scholarly journals Evaluasi Kepatuhan Pelaksanaan Standar Prosedur Operasional Manajemen Nyeri pada Pasien Luka Bakar di RSUP Dr. Hasan Sadikin Bandung

2019 ◽  
Vol 7 (2) ◽  
pp. 92-99
Author(s):  
Yudhanarko Yudhanarko ◽  
Suwarman Suwarman ◽  
Ricky Aditya
Keyword(s):  
Pain Management ◽  
General Hospital ◽  
Pain Assessment ◽  
Rating Scale ◽  
Emotional Experience ◽  
Numeric Rating Scale ◽  
Pain Scale ◽  
Standard Operating ◽  
Numeric Rating

Nyeri didefinisikan sebagai pengalaman sensorik dan emosional yang tidak menyenangkan terkait dengan kerusakan jaringan aktual atau potensial. Manajemen nyeri pada luka bakar merupakan bagian yang tidak terpisahkan dari terapi luka bakar. Nyeri pada luka bakar merupakan nyeri akut, penanganan yang tidak baik akan menyebabkan komplikasi, salah satunya nyeri kronik. Rumah Sakit Umum Pusat (RSUP) Dr. Hasan Sadikin Bandung telah membuat Standar Prosedur Operasional (SPO) manajemen nyeri yang berguna untuk meningkatkan kepatuhan dalam pelaksanaan manajemen nyeri. Penelitian ini bertujuan mengevaluasi kesesuaian teknik pengkajian, tindak lanjut dan evaluasi ulang nyeri pada pasien luka bakar dengan SPO manajemen nyeri. Penelitian menggunakan metode deskriptif observasional retrospektif terhadap 99 rekam medis pasien luka bakar yang memenuhi kriteria inklusi di RSUP Dr. Hasan Sadikin Bandung pada tahun 2018. Hasil penelitian didapatkankan bahwa pengkajian nyeri yang dilakukan sesuai dengan SPO menggunakan numeric rating scale atau Wong Baker faces pain scale ditemukan pada 99 pasien (100%). Tindak lanjut hasil pengkajian nyeri luka bakar yang dilakukan sesuai dengan SPO sebanyak 71 pasien (72%). Evaluasi ulang setelah tindak lanjut pengkajian nyeri yang sesuai SPO pada 93 pasien (94%). Simpulan, pengkajian nyeri di RSUP Dr. Hasan Sadikin Bandung sudah sesuai dengan SPO manajemen nyeri, namun tindak lanjut dan evaluasi ulang pada nyeri luka bakar belum sesuai dengan SPO manajemen nyeri.Evaluation of Compliance to Standard Operating Procedures for Pain Management in Patients with Burns in Dr. Hasan Sadikin General Hospital BandungPain is defined as an unpleasant sensory and emotional experience related to actual or potential tissue damage. Pain management for burns is an integral part of burn therapy. Pain in burns is an acute pain and poor management will lead to health complications including chronic pain. Dr. Hasan Sadikin General Hospital Bandung has made a standard operating procedure (SOP) for pain management to improve compliance to pain management standard. This study aimed to evaluate the compliance to the standards in assessment techniques, follow-up, and re-evaluation of pain in patients with burn according to the applicable pain management SOP. This was a retrospective descriptive observational study on 99 medical records of burn patients who met the inclusion criteria in Dr. Hasan Sadikin General Hospital Bandung in 2018. The results of the study revealed that the pain assessment for these patient was carried out according to the SOP which refers to the use of a numeric rating scale or Wong Baker face pain scale in 99 patients (100%). In the follow-up, 71 were performed according to the SOP (72%) while the re-evaluation was performed in compliance with the SOP in 93 patients (94%). In conclusion, pain assessment in Dr. Hasan Sadikin General Hospital Bandung is performed in accordance with SOP on pain management but not all patients receive follow-up and re-evaluation of burn pain in accordance with the SOP on pain management. 

scholarly journals Pre-Hospital Pain Management in Children with Injuries: A Retrospective Cohort Study

2021 ◽  
Vol 10 (14) ◽  
pp. 3056
Author(s):  
Ada Holak ◽  
Michał Czapla ◽  
Marzena Zielińska
Keyword(s):  
Pain Management ◽  
Pain Intensity ◽  
Pain Assessment ◽  
Rating Scales ◽  
Rating Scale ◽  
Low Frequency ◽  
Numeric Rating Scale ◽  
Health Concern ◽  
School Age Children ◽  
Medical Teams

Background: The all-too-frequent failure to rate pain intensity, resulting in the lack of or inadequacy of pain management, has long ceased to be an exclusive problem of the young patient, becoming a major public health concern. This study aimed to evaluate the methods used for reducing post-traumatic pain in children and the frequency of use of such methods. Additionally, the methods of pain assessment and the frequency of their application in this age group were analysed. Methods: A retrospective analysis of 2452 medical records of emergency medical teams dispatched to injured children aged 0–18 years in the area around Warsaw (Poland). Results: Of all injured children, 1% (20 out of 2432) had their pain intensity rated, and the only tool used for this assessment was the numeric rating scale (NRS). Children with burns most frequently received a single analgesic drug or cooling (56.2%), whereas the least frequently used method was multimodal treatment combining pharmacotherapy and cooling (13.5%). Toddlers constituted the largest percentage of patients who were provided with cooling (12%). Immobilisation was most commonly used in adolescents (29%) and school-age children (n = 186; 24%). Conclusions: Low frequency of pain assessment emphasises the need to provide better training in the use of various pain rating scales and protocols. What is more, non-pharmacological methods (cooling and immobilisation) used for reducing pain in injured children still remain underutilized.

Differences in calculated percentage improvement versus patient-reported percentage improvement in pain scores: a review of spinal cord stimulation trials

2021 ◽  
pp. rapm-2020-102238
Author(s):  
Jonathan M Hagedorn ◽  
Timothy R Deer ◽  
Nicholas C Canzanello ◽  
Stephen M Covington ◽  
Darrell R Schroeder ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Stimulation ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
Pain Scale ◽  
Concordance Correlation ◽  
Percentage Improvement ◽  
Patient Reported ◽  
The Mean ◽  
Numeric Rating

IntroductionSpinal cord stimulation is frequently used for the treatment of intractable chronic pain conditions. Trialing of the spinal cord stimulator device is recommended to assess the patient’s response to neurostimulation before permanent implantation. The trial response is often assessed by Numeric Rating Scale changes and patient-reported percentage pain improvement. Using number rating scale changes between prespinal and postspinal cord stimulation trial, a calculated percentage pain improvement can be obtained. The aim of this study was to assess the difference between calculated and patient-reported percentage improvement in pain scale during spinal cord stimulation trials.MethodsThis study was a retrospective single center review of all spinal cord stimulation trials from January 1 2017 to July 1 2019. A total of 174 patients were included. The paired t-test was used to compare numeric pain scores obtained prestimulation versus poststimulation. The mean difference between methods (patient-reported minus calculated) was compared with zero using the 1-sample t-test. Lin’s concordance correlation coefficient was computed with a 95% CI, calculated using Fisher z-transformation; and a bootstrapping approach was used to compare the concordance correlation coefficient between groups. In all cases, two-tailed tests were used with p<0.05 considered statistically significant.ResultsBased on prestimulation and poststimulation numeric rating scale scores, the mean±SD calculated percentage improvement in pain scale was 54±28. The mean±SD patient-reported percentage improvement in pain scale was 59±25. The overall 95% limits of agreement for the two methods are −30% to +41%. The overall concordance correlation coefficient was 0.76 (95% CI 0.69 to 0.81).ConclusionAlthough the two methods are highly correlated, there is substantial lack of agreement between patient-reported and calculated percentage improvement in pain scale, suggesting that these measures should not be used interchangeably for spinal cord stimulator trial outcome assessment. This emphasizes the need for improved metrics to better measure patient response to neuromodulation therapies. Additionally, patient-reported percentage improvement in pain was found to be higher than calculated percentage improvement in pain, potentially highlighting the multidimensional experience of pain and the unpredictability of solely using Numeric Rating Scale scores to assess patient outcomes.

CYP2D6 Basic Genotyping of Patients with Chronic Pain Receiving Tramadol or Codeine. A Study in a Greek Cohort

Pain Medicine ◽  
2020 ◽  
Vol 21 (11) ◽  
pp. 3199-3204 ◽  
Author(s):  
Chrysanthi Batistaki ◽  
Eleni Chrona ◽  
Andreas Kostroglou ◽  
Georgia Kostopanagiotou ◽  
Maria Gazouli
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Adverse Effects ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
Cyp2d6 Genotype ◽  
Chronic Pain Patients ◽  
Reduction Of Pain ◽  
Pain Patients ◽  
Numeric Rating

Abstract Objective To assess CYP2D6 genotype prevalence in chronic pain patients treated with tramadol or codeine. Design Prospective cohort study. Setting General hospital, pain management unit. Subjects Patients with chronic pain, treated with codeine or tramadol. Methods Patients’ pain was assessed at baseline (numeric rating scale [NRS]; 0–10). Prescription of codeine or tramadol was selected randomly. The assessment of patients’ response to the drug in terms of pain relief and adverse effects was performed after 24 hours. Reduction of pain intensity of &gt;50% or an NRS &lt;4 was considered a positive response. Patients’ blood samples were collected during the first visit. Genotyping for the common variants CYP2D6 *2, *3, *4, *5, *6, *9, *10, *14, and *17 was performed, and alleles not carrying any polymorphic allele were classified as CYP2D6*1 (wild-type [wt]). Results Seventy-six consecutive patients were studied (20 males, 56 females), aged 21–85 years. Thirty-four received tramadol and 42 codeine. The main genotypes of CYP2D6 identified were the wt/wt (35.5%), the *4/wt (17.1%), and the *6/wt (10.5%). Adverse effects were common, especially in carriers of *9/*9, *5/*5, *5/*4, and *10/*10, as well as in variants including the 4 allele (*4/*1 [38.4%] and *4/*4 [42.8%]). Conclusions Genotyping can facilitate personalized pain management with opioids, as specific alleles are related to decreased efficacy and adverse effects.

CAN PATIENTS WITH SAGITTALLY WELL-COMPENSATED LUMBAR DEGENERATIVE KYPHOSIS BENEFIT FROM SURGICAL TREATMENT FOR INTRACTABLE BACK PAIN?

Neurosurgery ◽  
2009 ◽  
Vol 64 (1) ◽  
pp. 115-121 ◽  
Author(s):  
Jee-Soo Jang ◽  
Sang-Ho Lee ◽  
Jung Mok Kim ◽  
Jun-Hong Min ◽  
Kyung-Mi Han ◽  
...  
Keyword(s):  
Back Pain ◽  
Oswestry Disability Index ◽  
Lumbar Lordosis ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
Leg Pain ◽  
Compensatory Mechanisms ◽  
The Mean ◽  
Numeric Rating

Abstract OBJECTIVE To analyze pre- and postoperative x-rays of sagittal spines and to review the surgical results of 21 patients with lumbar degenerative kyphosis whose spines were sagittally well compensated by compensatory mechanisms but who continued to suffer from intractable back pain METHODS We performed a retrospective review of 21 patients treated with combined anterior and posterior spinal arthrodesis. Inclusion criteria were: lumbar degenerative kyphosis patients with intractable back pain and whose spines were sagittally well compensated by a compensatory mechanism, defined as a C7 plumb line to the posterior aspect of the L5–S1 disc of less than 5 cm. Outcome variables included: radiographic measures of preoperative, postoperative, and follow-up films; clinical assessment using the mean Numeric Rating Scale, Oswestry Disability Index, and Patient Satisfaction Index; and a review of postoperative complications. RESULTS All patients were female (mean age, 64.5 years; age range, 50–74 years). The mean preoperative sagittal imbalance was 19.5 (± 17.6) mm, which improved to −15.8 (± 22.2) mm after surgery. Mean lumbar lordosis was 13.2 degrees (± 15.3) before surgery and increased to 38.1 degrees (± 14.4) at follow-up (P &lt; 0.0001). Mean thoracic kyphosis was 5.5 degrees (± 10.2) before surgery and increased to 18.9 degrees (± 12.4) at follow-up (P &lt; 0.0001). Mean sacral slopes were 12.9 degrees (± 11.1) before surgery and increased to 26.3 degrees (± 9.6) at follow-up (P &lt; 0.0001). The mean Numeric Rating Scale score improved from 7.8 (back pain) and 8.1 (leg pain) before surgery to 3.0 (back pain) and 2.6 (leg pain) after surgery (P &lt; 0.0001). The mean Oswestry Disability Index scores improved from 56.2% before surgery to 36.7% after surgery (P &lt; 0.0001). In 18 (85.5%) of 21 patients, satisfactory outcomes were demonstrated by the time of the last follow-up assessment. CONCLUSION This study shows that even lumbar degenerative kyphosis patients with spines that are sagittally well compensated by compensatory mechanisms may suffer from intractable back pain and that these patients can be treated effectively by the restoration of lumbar lordosis.

scholarly journals Effectiveness of Ketoprofen Suppositoria as Preemptive Analgesia for Postoperative Pain in Patients Undergoing Elective Surgery with General Anesthesia

2020 ◽  
Vol 2 (1) ◽  
pp. 20
Author(s):  
Lupi Lestari ◽  
Elizeus Hanindito ◽  
Arie Utariani
Keyword(s):  
Pain Management ◽  
Side Effects ◽  
Postoperative Pain ◽  
General Anesthesia ◽  
Rating Scale ◽  
Postoperative Pain Management ◽  
Numeric Rating Scale ◽  
Preemptive Analgesia ◽  
Acute Postoperative Pain ◽  
Numeric Rating

Introduction: Effective postoperative pain management provides improved patient comfort and satisfaction, earlier mobilization, fewer pulmonary and cardiac complications, reduced risk deep vein thrombosis, fast recovery, and reduced cost of care. Preemptive analgesia, initiated before the surgical procedure to prevent pain in the early postoperative period, has the potential to be more effective than a similar analgesic treatment initiated after surgery. As a part of multimodal analgesia, the use of NSAIDs should always be considered for acute postoperative pain management. NSAIDs can be used preoperatively as a part of the preemptive regimen and for postoperative pain control to increase the efficacy of opioids and reduce its side effects. Material and Method: This research was experimental research with a case-control design of the study. The samples separated into two groups, the first group got ketoprofen suppository before the induction, and the second group didn’t get the ketoprofen suppository The intensity of pain measured with the Numeric Rating Scale (NRS) or Wong-Baker Faces Pain Scale was the variable studied at different postoperative times (30 min, 60 min, 120 min, 2-6 hours, 6-12 hours). The total amount of rescue analgesics (fentanyl) and side effects were other variables of this study. Result and Discussion: The result is ketoprofen suppository as preemptive analgesia administrations can reduce postoperative pain. Numeric Rating Scale was significantly lower in the ketoprofen group compared to the control group (p < 0,05) at 30 min, 60 min, 230 min, 2-6 hours, 6-12 hours. The number of postoperative analgesics needed in the recovery room was significant differences among both groups (p < 0,05). Conclusion: Preemptive analgesia in patients who underwent an operation with general anesthesia with ketoprofen suppository was effectively in blocking noxious stimuli and central sensitization, with subsequent prevention of acute postoperative pain.

scholarly journals Pengaruh Teknik Relaksasi Guided Imagery Music terhadap Intensitas Nyeri pada Klien Post Operasi Apendicitis di Ruang Rawat Inap Bedah Rspad Gatot Soebroto Ditkesad Jakarta Tahun 2015

2019 ◽  
Vol 2 (1) ◽  
pp. 1-14
Author(s):  
Astrid Astrid ◽  
Memed Sena Setiawan
Keyword(s):  
Guided Imagery ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
Pain Scale ◽  
T Test ◽  
Control Group ◽  
Random Assignment ◽  
Purposive Sampling ◽  
Post Test ◽  
Numeric Rating

Apendicitis adalah peradangan dari apendiks vermiformis yang menyebabkan usus berhenti mengeluarkan sisa makanan yang tidak diserap oleh tubuh sehingga dilakukan Apendictomy dimana terjadi nyeri akut pada level severe. Tujuan penelitian ini untuk mengetahui pengaruh teknik relaksasi Guided Imagery Music terhadap intensitas nyeri post operasi apendicitis di ruang rawat inap bedah RSPAD Gatot Soebroto Ditkesad Jakarta. Desain penelitian menggunakan purposive sampling dengan rancangan random assignment pre test-post test with control group. Jumlah sampel adalah 36 orang (18 orang kelompok kontrol dan 18 orang kelompok intervensi). Nyeri diukur dengan menggunakan Numeric Rating Scale (NRS) dan Faces Pain Scale Resived (FPSR). Uji statistik menggunakan uji T test independen. Hasil uji menunjukkan ada pengaruh teknik relaksasi Guided Imagery Music terhadap intensitas nyeri pada klien post operasi Apendicitis. Perbedaan rata-rata intensitas nyeri pada kelompok kontrol sebesar 1,55 dan pada kelompok intervensi sebesar 3,17. Variabel confounding telah dilakukan uji normalitas didapatkan hasil tidak ada hubungan usia, jenis kelamin, koping, individu pendukung, lingkungan, pengalaman nyeri sebelumnya terhadap intensitas nyeri, ini dikarenakan klien tidak mampu mengalihkan perhatian dari rasa nyeri yang hebat post operasi apendicitis, sehingga hasil statistik nya tidak perlu dilakukan transformasi. Teknik relaksasi Guided Imagery Music dapat digunakan sebagai intervensi mandiri keperawatan untuk mengurangi intensitas nyeri klien post operasi apendicitis. Kata Kunci: Guided Imagery Music, Klien Post Operasi Apendicitis, Intensitas Nyeri

scholarly journals THE DIFFERENCE OF PAIN SCALE USING NUMERIC RATING SCALE AND VISUAL ANALOG SCALE IN POST-OPERATIVE PATIENTS

2019 ◽  
Vol 7 (1) ◽  
pp. 52
Author(s):  
Natya Ayu Paluwih ◽  
Riama Marlyn Sihombing ◽  
Kinanthi Lebdawicaksaputri
Keyword(s):  
Pain Intensity ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
Pain Scale ◽  
Comparative Approach ◽  
Mild Pain ◽  
Post Operative Pain ◽  
Perceived Pain ◽  
The Difference ◽  
Numeric Rating

Post-operative pain is acute and subjective therefore the perceived pain intensity will be different. In one of the western Indonesia Hospitals in measuring the pain threshold using 2 tools namely Numeric Rating Scale and Wong Baker Face. Measurement of the pain intensity can be done with NRS and VAS scale. The objective of this research was to identify the difference of pain scale using the NRS and VAS scale in post-operative patients. The research method was descriptive quantitative using comparative approach. The study was conducted on 1 November 2017 – 12 December 2017.The population of the study are the post-operative patients at the In-Patient wards in a private hospital in Western Part of Indonesia. The samples were obtained using purposive sampling with n = 41. Research instrument consists of observation sheet using NRS and VAS scale. The results showed most respondents during the first eight hours using NRS scale had mild pain (80.5%); first 16 hours had light pain (63.4%); and had mild pain in the first 24 hours (85.4%). Using VAS scale, most of the respondents on the first eight hours has mild pain (87.8%); first 16 hours has mild pain (68.3%); and has mild pain in the first 24 hours (87.8%). The conclusion of this study is there is no difference in pain scale of post-operative patients using VAS scale and NRS scale. So, hospitals can also use the VAS scale to assess pain scale in post-operative patients.

scholarly journals NUMERIC RATING SCALE ANALYSIS OF TRIGEMINAL NEURALGIA PATIENTS BEFORE AND AFTER MICROVASCULAR DECOMPRESSION

2021 ◽  
Vol 7 (1) ◽  
pp. 17-19
Author(s):  
Elena Ghentilis Fitri Amelia ◽  
Agus Turchan ◽  
Nancy Margarita Rehatta ◽  
Hanik Badriyah Hidayati
Keyword(s):  
Trigeminal Neuralgia ◽  
General Hospital ◽  
Microvascular Decompression ◽  
Facial Pain ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
Facial Reduction ◽  
Normality Test ◽  
Before And After ◽  
Numeric Rating

Background: Trigeminal Neuralgia is a common condition of facial pain and its significantly affect patients’ daily life. Microvascular decompression is one of the interventional pain management for trigeminal neuralgia. There is still a little data obtained on evaluation of facial pain after microvascular decompression in Indonesia. Objective: This research aimed to evaluate facial pain after microvascular decompression of trigeminal neuralgia patients in Dr. Soetomo General Hospital, PHC Hospital, and Bangil General Hospital, Indonesia. Methods: The research design was a pretest-posttest with total sampling. Data were obtained from medical records from January 2018 until June 2019. Researches used Numeric Rating Scale (NRS) as pain measurement. The data obtained were analyzed by descriptive statistical test, normality test, and paired t-test. Results: Trigeminal Neuralgia patients that has been treated with microvascular decompression have an average facial reduction from 7.33±2.29 to 1.89±3.41 with p = 0.001. This result showed that the microvascular decompression has significantly reduce facial pain in patients with trigeminal neuralgia. Conclusion: Microvascular decompression significantly reduce the facial pain of trigeminal neuralgia patients.

scholarly journals Influence of activation protocol on perceived pain during rapid maxillary expansion

2015 ◽  
Vol 85 (6) ◽  
pp. 1015-1020 ◽  
Author(s):  
Alberto Baldini ◽  
Alessandro Nota ◽  
Claudia Santariello ◽  
Valentina Assi ◽  
Fabiana Ballanti ◽  
...  
Keyword(s):  
Rating Scale ◽  
Skeletal Maturity ◽  
Numeric Rating Scale ◽  
Pain Scale ◽  
Rapid Maxillary Expansion ◽  
Maxillary Expansion ◽  
Perceived Pain ◽  
Group 2 ◽  
And Gender ◽  
Numeric Rating

ABSTRACT Objective:  To investigate the influence of two different activation protocols on the timing and intensity of pain during rapid maxillary expansion (RME). Materials and Methods:  A total of 112 prepubertal patients (54 males and 58 females, mean age 11.00 ± 1.80 years) with constricted maxillary arches underwent RME with two different activation protocols (group 1: one activation/day; group 2: two activations/day). Patients were provided with a numeric rating scale (NRS) and the Faces Pain Scale (FPS) to correctly assess their daily pain. Results:  Subjects treated with RME at two activations/day reported statistically significantly greater amounts of pain than subjects treated with RME at one activation/day. Differences related to gender and skeletal maturity were found. Conclusion:  The choice of activation protocol influences the perceived pain during RME, and less daily expansion is correlated to less pain. Pain reported during RME could be influenced by skeletal maturity and gender of the subjects under treatment.

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