scholarly journals The effectiveness of Patient Controlled Analgesia (PCA) morphine-ketamine compared to Patient Controlled Analgesia (PCA) morphine to reduce total dose of morphine and Visual Analog Scale (VAS) in postoperative laparotomy surgery

2017 ◽  
Vol 1 (2) ◽  
pp. 31
Author(s):  
PandeNyoman Kurniasari ◽  
IGusti Ngurah Mahaalit Aribawa ◽  
TjokordaGde Agung Senapathi ◽  
Made Wiryana ◽  
IKetut Sinardja ◽  
...  
Keyword(s):  
Total Dose ◽  
Visual Analog Scale ◽  
Patient Controlled Analgesia ◽  
Analog Scale

The Visual Analog Scale for Pain

2001 ◽  
Vol 95 (6) ◽  
pp. 1356-1361 ◽  
Author(s):  
Carol A. Bodian ◽  
Gordon Freedman ◽  
Sabera Hossain ◽  
James B. Eisenkraft ◽  
Yaakov Beilin
Keyword(s):  
Visual Analog Scale ◽  
Outcome Measure ◽  
Patient Controlled Analgesia ◽  
Analog Scale ◽  
Full Spectrum ◽  
Vas Score ◽  
Vas Scores ◽  
Relevant Outcome ◽  
Apparent Influence ◽  
Research Studies

Background The visual analog scale is widely used in research studies, but its connection with clinical experience outside the research setting and the best way to administer the VAS forms are not well established. This study defines changes in dosing of intravenous patient-controlled analgesia as a clinically relevant outcome and compares it with VAS measures of postoperative pain. Methods Visual analog scale measurements were obtained from 150 patients on the morning after intraabdominal surgery. On the same afternoon, 50 of the patients provided a VAS score on the same form used in the morning, 50 on a new form, and 50 were not asked for a second VAS measurement. Results Visual analog scale values and changes in value were similar for patients who were given a new VAS form in the afternoon and those who used the form that showed the morning value. The proportions of patients requesting additional analgesia were 4, 43, and 80%, corresponding to afternoon VAS scores of 30 or less, 31-70, and greater than 70, respectively. Change from morning VAS score had no apparent influence on patient-controlled analgesic dosing for patients with afternoon values of 30 or less or greater than 70, but changes in VAS scores of at least 10 did discriminate among patients whose afternoon values were between 31 and 70. Conclusions When pain is an outcome measure in research studies, grouping final VAS scores into a small number of categories provides greater clinical relevance for comparisons than using the full spectrum of measured values or changes in value. Seeing an earlier VAS form has no apparent influence on later values.

scholarly journals Μετεγχειρητική αναλγησία σε επεμβάσεις ολικής αρθροπλαστικής ισχίου

2011 ◽  
Author(s):  
Ηλίας Κανελλόπουλος
Keyword(s):  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Visual Analog Scale ◽  
Patient Controlled Analgesia ◽  
Analog Scale

Σκοπός: Η επισκληρίδιος και η ελεγχόμενη από τον ασθενή ενδοφλέβια αναλγησία (patient-controlled analgesia, PCA) είναι καθιερωμένες μέθοδοι για την αντιμετώπιση του άλγους μετά από ολική αρθροπλαστική ισχίου (ΟΑΙ). Η περιαρθρική διήθηση είναι μια εναλλακτική μέθοδος ελέγχου του άλγους που κερδίζει έδαφος λόγω της απλότητας της και, ενδεχομένως, των λιγότερων ανεπιθύμητων ενέργειών της. Η μελέτη μας έχει ως στόχο να αξιολογήσει την αποτελεσματικότητα και ασφάλεια της περιαρθρικής διήθησης στην αντιμετώπιση του άλγους μετά από ΟΑΙ. Υλικό και Μέθοδοι: Εξήντα τρεις ασθενείς που υποβλήθηκαν σε ΟΑΙ με ραχιαία αναισθησία επιλέχθηκαν τυχαία να λάβουν μετεγχειρητική αναλγησία με συνεχή επισκληρίδιο έγχυση με ροπιβακαΐνη (ομάδα επισκληριδίου), ή με διεγχειρητική περιαρθρική διήθηση με ροπιβακαΐνη, κλονιδίνη, μορφίνη, επινεφρίνη και κορτικοστεροειδή (ομάδα διήθησης) ή με PCA με μορφίνη (ομάδα PCA). PCA με μορφίνη χορηγήθηκε ως αναλγησία διάσωσης σε όλες τις ομάδες. Καταγράψαμε την κατανάλωση μορφίνης και εκτιμήσαμε την ένταση του πόνου σε ηρεμία και κίνηση χρησιμοποιώντας την οπτική αναλογική κλίμακα (visual analog scale, VAS), την απώλεια αίματος από την παροχέτευση του τραύματος και τη μέση αρτηριακή πίεση (mean arterial pressure, MAP) 1, 6, 12 και 24 ώρες μετεγχειρητικά. Αποτελέσματα: Η χρήση της περιαρθρικής διήθησης απέφερε σημαντική μείωση στην κατανάλωση μορφίνης σε σύγκριση με την ομάδα PCA και παρόμοια κατανάλωση με την ομάδα επισκληριδίου. Αυτό συνοδεύτηκε από σημαντική μείωση της έντασης του πόνου σε κατάσταση ηρεμίας στις 6, 12 και 24 ώρες και σε κίνηση στις 6 και 12 ώρες μετεγχειρητικά σε σύγκριση με την ομάδα PCA. Δεν υπήρχε καμία διαφορά στις ανεπιθύμητες ενέργειες μεταξύ των τριών ομάδων. Στις 24 ώρες μετεγχειρητικά η MAP ήταν υψηλότερη στην ομάδα PCA (p <0,05) και η απώλεια αίματος ήταν χαμηλότερη στην ομάδα διήθησης (p <0,05).Συμπεράσματα: Η περιαρθρική διήθηση στη μελέτη μας παρείχε καλύτερη αναλγησία από την PCA με μορφίνη μετά από ΟΑΙ και μείωσε την κατανάλωση οπιοειδών μετεγχειρητικά, ενώ δεν εμφανίστηκε κάποια ανεπιθύμητη ενέργεια από τη χρήση της. Η διήθηση φαίνεται να είναι εξίσου αποτελεσματική με την επισκληρίδιο αναλγησία.

scholarly journals Does Postoperative Delirium Limit the Use of Patient-controlled Analgesia in Older Surgical Patients?

2009 ◽  
Vol 111 (3) ◽  
pp. 625-631 ◽  
Author(s):  
Jacqueline M. Leung ◽  
Laura P. Sands ◽  
Sudeshna Paul ◽  
Tim Joseph ◽  
Sakura Kinjo ◽  
...  
Keyword(s):  
Structural Equation Model ◽  
Visual Analog Scale ◽  
Structural Equation ◽  
Postoperative Delirium ◽  
Assessment Method ◽  
Equation Model ◽  
Opioid Use ◽  
Patient Controlled Analgesia ◽  
Analog Scale ◽  
Scale Scores

Unlabelled BACKGROUNDPostoperative pain Is an independent predictor of postoperative delirium. Whether postoperative delirium limits patient-controlled analgesia (PCA) use has not been determined. Methods The authors conducted a nested cohort study in older patients undergoing noncardiac surgery and used PCA for postoperative analgesia. Delirium was measured by using the Confusion Assessment Method. The authors computed a structural equation model to determine the effects of pain and opioid consumption on delirium status and the effect of delirium on opioid use. Results Of 335 patients, 108 (32.2%) developed delirium on postoperative day (POD) 1, and 120 (35.8%) on POD 2. Postoperative delirium did not limit the use of PCA. Patients with postoperative delirium used more PCA in a 24-h period (POD 2) compared to those without delirium (mean dose of hydromorphone +/- SE adjusted for covariates was 2.24 +/- 0.71 mg vs. 1.25 +/- 0.67 mg, P = 0.02). Despite more opioid use, patients with delirium reported higher Visual Analogue Scale scores than those without delirium (POD 1: mean visual analog scale +/- SE at rest 4.2 +/- 0.23 vs. 3.3 +/- 0.22, P = 0.0051; POD 2: 3.3 +/- 0.23 vs. 2.5 +/- 0.19, P = 0.004). Path coefficients from structural equation model revealed that pain and opioid use affect delirium status, but delirium does not affect subsequent opioid dose. Conclusions Postoperative delirium did not limit PCA use. Despite more opioid use, visual analog scale scores were higher in patients with delirium. Future studies on delirium should consider the role of pain and pain management as potential etiologic factors.

Preemptive Analgesic Effects of Ketorolac in Ankle Fracture Surgery

2001 ◽  
Vol 94 (4) ◽  
pp. 599-603 ◽  
Author(s):  
Peter H. Norman ◽  
M. Denise Daley ◽  
Ronald W. Lindsey
Keyword(s):  
Postoperative Pain ◽  
Visual Analog Scale ◽  
Ankle Fracture ◽  
Postoperative Bleeding ◽  
Patient Controlled Analgesia ◽  
Analog Scale ◽  
Analgesic Effects ◽  
Intergroup Comparison ◽  
Fracture Surgery ◽  
Tourniquet Inflation

Background Preemptive analgesia has been difficult to show in human experiments. If ketorolac has preemptive effects, then there may be an advantage to administering it at the beginning of surgery despite the potential for increased blood loss. Methods The authors performed a randomized, double-blind, controlled trial of 48 patients scheduled for ankle fracture surgery in a county trauma hospital. Anesthesia management was standardized and included adequate opioid analgesia (5 microg/kg fentanyl and 0.1 mg/kg morphine). Intravenous 30 mg ketorolac was administered to 23 patients before tourniquet inflation and to 25 patients after tourniquet inflation. Visual analog scale pain scores, morphine patient-controlled analgesia consumption, nausea-vomiting, and postoperative bleeding were measured. Results The 23 patients given ketorolac before tourniquet inflation had no increase in pain postoperatively compared with their preoperative baseline (P = 0.280). The 25 patients who received ketorolac minutes later after tourniquet inflation had significant increases in their postoperative pain compared with their preoperative baseline (P = 0.00116). This effect was short-lived, and by 6 h the pain score in this group was not significantly more than it was preoperatively. Intergroup comparison showed a lower visual analog scale score at 2 (P = 0.0203) and 4 h (P = 0.00549) in the preemptive group and lower nausea scores at hour 6 (P = 0.00704). There was no difference in patient-controlled analgesia consumption between groups. Conclusions Intravenous 30 mg ketorolac appears to have preemptive analgesic effects in patients undergoing ankle fracture repair. Ketorolac administered before tourniquet inflation prevents postoperative pain being perceived as more intense than preoperative pain.

Dreierkombination (Thomapyrin®) ist wirksamer bei Kopfschmerzen als Monosubstanzen und Zweierkombination

2005 ◽  
Vol 24 (07) ◽  
pp. 626-639 ◽  
Author(s):  
V. Pfaffenrath ◽  
L. Pageler ◽  
H. Peil ◽  
B. Aicher ◽  
H. C. Diener
Keyword(s):  
Pain Intensity ◽  
Visual Analog Scale ◽  
A Priori ◽  
Intensity Difference ◽  
Visuelle Analogskala ◽  
Analog Scale ◽  
Pain Intensity Difference

ZusammenfassungDie Wirksamkeit, Sicherheit und Verträglichkeit einer Einzelgabe von zwei Tabletten der fixen Dreierkombination mit 250 mg Azetylsalizylsäure (ASS) plus 200 mg Paracetamol plus 50 mg Koffein (Thomapyrin®) gegenüber zwei Tabletten mit 500 mg ASS, oder zwei Tabletten mit 500 mg Paracetamol, oder zwei Tabletten mit 50 mg Koffein beziehungsweise Plazebo wurde in einer klinischen Studie an 1 743 Patienten geprüft, die ihre episodischen Kopfschmerzen vom Spannungstyp oder ihre Migräne mit und ohne Aura üblicherweise erfolgreich mit verschreibungsfreien Analgetika behandeln. Die Dreierkombination war im a priori definierten primären Endpunkt “Zeit bis zu 50% Schmerzreduktion” sowohl der Zweierkombination aus ASS plus Paracetamol (p = 0,0181), als auch den Monoanalgetika ASS (p = 0,0398) und Paracetamol (p = 0,0016), sowie auch der Monotherapie mit Koffein (p < 0,0001) und Plazebo (p < 0,0001) überlegen. Alle Behandlungen außer der Koffein-Monotherapie waren der Plazebobehandlung überlegen (p < 0,0001). Die überlegene Wirksamkeit der Dreierkombination gilt auch für alle sekundären Endpunkte wie beispielsweise der “Verringerung der Kopfschmerzen auf 10 mm VAS (visual analog scale = visuelle Analogskala zur Schmerzmessung), dem gewichteten % SPID (sum of pain intensity difference = aufsummierte Schmerzintensitätsdifferenz gegenüber dem Ausgangsschmerz in Prozent), dem Ausmaß der Beeinträchtigung der alltäglichen Aktivitäten und der globalen Beurteilung der Wirksamkeit durch die Patienten. Alle Behandlungen waren gut verträglich, die Inzidenz von unerwünschten Begleiterscheinungen war gering.

Perceived Tension, Movement, and Pleasantness in Harmonic Musical Intervals and Noises

2020 ◽  
Vol 37 (4) ◽  
pp. 298-322 ◽  
Author(s):  
Marco Costa ◽  
Mattia Nese
Keyword(s):  
Visual Analog Scale ◽  
Energy Content ◽  
High Pitch ◽  
Analog Scale ◽  
Psychophysical Procedure ◽  
Preliminary Study

Perceived valence, tension, and movement of harmonic musical intervals (from the unison to the octave presented in a low- and high-register) and standard noises (brown, pink, white, blue, purple) were assessed in two studies that differed in the crossmodal procedure by which tension and movement were rated: proprioceptive device or visual analog scale. Valence was evaluated in both studies with the visual analog scale. In a preliminary study, the proprioceptive device was calibrated with a psychophysical procedure. Roughness of the stimuli was included as covariate. Tension was perceived higher in dissonant intervals and in intervals presented in the high register. The higher the high-pitch energy content in the standard noise, the higher the perceived tension. The visual analog scale resulted in higher tension ratings than the proprioceptive device. Perception of movement was higher in dissonant intervals, in intervals in the high register, and in standard noises than in musical intervals. High-pitch spectrum noises were associated with more sense of movement than low-pitch spectrum noises. Consonant intervals and low-register intervals were evaluated as more pleasant than dissonant and high-register intervals. High-pitch spectrum purple and blue noises were evaluated as more unpleasant than low-pitch spectrum noises.

scholarly journals Management of cubital tunnel syndrome by anterior trans-muscular transposition of the ulnar nerve

2019 ◽  
Vol 34 (1) ◽  
Author(s):  
Ahmed Shawky Ammar ◽  
Mohamed Ahmed El Tabl ◽  
Dalia Salah Saif
Keyword(s):  
Clinical Outcome ◽  
Ulnar Nerve ◽  
Visual Analog Scale ◽  
Electrophysiological Study ◽  
Cubital Tunnel Syndrome ◽  
Nerve Entrapment ◽  
Cubital Tunnel ◽  
Analog Scale ◽  
Tunnel Syndrome ◽  
Dash Questionnaire

Abstract Background Various surgical options are used for the treatment of ulnar nerve entrapment at the elbow. In this study, anterior trans-muscular transposition of the ulnar nerve was used for the treatment of cubital tunnel syndrome. Objectives To evaluate the surgical results of anterior trans-muscular transposition technique for the treatment of cubital tunnel syndrome with particular emphasis on clinical outcome. Methods Forty patients with cubital tunnel syndrome were operated using anterior trans-muscular transposition technique. Patients were classified into post-operative clinical outcome grades according to the Wilson & Krout criteria, and they were followed up by visual analog scale (VAS), the Disability of Arm Shoulder and Hand (DASH) questionnaire, electrophysiological study, and post-operative clinical evaluation. Results Forty patients with cubital tunnel syndrome who underwent anterior trans-muscular transposition of the ulnar nerve show a significant clinical improvement at 24 months post-surgery regarding visual analog scale (VAS), the Disability of Arm Shoulder and Hand (DASH) questionnaire, electrophysiological study, and the Wilson & Krout grading as 87.5% of the patients recorded excellent and good outcome. Conclusion Anterior transmuscular transposition of the ulnar nerve is a safe and effective treatment for ulnar nerve entrapment at the elbow.

Treating traumatic thoracolumbar spine fractures using minimally invasive percutaneous stabilization plus balloon kyphoplasty: a 102-patient series

2021 ◽  
pp. neurintsurg-2020-017238
Author(s):  
Henri Salle ◽  
Alexandre Meynard ◽  
Emilie Auditeau ◽  
Clément Gantois ◽  
Aymeric Rouchaud ◽  
...  
Keyword(s):  
Visual Analog Scale ◽  
Open Surgery ◽  
Body Height ◽  
Thoracolumbar Spine ◽  
Visual Analog Scale Score ◽  
Posterior Wall ◽  
Balloon Kyphoplasty ◽  
Expected Improvement ◽  
Thoracolumbar Fractures ◽  
Analog Scale

BackgroundThere is no consensus on the treatment for spinal injuries resulting in thoracolumbar fractures without neurological impairment. Many trauma centers are opting for open surgery rather than a neurointerventional approach combining posterior percutaneous short fixation (PPSF) plus balloon kyphoplasty (BK).ObjectiveTo assess the safety and efficacy of PPSF+BK and to estimate the expected improvement by clarifying the factors that influence improvement.MethodsWe retrospectively reviewed patients who underwent PPSF+BK for the treatment of single traumatic thoracolumbar fractures from 2007 to 2019. Kyphosis, loss of vertebral body height (VBH), clinical and functional outcomes including visual analog scale and Oswestry disability index were assessed. We examined the overall effects in all patients by constructing a linear statistical model, and then examined whether efficacy was dependent on the characteristics of the patients or the fractures.ResultsA total of 102 patients were included. No patient experienced neurological worsening or wound infections. The average rates of change were 74.4% (95% CI 72.6% to 76.1%) for kyphosis and 85.5% (95% CI 84.4% to 86.6%) for VBH (both p<0.0001). The kyphosis treatment was more effective on Magerl A3 and B2 fractures than on those classified as A2.3, as well as for fractures with slight posterior wall protrusion on the spinal canal. A higher postoperative visual analog scale score was predictive of poorer outcome at 1 year.ConclusionsThis is the largest series reported to date and confirms and validates this surgical treatment. All patients exhibited improved kyphosis and restoration of VBH. We advise opting for this technique rather than open surgery.

scholarly journals Sublingual immunotherapy increases Treg/Th17 ratio in allergic rhinitis

Open Medicine ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. 826-832
Author(s):  
Jiarong Wang ◽  
Liansheng Qiu ◽  
Yimin Chen ◽  
Minyun Chen
Keyword(s):  
T Cells ◽  
Allergic Rhinitis ◽  
Retrospective Study ◽  
Regulatory T Cells ◽  
Visual Analog Scale ◽  
Peripheral Blood ◽  
Sublingual Immunotherapy ◽  
Analog Scale ◽  
Vas Score ◽  
Medication Score

Abstract Background Few studies investigated the effects of sublingual immunotherapy (SLIT) on the peripheral regulatory T cells (Tregs)/Th17 ratio. Objective To investigate the effectiveness of SLIT in children with allergic rhinitis (AR) and the effects on the Tregs/Th17 ratio. Methods This was a retrospective study of children who were treated for AR between April 2017 and March 2018 at one hospital. The patients were grouped according to the treatments they received: SLIT + pharmacotherapy vs pharmacotherapy alone. Results Eighty children (51 boys and 29 girls; 40/group) were included. The visual analog scale (VAS) and medication scores at 1 year in the SLIT + pharmacotherapy group were 2.70 ± 1.08 and 1.1 ± 0.8, respectively, which were lower than at baseline (7.7 ± 1.2 and 3.6 ± 1.0, respectively) (both Ps < 0.05). For the pharmacotherapy group, the VAS score was decreased at 1 year vs baseline (3.3 ± 1.2 vs 7.4 ± 1.0; P < 0.05), but the medication score did not change (P > 0.05). In the SLIT + pharmacotherapy group, the Treg percentage increased, while the Th17 percentage decreased at 1 year (both Ps < 0.01). The percentages of Tregs and Th17s did not change in the pharmacotherapy group (both Ps > 0.05). Conclusions SLIT + pharmacotherapy can increase the Treg percentage and decrease the Th17 percentage in the peripheral blood of children with AR.

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