ResultsThe mean Sino-Nasal Outcome Test 22 score decreased from 41.8 ± 15.8 pre-operatively to 13.3 ± 9.5 post-operatively (p < 0.001). Accordingly, the mean endoscopic score decreased from 6.8 ± 1.8 to 0.2 ± 0.7 (p < 0.001). The mean intra-operative pain score was 2.9 ± 3.2, and 29 patients (96.7 per cent) reported no pain in the post-operative period (visual analogue scale score = 0).ConclusionOur study confirms that minimally invasive surgery represents a safe, repeatable procedure that results in remarkable subjective and objective improvement, without intra- and post-operative pain or discomfort.


2019 ◽  
Vol 44 (8) ◽  
pp. 845-849 ◽  
Author(s):  
Angela A. Wang ◽  
Douglas T. Hutchinson

Syndactyly release may be done by skin graft or graftless techniques. We prospectively examined bilateral syndactyly releases in the same patient at one operation. The grafted side was randomized and the contralateral side was done graftless. Fourteen patients had surgery at a mean age of 27 months (range 7–166). The mean follow-up was 52 months (range 6–111). The mean tourniquet time was 97 minutes (range 66–135) for graft and 84 minutes (55–120) for graftless. The mean finger abduction was 57° (32°–80°) for graft and 54° (38°–80°) for graftless. The mean web creep score was 1.2 (0–3) for graft and 2.1 (0–3) for graftless. The mean scar score was 1.9 (1–3) bilaterally. The mean parents’ visual analogue scale for graft cosmesis was 7.1 (5–9) and 6.2 (4.3–8) for graftless. The surgeon’s visual analogue scale for graft was 7.9 (6.4–9.5) and 6.2 (4–8.7) for graftless. The therapist’s visual analogue scale was 7.9 (6.5–10) and 6.4 (4.7–8) for graftless. Although there is a longer tourniquet time with grafting, there may be advantages in appearance and web creep. Level of evidence: II


2011 ◽  
Vol 105 (10) ◽  
pp. 1503-1511 ◽  
Author(s):  
S. L. Tey ◽  
R. Brown ◽  
A. Chisholm ◽  
A. Gray ◽  
S. Williams ◽  
...  

Nuts are known for their hypocholesterolaemic properties; however, to achieve optimal health benefits, nuts must be consumed regularly and in sufficient quantity. It is therefore important to assess the acceptability of regular consumption of nuts. The present study examined the long-term effects of hazelnut consumption in three different forms on ‘desire to consume’ and ‘overall liking’. A total of forty-eight participants took part in this randomised cross-over study with three dietary phases of 4 weeks: 30 g/d of whole, sliced and ground hazelnuts. ‘Overall liking’ was measured in a three-stage design: a pre- and post-exposure tasting session and daily evaluation over the exposure period. ‘Desire to consume’ hazelnuts was measured during the exposure period only. Ratings were measured on a 150 mm visual analogue scale. Mean ratings of ‘desire to consume’ were 92 (sd 35) mm for ground, 108 (sd 33) mm for sliced and 116 (sd 30) mm for whole hazelnuts. For ‘overall liking’, the mean ratings were 101 (sd 29) mm for ground, 110 (sd 32) mm for sliced and 118 (sd 30) mm for whole hazelnuts. Ground hazelnuts had significantly lower ratings than both sliced (P ≤ 0·034) and whole hazelnuts (P < 0·001), with no difference in ratings between sliced and whole hazelnuts (P ≥ 0·125). For each form of nut, ratings of ‘overall liking’ and ‘desire to consume’ were stable over the exposure period, indicating that not only did the participants like the nuts, but also they wished to continue eating them. Therefore, the guideline to consume nuts on a regular basis appears to be a sustainable behaviour to reduce CVD.


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