Intranasal sufentanil compared with a classic protocol for acute pain management in an emergency department: A prospective sequential study

Trauma ◽  
2021 ◽  
pp. 146040862110324
Author(s):  
Bernard Kreps ◽  
Stefano Malinverni ◽  
Emma Carles ◽  
Magali Bartiaux ◽  
Pierre Youatou Towo
Keyword(s):  
Emergency Department ◽  
Side Effects ◽  
Pain Relief ◽  
Pain Intensity ◽  
Acute Pain ◽  
Visceral Pain ◽  
Intervention Group ◽  
Control Group ◽  
Sequential Study ◽  
Significant Difference

Introduction Pain is a frequent complaint in the emergency department and should be measured and treated according to the existing protocols. The intranasal route offers several advantages over the oral or intravenous routes. The aim of the study was to evaluate the efficacy and safety of intranasal sufentanil as the primary opioid for acute pain in the emergency department. Materials and methods This was a prospective open-label sequential study in patients who presented to the emergency department with severe non-visceral pain. The control group was treated according to the current standard of care including oral or intravenous opioids whereas the intervention group was treated according to a modified protocol, including intranasal sufentanil as the only opioid. Pain intensity was measured at different time points. The occurrence of side effects, the placement of intravenous lines and the need for additional analgesia were also recorded. Results Pain intensity in the two groups was not comparable at baseline (8.5; IQR 8–10 in the intervention group vs 7.9; IQR 7–9.4 in the control group; p = .026). However, the median reduction of the pain score was significantly larger in the intervention group compared to the control group after 15 minutes (2.5; IQR 1.2 – 4 vs 1.6; IQR 1–2.4; p = .005) and after 30 min (4; IQR 3–5.7 vs 3.1; IQR 2–4.4; p = .02). No significant difference in pain scores between the two groups was observed after 60 min from baseline. Conclusions Patients receiving intranasal sufentanil for severe pain achieved better pain relief at 15 min and 30 min compared to those receiving standard care. Vertigo, nausea, vomiting and diaphoresis were side effects more frequently observed in the sufentanil group. No differences in pain relief were observed after 30 and 60 min from baseline.

Investigation the Effects of Adding Intravenous Transoxalic Acid and Its Complications in the Prevention of Postpartum Hemorrhage after Vaginal Delivery in Patients Admitted to Ali-ibn-Abitaleb Hospital in Zahedan

2021 ◽  
Author(s):  
Tahereh Hajian ◽  
Maryam Razavi ◽  
Ali Dashipour
Keyword(s):  
Side Effects ◽  
Postpartum Hemorrhage ◽  
Intervention Group ◽  
Vital Signs ◽  
Control Group ◽  
Drug Side Effects ◽  
Blood Samples ◽  
Significant Difference ◽  
The Mean ◽  
Uterine Fundus

Background: This study was designed to investigate the effect of tranexamic acid and its side effects in preventing postpartum hemorrhage in patients referred to Ali ibn Abitaleb Hospital in Zahedan during 2020-2021. Methods: Patients were divided into two groups of 85 patients. Vital signs as well as drug side effects related to tranexamicity are monitored and recorded every15 minutes in the first hour and every 30 minutes in the second hour. Also, blood samples are taken from patients to measure hemoglobin and hematocrit within6 hours after delivery. The number and weight difference of droschitis used during 2 hours after delivery are also measured. In addition, PPH (Postpartum hemorrhage) cases in both groups were checked by repeated examination of the uterine fundus during the first 2 hours and after 6 weeks. Results: There was no statistically significant difference between the two groups in terms of the number of deliveries and further decrease in hemoglobin levels in the control group compared to the intervention group. Nausea, vomiting, and dizziness were observed in the intervention group and thrombosis was not observed in any group. According to the independent samples t-test, there was a statistically significant difference between the mean blood volume lost between the two groups. The mean hematocrit drop was statistically significant between the two groups. No blood transfusion was observed in any of the patients. Conclusion: Tranxamic acid injections can effectively reduce postpartum hemorrhage and reduce maternal hemoglobin and hematocrit following this complication.

scholarly journals Pengaruh Relaksasi Aromaterapi Jasmine terhadap Kualitas Tidur pada Lansia di Karang Werdha

2018 ◽  
Vol 6 (3) ◽  
pp. 461
Author(s):  
Mahda Febriyanti Eka Pertiwi Putri ◽  
Murtaqib Murtaqib ◽  
Mulia Hakam
Keyword(s):  
Side Effects ◽  
Intervention Group ◽  
The Elderly ◽  
Average Score ◽  
Control Group ◽  
P Value ◽  
Control Group Design ◽  
Sleeping Pills ◽  
Significant Difference ◽  
Negative Side Effects

During the quality of sleep the elderly is good, some changes that will occur to the elderly arenormal as well, but if not, it will cause health problems. This research aims to analyze theeffect of jasmine aromatherapy relaxation on sleeping quality to the elderly at elderlyassociation in Jenggawah Jember. This research used quasy experimental design methodwith pre-post test and control group design. Sleeping quality was measured using a PSQIquestionnaire and interventions which were given for 28 days. The result of dependent t testshowed no significant difference on the average score of control group (p value = 1,000).While in the intervention group there was a decrease in the mean score of PSQI after beinggiven jasmine aromatherapy relaxation, so that there was a significant difference in sleepingquality of the intervention group (p value = 0,001). Independent t tests showed significantdifferences between the control group and the intervention group after jasmine aromatherapyrelaxation (p value = 0,001). Overall, jasmine aromatherapy relaxation can improve sleepingquality in the elderly, so that jasmine aromatherapy relaxation may be used as an alternativenon-pharmacological treatment which has no adverse side effects compared to the use oflong-term sleeping pills that would give negative side effects to its users. Keywords: aromatherapy, sleeping quality, elderly.

The Effect of Olive Oil and Honey Combination on Episiotomy Wound Healing and Pain Relief: A Randomized Clinical Trial

2020 ◽  
Vol 16 (2) ◽  
pp. 145-151
Author(s):  
Arezoo Shayan ◽  
Hadis Sourinezhad ◽  
Fariba Barzegar ◽  
Hassan Ahmadinia ◽  
Zahra Masoumi ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Wound Healing ◽  
Pain Relief ◽  
Pain Intensity ◽  
Olive Oil ◽  
Randomized Clinical Trial ◽  
Intervention Group ◽  
Perineal Pain ◽  
Control Group ◽  
Primiparous Women

Background: Episiotomy is one of the most common surgical procedures in the world that is associated with perineal pain and can be exposed to infection, or might be healed with delay. Objective: The aim of this study was to investigate the effects of honey-olive oil combination on episiotomy wound healing and pain relief in primiparous women. Methods: This single-blind, parallel randomized clinical trial (IRCT20120215009014N208) was conducted on 80 primiparous women. They were allocated randomly to each of the groups through random allocation rule: 40 in honey-olive oil group and 40 in the control group. Every 12 hours and for 14 days, the treatment group used about 1 inch of the cream on the wound area. Pain intensity and wound healing were measured by REEDA Scale and Visual Analogue Scale on days 7, 10, and 14 in both groups. The statistical analyst was not informed about the allocation of the groups. A significant level of 0.05 was considered. Results: There was a significant difference between healing score and pain intensity between the two groups on 7th, 10th and 14th postpartum days (p <0.05). Wound healing occurred much faster (Scores on days 7,10, and 14 were 11.25±2.13, 7.47±1.96 and 4.95±1.53 in the control group and 4.45±1.25, 2.32±.69 and 10±.30 in the intervention group, p <0.05). Moreover, pain intensity was significantly relieved in those who used Honey and olive oil cream (the scores were 5.6750±1.43, 3.3500±1.52, 2.2250±1.34 in the control group and 1.9750±1.52, .2250±.57, .0250±.15 in the intervention group, p<0.05). Conclusion: Using honey and olive oil combination improves episiotomy wound healing and also relieves its’ associated pain.

scholarly journals Does Nursery-Based Intensified Anticipatory Guidance Reduce Emergency Department Use for Nonurgent Conditions in the First Month of Life? A Randomized Controlled Trial

2016 ◽  
Vol 2016 ◽  
pp. 1-6
Author(s):  
Kelly Kamimura-Nishimura ◽  
Vikram Chaudhary ◽  
Folake Olaosebikan ◽  
Maryam Azizi ◽  
Sneha Galiveeti ◽  
...  
Keyword(s):  
Emergency Department ◽  
Controlled Trial ◽  
Intervention Group ◽  
Newborn Care ◽  
Secondary Outcome ◽  
Control Group ◽  
Anticipatory Guidance ◽  
Guidance Program ◽  
Significant Difference ◽  
The Impact

Objective.We aimed to evaluate the impact of an intensified anticipatory guidance program in the nursery on Emergency Department (ED) use for nonurgent conditions (NUCs) in the neonatal period.Methods. Parturient mothers of healthy newborns were randomized to an intervention group or control group. Baseline and 1-month follow-up knowledge surveys regarding newborn care were conducted. The primary outcome was the proportion of neonates who used the ED for a NUC. Secondary outcome was change in caregivers’ knowledge on NUC.Results. Of a total of 594 mothers, 323 (54%) agreed to participate and were randomized to intervention (n=170) or control (n=153) group. Most were Hispanic (68%), single (61%), primiparous (39%), and without high school diploma (44%). 35 (21%) neonates in the intervention group and 41 (27%) in the control group were brought at least once for a NUC to the ED (p=0.12). There was no statistically significant difference in within subject change on knowledge scores between the two study arms.Conclusions. Neonatal ED visits for NUCs occur frequently. This nursery-based intensified anticipatory guidance program had no statistically significant impact on neonatal ED use for NUC, nor on neonatal care-relevant knowledge among parturient mothers. Alternative modalities and timing of parental educational intervention may need to be considered. This trial is registered with Clinical Trials NumberNCT01859065(Clinicaltrials.gov).

scholarly journals Evaluating lubiprostone for effective bowel preparation before colonoscopy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yasser Hamada ◽  
Ibrahim Emam ◽  
Rabab Maher ◽  
Hassan El-Garem
Keyword(s):  
Single Dose ◽  
Side Effects ◽  
Bowel Preparation ◽  
Intervention Group ◽  
The Other ◽  
Current Evidence ◽  
Control Group ◽  
Significant Difference ◽  
Colon Preparation ◽  
Scale 8

Abstract Background Colon preparation is a fundamental step for performing a successful colonoscopy. We aimed to evaluate the effectiveness of administering lubiprostone (LB) added to a single dose of oral polyethylene glycol (PEG) solution in achieving satisfactory colon cleanliness and decreasing the side effects. Results One-hundred percent of the control group patients reported that the experienced taste was worse than expected, while in the intervention group half of the patients (50%) said that the taste was natural and 48% experienced taste worse than expected (p<0.0001). Regarding Boston bowel preparation scale (BBPS), there was a significant difference in the overall Boston scale (p=0.02) with more efficacy in the intervention group as 66% of patients in the intervention group had good bowel preparation (5–7) and 24% excellent preparation (8–9). On the other hand, the overall Boston scale in the control group showed that 54% of patients were between 5 and 7, and only 16% of patients had overall Boston scale 8–9. In terms of the side effects of the preparation in both arms, the majority of cases in the intervention arm did not complain of any side effects (78%), while the majority of the complaints were vomiting in 16% of the intervention cases. Conclusion The current evidence suggested that adding LB to the colon preparation significantly improved the tolerability and efficacy.

scholarly journals LO52: Distraction in the ED using Virtual reality for Intravenous Needs in Children to Improve comfort- DEVINCI - a pilot RCT

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S26-S26
Author(s):  
E. D. Trottier ◽  
E. Osmanlliu ◽  
B. Bailey ◽  
M. Lagacé ◽  
M. Certain ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Side Effects ◽  
Standard Care ◽  
Psychological Intervention ◽  
Intervention Group ◽  
Procedural Pain ◽  
Control Group ◽  
Group Standard ◽  
Memory Of Pain ◽  
Significant Difference

Introduction: Venipuncture is a frequent cause of pain and distress in the pediatric emergency department (ED). Distraction, which can improve patient experience, remains the most studied psychological intervention. Virtual reality (VR) is a method of immersive distraction that can contribute to the multi-modal management of procedural pain and distress. Methods: The main objectives of this study were to determine the feasibility and acceptability of Virtual Reality (VR) distraction for pain management associated with venipunctures and to examine its preliminary effects on pain and distress in the pediatric ED. Children 7-17 years requiring a venipuncture in the pediatric ED were recruited. Participants were randomized to either a control group (standard care) or intervention group (standard of care + VR). Principal clinical outcome was the mean level of procedural pain, measured by the verbal numerical rating scale (VNRS). Distress was also measured using the Child Fear Scale (CFS) and the Procedure Behavior Check List (PBCL) and memory of pain using the VNRS. Side effects were documented. Results: A total of 63 patients were recruited. Results showed feasibility and acceptability of VR in the PED and overall high satisfaction levels (79% recruitment rate of eligible families, 90% rate of VR game completion, and overall high mean satisfaction levels). There was a significantly higher level of satisfaction among healthcare providers in the intervention group, and 93% of those were willing to use this technology again for the same procedure. Regarding clinical outcomes, no significant difference was observed between groups on procedural pain. Distress evaluated by proxy (10/40 vs 13.2/40, p = 0.007) and memory of pain at 24 hours (2.4 vs 4.2, p = 0.027) were significantly lower in the VR group. Venipuncture was successful on first attempt in 23/31 patients (74%) in the VR group and 15/30 (50%) patients in the control group (p = 0.039). Five of the 31 patients (16%) in the VR group reported side effects Conclusion: The addition of VR to standard care is feasible and acceptable for pain and distress management during venipunctures in the pediatric ED. There was no difference in self-reported procedural pain between groups. Levels of procedural distress and memory of pain at 24 hours were lower in the VR group.

scholarly journals The Effects of Transcutaneous Electrical Nerve Stimulation on Post-Episiotomy Pain Severity in Primiparous Women: A Randomized, Controlled, Placebo Clinical Trial

2019 ◽  
Vol 8 ◽  
pp. 1404
Author(s):  
Seyedeh Soma Zakariaee ◽  
Roonak Shahoei ◽  
Leila Hashemi Nosab ◽  
Ghobad Moradi ◽  
Mina Farshbaf
Keyword(s):  
Clinical Trial ◽  
Pain Relief ◽  
Transcutaneous Electrical Nerve Stimulation ◽  
Intervention Group ◽  
Pain Severity ◽  
Control Group ◽  
Electrical Nerve Stimulation ◽  
Significant Difference ◽  
The Mean ◽  
Primiparous Women

Background: Episiotomy or cutting the perineum is the most common operation in obstetrics. Perineal pain is the main complication of episiotomy that affects the quality of life and mental health of the mother. Reducing the pain and side effects of the chemical drugs prescribed for pain relief has attracted the attention of both physicians and scientists. This study was conducted to determine the effects of transcutaneous electrical nerve stimulation (TENS), as an alternative method, on post-episiotomy pain severity. Materials and Methods: This randomized clinical trial was performed on 120 primiparous women who had referred to Sanandaj Besat Hospital in 2018. The patients were divided randomly into three groups, including the intervention group (TENS-On), the placebo group (TENS-Off), and the control group. TENS electrodes were placed near the episiotomy site in genitofemoral and pudendal nerves. The pain was measured after episiotomy in lying, sitting, and activity positions. The pain severity was measured using a pain measurement instrument (numeral rating score) at four-time points, i.e., before the intervention as well as 30, 60, and 120 minutes after the TENS intervention. For data analysis, Pearson correlation, student’s t-test, Kruskal-Wallis test, ANOVA test, and Mann-Whitney U tests were used. Results: Intragroup evaluation results for placebo and control groups demonstrated no significant difference in the pain score (P>0.05). A significant difference was observed between the mean pain severity of the intervention group and that of the group with walking activities (P=0.04). In terms of the intergroup evaluation, there was a significant difference observed between the mean pain severity of the lying position and that of the control group (P=0.008). Regarding the sitting position, no significant difference was observed between its mean pain severity and that of the other two groups (P=0.04). Conclusion: TENS is an effective and safe method for post-episiotomy pain relief and a routine method used in the obstetrics and gynecology ward. [GMJ.2019;8:e1404]

scholarly journals Is there an alternative to diclofenac i/m injections for rapid relief of severe pain? Results of randomized controlled and partially blind forsage study

2020 ◽  
Vol 58 (4) ◽  
pp. 387-394
Author(s):  
A. E. Karateev ◽  
E. Yu. Pogozheva ◽  
E. S. Filatova ◽  
A. M. Lila ◽  
V. N. Amirdjanova ◽  
...  
Keyword(s):  
Pain Relief ◽  
Pain Intensity ◽  
Acute Pain ◽  
Analgesic Effect ◽  
Rapid Onset ◽  
Significant Pain ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1 ◽  
New Onset

Diclofenac Potassium sachets (DPS) is a new faster-absorption and rapid onset of pain relief drug dosage form of Diclofenac with high analgesic potential.Objective. To assess efficacy and safety of Diclofenac sachets and intramuscular injections in relieving acute pain in patients with rheumatic diseases (RDs).Materials and methods: The study group included 30 RD patients, 53.3% females and 46.7% males, mean age 41.8 ± 10.7 years, with severe acute pain (≥7 cm VAS pain rating, VAS 0-10 cm). After signing informed consent patients were randomized into DPS 50 mg t.i.d. and Diclofenac 75 mg i/m b.i.d. The first administration of Diclofenac was blind, i.e., patients from both groups were also administered placebo – either placebo injection in Group 1 randomized to sachet or placebo sachet in Group 2. The study lasted for 3 days. Level of analgesia was assessed in 15, 30, 60, 120, 180 minutes after the first administration, then three times a day during two following days and in the morning on day 4. Serum levels of CRP, IL-6 and P substance biomarkers were also monitored.Results. Pain relief in Group 1 was documented already in 15 min after administration – from 8.1±0.8 to 5.7±1.7 cm VAS (р=0.012), with continuing increase of analgesic effect thereafter. Group 2 demonstrated significant pain relief in 1 hour after Diclofenac administration – from 7.6±0.7 to 4.5±1.9 cm VAS (р=0.04). Based on obtained data analgesic effect was more powerful in Group 1 vs Group 2 in 15 and 30 minutes after drug administration (р=0.019; р=0.037). Starting from the 3rd hour post-administration there was no statistically significant difference in pain intensity between the two groups. Final assessment in the morning on day 4 showed significant pain reduction by 4.5±2.6 cm VAS in Group 1 vs baseline, and by 3.6±1.4 cm VAS in Group 2 (p=0.545). Functional improvement in both groups reached 3.7±1.9 and 3.3±1.3 cm VAS, respectively (p=0.837). The results were rated as “good” and “excellent” by 77.0% in Group 1, and 61.5% – in Group 2 (р=0.302). No correlation between decreasing pain intensity and fluctuating CRP, IL-6, and substance P concentrations was established. Three patients from Group 1 reported new-onset dyspepsia, resulting in discontinuation of treatment in 2 of them. Similarly, 2 discontinuations occurred in 2 patients with new-onset dyspepsia in Group 2, plus one additional withdrawal due to gastric ulcer and elevated blood pressure.Conclusion. DPS is not inferior to i/m Diclofenac injections in terms of analgesic potential and rapid onset of pain relief. Oral intake is associated with fewer adverse reactions compared to i/m injections. 

scholarly journals The efficacy and safety of silymarin in the treatment of chemotherapy-induced peripheral neuropathy, a randomized double-blinded clinical trial

2021 ◽  
Author(s):  
Ramin Shekarriz ◽  
Hojjat Ghorbani ◽  
Mahmoud Mousazadeh ◽  
Khatereh Vahedi ◽  
Ebrahim Salehifar
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Intervention Group ◽  
Gastrointestinal Symptoms ◽  
Treated Group ◽  
Control Group ◽  
Significant Difference ◽  
Eortc Qlq ◽  
Double Blinded

Aim: The aim of this study was to evaluate the efficacy and side effects of silymarin in the treatment of CIPN. Methods: Patients who referred to outpatient oncology department of a referral educational hospital affiliated to Mazandaran University of Medical Sciences and experienced CIPN were randomized to receive silymarin or placebo. Intervention group received 140 mg of the Silymarin twice daily accompanied and 300 mg/day Gabapentin, whereas control group received 300 mg/day of Gabapentin and placebo twice daily for 3 months. The grade of neuropathy was determined according to the CTCAE criterion. The improvement of neuropathy was defined as the reduction of at least one neuropathic score. The visual analogue scale (VAS) was used to assess the severity of patients’ pain and the EORTC-QLQ-C30 criterion was used to assess the quality of life. Patients were evaluated initially and at the follow up visit 3 months after the enrollment. Results: A total of 80 patients were enrolled in the study. There was no significant difference between the groups in terms of severity of neuropathy at baseline. At the end of the study, the number of people with improved neuropathy in the silymarin group was 82.8% patients, which was significantly higher than 48.4% observed in the patients received placebo (P= 0.005). The silymarin-treated group showed a significant reduction in pain compared with those receiving placebo. Despite the improvement in quality of life in the intervention group compared to the comparison group, this difference was not statistically significant. Gastrointestinal symptoms were the only reported side effects with a similar incidence in two groups. Conclusion: The present data demonstrate the potential clinical use of silymarin as an adjuvant therapy to reduce CIPN symptoms.

scholarly journals Effect of Progressive Muscle Relaxation on Sleep Quality and Side Effects of Chemotherapy in Children with Cancer: Randomized Clinical Trial

2021 ◽  
Vol 9 (T4) ◽  
pp. 300-308
Author(s):  
Erna Sulistyawati ◽  
Allenidekania Allenidekania ◽  
Dewi Gayatri
Keyword(s):  
Clinical Trial ◽  
Side Effects ◽  
Sleep Quality ◽  
Randomized Clinical Trial ◽  
Muscle Relaxation ◽  
Intervention Group ◽  
Progressive Muscle Relaxation ◽  
Control Group ◽  
Children With Cancer ◽  
Significant Difference

BACKGROUND: Sleep disturbance affects quality of life in children receiving chemotherapy. AIM: The aim of this study was to identify the effect of progressive muscle relaxation on the sleep quality and side effects of chemotherapy in children with cancer. METHODS: This study used randomized clinical trial with single blind method, where 30 children were allocated randomly to the control group and intervention group. The intervention group received progressive muscle relaxation twice a day, in the morning and evening, 15 minutes each session for 7 days. Control group received routine nursing care. RESULTS: The study concluded there was no significant difference in the two groups on fatigue and pain. However, progressive muscle relaxation had significant relation to decreased sleep quality score. CONCLUSION: Relaxation therapy, particularly progressive muscle relaxation, may be one of the nursing cares to improve sleep quality and reduce the side effects of chemotherapy in children with cancer.

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