scholarly journals Postoperative pain and comfort scores: Do they correlate?

2019 ◽  
Vol 47 (5) ◽  
pp. 435-441
Author(s):  
Michelle W Miu ◽  
Andrew Martin ◽  
Allan M Cyna
Keyword(s):  
Postoperative Pain ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
P Value ◽  
Nocebo Effect ◽  
Suitable Alternative ◽  
Pain Experience ◽  
Pain Scores ◽  
Comfort Levels ◽  
Numerical Rating

Research on the nocebo effect has shown that some words can hurt. Pain is defined as ‘unpleasant’ and ‘associated with actual or potential tissue damage’. So, a sensation described as ‘pain’ may function as a negative suggestion or nocebo communication. This can lead to pain being experienced or exacerbated where it would not have been otherwise. The nocebo effect has also been implicated as adversely affecting the pain experience during the assessment of pain postoperatively. Words that avoid this potential nocebo effect such as ‘comfort’ may represent a more satisfactory alternative. We therefore aimed to determine whether ‘comfort’ and ‘pain’ scores correlate when assessing patients postoperatively at the same timepoint. Patients were questioned before routine post-anaesthesia rounds to rate their pain and comfort levels, with the sequence of questions randomised. Patients were asked to rate pain and comfort on a 0–10 verbal numerical rating scale, where 0 represents ‘no pain’ or ‘no comfort’ and 10 ‘worst pain’ or ‘most comfort’ imaginable, respectively. To provide a clinically relevant correlation of approximately 0.7 between pain and inverted comfort scores, a sample size of 100 would provide adequate precision (95% confidence interval (CI) 0.58–0.79). A P-value of <0.05 was considered significant. We recruited 100 patients. A positive correlation of 0.62 was found between pain and inverted comfort scores (95% CI 0.47–0.72; P<0.0001). The question sequence of asking about pain or comfort did not affect either score. Comfort and pain scores are moderately correlated. This finding represents a first step in validating comfort scores and suggests that they could be considered a suitable alternative to pain scores when assessing patients postoperatively. As comfort is not an exact antonym to pain, caution is required when using these measures interchangeably.

scholarly journals Analgesic Efficacy of Perioperative Esmolol as an Adjunct to Morphine in Mastectomy- A Prospective Observational Study

2021 ◽  
Author(s):  
Jose Tania ◽  
Vadakkoot Raghavan Hema ◽  
Prabhakaran Vineetha
Keyword(s):  
Side Effects ◽  
Postoperative Pain ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Control Group ◽  
P Value ◽  
Numerical Rating ◽  
The Mean

Introduction: Multimodal analgesia with opioids as the prime component is the mainstay of postoperative analgesia for mastectomy, which can lead to many opioid related unwanted side-effects. Esmolol infusion has been found as a useful adjunct in reducing opioid requirements. Aim: To find the effect of perioperative esmolol infusion on postoperative pain and opioid requirements. Materials and Methods: This prospective observational study was done in 140 American Society of Anaesthesiologists (ASA) physical status l and ll patients, between 20-65 years of age posted for mastectomy under general anaesthesia. Esmolol group (group E) received 0.25 mg/kg of esmolol bolus ten minutes before induction followed by continuous infusion 5 μg/kg/min till end of surgery while control group (group C) received equivalent volumes of saline. Primary outcome measures were Numerical Rating Scale (NRS) for pain, total postoperative opioid consumption and time to first rescue analgesic dosage till 24 hours. Intraoperative haemodynamics and other side-effects were secondary outcomes. Descriptive statistics of numerical rating scores and analgesic requirements were analysed in terms of mean and standard deviation. Independent t-test was used to compare numerical rating scores and analgesic requirement of the two groups. A p-value of <0.05 was considered statistically significant. Results: The mean numerical pain scores were significantly lower in the esmolol group for the first 24 hour. The mean time to first rescue analgesic was 17.59±5.012 hour in the esmolol group and 8.21±2.22 hour in the control group which was statistically significant (p<0.001). The total tramadol consumption was also significantly lesser in the esmolol group (42.14±29.03 mg), compared to control group (102.86±22.3 mg), (p=0.0001). Mean heart rate was statistically lower in the esmolol group, but there was no incidence of bradycardia requiring treatment. Mean Arterial Pressures (MAP) were comparable. Conclusion: Perioperative esmolol infusion when used as an adjunct to morphine decreased postoperative pain and analgesic requirements for the first 24 hours without any haemodynamic disturbances.

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 EUS-Guided Versus Percutaneous Celiac Neurolysis for the Management of Intractable Pain Due to Unresectable Pancreatic Cancer: A Randomized Clinical Trial

2020 ◽  
Vol 9 (6) ◽  
pp. 1666
Author(s):  
Won Jae Yoon ◽  
Yul Oh ◽  
Changhoon Yoo ◽  
Sunguk Jang ◽  
Seong-Sik Cho ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Abdominal Pain ◽  
Back Pain ◽  
Cancer Patients ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Intractable Pain ◽  
Point Reduction ◽  
Pain Scores ◽  
Numerical Rating

Although endoscopic ultrasound-guided celiac neurolysis (EUS-CN) and percutaneous celiac neurolysis (PCN) are utilized to manage intractable pain in pancreatic cancer patients, no direct comparison has been made between the two methods. We compared the efficacy and safety of EUS-CN and PCN in managing intractable pain in such patients. Sixty pancreatic cancer patients with intractable pain were randomly assigned to EUS-CN (n = 30) or PCN (n = 30). The primary outcomes were pain reduction in numerical rating scale (NRS) and opioid requirement reduction. Secondary outcomes were: successful pain response (NRS decrease ≥50% or ≥3-point reduction from baseline); quality of life; patient satisfaction; adverse events; and survival rate at 3 months postintervention. Both groups reported sustained decreases in pain scores up to 3 months postintervention (mean reductions in abdominal pain: 0.9 (95% confidence interval (CI): −0.8 to 4.2) and 1.7 (95% CI: −0.3 to 2.1); back pain: 1.3 (95% CI: −0.9 to 3.4) and 2.5 (95% CI: −0.2 to 5.2) in EUS-CN, and PCN groups, respectively). The differences in mean pain scores between the two groups at baseline and 3 months were −0.5 (p = 0.46) and −1.4 (p = 0.11) for abdominal pain and 0.1 (p = 0.85) and −0.9 (p = 0.31) for back pain in favor of PCN. No significant differences were noted in opioid requirement reduction and other outcomes. EUS-CN and PCN were similarly effective and safe in managing intractable pain in pancreatic cancer patients. Either methods may be used depending on the resources and expertise of each institution.

scholarly journals PENGARUH FOOTBATH TREATMENT TERHADAP NYERI POST SECTIO CAESAREA DI RUANG MELATI RSUD DR SOEKARDJO TASIKMALAYA TAHUN 2019

2020 ◽  
Vol 3 (1) ◽  
pp. 1-5
Author(s):  
Detty Chotimah ◽  
Yulia Herliani ◽  
Endang Astiriyani
Keyword(s):  
Rating Scale ◽  
Numerical Rating Scale ◽  
Sampling Technique ◽  
Sectio Caesarea ◽  
Rank Test ◽  
P Value ◽  
Abdominal Incision ◽  
Signed Rank ◽  
Numerical Rating ◽  
Signed Rank Test

Sectio caesarea is a surgical procedure in giving birth with an abdominal incision and uterus that have higher morbidity than normal childbirth. Foot bath treatment is one part of post natal spa can release endorphins in the brain which is a natural pain reliever. The purpose of this research is to determine the effect of foot bath treatment on post SC pain in Melati room RSUD dr Soekardjo Tasikmalaya. This research was used pre eksperimental with pretest posttest design. The research instrument used Numerical Rating Scale (NRS). Sampling technique was used purposive sampling with 30 respondents. Foot bath treatment is done for 15 minutes. The analyzed was by Wilcoxon Signed Rank Test. The result of this research showed that the scale of pain before getting foot bath treatment is mostly moderate pain as many as 26 peoples (87,7%). The scale of pain after getting foot bath treatment is mostly mild pain as many as 25 peoples (83,3%). The result of the statistical test showed p value 0,000 <0,05 it means there is an effect of foot bath treatment to post SC pain.

scholarly journals Proportion of immediate severe postoperative pain in laparoscopic sterilization under general anaesthesia: A cross-sectional study (postoperative pain in laparoscopic sterilization)

2021 ◽  
Vol 43 (5-6) ◽  
pp. 111-116
Author(s):  
Girijanandan Menon ◽  
Manjit George
Keyword(s):  
Postoperative Pain ◽  
General Anaesthesia ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Post Operative Pain ◽  
Severe Postoperative Pain ◽  
Numerical Rating ◽  
Laparoscopic Sterilization

Background: Effective control of immediate post operative abdominal pain following laparoscopic sterilization is challenging. The objective of the study was to estimate the incidence of immediate severe postoperative pain following laparoscopic sterilization under general anaesthesia by the proportion of patients with the pain assessed on a numerical rating scale. Methods: A cross sectional study was conducted with the approval of institutional review board and ethics committee. Fifty seven participants with written informed consent underwent the study over a period of six months. Pain was assessed by a trained recovery nurse and data was collected and analyzed. The main outcome measure was immediate severe post operative pain on numerical rating scale (NRS). Results: Among the 57 participants, 14 (24.6%) had immediate severe post operative pain with median score of five in the inter quartile range of 0 to 5.75 and 43 (75.4%) participants had no severe pain. Conclusion: The incidence of immediate severe postoperative abdominal pain after laparoscopic sterilization under general anaesthesia is high. Therefore, the management of pain following laparoscopic sterilization requires individually based multimodal analgesia.

scholarly journals STIMULASI KUTANEUS LEBIH EFEKTIF MENURUNKAN NYERI DISMENORE PADA REMAJA DIBANDINGKAN DENGAN KUNYIT ASAM

2018 ◽  
Vol 7 (2) ◽  
pp. 143
Author(s):  
Natalia Devi Oktarina ◽  
Suwanti Suwanti ◽  
M. Imron Rosyidi
Keyword(s):  
Rating Scale ◽  
Numerical Rating Scale ◽  
T Test ◽  
Control Group ◽  
P Value ◽  
Control Group Design ◽  
Purposive Sampling ◽  
Group Design ◽  
Numerical Rating

Nyeri dismenore adalah nyeri di daerah panggul akibat menstruasi dan produksi zat prostaglandin yang membuat dinding rahim berkontraksi dan pembuluh darah sekitarnya terjepit (kontriksi) yang menimbulkan iskemi jaringan. Penanganan nyeri dismenore dapat dilakukan dengan nonfarmakologis diantaranya dengan pemberian minuman kunyit asam dan stimulasi kutaneus. Penelitian ini untuk mengetahui perbedaan efektivitas pemberian kunyit asam yang baisa dikonsumsi remaja dengan pemberian stimulasi kutaneusterhadap penurunan intensitas nyeri dismenore pada siswi remaja putri. Penelitian ini menggunakan desain penelitian quasy eksperiment dengan rancangan pretest-posttest with control group design. Pengambilan sampel dengan cara purposive sampling. Besarnya sampel adalah 40 remaja di Desa Candirejo Kabupaten Semarang. Instrumen penelitiannya berupa lembar observasi nyeri Numerical Rating Scale. Analisis data menggunakan uji statistik t-test independent. Hasil penelitian melalui uji statistik t-test independent menunjukkan nilai p-value 0,002  yang artinya ada perbedaan efektivitas pemberian kunyit asam dan stimulasi kutaneus terhadap penurunan intensitas nyeri haid dengan rata-rata penurunan skala nyeri lebih tinggi pada stimulasi kutaneus. Kesimpulannya adalah stimulasi kutaneus lebih efektif menurunkan skala nyeri dismenore pada remaja putri.Berdasarkan dari hasil penelitian yang dilakukan diharapkan intervensi stimulasi kutaneus dapat diterapkan dan diaplikasikan sebagai intervensi baru bagi remaja ataupun masyarakat untuk mengatasi dismenore. Kata kunci      : nyeri dismenore, kunyit asam, stimulasi kutaneus

scholarly journals EFEKTIFITAS KOMPRES SEREI HANGAT TERHADAP PENURUNAN SKALA NYERI ARTHRITIS RHEUMATOID PADA LANSIA DI DESA NAUMBAI WILAYAH KERJA PUSKESMAS KAMPAR

Jurnal Ners ◽  
2020 ◽  
Vol 4 (1) ◽  
pp. 29-34
Author(s):  
RIDHA HIDAYAT
Keyword(s):  
Rating Scale ◽  
Numerical Rating Scale ◽  
P Value ◽  
Test Design ◽  
Purposive Sampling ◽  
Numerical Rating ◽  
Arthritis Rheumatoid

Arthritis rematoid seringkali melibatkan organ tubuh lainnya yang disertai nyeri dan kaku pada system otot dan jaringan ikat.Penelitian ini bertujuan untuk mengetahui efektifitas kompres serai hangat terhadap skala nyeri arthritis rematoid pada lansia di Desa Naumbai Wilayah Kerja Puskesmas Kampar.Metode penelitian ini adalah Quasi Eksperimen dalam satu kelompok ( one group pre test-pos test design). Populasi adalah seluruh pasien arthritis rheumatoid di Desa Naumbai dengan jumlah 127 orang. Adapun penentuan sampel menggunakan purposive sampling, jumlah sampel pada penelitian ini sebanyak 33 orang. Instrumen yang digunakan adalah lembar observasi dan Numerical Rating Scale dan Skala nyeri wajah. Analisa yang digunakan adalah analisa univariat dan bivariate dengan menggunakan uji T-Dependent. Hasil penelitian menunjukkan adanya perbedaan secara bermakna antara skala nyeri responden setelah diberikan kompres serai hangat dengan nilai p-value (0,000) < α (0,05). Diharapkan penderita arthritis rheumatoid dengan nyeri dapat mengaplikasikan kompres serai hangat untuk penurunan skala nyeri.

scholarly journals PENGARUH PEMBERIAN TEHNIK AKUPRESUR TERHADAP PENURUNAN NYERI PERSALINAN KALA I PADA IBU PRIMIPARA DI RUANG WIDYA RUMAH SAKIT CIREMAI CIREBON TAHUN 2016

2020 ◽  
Vol 7 (2) ◽  
pp. 880-886
Author(s):  
Awaludin Jahid Abdillah ◽  
Iyus Meni
Keyword(s):  
Rating Scale ◽  
Numerical Rating Scale ◽  
Labor Pain ◽  
P Value ◽  
Test Design ◽  
Research Results ◽  
Uterine Contractions ◽  
Post Test ◽  
Numerical Rating ◽  
Reduction Effect

Nyeri persalinan dapat menimbulkan stres yang menyebabkan pelepasan hormon yang berlebihan seperti katekolamin dan steroid. Hormon ini dapat menyebabkan terjadinya ketegangan otot polos dan vasokontriksi pembuluh darah. Hal ini dapat mengakibatkan penurunan kontraksi uterus,penurunan sirkulasi utero plasenta, pengurangan aliran darah dan oksigen ke uterus, serta timbulnya iskemia uterus yang membuat impuls nyeri bertambah banyak akupresur, stimulasi kulit dapat memberi efek penurunan nyeri yang efektif. Tehnik akupresur dapat dimanfaatkan sebagai menurunkan rasa nyeri pada saat persalinan. Tujuannya adalah  untuk mengetahui pengaruh  pemberian tehnik akupresur terhadap nyeri persalinan kala I pada ibu primapara. Jenis penelitian ini adalah Pre eksperiment dengan rancangan pre and post test design.  Populasi adalah  ibu bersalin kala I primipara di ruang Widya Rumah Sakit Ciremai Cirebon Tahun 2016, Sampel menggunakan tehnik total sampling dengan jumlah sampel 22 responden. Instrumen penelitian menggunakan  Numerical Rating Scale. Metode pengambilan data dalam  penelitian ini menggunakan observasi, dianalisis dengan Wilcoxon Matchead Pairs p-value ≤0.05.Dari hasil penelitian dengan menggunakan uji Wilcoxon Matchead Pairs, menunjukan nilai ρ=0.000 (0,000≤0.05), berarti ada pengaruh pemberian tehnik akupresur terhadap penurunan nyeri persalinan. Sehubungan dengan hasil penelitian diharapkan perlunya memberikan pelatihan tentang tehnik akupresur baik bagi rumah sakit, ilmu keperawatan, praktik keperawatan dan ibu bersalin primipara.Kata Kunci : intensitas nyeri, persalinan, tehnik akupresur  ABSTRACTLabor pain can cause stress which causes excessive release of hormones such as catecholamines and steroids. These hormones can cause smooth muscle strain and vasoconstriction of blood vessels. This can lead to decreased uterine contractions, decline in utero placental circulation, reducing blood flow and oxygen to the uterus, as well as the onset of ischemia of the uterus which make implus pain increased. acupressure, skin stimulation can provide effective pain reduction effect. Acupressure technique can be used as a decrease pain during labor . The purpose is to determine the effect on the provision of acupressure techniques to the first stage of labor pain in the mother primapara.This research is a Pre experimental design with pre and post test design maternity respondents in the room when I primiparas Widya Hospital Cirebon Ciremai 2016, use the technique of total smpling with a sample of 22 respondents . research instruments using Numerical Rating Scale. The method of collecting data in this study using observation, Matchead Pairs analyzed by Wilcoxon p-value ≤0.05 .From the results of research using the Matchead Pairs Wilcoxon, research results show the value ρ = 0.000 ( 0,000≤0.05 ), means that there is the effect of acupressure techniques to decrease labor pain.In connection with the research results expected need for providing training in acupressure technique is good for hospitals , nursing science, nursing practice and maternal primiparous.Keywords : pain intensity, labor, acupressure technique

scholarly journals PENGARUH SENAM HAMIL TERHADAP NYERI PUNGGUNG PADA IBU HAMIL

2020 ◽  
Vol 10 (1) ◽  
pp. 1259-1265
Author(s):  
Uun Kurniasih
Keyword(s):  
Back Pain ◽  
Pregnant Women ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Intervention Group ◽  
Control Group ◽  
P Value ◽  
Purposive Sampling ◽  
Post Test ◽  
Numerical Rating

Salah satu ketidaknyamanan yang sering timbul pada kehamilan adalah nyeri punggung. Nyeri punggung merupakan gangguan yang banyak dialami oleh ibu hamil sepanjang masa-masa kehamilan hingga periode pasca natal . Salah satu upaya yang bisa dilakukan untuk mengurangi nyeri punggung selama kehamilan adalah dengan melakukan senam hamil. Penelitian ini bertujuan untuk mengetahui skala nyeri sebelum dan sesudah dilakukan senam hamil dan untuk mengetahui pengaruh senam hamil terhadap nyeri punggung pada ibu hamil di UPTD Puskesmas Mundu Kabupaten Cirebon Tahun 2018.Penelitan ini menggunakan desain penelitian quasi eksperimen dengan pretest–posttest with control group. Pengambilan sampel menggunakan purposive sampling dengan jumlah sampel 28 responden, 14 subjek untuk kelompok intervensi dan 14 subjek untuk kelompok  kontrol. Teknik pengumpulan data dengan cara observasi. Sedangkan instrumen yang digunakan adalah Numerical Rating Scale (NRS). Analisa data yang digunakan adalah uji Mann – Whitney.Hasil Penelitian ini menunjukkan bahwa hasil dari pre test dan post test pada kelompok kontrol mayoritas dengan intensitas nyeri sedang yaitu 7 orang (50%) dan nyeri berat yaitu 6 orang (42%), sedangkan pada melompok intervensi mayoritas nyeri ringan yaitu 7 orang (50%) dan nyeri sedang yaitu 7 orang (50%). Berdasarkan analisa statistik didapatkan niai p value adalah  0,001 maka Ho ditolak dan Ha diterima artinya senam hamil efektif menurunkan intensitas nyeri punggung pada ibu hamill di UPTD Puskesmas Mundu Kabupaten Cirebon tahun 2018Kata Kunci   : Senam, nyeri punggung, ibu hamil  ABSTRACTLow Back pain is one of the discomfort which often occurred during pregnancy. Lowback pain is a condition experienced by many pregnant women troughout pregnancy period to the post  delivery period. One of the solutionto address this issue is by doing exercise for pregnancy women. The studi was conducted to find out the effect of pregnancy exercisseto reduce low back paint issue.This studi aims to determine the scalae of pain before and after pregnancy exercise and to determine the effect of pregnancy exercise againt back pain in pregnancy women in UPTD puskesmas Mundu Cirebon Regency 2018. This research uses quasi experimental research design with Pretest –Posttest with Control Group. Sampling using purposive sampling with the number of samples of 28 respondent, 14 for the intervention group and 14 subjects for the control group. Data collection techniques by observation. While the instrument used is the Numerical Rating Scale (NRS). The data analysis used is Mann –Whitney test. The resukt of this study indicate that resukt of pre-test and post-test in the mayoritycontrol group with moderate pain intensisity of 7 people (50%) and severe pain that is 6 people (42,9%), while in the intervention group the majority of mild pain 7 peiple (50%). Based on statistical analysis in the value of p value is 0,001, then H0 is rejected reduce the intensity of back pain in pregnant women in UPTD Puskesmas Mundu Cirebon  2018.Keywords: Exercise, back pain, pregnancy women

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