A Comparative Study of the Duration and Efficacy of Tetracaine 1% and Bupivacaine 0.75% in Controlling Pain following Photorefractive Keratectomy (PRK)

1997 ◽  
Vol 7 (4) ◽  
pp. 327-333 ◽  
Author(s):  
S. Verma ◽  
M.C. Corbett ◽  
A. Patmore ◽  
G. Heacock ◽  
J. Marshall
Keyword(s):  
Pain Control ◽  
Pain Scale ◽  
Photorefractive Keratectomy ◽  
Visual Analogue Pain Scale ◽  
Refractive Outcome ◽  
Visual Analogue Pain ◽  
Significant Difference ◽  
Corneal Wound ◽  
Topical Anaesthetics ◽  
To Receive

Objective To evaluate if topical bupivacaine 0.75% provides better pain control after excimer laser over topical tetracaine 1% without affecting corneal wound healing, refractive outcome of visual function. Design A prospective, double-masked trial was conducted in which 38 patients were randomized to receive either tetracaine or bupivacaine every 30 minutes for 24 hours post-operatively. Pain was recorded over a four day period using a Visual Analogue Pain Scale. The rate of epithelial healing was assessed during digitized retro-illumination photography. Visual performance was recorded using best corrected Snellen acuity, objective measurements of haze, halo and glare over a six month period. Results Tetracaine afforded better pain control (p=0.05). Full epithelial closure occurred in all patients within 72 hours and no statistically significant difference was recorded in any of the parameters measured. Conclusions Contrary to our expectation, the longer acting anaesthetic, bupivacaine, was inferior to tetracaine. Limited and supervised use of topical anaesthetics is recommended in controlling pain following photorefractive keratectomy.

Percutaneous Bunionette Correction: Retrospective Case Series

2020 ◽  
pp. 193864002093750
Author(s):  
Gustavo Nunes ◽  
Tiago Baumfeld ◽  
Caio Nery ◽  
Daniel Baumfeld ◽  
Paulo Carvalho ◽  
...  
Keyword(s):  
Case Series ◽  
Distal Region ◽  
Pain Scale ◽  
Invasive Technique ◽  
Visual Analogue Pain Scale ◽  
Retrospective Case ◽  
Visual Analogue Pain ◽  
Significant Difference ◽  
American Orthopaedic

Introduction. Bunionette is a deformity of the fifth metatarsal in which there is a painful lateral bony prominence of the distal region of this bone caused by various anatomical and biomechanical changes. The aim of this study is to report on a minimally invasive technique without the use of hardware to treat these deformities. Methods. This is a case series of 18 patients, 25 feet, who underwent bunionette percutaneous surgical treatment. All patients answered the American Orthopaedic Foot and Ankle Society (AOFAS) scale and the visual analogue pain scale (VAS) preoperatively and at the last follow-up. Standard radiological evaluation included measurement of intermetatarsal (4-5 IMA) and fifth toe metatarsophalangeal (5-MTTP) angles. Time to radiographic consolidation, complications, and satisfaction rate were also documented. Results. The average follow-up was 15.9 months, the AOFAS increased from 49.6 to 92.4 and the VAS decreased from 7.7 to 1.2. It was observed that average 5-MTTP decreased from 15° to 2.7° and that 4-5-IMA decreased from 9.1° to 3.3°. These outcomes showed a statistically significant difference ( P < .001). The most common observed complication was the formation of a hypertrophic bone callus in the third postoperative month in three operated feet (12%). One patient had algodystrophy, which improved after conservative treatment. There were no cases of infection, neuropraxis, or recurrences. Fifteen patients rated the result as excellent, 2 as good, and 2 as regular. Conclusion. Percutaneous osteotomy of the fifth metatarsal without the use of hardware is a safe, reproducible technique and presents good clinical and radiographic results for the treatment of bunionette. Levels of Evidence: Therapeutic studies, Level IV: Case series

scholarly journals Comparison of post operative pain in tonsillectomy: a three year prospective study

2020 ◽  
Vol 6 (12) ◽  
pp. 2189
Author(s):  
Akshay Jain ◽  
Smruti Milan Tripathy
Keyword(s):  
Prospective Study ◽  
Pain Scale ◽  
Visual Analogue Pain Scale ◽  
Bipolar Cautery ◽  
Visual Analogue Pain ◽  
Pain Scores ◽  
Post Operative Period ◽  
Post Operative Pain ◽  
Significant Difference ◽  
Cold Dissection

<p><strong>Background:</strong> Tonsillectomy is the oldest surgery performed by otorhinolaryngologists worldwide. Through ages different techniques have been tried to improve the post surgical outcome and reduce morbidity among patients. Aim of the current study was to compare the post-operative pain among the patients undergoing tonsillectomy by cold dissection, bipolar cautery dissection and coblation dissection.</p><p><strong>Methods:</strong> 142 Patients undergoing tonsillectomy in ENT department of TMMC during the period of 3 year were included in the study. Patients were randomly distributed to undergo different techniques of tonsillectomy. The post-operative pain in patients was assessed using the pre-standardized visual analogue pain scale and results were analyzed.</p><p><strong>Results:</strong> No statistically significant difference was found among the groups undergoing tonsillectomy by cold dissection, bipolar dissection and coblator dissection as the p&gt;0.05. The immediate post-operative pain was found to be slightly higher among the group undergoing tonsillectomy by coblator dissection and the analgesics dose needed in the post-operative period remained the same for all for patients of all the three groups.</p><p><strong>Conclusions:</strong> No statistically significant difference was found in the post-operative pain scores of patients undergoing tonsillectomy by CD, BD and CBD techniques.</p>

scholarly journals The Effect of Two Different Doses Protocol of Bupivacaine for Femoral Block on Postoperative Analgesia: A Retrospective Analysis of Single Center Data

2021 ◽  
Author(s):  
Adem Selvi ◽  
Gökhan Yılıdız ◽  
Erbil Türksal ◽  
Rıdvan Özbek ◽  
Mustafa Caner Okkaoğlu ◽  
...  
Keyword(s):  
Side Effects ◽  
Femoral Nerve Block ◽  
Femoral Nerve ◽  
Analgesic Efficacy ◽  
Pain Scale ◽  
Visual Analogue Pain Scale ◽  
Visual Analogue Pain ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

INTRODUCTION: In our study, we aimed to compare the analgesic efficacy, side effect profile and its effect on opioid consumption of the femoral nerve block applied with different concentrations of local anesthetic agents (%0.5 bupivacaine and %0.25 bupivacaine) in the same volume (20 mL) after total knee replacement (TKR) operation. METHODS: The files of patients who underwent unilateral TKR surgery under spinal anesthesia between August 2018 and June 2019 were retrospectively reviewed. A total of 163 patients were included in the study, 81 patients in group 1 who received %0.25 bupivacaine, and 82 patients in group 2 who received %0.50 bupivacaine for femoral block. The highest visual analogue pain scale (VAS) scores in the postoperative 24 hours, the amount of tramadol requested and consumed with intravenous patient-controlled analgesia (PCA) devices, and whether there was a significant difference in terms of side effects (nausea, vomiting, motor and sensory deficit) were analyzed. RESULTS: The highest VAS score in group 1 was 2.95 ± 1.31, in group 2 it was 2.84 ± 1.06, and there was no significant difference between them. The mean consumption of tramadol was 197.04 ± 92.03 mg in group 1 and 208.05 ± 85.06 mg in group 2. There was no difference between the demand and consumption of tramadol and side effects. DISCUSSION AND CONCLUSION: 20 mL %0.25 bupivacaine for the femoral block provided the equivalent analgesic efficacy to the same volume of %0.50 bupivacaine. We think that the use of % 0.25 bupivacaine is a more reliable option to reduce systemic side effects, motor block risk and complications.

scholarly journals Incidence and management of inguinodynia after inguinal plasty

2020 ◽  
Vol 8 (10) ◽  
pp. 3432
Author(s):  
Juan J. Granados-Romero ◽  
Jesus C. Ceballos-Villalva ◽  
Israel García-Olivo ◽  
Cruz Escobar Jonathan E. ◽  
María J. Corona-Torres ◽  
...  
Keyword(s):  
Hospital Costs ◽  
Laparoscopic Approach ◽  
Systematic Investigation ◽  
Pain Scale ◽  
Diagnostic Methods ◽  
Visual Analogue Pain Scale ◽  
Open Approach ◽  
Cross Sectional ◽  
Visual Analogue Pain ◽  
Quality Life

Background: Hernia is defined as a defect of fascial and muscle-aponeurotic structures, allowing the protrusion of elements. The most frequent is inguinal region, prevailing in men 3:1 vs female. The most frequent complications are persistent chronic pain.Methods: A descriptive, prospective and cross-sectional study was performed in postoperative inguinal plasty patients, using a laparoscopic approach and open approach, the presence or absence of inguinodynia was studied using the visual analogue pain scale (VAS) and the Semmes-Weinstein monofilament, in addition to a systematic investigation in the following PubMed, Medline, Clinical Key and Index Medicus databases, with articles from July 2019 to April 2020.Results: Inguinodynia was present in laparoscopic surgery and open approach, 58 patients had inguinodynia at two weeks associated with the inflammatory response of the tissues and the presence of a foreign body (mesh), 77% of the patients with persistence of pain at 3 months reported mild pain (VAS 1-4), 21% moderate pain that did not limit their daily activities (VAS 5-8) and 2% of the patients reported severe pain which limited physical activity and effort   (VAS 9-10).Conclusions: Inguinodynia has an impact on hospital costs and quality life, we consider it is essential to domain the anatomical variants of the region. We propose an extensive follow-up of this group of patients, to make a comparison of diagnostic methods, as well as conservative management vs. modern techniques for pain control.

scholarly journals Buccal Mucosal Grafts for Urethroplasty: Comparison of Postoperative Oral and Perineal Morbidity

2009 ◽  
Vol 91 (2) ◽  
pp. 116-117 ◽  
Author(s):  
Khalid Abdel-Galil ◽  
Ian Eardley ◽  
Richard Loukota
Keyword(s):  
Donor Site ◽  
Pain Scale ◽  
Perineal Pain ◽  
Visual Analogue Pain Scale ◽  
Urethral Reconstruction ◽  
Visual Analogue Pain ◽  
Buccal Mucosa Graft ◽  
Buccal Mucosal Graft ◽  
Graft Harvest ◽  
Scale Scores

INTRODUCTION A prospective study of postoperative oral and perineal pain experienced by a group of patients undergoing buccal mucosal graft harvest for urethral reconstruction. PATIENTS AND METHODS A consecutive group of 24 male patients undergoing buccal mucosa graft harvest for urethral recon8truction of stricture disease was prospectively studied between June 2006 and December 2008. All patients were examined pre-operatively and entered into the study prospectively. After surgery, all patients were reviewed at 24 h and 48 h. On both occasions, they were asked to complete a proforma containing visual analogue pain scales for both the oral donor site as well as the perineum. RESULTS A statistically significant higher level of pain was experienced from the perineum than the oral donor site on both the first and second postoperative days. CONCLUSIONS Comparative analysis of visual analogue pain scale scores between oral donor site and perineum showed that patients experience significantly more pain from the latter postoperatively.

scholarly journals Transcutaneous Electrical Stimulation and Postoperative Total Knee Arthroplasty Pain

1998 ◽  
Vol 3 (2) ◽  
pp. 101-104
Author(s):  
Mohamed N Mahomed ◽  
Gianni L Maistrelli ◽  
Ayoob Mossanen ◽  
Derek Glazier
Keyword(s):  
Electrical Stimulation ◽  
Total Knee Replacement ◽  
Range Of Motion ◽  
Pain Scale ◽  
Control Group ◽  
Visual Analogue Pain Scale ◽  
Transcutaneous Electrical Stimulation ◽  
Visual Analogue Pain ◽  
Total Knee ◽  
Analgesic Use

OBJECTIVE: To determine the efficacy of the Synaptic 2000 in reducing total knee replacement postoperative pain in a prospective randomized controlled trial.DESIGN: Patients were prospectively randomly assigned to two groups, one receiving seven days of transcutaneous electrical stimulation (TES) therapy in addition to standard postoperative care, and the other receiving standard postoperative care. Both groups received postoperative patient-controlled analgesia and were switched to oral opiates.SETTING: Patients were treated at a university teaching hospital for elective primary unilateral total knee replacement.PATIENTS: All patients consented to enter the study. All had primary osteoarthritis. Fifteen patients were entered into each arm of the study, and all patients completed the study. The mean age of patients was 64 years for treatment and 71 years for controls.OUTCOME MEASURES: Outcome measures were analgesic consumption, return of knee range of motion and score on a visual analogue pain scale.RESULTS: No significant differences were noted in postoperative analgesic use, knee range of motion, length of stay or visual analogue pain scale score. Mean total analgesic use of morphine was 148 mg in the TES group and 108 mg in the control group. The TES group mean knee range of motion on postoperative day 7 was 75.3°; it was 73.6° in the control group. Group mean length of stay was 9.5 days in the TES group and 8.3 days in the control group.

Epidural Morphine plus Bupivacaine for Relief of Postoperative Pain following Harrington Rod Insertion for Correction of Idiopathic Scoliosis

1995 ◽  
Vol 23 (3) ◽  
pp. 211-217 ◽  
Author(s):  
Y Adu-Gyamfi
Keyword(s):  
Side Effects ◽  
Idiopathic Scoliosis ◽  
Pain Score ◽  
Epidural Catheter ◽  
Epidural Morphine ◽  
Pain Scale ◽  
Injection Pain ◽  
Visual Analogue Pain Scale ◽  
Visual Analogue Pain ◽  
Harrington Rod

The aim of this study was to assess the efficacy of epidural morphine plus bupivacaine for post-operative pain control following Harrington rod insertion. In 22 scoliotic patients, studied prospectively, the epidural catheter was positioned under direct vision, intra-operatively before wound closure. Post-operatively, the patients received 2 mg morphine in 4 ml of 0.25% bupivacaine through the epidural catheter whenever they complained of pain. The pain score was assessed before and after every injection, using the Visual Analogue Pain Scale, and side-effects were monitored. All patients had adequate pain relief following analgesic administration. The mean (± SD) pre-injection pain score decreased from 2.5 ± 0.15 on the first post-operative day to 0.7 ± 0.2 by the fourth day. The side-effects, including nausea, vomiting and pruritus, were minimal. It is concluded that morphine, in 0.25% bupivacaine administered through an intra-operatively placed epidural catheter, provides a safe and effective post-operative analgesia in patients undergoing Harrington rod insertion for idiopathic scoliosis.

scholarly journals EndoTech® minimally invasive trigger thumb release

2021 ◽  
Vol 3 (2) ◽  
pp. 157-160
Author(s):  
Michael J Fitzmaurice
Keyword(s):  
Minimally Invasive ◽  
Pain Scale ◽  
Minimally Invasive Technique ◽  
Endoscopic Technique ◽  
Invasive Technique ◽  
Visual Analogue Pain Scale ◽  
Trigger Thumb ◽  
Visual Analogue Pain ◽  
Minimal Incision

We describe a novel minimally invasive technique for the treatment of trigger thumb. 37 patients with a total of 41 thumbs were included in the study. A visual analogue pain scale was used before surgery and also at 2 week and 6 month follow up visits. The pain was significantly improved from a pre op of 7.92 (+/- 1.6) to .65 (+/- .8) at the 2 week follow up and finally .29 (+/- 1.8) at the 6 month follow up. All of the patients had relief of triggering and only 1 patient required any therapy. This endoscopic technique for trigger thumb allows the surgeon to perform a trigger release with a minimal incision and provides excellent relief without any complications.

scholarly journals Effect of unicornuate uterus on women's reproductive health

2019 ◽  
Keyword(s):  
Quality Of Life ◽  
Reproductive Health ◽  
Clinical Symptoms ◽  
Normal Karyotype ◽  
Pain Scale ◽  
Control Group ◽  
Visual Analogue Pain Scale ◽  
Visual Analogue Pain ◽  
Unicornuate Uterus

Objectives. The effect of the unicornuate uterus on the reproductive health and quality of life of woman has been analyzed. Materials and methods. The study included 26 patients with unicornuate uterus aged 25 to 42 years and 20 women without gynecological pathology. Diagnosis of uterine abnomalies was based on patient complaints, medical history and life history, as well as clinical and laboratory and instrumental examinations. The severity of dysmenorrhea was determined using a visual analogue pain scale, women's quality of life was assessed using a short SF-12 health questionnaire. Results. The average age of the surveyed women was 30.2 ± 3.9 years. All patients with unicornuete uterus by subclasses were distributed as follows: subclass U4a (unicornuate uterus with rudimentary cavity) – 69.2% of patients, subclass U4b (unicornuate uterus without rudimentary cavity in the contralateral horn or with its aplasia) – 30.8%. In all patients was confirmed normal karyotype – 46XX. The combination of a unicornuate uterus with a defect of the urinary system (aplasia, doubling, or kidney dystopia) occurred in 23.1% of women. It has been found that in women with unicornuate uterus, clinical symptoms in 76.9% of cases are accompanied by dysmenorrhea. The unicornuate uterus in 69.2% of cases causes negative reproductive outcomes, among which 26.9% – early spontaneous abortions, 11.5% – ectopic pregnancy. In 46.2% of cases the unicornuate uterus is combined with other gynecological pathology, whereby the incidence of concomitant gynecologic pathology is significantly more frequent in U4a patients than in the U4b subclass (˂0.01). The severity of dysmenorrhea in the main group was 5.8 ± 1.8 points (the difference was significant compared with the control group, p = 0.0032). Conclusions. Due to the low physical subunit, the unicornuate uterus significantly impairs the quality of life of women, which was significantly lower in the group of patients with unicornuate uterus compared to the control group (total SF-12 score: 85.4 ± 11.2 vs. 95.8 ± 12.1; p = 0.002).

scholarly journals Catastrophization is related to the patient and not to the severity of migraine

2021 ◽  
Vol 79 (8) ◽  
pp. 682-685
Author(s):  
Eduardo Almeida Guimarães Nogueira ◽  
Flavia Rodrigues de Oliveira ◽  
Vitor Martinez de Carvalho ◽  
Carina Telarolli ◽  
Yara Dadalti Fragoso
Keyword(s):  
Online Survey ◽  
Depression Scale ◽  
Pain Scale ◽  
Anxiety And Depression ◽  
Visual Analogue Pain Scale ◽  
Depression And Anxiety ◽  
Hospital Anxiety ◽  
Visual Analogue Pain ◽  
One Year ◽  
The Individual

ABSTRACT Background: Catastrophization is a psychological aspect of pain that alters its perception and expression. Objective: To investigate the feature of catastrophization in migraine. Methods: An online survey of individuals suffering from migraine attacks at least twice a month, for at least one year was carried out. Confidentiality was assured and participants gave details of their headache (including a visual analogue pain scale) and answered the Hospital Anxiety and Depression Scale and the Catastrophization Scale questionnaires. Results: The survey included 242 individuals with migraine attacks at least twice a month. The median scores observed in this group of individuals were 7 for pain, 11 for anxiety, 7 for depression, and 2 for catastrophization. Catastrophization had no correlation with the duration (p=0.78) or intensity (p=0.79) of the migraine. There was no correlation between catastrophization and headache frequency (p=0.91) or the monthly amount of headache medication taken (p=0.85). High scores for catastrophization (≥3.0) were identified in one third of the participants. These high scores were not associated with age, headache duration, pain severity, frequency of attacks, or traits of depression or anxiety. There was a moderate association between both depression and anxiety traits with catastrophization. Conclusions: Catastrophization seems to be a trait of the individual and appears to be unrelated to the characteristics of the migraine.

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