Effect of inhaler and topical lavender oil on pain management of arteriovenous fistula cannulation

2021 ◽  
pp. 112972982110310
Author(s):  
Sevda Tüzün Özdemir ◽  
Asiye Akyol

Background: The recurrent arteriovenous fistula (AVF) intervention in the treatment of hemodialysis induces pain in patients. Lavender oil has analgesic, antimicrobial, and calming effects. This oil is widely used in patients to reduce anxiety and stress associated with pain caused by analgesics. Method: The present study is a randomized controlled and experimental clinical trial in which patients ( n = 90) who underwent hemodialysis with AVFs were randomly divided into three groups. The intensity of pain was measured in all patients at three different stages during the insertion of arterial needles for hemodialysis: (1) The topical application of 100% lavender essential oil, (2) the inhaler application of 100% lavender essential oil, and (3) no intervention. The placebo (water) was applied to groups 1 and 2. Results: Our findings revealed that the mean pre-application pain scores in hemodialysis patients were 57.58 ± 20.28 in the working group, 48.53 ± 20.23 in the control group, 19.49 ± 15.66 in the post-application group, and 45.33 ± 25.52 in the control group ( p < 0.005). The average pain scores after the application of lavender oil were 22.66 ± 15.35 in the inhaler lavender group, 16.33 ± 15.97 in the topical lavender group, and 45.33 ± 25.52 in the control group. Conclusions: After inhaler and topical application of lavender oil, a significant decrease in the severity of pain was recorded for patients at the time of arterial insertion of needles.

2021 ◽  
Author(s):  
Somaeh. Salehi Sarbijan ◽  
Roghiah Mehdipoor Rabori ◽  
Esmat Nouhi

Abstract Background: A large number of children are subject to prevention, diagnosis, and treatment procedures that mostly require venous blood sampling. Painful procedures such as blood sampling in children have annoying physical and emotional effects and can lead to wider negative consequences such as physical, behavioral, and social disorders in children. This study aimed to determine the effect of distraction by balloon inflating on the amount of pain during taking blood samples from children aged 4 to 7. Method: This study had a randomized controlled clinical trial that was conducted on 80 children admitted to the pediatric department of Imam Khomeini Hospital in Jiroft-Kerman province who met the inclusion criteria after obtaining their parent’s consent. The children were randomly grouped into the intervention (n = 40) and control (n = 40) groups. The pain level in children in the intervention group was measured during the venous blood sampling while the children were watching inflating a balloon. However, the pain in children in the control group was measured without any intervention during blood sampling. Wong–Baker Faces Pain Rating Scale questionnaire was used for pain assessment. Results: The average pain scores for the children in the two groups showed no significant difference before the intervention but the average pain scores after the intervention in the intervention and control groups were 1.38±2.56 and 4.2±1.58; showing a significant difference between the two groups after the intervention (p-value < 0.05). Conclusion: Using balloon inflation distraction during venous blood sampling reduces pain in children.


2018 ◽  
Vol 20 (2) ◽  
pp. 190-194
Author(s):  
Amirmohsen Jalaeefar ◽  
Arash Mohammadi Tofigh ◽  
Atoosa Gharib ◽  
Mohsen Khandaghy ◽  
Mohammad Reza Rahimi

Introduction: Arteriovenous fistula is the best choice for vascular access in hemodialysis patients. However, arteriovenous fistula dysfunction is a major clinical issue. The most common cause of arteriovenous fistula failure is intimal hyperplasia. In this study, we have investigated the effect of N-acetylcysteine on neo-intimal hyperplasia after arteriovenous fistula creation in rats. Methods: This study was conducted in 24 rats which were randomly divided into two groups: control and N-acetylcysteine groups. An end-to-side anastomosis was made between the femoral artery and vein. The control group received distilled water intraperitoneally while the animals in N-acetylcysteine group received 300 mg/kg/day of N-acetylcysteine via the same route. After 28 days, the thickness of intima and media was measured using hematoxylin and eosin. Results: There was no significant difference between the two groups regarding age ( p = 0.6) and weight ( p = 0.1). The mean intima thickness in N-acetylcysteine group was significantly less than control group (17 ± 20 and 119 ± 46 µm, respectively; p < 0.001). The mean intima/media thickness in the N-acetylcysteine group was significantly less than control group (0.5 ± 0.63 vs 2.05 ± 1.17 µm; p < 0.001). Conclusion: N-acetylcysteine is effective in inhibiting neo-intimal hyperplasia in a rat model of arteriovenous fistula.


Author(s):  
Wanjun Ren ◽  
Yuejuan Du ◽  
Huili Jiang ◽  
Dongmei Xu

Background Chronic kidney disease has become a serious public health problem in China. Our study is to explore effect of hydraulic expansion on arteriovenous fistula (AVF) of hemodialysis patients. Methods A total of 190 patients with end-stage renal disease (ESRD) were randomly divided into hydraulic expansion group (n = 117) and conventional surgery group (n = 73). Age, sex, the cause of ESRD, height, weight, body mass index (BMI), blood pressure, and diameter of artery and vein from ultrasonography before surgery from patients were recorded. Doppler ultrasonography of vessel was performed with a 12-MHz scanning probe for vascular measurements. The time of first cannulation was recorded. Primary and secondary patency rates were compared between the two groups. Results The mean arterial pressure for this cohort of patients was around 98.12 mm Hg. The mean diameters of artery and vein ready for anastomoses measured by ultrasonography before surgery were 1.96 and 2.04 mm, respectively. Age, weight, BMI, sex ratio, the cause of renal failure, history of catheter insertion, mean arterial pressure, frequency of hemodialysis, blood flow of hemodialysis, and the mode of anastomoses of AVF in conventional surgery group were similar to hydraulic expansion group. There were no differences in stroke volume of radius arterial and venous pressure before dilation between the two groups. The stroke volume of radius artery increased significantly after hydraulic expansion than before dilation and control group. The primary patency rates of AVF in patients with hydraulic expansion were higher significantly than conventional surgery group. The secondary patency rates in conventional surgery group were not different from hydraulic expansion group. Conclusion Hydraulic expansion showed no difference from conventional surgery in complication after operation, and could decrease the time reliance on catheters and the risk of catheter-related infection, thrombosis, and decrease the related medical care costs.


Author(s):  
Ronnie L. Shammas ◽  
Caitlin E. Marks ◽  
Gloria Broadwater ◽  
Elliot Le ◽  
Adam D. Glener ◽  
...  

Abstract Background Psychosocial distress, depression, or anxiety can occur in up to 50% of women after a breast cancer diagnosis and mastectomy. The purpose of this study was to assess the potential benefit of lavender oil as a perioperative adjunct to improve anxiety, depression, pain, and sleep in women undergoing microvascular breast reconstruction. Methods This was a prospective, single-blinded, randomized, controlled trial of 49 patients undergoing microvascular breast reconstruction. Patients were randomized to receive lavender oil or placebo (coconut oil) throughout their hospitalization. The effect of lavender oil on perioperative stress, anxiety, depression, sleep, and pain was measured using the hospital anxiety and depression scale, Richards–Campbell Sleep Questionnaire, and the visual analogue scale. Results Twenty-seven patients were assigned to the lavender group and 22 patients were assigned to the control group. No significant differences were seen in the perioperative setting between the groups with regard to anxiety (p = 0.82), depression (p = 0.21), sleep (p = 0.86), or pain (p = 0.30) scores. No adverse events (i.e., allergic reaction) were captured, and no significant differences in surgery-related complications were observed. When evaluating the entire cohort, postoperative anxiety scores were significantly lower than preoperative scores (p < 0.001), while depression scores were significantly higher postoperatively as compared with preoperatively (p = 0.005). Conclusion In the setting of microvascular breast reconstruction, lavender oil and aromatherapy had no significant adverse events or complications; however, there were no measurable advantages pertaining to metrics of depression, anxiety, sleep, or pain as compared with the control group.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hiroyuki Yamamoto ◽  
Akihide Konishi ◽  
Toshiro Shinke ◽  
Hiromasa Otake ◽  
Masaru Kuroda ◽  
...  

Abstract Background The impact of reduction in glycemic excursion on coronary plaques remains unknown. This study aimed to elucidate whether a dipeptidyl peptidase 4 inhibitor could reduce the glycemic excursion and stabilize the coronary plaques compared with conventional management in coronary artery disease (CAD) patients with impaired glucose tolerance (IGT). Methods This was a multicenter, randomized controlled trial including CAD patients with IGT under lipid-lowering therapy receiving either vildagliptin (50 mg once a day) or no medication (control group) regarding glycemic treatment. The primary endpoint was changes in the minimum fibrous cap thickness and lipid arc in non-significant native coronary plaques detected by optical coherence tomography at 6 months after intervention. Glycemic variability expressed as the mean amplitude of glycemic excursion (MAGE) measured with a continuous glucose monitoring system was evaluated before and 6 months after intervention. Results A total of 20 participants with 47 lesions were allocated to either the vildagliptin group (10 participants, 22 lesions) or the control group (10 participants, 25 lesions). The adjusted difference of mean changes between the groups was − 18.8 mg/dl (95% confidence interval, − 30.8 to − 6.8) (p = 0.0064) for the MAGE (vildagliptin, − 20.1 ± 18.0 mg/dl vs. control, 2.6 ± 12.7 mg/dl), − 22.8° (− 40.6° to − 5.1°) (p = 0.0012) for the mean lipid arc (vildagliptin, − 9.0° ± 25.5° vs. control, 15.8° ± 16.8°), and 42.7 μm (15.3 to 70.1 μm) (p = 0.0022) for the minimum fibrous cap thickness (vildagliptin, 35.7 ± 50.8 μm vs. control, − 15.1 ± 25.2 μm). Conclusions Vildagliptin could reduce the MAGE at 6 months and may be associated with the decreased lipid arc and increased minimum FCT of the coronary plaques in CAD patients with IGT as compared with the control group. These findings may represent its potential stabilization effect on coronary plaques, which are characteristic in this patient subset. Trial registration Registered in the UMIN clinical trial registry (UMIN000008620), Name of the registry: VOGUE trial, Date of registration: Aug 6, 2012, URL: https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000010058


Author(s):  
Asieh Mehdipour ◽  
Parvin Abedi ◽  
Somayeh Ansari ◽  
Maryam Dastoorpoor

Abstract Objectives Postmenopausal women are at greater risk of depression. Depression may negatively affect the quality of life of women. An emotional freedom technique (EFT) is an evidence-based therapy combining cognitive and exposure components with acupressure. This study aimed to evaluate the effect of EFT on depression in postmenopausal women. Methods This was a randomized controlled trial in which 88 women with mild to moderate depression recruited from a menopausal clinic in Ahvaz, Iran, and randomly assigned into two groups of EFT (n=44) and control for sham therapy (n=44). Women in the EFT group received two sessions of training and asked to continue EFT for 8 weeks, one time per day. The Beck Depression Inventory (BDI2) completed by women before and after the intervention. The control group received training on sham acupressure points similar to the intervention group. Data collected using a demographic and BDI2. Women requested to complete the BDI2 before and after the intervention. The independent t-test, chi-square, and ANCOVA were used to analyze data. Results The mean depression score in the intervention group reduced from 20.93 ± 4.6 to 10.96 ± 4.38 in comparison to the control group that reduced from 19.18 ± 2.79 to 17.01 ± 6.05 after intervention (p=0.001). After the 8 week intervention, the frequency of moderate depression decreased from 56.8 to 9.35% in the intervention and from 50 to 29.5% in the control group. In total, 63.4 and 34.15% in the intervention and control groups were free of depression respectively after the intervention (p<0.001). Conclusions The results of this study showed that using EFT for 8 weeks could significantly reduce the mean score of depression in postmenopausal women. Using this method in public health centers for postmenopausal women is recommended.


2018 ◽  
Vol 129 (4) ◽  
pp. 1017-1023 ◽  
Author(s):  
Eduardo Vieira ◽  
Thiago C. Guimarães ◽  
Igor V. Faquini ◽  
Jose L. Silva ◽  
Tammy Saboia ◽  
...  

OBJECTIVEDecompressive craniectomy (DC) is a widely used procedure in neurosurgery; however, few studies focus on the best surgical technique for the procedure. The authors’ objective was to conduct a prospective randomized controlled trial comparing 2 techniques for performing DC: with watertight duraplasty and without watertight duraplasty (rapid-closure DC).METHODSThe study population comprised patients ranging in age from 18 to 60 years who were admitted to the Neurotrauma Service of the Hospital da Restauração with a clinical indication for unilateral decompressive craniectomy. Patients were randomized by numbered envelopes into 2 groups: with watertight duraplasty (control group) and without watertight duraplasty (test group). After unilateral DC was completed, watertight duraplasty was performed in the control group, while in the test group, no watertight duraplasty was performed and the exposed parenchyma was covered with Surgicel and the remaining dura mater. Patients were then monitored daily from the date of surgery until hospital discharge or death. The primary end point was the incidence of surgical complications (CSF leak, wound infection, brain abscess, or subgaleal fluid collections). The following were analyzed as secondary end points: clinical outcome (analyzed using the Glasgow Outcome Scale [GOS]), surgical time, and hospital costs.RESULTSFifty-eight patients were enrolled, 29 in each group. Three patients were excluded, leaving 27 in the test group and 28 in the control group. There were no significant differences between groups regarding age, Glasgow Coma Scale score at the time of surgery, GOS score, and number of postoperative follow-up days. There were 9 surgical complications (5 in the control group and 4 in the test group), with no significant differences between the groups. The mean surgical time in the control group was 132 minutes, while in the test group the average surgical time was 101 minutes, a difference of 31 minutes (p = 0.001). The mean reduction in total cost was $420.00 USD (a 23.4% reduction) per procedure in the test group.CONCLUSIONSRapid-closure DC without watertight duraplasty is a safe procedure. It is not associated with a higher incidence of surgical complications (CSF leak, wound infection, brain abscess, or subgaleal fluid collections), and it decreased surgical time by 31 minutes on average. There was also a hospital cost reduction of $420.00 USD (23.4% reduction) per procedure.Clinical trial registration no.: NCT02594137 (clinicaltrials.gov)


2021 ◽  
Vol 2 (1) ◽  
pp. 15-25
Author(s):  
Muhammad Anggun ◽  
Titik Kusumawinakhyu ◽  
Irma Finurina Mustikawati ◽  
Wiharto Wiharto

Hemodialysis is a routinely performed therapy on chronic kidney patients, leading to psychological problems among subjects who undergo hemodialysis, such as anxiety and depression. One of the efforts to overcome anxiety and depression is with the dhikr intervention. Dhikr presents hearts to remember and be obedient to Allah followed by the words and actions in various conditions.  Discover dhikr's influence on the level of anxiety and depression in patients on hemodialysis in  Purwokerto Islamic Hospital. It was a quantitative study using quasi experiment with a non-quivalent control group design. The number of samples was 12 subjects consisting of 6 subjects in the control group and six subjects in the intervention group with the purposive sampling technique. Instruments were used to measure anxiety and depression are the HADS ( Hospital Anxiety and Depression Scale ) before and after dhikr intervention as much as 12 times. Research is carried out in Hemodialysis Unit of  Purwokerto Islamic Hospital. Test statistics on research are used paired t-test and independent t-tests. This study showed a decrease in the mean level of anxiety from 5, 83 to 1.67 in the experimental group ( p = 0.003). The mean level of depression experienced a decline of 9, 67 becomes 4.67 on a group experiment ( p = 0.003). Dhikr reduces the level of anxiety and depression in hemodialysis patients at the Purwokerto Islamic Hospital.


2021 ◽  
pp. 109980042110502
Author(s):  
Zhan Liang ◽  
Hilary Yip ◽  
Kimberly Sena Moore ◽  
Tanira Ferreira ◽  
Ming Ji ◽  
...  

Objective The objective of this study was to evaluate effects of a self-managed music-guided exercise intervention on muscle strength among intensive care unit (ICU) survivors. Methods We used a two-arm randomized-controlled trial. Following ICU discharge, eligible participants were assigned to one of two groups: music group ( n = 13) or active control group ( n = 13). The music group was taught to self-manage upper and lower extremity exercise movements by listening to an individualized music-guided playlist twice daily for 5 days. The active control group was provided an exercise brochure and advised to perform the same exercises at the same intervals. Dynamometers were used to measure muscle strength. T-tests and Weighted GEE models were used for testing the intervention effect between groups. Results Twenty-six subjects were enrolled. The mean age was 62.8 ( SD = 13.8), 53.8% were male, 65.4% were Caucasian, and the mean APACHE severity of illness score was 59 ( SD = 23.4). Reasons for ICU admission were mainly cardiac and medical. The music group showed significant improvements in handgrip, plantar flexion, leg extension, elbow flexion, and shoulder adduction strengths on left and right sides. Additionally, left and right leg extensor and left plantar flexor strengths showed significant post-differences, and small to moderately large effect sizes, between the music group and control group. Conclusion These findings suggest that a music-guided exercise intervention has the potential to improve muscle strength in ICU survivors and prevent further post-ICU deterioration in ICU survivors. Future trials should build upon these preliminary findings.


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