Topical capsaicin versus topical ibuprofen in acute musculoskeletal injuries: A randomized, double-blind trial

Background: Acute musculoskeletal pain is one of the common causes of emergency admissions. Topical analgesics are an easily tolerated option in the treatment of these pains. Objective: This study aimed to compare the efficacy of topical capsaicin and topical non-steroidal anti-inflammatory drugs in acute musculoskeletal injuries. Methods: In this prospective, randomized, controlled, double-blinded study, patients were allocated to two groups—the topical non-steroidal anti-inflammatory drug (n = 60) and topical capsaicin (n = 59). For both groups, the first dose treatment was applied as a thin layer in the emergency department to a maximum area of 5 × 5 cm. The remaining doses were administered at home by the patients for 72 h. The initial visual analog scale scores were compared with the 60th and 120th minute as well as the 24th and 72nd hour values. Differences between the visual analog scale scores, clinical response to the treatment, and side effects were evaluated. Results: The proportional reduction in visual analog scale scores for topical capsaicin was significantly higher, especially at 36 and 72 h. These rates were 0.75 (95% confidence interval: 0.77–1.42; p = 0.029) and 9.08 (95% confidence interval: 1.02–17.14; p = 0.028) at 36 h, respectively. At 72 h, they were 1.27 (95% confidence interval: 0.48–2.05; p = 0.002) and 17.07 (95% confidence interval: 8.39–25.76; p < 0.001), respectively. In the topical capsaicin group, the clinical response to treatment was significantly higher (p = 0.001). Treatment-related systemic side effects were experienced only in the topical non-steroidal anti-inflammatory drug group (1.7%). Conclusion: Topical capsaicin can be used safely in patients presenting to the emergency department with acute pain with its high analgesic efficacy and absence of systemic side effects.

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Validation of an Electronic Visual Analog Scale mHealth Tool for Acute Pain Assessment: Prospective Cross-Sectional Study

Journal of Medical Internet Research ◽

10.2196/13468 ◽

2020 ◽

Vol 22 (2) ◽

pp. e13468 ◽

Cited By ~ 3

Author(s):

Carles Escalona-Marfil ◽

Andrea Coda ◽

Jorge Ruiz-Moreno ◽

Lluís Miquel Riu-Gispert ◽

Xavier Gironès

Keyword(s):

Confidence Interval ◽

Visual Analog Scale ◽

Cross Sectional Study ◽

Pain Level ◽

Sectional Study ◽

Analog Scale ◽

Good Reliability ◽

Cross Sectional ◽

Paper Format ◽

Simple Economic

Background Accurate measurement of pain is required to improve its management and in research. The visual analog scale (VAS) on paper format has been shown to be an accurate, valid, reliable, and reproducible way to measure pain intensity. However, some limitations should be considered, some of which can be implemented with the introduction of an electronic VAS version, suitable to be used both in a tablet and a smartphone. Objective This study aimed to validate a new method of recording pain level by comparing the traditional paper VAS with the pain level module on the newly designed Interactive Clinics app. Methods A prospective observational cross-sectional study was designed. The sample consisted of 102 participants aged 18 to 65 years. A Force Dial FDK 20 algometer (Wagner Instruments) was employed to induce mild pressure symptoms on the participants’ thumbs. Pain was measured using a paper VAS (10 cm line) and the app. Results Intermethod reliability estimated by ICC(3,1) was 0.86 with a 95% confidence interval of 0.81 to 0.90, indicating good reliability. Intramethod reliability estimated by ICCa(3,1) was 0.86 with a 95% confidence interval of 0.81 to 0.90, also indicating good reliability. Bland-Altman analysis showed a difference of 0.175 (0.49), and limits of agreement ranged from –0.79 to 1.14. Conclusions The pain level module on the app is highly reliable and interchangeable with the paper VAS version. This tool could potentially help clinicians and researchers precisely assess pain in a simple, economic way with the use of a ubiquitous technology.

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

10.1101/2020.11.03.20225367 ◽

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.

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Association Between Type of Face Mask and Visual Analog Scale Scores During Pain Assessment

Pain Management Nursing ◽

10.1016/j.pmn.2021.09.005 ◽

2021 ◽

Author(s):

Merav Ben Natan ◽

Yaniv Steinfeld ◽

Sara Badash ◽

Galina Shmilov ◽

Milena Abramov ◽

...

Keyword(s):

Visual Analog Scale ◽

Pain Assessment ◽

Face Mask ◽

Analog Scale ◽

Scale Scores

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Visual Analog Scale Scores for Labor Pain

Anesthesia & Analgesia ◽

10.1213/00000539-199906000-00042 ◽

1999 ◽

Vol 88 (6) ◽

pp. 1421 ◽

Cited By ~ 32

Author(s):

Franklin Dexter

Keyword(s):

Visual Analog Scale ◽

Labor Pain ◽

Analog Scale ◽

Scale Scores

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Comparison of outcomes of osteosynthesis in type II accessory navicular by variable fixation methods

Foot & Ankle Orthopaedics ◽

10.1177/2473011418s00378 ◽

2018 ◽

Vol 3 (3) ◽

pp. 2473011418S0037

Author(s):

Hyun-woo Park ◽

Ho-seong Jang ◽

Jae Wan Suh ◽

Sunghyun Kim

Keyword(s):

Visual Analog Scale ◽

Tension Band ◽

Tension Band Wiring ◽

Social Activities ◽

Type Ii ◽

Analog Scale ◽

Fixation Methods ◽

Scale Scores ◽

Accessory Navicular ◽

Screw Group

Category: Midfoot/Forefoot Introduction/Purpose: To compare the outcomes of fixation methods for osteosynthesis of a type II symptomatic accessory navicular between screw and tension band wiring. Methods: Forty-four patients (mean age, 29.2 years; range, 13–54 years; 21 males and 23 females) who had undergone operative treatment after failed conservative treatment were chosen for the study between 2007 and 2014. The patients were divided into two groups by the method of osteosynthesis: group 1 (screw) and group 2 (tension band wiring). Pre and postoperative evaluations were performed, using the midfoot scale from the American Orthopaedic Foot & Ankle Society (AOFAS), a visual analog scale, time to return to social activities, and plain radiography. Results: The AOFAS midfoot and visual analog scale scores of both groups were improved at the last postoperative follow-up. The time to return to social activities was 12.3 weeks in the screw group and 11.9 weeks in the tension band wiring group (p = 0.394). A broken screw was observed in one case in the screw group and a broken k-wire was detected in two cases in the tension band wiring group. Nonunion was observed in two cases in each group. Conclusion: The tension band wiring technique could be another treatment choice of osteosynthesis for fixation of the accessory navicular bone.

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Ondansetron Is Effective to Treat Spinal or Epidural Morphine-induced Pruritus

Anesthesiology ◽

10.1097/00000542-199902000-00017 ◽

1999 ◽

Vol 90 (2) ◽

pp. 432-436 ◽

Cited By ~ 85

Author(s):

Alain Borgeat ◽

Hans-Ruedi Stirnemann

Keyword(s):

Placebo Group ◽

Side Effects ◽

Visual Analog Scale ◽

Case Reports ◽

Controlled Study ◽

Epidural Administration ◽

Analog Scale ◽

Double Blind ◽

Hemoglobin Oxygen Saturation ◽

Group A

Background Spinally and epidurally administered morphine is frequently associated with pruritus. Isolated case reports indicate that ondansetron may be effective in this context. This study aims to investigate the effectiveness of ondansetron to treat this side effect. Methods In a prospective, randomized, double-blind, placebo-controlled study, 100 patients with pruritus (> 4 on a visual analog scale, on which 0 represents no pruritus and 10 represents worst pruritus imaginable) after spinal or epidural administration of morphine, received either 8 mg ondansetron intravenously (ondansetron group) in 100 ml NaCl 0.9% or vehicle (placebo group). A decrease of more than 4 points on the visual analog scale 60 min after treatment was considered a success. Changes in levels of pain and sedation, hemodynamic values, and other side effects were checked regularly. The presence or absence of pruritus was assessed for the last time 24 h later. Results The two groups were similar for demographic characteristics, the route of administration of morphine, and severity of pruritus at the beginning of the study. The ondansetron group showed a success rate of 70% versus 30% for the placebo group (P > 0.05). Among the successfully treated patients, three (9%) in the ondansetron group and six (40%) in the placebo group reported the recurrence of pruritus (P < 0.05). Among the successfully treated patients, none complained of residual pruritus 24 h later. No changes in pain or sedation levels were noted. Hemodynamic values remained stable, hemoglobin oxygen saturation did not decrease, and no other side effects were observed. Conclusion The administration of 8 mg ondansetron intravenously is an effective treatment for spinally or epidurally administered morphine-induced pruritus. In this clinical condition the treatment is safe and well tolerated.

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Visual Analog Scale Scores for Labor Pain

Anesthesia & Analgesia ◽

10.1213/00000539-199906000-00041 ◽

1999 ◽

Vol 88 (6) ◽

pp. 1421 ◽

Cited By ~ 3

Author(s):

William Camann

Keyword(s):

Visual Analog Scale ◽

Labor Pain ◽

Analog Scale ◽

Scale Scores

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Reducing the Pain of Local 1% Lidocaine Infiltration with a Preceding Bacteriostatic Saline Injection

Journal of the American Podiatric Medical Association ◽

10.7547/1010223 ◽

2011 ◽

Vol 101 (3) ◽

pp. 223-230 ◽

Cited By ~ 1

Author(s):

Stephen L. Barrett ◽

Jim Maxka ◽

Jamie N. Mieras ◽

Kimbal E. Cooper

Keyword(s):

Benzyl Alcohol ◽

Visual Analog Scale ◽

Saline Solution ◽

Prospective Trial ◽

Injection Technique ◽

Medical Procedure ◽

Analog Scale ◽

Double Blind ◽

Scale Scores ◽

Lidocaine Injection

Background: Lidocaine injection for local anesthesia is a common podiatric medical procedure. We tested the hypothesis that injection of bacteriostatic saline solution containing 0.9% benzyl alcohol before the lidocaine infiltration can reduce the burning caused by lidocaine injection. Methods: This double-blind prospective trial involved 45 participants who each received four injections in two areas of the dorsum of the foot and rated the perceived pain on a visual analog scale. The order of the injections was designed to disguise the control and intervention arms of the study. Results: The sensation of the lidocaine injection after the injection of saline was reduced significantly (P = .028). The percentage of lidocaine injections with visual analog scale scores of 0 increased by 36% after preinjection with bacteriostatic saline solution containing 0.9% benzyl alcohol. Conclusions: The fact that 40% of the intervention visual analog scale pain scores for lidocaine injections were 0 suggests that a near painless lidocaine injection technique is an achievable goal and that the present technique is a simple and inexpensive method of reducing the pain of lidocaine injections. (J Am Podiatr Med Assoc 101(3): 223–230, 2011)

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