Pain assessment behavioral scale in agonic cancer patients: Experience in total care—An end-of-life care home service.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e19636-e19636
Author(s):  
Maricarmen Alfaro ◽  
Raquel Baldeos ◽  
Beatriz Rosales ◽  
Maria Berenguel ◽  
Alfredo Aguilar
Keyword(s):  
Pain Score ◽  
Cancer Patients ◽  
Pain Assessment ◽  
Severe Pain ◽  
Care Home ◽  
Self Report ◽  
Moderate Pain ◽  
Primary Tumors ◽  
Mild Pain ◽  
Behavioral Scale

e19636 Background: Assessing pain in nonverbal, especially agonic cancer patients is a great challenge. In the absence of self-report, measurement of pain could be difficult and patient`s behavior could be useful. The aim of this work was to evaluate the Pain Assessment Behavioral Scale (PABS) in cancer agonic patients. Methods: PABS scale was used to evaluate 118 cancer patients enter in agony. Pain levels was categorized according to PABS score in Mild Pain (score 1-3), Moderate Pain (score 4-5), Severe Pain (score>6). We correlated levels of pain with age, sex, cancer metastatic site or active tumor localization with the ANOVA, Chi square or Fisher tests when were appropriated. A P<0.05 was considered significant. Results: Fifty two patients (44.1%) were male and 66 female (55.9%). The median age was 74 (Standar Deviation [SD]:13.1; Range: 30-94). Most frequent primary tumors were colorectal (16%), lung (11%), Pancreas (9.3%), Breast (8.5%), lymphomas (6.8%), prostate (6.8%) and gastric (5.6%) cancer. Involvement of primary active tumor or active metastases was present in lung (22%), Central Nervous System (CNS) (13.6%), liver (22%), and bone (7.6%). The median of PABS score was 5 (SD=1.25; range: 2 – 8). Seven cases had mild pain (5.9%), 105 moderate pain (89%) and 6 severe pain (5.1%). There was no correlation of pain levels with age (P=0.420), sex (P=0.098), active tumor or metastatic involvement of lung (P=0.321), CNS (P=0.972), Liver (P=0.575) or bone (P=0.529). Conclusions: In our experience, PABS scale is a useful tool to evaluate pain in agony cancer patients. We found no correlation between active tumor or metastatic localization with the intensity of pain.

AN AUDIT OF THE MANAGEMENT OF ACUTE PAIN IN CHILDREN

2016 ◽  
Vol 101 (9) ◽  
pp. e2.3-e2
Author(s):  
Junndeep Sidhu ◽  
Neil Tickner
Keyword(s):  
Pain Score ◽  
Respiratory Depression ◽  
Acute Pain ◽  
Pain Assessment ◽  
Clinical Management ◽  
Severe Pain ◽  
Opioid Analgesia ◽  
Moderate Pain ◽  
Strong Opioid ◽  
Pain Scores

AimTo evaluate clinical management of acute pain with respect to pain assessment, scoring and timing of analgesia and whether appropriate supportive medicines were prescribed alongside strong opiates. A previous pain audit found dosing of analgesia was appropriate but did not assess clinical management against pain scores. Our paediatric guideline does not currently stipulate guidance on appropriate time frames to administer analgesia and re-assess pain. Standards were developed with a multidisciplinary team to audit against.MethodsData were collected over two weeks on paediatric wards excluding intensive care and day surgery. Inclusion criteria: Pain score of ≥1 during admission, or clear documentation of pain prior to ward admission, and analgesia prescribed for the indication of pain relief. Pain assessment was audited based on recorded pain scores on observation charts. Analgesia prescribed and administered was audited from drug charts. Audit standards:(1) Following a pain score of ≥1 (out of 3), subsequent dosing and assessment of pain scores must be achieved in 80% of patients as follows:(a) Severe/worst pain (score 3): Should receive appropriate analgesia within 20 minutes of assessment and pain re-evaluated within 5-minute intervals for intravenous and intranasal route or within 30 minutes of receiving oral analgesia.(b) Mild/moderate pain (score 1–2): Should receive appropriate analgesia within 30 minutes of assessment and pain re-evaluated within 60 minutes of receiving analgesia.(2) 80% of patients prescribed regular analgesia should have their pain score assessed at least 4-hourly.(3) 90% of patients prescribed strong opioid analgesia should be co-prescribed naloxone prn for respiratory depression and pruritus/urinary retention.ResultsTwenty-five patients were audited. In total there were 59 severe pain scores and 92 mild/moderate. Observation charts allowed for documentation of pain scores at 15-minute intervals but only hourly recordings were observed throughout the audit period. 58% (34/59) and 30% (28/92) of pain scores indicating severe or mild/moderate pain respectively received analgesia in the same hour the pain score was recorded. In total there were 71 analgesia administrations for severe pain and 92 for mild/moderate pain. 52% (37/71) and 34% (31/92) of analgesia administrations after severe or mild/moderate pain scores respectively had a pain score re-assessed within 60 minutes.Eighteen patients were prescribed regular analgesia of whom 15 (83%) had pain assessed a minimum of every 4 hrs. Eleven patients were prescribed strong opioid analgesia, 45% of whom were not prescribed any naloxone, 27% had naloxone fully prescribed (pruritus and respiratory depression), and 27% had naloxone prescribed for respiratory depression alone.ConclusionDespite lack of guidance around timing of pain assessment and administration of drugs, pain scores were being recorded regularly and acted upon, although not within a structured time frame. Observation charts allowed for assessment of pain scores at 15-minute intervals but only ‘on the hour’ documentation were observed. Specific guidance around timing of analgesia administration and assessment will be introduced to the revised guideline with medical and nurse training sessions to standardise practice and improve management of pain, in addition to safe prescribing of opiates.

Frequency and severity of pain in hospitalized cancer patients at a tertiary cancer center.

2019 ◽  
Vol 37 (31_suppl) ◽  
pp. 103-103
Author(s):  
Shalini Dalal ◽  
Akhila Sunkepally Reddy ◽  
Joseph Anthony Arthur ◽  
Ali Haider ◽  
Rony Dev ◽  
...  
Keyword(s):  
Pain Score ◽  
Cancer Patients ◽  
Severe Pain ◽  
Significant Proportion ◽  
Moderate Pain ◽  
Early Management ◽  
Current Frequency ◽  
Significant Difference ◽  
Patients Experience ◽  
Hospital Days

103 Background: Recent regulations in response to the opioid crisis has presented unforeseen challenges in treating cancer patients with pain, such as frequent opioid shortages and clinicians moving away from prescribing opioids. This is especially concerning in cancer hospitals where a significant proportion of patients experience pain. Understanding the current frequency and severity of pain in hospitalized cancer patients are key hospital quality indicators, and will help in directing appropriate pain initiatives and resources. We aimed to determine the frequency, severity and changes in pain severity experienced by hospitalized cancer patients. Methods: The institutional electronic database was used to extrapolate pain scores for all cancer patients discharged over one year. The proportion of hospital-days with pain overall, on admission, and discharge is reported. A severe-pain day was a hospital-day with ≥ 1 severe pain score. A moderate-pain day was a non-severe pain day with ≥ 1 moderate pain score. Results: A total of 17097 unique patients accounted for 30056 hospital-days. Overall, the proportion of severe-, moderate-, mild-, and no pain-days was 29%, 23%, 10%, and 37% respectively. The monthly pain reports (Table) demonstrates no significant difference in pain frequency or severity over time. As compared to the first hospital-day, the proportion of severe pain days on discharge decreased from 33% to 16% (p <0.01) (Medical service 28% to 16%; Pediatrics 12% to 6%, Surgical 45% to 17%). Moderate- to-severe pain days decreased from 54% to 39% (p<0.01). Conclusions: A significant proportion of hospitalized cancer patients experience moderate-to-severe pain. Comprehensive assessment of the multiple dimensions of pain and strategies for early management are needed to reduce the number of moderate and severe pain days in the inpatient setting. [Table: see text]

Pain and Health-Related Quality of Life (HRQoL) in Patients with Relapsed and Plateau-Phase (PP) Multiple Myeloma (MM) Treated with Denosumab

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 2388-2388 ◽  
Author(s):  
Karen C Chung ◽  
Arie Barlev ◽  
Yi Qian ◽  
Susie Jun
Keyword(s):  
Severe Pain ◽  
Short Form ◽  
Human Monoclonal Antibody ◽  
Moderate Pain ◽  
Mild Pain ◽  
Osteoclast Activity ◽  
The Past ◽  
Hrqol Data ◽  
The Impact

Abstract BACKGROUND: MM is the second most common hematalogical malignancy in the U.S. The expansion of myeloma cells in bone, which is characteristic of MM, results in increased osteoclast activity that cause osteolytic lesions, which can lead to spinal cord compression, pathologic fracture, surgery or radiation therapy to bone, and bone pain. Denosumab is a fully human monoclonal antibody that can inhibit bone resorption by reducing the number and activity of osteoclasts by inhibiting RANK ligand, a key mediator of osteoclast activity. The objective of this analysis was to evaluate the pain and HRQoL in patients with MM being treated with denosumab. METHODS: 96 patients with either ≥2 prior treatment regimens and relapsed following a response to any conventional MM therapy (relapsed) or response to the most recent MM therapy and stable M-protein for ≥3 months (PP) were enrolled in a phase 2, multicenter, open-label, single-arm study of denosumab. Patients received 120mg denosumab SC on days 1, 8, 15, and 29 then every 28 days thereafter until disease progression or discontinuation. The Brief Pain Inventory-Short Form (BPI) and Functional Assessment of Cancer Therapy-General (FACT) were assessed at baseline (BL) and prior to treatment on day 1 of each 28-day cycle. BPI “pain at worst in the past 24 hours” scores were categorized as no pain (BPI 0), mild pain (BPI 1–4), moderate pain (BPI 5–6) or severe pain (BPI 7–10). BL and month 3 (relapsed) and month 5 (PP) pain and HRQoL data were analyzed. Longitudinal data regarding pain and HRQoL data were reported at BL and the latest assessment timepoint where &lt;30% of patients had dropped out. RESULTS: 45 patients with relapsed MM (Table 1) and 37 patients with PP MM (Table 2) had BL and ≥1 post-BL assessment. 30% or more patients dropped out after month 3 of treatment in relapsed patients and after month 5 in PP patients. In relapsed patients, 12 (27%), 21 (47%), 8 (18%), and 4 (9%) patients reported no pain, mild pain, moderate pain and severe pain at BL, respectively. In PP patients, 15 (41%), 13 (35%), 5 (14%), and 4 (11%) patients reported no pain, mild pain, moderate pain and severe pain at BL, respectively. 68% and 89% of relapsed and PP patients, respectively, demonstrated improvement or no categorical change in pain. At BL, mean (sd) FACT total scores (0–108, higher score indicating better HRQoL) for relapsed and PP patients were 77.4 (15.3) and 82.5 (11.2), respectively. FACT total scores remained relatively constant in relapsed and PP patients, 77.9 (19.4) and 83.6 (13.3), respectively. In addition, mean change from baseline in FACT domain scores varied between 1.2 to 0.2 in relapsed patients and between 0.3 to 1.1 in PP patients. CONCLUSION: The majority of patients with relapsed and PP MM demonstrated maintenance or improvement in pain and maintenance of HRQoL during treatment with denosumab. These results suggest denosumab may be associated with stabilization of pain and maintenance of HRQoL in patients with MM. Randomized trials are needed to further understand the impact of denosumab on pain and HRQoL in patients with MM. Table 1. “Pain at Worst in the past 24 hours” Category Shift between BL and month 3 in relapsed patients (n=45). Follow-up Pain Category No Pain Mild Moderate Severe TOTAL BL Pain Category No Pain 7 2 2 1 12 Mild 4 10 4 3 21 Moderate 2 3 1 2 8 Severe 0 0 2 2 4 TOTAL 13 15 9 8 45 Table 2. “Pain at Worst in the past 24 hours” Category Shift between BL and month 5 in PP patients (n=37). Follow-up Pain Category No Pain Mild Moderate Severe TOTAL BL Pain Category No Pain 13 2 0 0 15 Mild 4 7 1 1 13 Moderate 1 2 1 1 5 Severe 0 0 2 2 4 TOTAL 18 11 4 4 37

scholarly journals Effectiveness of Mobilizations along With Hot Therapy versus Mobilizations for Management of Chronic Neck Pain Due to Over Usage of Smart Phones among Young at LUMHS Jamshoro

2021 ◽  
pp. 57-62
Author(s):  
Jeetendar Valecha ◽  
Syed Mukhtar Ahmed ◽  
Tasghir Nabi ◽  
Mahesh Kumar Mugria ◽  
Siknader Ali Sangrasi ◽  
...  
Keyword(s):  
Neck Pain ◽  
Severe Pain ◽  
Chronic Neck Pain ◽  
Smart Phones ◽  
Moderate Pain ◽  
Mild Pain ◽  
Group A ◽  
Group B ◽  
Rehabilitation Sciences ◽  
Therapy Treatment

Objective: To determine the effectiveness of mobilizations along with hot therapy versus mobilizations for the management of chronic neck pain due to over usage of smart phones among young. Materials and Methods: This interventional clinical trial was conducted at OPD, Institute of Physiotherapy & Rehabilitation Sciences (IPRS) in Liaquat University Medical and Health Sciences Jamshoro (LUMHS). All the individuals from LUMHS Jamshoro including students, age 18-35 years and either of gender were included. All the individuals were divided in two groups (group A and group B). Cases of group A were underwent management of mobilization with hot therapy and cases of group B underwent only mobilization management. Outcome was observed in the terms of decrease the pain during work, reading and sleeping. All the data was recorded via study proforma. Results: Total 64 individuals were studied. Mean age was 26.2+4.2 years in group A and 28.6+5.3years. Males were in majority in both groups. According to the pain assessment on movement, mild pain was in 18.8%, moderate pain was 50.0%, severe pain was in 12.5% and very severe pain was in 18.85 of the patients of group A. However in group B most of the patients 93.8% had mild pain and 6.2% patients had severe pain, while no any patients with moderate pain and very severe pain was found in group B. After treatment pain was more decreased in patients of group A as pain during work, reading and sleeping was significantly higher in only mobilizations treatment group as compared to those underwent mobilizations with hot therapy treatment, p-values were quite significant. Conclusion: It was concluded that the treatment of mobilization with Hot pack was more effective than treatment only mobilization.

scholarly journals Frequency of plantar fasciitis due to improper shoes among different universities students

2021 ◽  
Vol 12 (1) ◽  
pp. 454-464
Author(s):  
Abdul wahid ◽  
Muhammad Arsalan Ali Sajid ◽  
Ambreen Muzaffar ◽  
Muhammad Zohaib Hussain
Keyword(s):  
Plantar Fasciitis ◽  
Severe Pain ◽  
Plantar Fascia ◽  
Cross Sectional Study ◽  
Moderate Pain ◽  
Cross Sectional ◽  
Mild Pain ◽  
Plantar Fasciopathy ◽  
Back Ground ◽  
Multiple Etiology

Back ground: study was conducted to determine the frequency of plantar fasciitis among three different universities students due to improper shoes. It was cross-sectional study. Plantar fasciitis is the inflammation of plantar fascia; plantar fascia is a thick connective tissue that forms the medial arch of foot. Improper shoes cause constant pressure and irritation on plantar fascia that leads to inflammation. When someone wears improper shoes, pronation activity of the foot decreased and it can lead to plantar fasciitis. Objective: The objective of study was to determine the frequency of plantar fasciitis due to improper shoes among three different universities students. Material and Methods: Study was cross-sectional and the data was collected from university students. Data was collected by using questionnaire and by applying statistical procedures results were concluded. Results: There were the following results in this study as, 35.5% participants without pain, 45% with mild pain, 16% with moderate pain and 3.6% with severe pain. There were 84% participants with single etiology, 13% participants with multiple etiology and 3% participants with nerve entrapment. There were 31 participants with no pain, 49 participants with mild pain, 11 participants with moderate pain and 2 participants with severe pain between ages 20-25 years. And between ages 26-30 there were 29 participants with no pain, 27 with mild pain, 16 with moderate pain and 4 participants with severe pain. Conclusion: Study concluded that 55.6% participants were between ages of 20-25 years. 54.4% participants were females, 59.2% participants were with no pain, 84% participants were with single etiology that is plantar fasciopathy. There were mostly participants suffered with mild pain and only 3.6% participants showed response with severe pain. There were mostly participants suffered with single etiology and the number of affected participants with plantar fasciitis slightly increased with age.

scholarly journals Analysis of Severe Pain and its Treatment in a Palliative Care Unit in a Regional Cancer Centre

2017 ◽  
Vol 7 (3) ◽  
pp. 103
Author(s):  
Kannan P ◽  
Gunaseelan K ◽  
Parthasarathy V
Keyword(s):  
Palliative Care ◽  
Cancer Pain ◽  
Pain Score ◽  
Cancer Patients ◽  
Severe Pain ◽  
Palliative Care Unit ◽  
Cancer Centre ◽  
Prevalence Of Pain ◽  
Regional Cancer Centre

<p><strong>Objective</strong>: Pain is one of the most common symptoms that troubles cancer patients and precludes satisfactory quality of life. Globally, nearly 80% of the cancer patients receive little or no pain medication and cancer pain is barely controlled. This study was done to analyse the prevalence of pain and pain treatment in patients presenting to palliative care unit in a regional cancer centre.</p><p><br /><strong>Methods</strong>: Palliative care registry and follow-up forms of 2142 patients who got registered in our palliative care unit were analysed to obtain the demographic details, treatment characteristics and to determine the prevalence of pain, its severity, and treatment in cancer patients in our regional cancer centre.</p><p><br /><strong>Results</strong>: Nearly 50% of the cancer population had head and neck and gastrointestinal tract malignancies and received only best supportive care. Stage IV disease was found in 40% of patients, and skeletal metastasis (52%) was most common. This study showed a 92.4% prevalence of cancer pain in our centre. About 40% of patients with pain had a pain score of 7-10 by Numerical rating scale on initial presentation to the palliative care unit. About 65% of the patients with severe pain had a response to treatment withmorphine during their first follow-up to palliative care unit after initial registration. The average overall pain score of the patients per visit decreased from around 7 to 4 at a median follow-up of ten months.</p><p><br /><strong>Significance of results</strong>: Thus, there is a high prevalence of pain in cancer patients and patients with severe pain receive little or no opioid medication at all probably due to the lack of adequate education and training to the primary oncologists and residents regarding prescription of strong opioids. This audit may help in the modification of existing and formulation of new policies in the delivery of palliative care.</p>

scholarly journals ARTHROSCOPIC TREATMENT FOR LATERAL EPICONDYLITIS: OUTCOMES IN 104 CASES OF A SINGLE INSTITUTION

2019 ◽  
Vol 27 (3) ◽  
pp. 156-159
Author(s):  
Alexandre Tadeu do Nascimento ◽  
Gustavo Kogake Claudio ◽  
Pedro Bellei Rocha ◽  
Juan Pablo Zumárraga ◽  
Olavo Pires de Camargo
Keyword(s):  
Severe Pain ◽  
Short Form ◽  
Arthroscopic Surgery ◽  
Case Series ◽  
Lateral Epicondylitis ◽  
Dash Score ◽  
Moderate Pain ◽  
Duration Of Symptoms ◽  
Mild Pain ◽  
Sf 36

ABSTRACT Objective: To evaluate the outcomes of patients that underwent arthroscopic surgery for lateral epicondylitis (LE), after failed conservative treatment. Methods: One hundred four patients with LE treated with arthroscopic debridement of the extensor carpi radialis brevis (ECRB) tendon were enrolled in this retrospective study. They were evaluated using Disabilities of the Arm, Shoulder and Hand (DASH) score, Visual Analogue Scale (VAS) and Short Form Health Survey (SF-36) scale. Mean age at surgery was 46.9 years. Duration of symptoms was 2.1 years (range: 6 m to 10 yrs.). Mean follow-up was 34.4 months (range: 6 to 68 m). Results: Mean postoperative scores were: 20.67 points on the DASH; 1.8 points on the VAS at rest, with 48 cases (46%) without pain, 40 (38%) with mild pain, 13 (13%) with moderate pain and 4 (4%) with severe pain; 4.7 points on the VAS in activity, with 21 (20%) without pain, 21 (20%) with mild pain, 35 (34%) with moderate pain and 27 (26%) with severe pain; and SF-36 was 66.8 points. Of the 23 patients who practiced sports regularly or with higher physical demand from the upper limbs, 17 (74%) were able to return to the same activity at the same level. No significant complications were observed postoperatively, except for 3 (2.8%) cases of postoperative superficial infection. Conclusion: Surgical treatment with arthroscopy for recalcitrant LE is effective and safe, presenting positive outcomes in the studied patients. Level of evidence IV, Case Series.

The Analgesic Effect of Magnetic Acupressure During Bone Marrow Aspiration and Biopsy Procedure in Cancer Patients: A Randomized, Blinded, Placebo Controlled Trial.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 71-71
Author(s):  
Ting Bao ◽  
Xiaobu Ye ◽  
Janice Skinner ◽  
Bing Cao ◽  
Joy Fisher ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Pain Score ◽  
Cancer Patients ◽  
Severe Pain ◽  
Conflicts Of Interest ◽  
Controlled Trial ◽  
Multivariate Logistic Regression Analysis ◽  
Bone Marrow Aspiration ◽  
Comprehensive Cancer Center ◽  
Data Collector

Abstract Abstract 71 Introduction: Bone marrow aspiration and biopsy (BMAB) is one of the most frequently performed and painful procedures in cancer patients. Magnetic acupressure has been used to reduce pain in patients in China. Our study was designed to study the efficacy of magnetic acupressure in reducing pain in cancer patients undergoing BMAB. Patients and Methods: Patients eligible for this IRB approved study had cancer, had a BMAB planned, and had not previously had acupuncture or acupressure. They were stratified by the number of prior BMAB they had experienced and randomly assigned to receive either magnetic acupressure at large intestine 4 point or at a non-acupuncture point (placebo) located in the proximal fourth interosseus space of the hand. All BMAB procedures were done by one operator (JS) and all acupressure was performed by one experienced operator (TB). All patients as well as the BMAB operator and data collector were blinded to treatment assignment. A visual analog score (VAS) was used to measure the patient's baseline pre-BMAB pain and the pain associated with the BMAB procedure. The acupressure operator was blinded to baseline pain scores and the pain associated with the BMAB by having the patient complete a form which was seen only by an independent data collector. The differences in VAS associated with the BMAB in the real versus placebo acupressure cohorts were compared to determine the analgesic efficacy of magnetic acupressure. Results: From 5/08 to 6/09, 77 cancer patients (47 male, 63 Caucasian, with a median age: 56 yrs, range: 21-80) undergoing BMAB at the Johns Hopkins Kimmel Sidney Comprehensive Cancer Center were enrolled in the study. Thirty-seven patients were randomized to the intervention arm and 40 to the control arm. Thirty-one patients (84%) in the intervention arm and 30 patients (75%) in the control arm had more than 1 BMAB prior to this study (p=0.34). Gender, analgesic or anxiolytic medications intake within 12 hours of BMAB and the pain score before BMAB were well balanced between two arms. The primary outcome was patient rated VAS pain score (0 to 10) during BMAB assessed after the procedure. Only one patient (2.7%) in the intervention arm experienced severe pain (VAS≥7) compared to 8 patients (20%) in the control arm (p=0.03, two- tailed Fisher's exact test). Using a multivariate logistic regression analysis to adjust for the number of BMAB patients had prior to this study, the odds of patients experiencing severe pain during BMAB procedure was 8.4 times (95% CI: 0.98-71.9) higher in the control arm versus the intervention arm. Forty-five percent of patients in each arm requested acupressure for future BMABs. No significant side effects or discomforts related to acupressure were reported by patients in either arm. Conclusions: These results suggest that magnetic acupressure significantly reduces the proportion of patients experiencing severe pain during BMAB. As acupressure requires minimal training and expense and was not associated with adverse events, it could be readily incorporated as a treatment option in this patient population. A larger, multi-centered, randomized, placebo controlled trial is planned to confirm these observations. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Efficacy of 10% Ichthammol Glycerine Pack and Steroid-antibiotic Pack for Relieving Pain in Acute Otitis Externa. A Comparative Study.

2019 ◽  
Vol 4 (1) ◽  
pp. 634-638
Author(s):  
Karuna Shrestha ◽  
Rajeev Shah ◽  
Srijana Sapkota
Keyword(s):  
Severe Pain ◽  
Otitis Externa ◽  
Combined Therapy ◽  
Treatment Modalities ◽  
Moderate Pain ◽  
Painful Condition ◽  
Female Ratio ◽  
Mild Pain ◽  
Number Of Patients ◽  
Antibiotic Ointment

Introduction: Otitis externa is a common painful condition presents with generalized infection of external auditory canal, typically reveals erythema and edema of the skin. Aural packing plays an important role in relieving the pain and edema. For packing, either we impregnated with 10% Ichthammol glycerine or steroid-antibiotic ointment. Objective: To compare the efficacy of 10% Ichthammol Glycerine pack with steroid-antibiotic ointment pack for relieving the pain in acute otitis externa. Methodology: A prospective, non-randomized clinical trial was carried out in 94 patients at Birat Medical College and Teaching Hospital, Biratnagar, Nepal from February 2018 to July 2018. Patients diagnosed with acute otitis externa were included in this study, where 47 patients were treated with 10% IG pack and remaining 47 patients treated with a combination steroid antibiotic ointment pack. Before aural packing was carried out, pain was assessed using visual analogue scale (VAS). Both groups of patients were evaluated after 48 hours for assessment of pain. Results: The total number of patients included in this study was 94. Among them 41 (43.6%) were male and 53(56.4%) were female where male and female ratio was 1:1.29. Majority of the patients were below 40 years (83%). Treatment with steroid-antibiotic ointment pack had significant reduction in pain after 48 hours post treatment, none of them had severe pain, 4(8.5%) had moderate pain remaining and 43(91.4%) had only mild pain. Whereas in patients treated with 10% IG pack 1(2.1%) had severe pain, 14(29.7%) had moderate pain and 32(68%) had mild pain. There was statistically significant decrease in pain with steroid-antibiotic pack. Conclusions: Both treatment modalities are effective but this study showed steroid-antibiotic ointment pack, the combined therapy is more effective than 10% IG pack for relieving the pain in acute otitis externa.

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