Effect of Premedication with Anti-inflammatory Drugs on Post-Endodontic Pain: A Randomized Clinical Trial

Abstract In spite of advances in root canal therapy and better knowledge of pulpal and periapical inflammation, up 40% of endodontic patients report varying degrees of pain. The aim of this present study was to compare the effect of single preoperative dose of ibuprofen or dexamethasone on post-endodontic pain. Sixty volunteers were divided into three groups (n=20 per group): PL, placebo; IB, 400 mg of ibuprofen; and DE, 8 mg of dexamethasone. The primary outcome was the post-endodontic pain intensity measured with a numerical rating scale (4, 8, 12, 24, and 48 h). Secondary outcomes included number of anesthetic cartridges used and consumption of rescue medication. Data were analyzed by one-way ANOVA, chi-square and Kruskal-Wallis tests. There was no significant difference among groups (p>0.05) considering the pain intensity. Only 37% of IB group patients and 28% of DE group patients used some rescue medication. On the other hand, 74% of PL group patients mentioned the consumption of rescue medication; PL group had a statistically significant difference (p<0.05) in comparison with IB and DE groups. The number of anesthetic cartridges used had no statistically significant difference among the groups (p>0.05). Significant differences were not found in the reduction of pain intensity and the number of anesthetic cartridges used. Considering the consumption of rescue medication (secondary outcome), preoperative administration of Ibuprofen or dexamethasone reduces post-endodontic pain and discomfort in comparison with a placebo. Premedication with anti-inflammatory drugs drugs could be contributed to control of the post-endodontic pain, mainly in patients more sensible for pain.

Download Full-text

Comparison of honey and phenytoin (PHT) cream effects on intensity of pain and episiotomy wound healing in nulliparous women

Journal of Complementary and Integrative Medicine ◽

10.1515/jcim-2016-0139 ◽

2017 ◽

Vol 15 (1) ◽

Cited By ~ 6

Author(s):

Mohadesseh Lavaf ◽

Masoumeh Simbar ◽

Faraz Mojab ◽

Hamid Alavi Majd ◽

Mansoureh Samimi

Keyword(s):

Wound Healing ◽

Pain Intensity ◽

Rating Scale ◽

Numerical Rating Scale ◽

Nulliparous Women ◽

Significant Difference ◽

Numerical Rating ◽

Healing Score ◽

Double Blinded ◽

Better Than

AbstractBackgroundThis study investigates and compares the effect of phenytoin and honey cream on intensity of pain and episiotomy wound healing in nulliparous women.MethodsThis research was conducted by double-blinded randomized clinical trial method on 120 nulliparous women in three groups of phenytoin, honey and placebo. After delivery and episiotomy, mothers used a knuckle of the prescribed creams on their episiotomy area, every night until 10-night. Evaluation of wound healing using REEDA scale and pain intensity with numerical rating scale of pain took place within the first 24 h and after 7 and 14 days of delivery.ResultsResults showed significant differences between healing scores of the three groups for the seventh day after delivery. Healing score in the honey group was lower than that in placebo group. On the fourteenth day after delivery, the healing scores showed no significant differences between the three groups. Measuring pain intensity did not show any significant difference in the three groups after 7 and 14 days of delivery.ConclusionsBoth honey and phenytoin led to episiotomy wound healing; however, honey caused the wound healing better than the phenytoin. Honey and phenytoin did not reduce episiotomy pain.

Download Full-text

The effects of a novel pilates exercise prescription method on people with non-specific unilateral musculoskeletal pain: a randomised pilot trial

Proceedings of Singapore Healthcare ◽

10.1177/2010105816644265 ◽

2016 ◽

Vol 25 (4) ◽

pp. 201-206

Author(s):

Augustine Joshua Devasahayam ◽

Doreen Ren Yan Ho ◽

Elsa Yee Sum Leung ◽

Ming Rong Goh ◽

Patricia Koh

Keyword(s):

Musculoskeletal Pain ◽

Rating Scale ◽

Exercise Prescription ◽

Numerical Rating Scale ◽

Pilot Trial ◽

Neuromuscular Control ◽

Secondary Outcome ◽

Patient Specific ◽

Control Group ◽

Numerical Rating

Background: Pain alters the neuromuscular activation and results in altered movement adaptations. A new exercise prescription method proposes that we can restore the neuromuscular control by rehabilitating the deficient neural drive through Pilates exercises. This is done by identifying the postural control deficits using single-leg tests such as hopping, half squats and heel raises. The aim of this study was to find out if this method of prescribing exercises results in clinically relevant outcomes. Methods: Fifteen patients with chronic non-specific low back pain with unilateral musculoskeletal pain were recruited. Following consent, all patients were randomly assigned either to perform gym or Pilates-based individualised exercises once weekly for six weeks. The primary outcome was to measure the pain intensity using a 0–10 numerical rating scale. The secondary outcome measures were: the global perceived effect scale (GPE; 0–10), the patient-specific functional scale (PSFS; the patient-generated measure of disability) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC; the condition-specific measure of disability). Results: There were statistically significant differences noted after intervention within the control group in the numerical rating scale ( P=0.041), GPE ( P=0.024), PSFS ( P=0.039) and within the experimental group in the WOMAC ( P=0.008), GPE ( P=0.007) and PSFS ( P=0.007). However, as there were clinically significant baseline differences, the within-group difference could be due to regression to the mean. There were no statistically significant results between the two groups after intervention. Conclusion: This new prescription method for Pilates-based exercises may improve disability and global perception of recovery. However, the outcomes are not different from a regular gym-based exercise programme.

Download Full-text

Effect of warm footbath with vibration on arteriovenous fistula puncture-related pain in hemodialysis patients

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20170165 ◽

2017 ◽

Vol 5 (2) ◽

pp. 631

Author(s):

Zahra Abbas Ali Madadi ◽

Jalil Azimian ◽

Farzaneh Falahatpishe ◽

Mahmoud Alipour Heidari

Keyword(s):

Pain Intensity ◽

Arteriovenous Fistula ◽

Rating Scale ◽

Control Method ◽

Numerical Rating Scale ◽

Simple Random Sampling ◽

Hemodialysis Patients ◽

Numerical Rating ◽

Rating Scale Data ◽

Frequent Hemodialysis

Background: Pain and stress of hemodialysis are experienced by more than 50% of patients who are suffering from renal disease; hence decreasing a part of these adverse effects can be effective on individual’s long term coping with hemodialysis. The current study was done to determine the effect of warm footbath with vibration on arteriovenous fistula puncture-related pain in hemodialysis patients.Methods: This clinical trial was conducted on 31 hemodialysis patients in 2014. The patients were selected by simple random sampling method and placed in one group. First, the pain intensity of all patients was measured in the six frequent hemodialysis sessions without any intervention (control method). After two weeks, the intervention of warm footbath with vibration was done on all patients and the pain intensity was measured for six frequent hemodialysis sessions (intervention method). The patients were received 40±2 °C footbath with vibration by foot massage spa machine for ten minutes; then, fistula needles were placed and the pain intensity was assessed by using a numerical rating scale. Data were analyzed by ANOVA and T test.Results: The study group had contained 20 males (64.5%), 11 females (35.5%), with an average age of 44.16±14.85 and a range of 18 to 65 years old, which shows that the pain intensity of the warm footbath with vibration method was lower than the control method (P< 0.05).Conclusions: Warm footbath with vibration can be used as an effective palliative method to reduce pain of hemodialysis patients.

Download Full-text

Sedation in the post-anaesthesia care unit

Acta medica Lituanica ◽

10.6001/actamedica.v19i3.2448 ◽

2012 ◽

Vol 19 (3) ◽

pp. 195-200

Author(s):

Andrius Macas ◽

Lina Andriuškevičiūtė ◽

Jūratė Paltanavičiūtė ◽

Ieva Slauzgalvytė

Keyword(s):

Rating Scale ◽

Numerical Rating Scale ◽

Quality Of Sleep ◽

Post Anaesthesia Care Unit ◽

Activity Assessment ◽

Anaesthetic Care ◽

Significant Difference ◽

Numerical Rating ◽

Anaesthesia Care

Background. Post-anaesthetic sedation is a common practice as it pro vides greater comfort and psychological stability for patients. Some spe cialists claim that sedation in the post-anaesthetic care unit (PACU) is applied too seldom due to several reasons. The goal of this study is to evaluate sedation in PACU in several aspects. Materials and methods. A total of 299 patients admitted to the PACU after general, orthopedic-traumatologic or urologic surgical procedures were enrolled in this prospective study. The patients evaluated their qual ity of sleep and the worst intensity of pain experienced in PACU, which was assessed using the Numerical Rating Scale. Nurses evaluated sedation using the Motor Activity Assessment Scale and filled in the questionnaire about the importance of sedation. Results. Statistically significant difference was observed in the quality of sleep between the patients sedated using benzodiazepines and opioids together and non-sedated patients (p = 0.025). There is no considerable difference in the statistics concerning the behavior of the patients. The patients prescribed only with opioids IV or IM, as well as the patients prescribed with opioids together with benzodiazepines, feel less intense pain compared to the non-sedated patients (p = 0.016, p = 0.03). Accord ing to the personnel, sedation is necessary in PACU. Half of them think that patients prescribed with opioids need additional sedation. Conclusions. Sedation is necessary in PACU. This fact is evident in the statistically significant difference of comfort factors among the patients as well as in the opinion of the nursing personnel that spend most of the time communicating and caring about the comfort of the patients.

Download Full-text

Radial extarcorporeal shock waves: therapeutic myofascial protocol

Journal of Advanced Health Care ◽

10.36017/jahc2107-001 ◽

2021 ◽

pp. 1-5

Author(s):

Barassi Giovanni ◽

Guglielmi Vito ◽

Della Rovere Franco ◽

Di Iulio Antonella ◽

Licameli Marco ◽

...

Keyword(s):

Shock Waves ◽

Rating Scale ◽

Myofascial Pain ◽

Numerical Rating Scale ◽

Trigger Points ◽

Upper Trapezius ◽

Significant Difference ◽

Before And After ◽

Numerical Rating ◽

Base Of Support

The purpose of this study is to evaluate the effectiveness of radial shock waves in myofascial upper trapezius syndrome following the global treatment scheme of key trigger points. Materials and methods 26 patients treated with rESWT (Radial shock wave therapy) after a global postural and myofascial assessment of the patient and the identification of the key trigger points. At the end of the treatment each subject was re-evaluated through the Numerical Rating Scale - NRS and through the examination with Electronic Baropodometer. In this study, we compared the values of NRS and the values of postural biometrics before and after 2 sessions of rESWT, and a statistically significant difference (P <0.05) in all measurements emerged in the values measured with NRS. In the static percentage load, a statistically significant reduction in the percentage load differences (right / left) (P <0.05) was observed in all three evaluation moments (T0, T1, T2). The percentage and statistically significant improvement (P <0.05) were recorded at time T2 in the surface of the ellipse. Greater control of balance and greater awareness of the base of support was found in the calculation of the sway path, in particular with closed eyes. Based on this experience, the use of radial shock waves in pathologies related to myofascial pain with postural implications would be desirable.

Download Full-text

What is the clinical relevance of the Numerical rating scale for pain?

10.1093/med/9780198834359.003.0059 ◽

2018 ◽

Author(s):

Felicia Cox

Keyword(s):

Chronic Pain ◽

Pain Intensity ◽

Rating Scale ◽

Numerical Rating Scale ◽

Clinical Importance ◽

Patient Global Impression ◽

Numerical Rating ◽

Group A ◽

Clinically Significant ◽

Global Impression Of Change

The landmark paper discussed in this chapter is ‘Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale’, published by Farrar et al. in 2001. The numerical rating scale is now the standard instrument used in chronic pain studies to measure pain intensity. Farrar et al. determined the changes in pain intensity that were clinically significant for studies of chronic pain while measuring the patient’s global impression of change. The paper used pooled data from ten recent studies of pregabalin in 2,724 subjects. The authors reported a consistent relationship between pain intensity and patient global impression of change, regardless of study, disease type, age, sex, study result, or treatment group. A reduction of approximately two points on the numerical rating scale, or of 30% in the global impression of change of pain intensity, represented a clinically important difference.

Download Full-text

An investigation into the effects of a virtual reality system on phantom limb pain: a pilot study

British Journal of Pain ◽

10.1177/2049463719859913 ◽

2019 ◽

Vol 14 (2) ◽

pp. 92-97 ◽

Cited By ~ 1

Author(s):

Jai Kulkarni ◽

Steve Pettifer ◽

Sue Turner ◽

Cliff Richardson

Keyword(s):

Virtual Reality ◽

Pilot Study ◽

Statistical Difference ◽

Rating Scale ◽

Numerical Rating Scale ◽

Phantom Limb Pain ◽

Phantom Limb ◽

Limb Pain ◽

Chi Square ◽

Numerical Rating

Background: There is no first-line treatment available for phantom limb pain (PLP). For some years, there has been interest in the use of mirrors and other techniques based on visual feedback. Unfortunately, up until now, all published studies have had methodological weaknesses with two recent systematic reviews concluding that therapies of this kind need more evidence to support their use. Aim: To evaluate the effects of a virtual reality (VR) activity on PLP. Methods: This was a prospective pilot study of upper limb amputees using questionnaires to evaluate a VR system. Eleven participants were recruited, with nine completing all three sessions of VR. Participants undertook three sessions of VR, one a month for 3 months. Outcome measures were PLP pain intensity using an 11-point numerical rating scale (NRS), number of PLP episodes and duration of the PLP episodes. All participants were also asked for their judgement of change. Open-ended questions captured the qualitative experience of all aspects of the VR experience. Results: The mean PLP pain score following three VR sessions reduced (6.11 v 3.56) but this was not a statistical difference (t = 2.1, df = 8, p = 0.07). No statistical difference was found for the number of PLP episodes (Pearson chi-square = 3.43, df = 2, p = 0.18) or the duration of each PLP episode (Pearson chi-square = 22.50, df = 16, p = 0.13). Three groups emerged: those whose pain reduced (the majority), those whose pain remained the same (small number) and one those whose pain increased slightly. Discussion: There is insufficient evidence from these results to identify an effect of VR on PLP; however, this is a small group and qualitatively most were content with the treatment and wanted a longer trial.

Download Full-text

1094 Depression Is Not Associated With The Presence Of Or The Severity Of Obstructive Sleep Apnea: Retrospective Study Of 841 Polysomnography Subjects

SLEEP ◽

10.1093/sleep/zsaa056.1089 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A416-A416

Author(s):

K Im ◽

L Kim ◽

R Immen

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Rating Scale ◽

Numerical Rating Scale ◽

Significant Proportion ◽

Chi Square ◽

Relative Paucity ◽

Obstructive Sleep ◽

Significant Difference ◽

Chi Square Analysis

Abstract Introduction Both depression and obstructive sleep apnea (OSA) are very common medical conditions. Studies showed a co-occurrence of depression and OSA with a higher prevalence of one if the other is present. However, there is relative paucity of studies assessing the rate of depression based on the OSA severity. Methods Retrospective analysis of data collected from patients undergoing polysomnography (PSG) at an academic sleep disorders center was performed. A total of 841 subjects were included and stratified into four groups using AHI. A Chi-square analysis was applied to assess the association of varying levels of AHI and the presence of depression. Results Although a significant proportion of patients with AHI greater than 5 endorsed depression (60/165 in group with AHI 15 or greater and 115/278 in group with AHI between 5 and 15), this finding was also replicated in patients with AHI less than 5 (86/202 in AHI between 1 and 5 and 88/196 in those with AHI less than 1). As there was significant difference in rate of depression among women (54.1%) and men (26.1%) (p <0.0001), Chi-square analysis was performed for the rate of depression based on the level of AHI, adjusted for gender. In women the rate of depression from the most severe AHI to less severe AHI group were 0.48, 0.53, 0.60, and 0.53 respectively and in men it was 0.30, 0.27, 0.20, and 0.27 respectively, with no statistical difference between any groups. Conclusion Among patients who seek PSG assessment, depression appears to be more prevalent than the general public. Rate of depression is much higher among women than men in this group. However, the presence of OSA or severity of OSA does not have any correlation with the rate of depression in both women and men. These findings might be suggestive of the complexity of the association between depression and OSA. One limitation of this study is the dichotomous nature of depression (presence or absence of). The finding from this study warrants a future study utilizing a numerical rating scale of depression for severity measure to correlate it with the severity of OSA. Support NA.

Download Full-text

Jaw Exercise Therapy and Psychoeducation to Reduce Oral Parafunctional Activities for the Management of Persistent Dentoalveolar Pain

Pain Research and Management ◽

10.1155/2018/5042067 ◽

2018 ◽

Vol 2018 ◽

pp. 1-7

Author(s):

Izumi Makino ◽

Young-Chang Arai ◽

Shuichi Aono ◽

Masayuki Inoue ◽

Hiroki Sakurai ◽

...

Keyword(s):

Standard Deviation ◽

Combination Therapy ◽

Pain Intensity ◽

Rating Scale ◽

Numerical Rating Scale ◽

End Of Treatment ◽

Before And After ◽

Numerical Rating ◽

Therapy Treatment ◽

Nonpharmacological Treatments

Objective. To retrospectively analyze the effects of our original combination therapy treatment on patients with nonodontogenic persistent dentoalveolar pain. Methods. Twenty-one patients suffering from persistent dentoalveolar pain (nineteen females and two males; mean age ± standard deviation: 55.7 ± 19.6 years) participated in this study. They were treated with a therapy combination of jaw exercise and psychoeducation to reduce oral parafunctional activities every month. The intensity of pain in these subjects was evaluated using a numerical rating scale (NRS) before and after treatment. Results. The NRSs at the baseline ranged from 5 to 10 (median, 8), from 0 to 10 (median, 2) at one month after treatment, from 0 to 10 (median, 1) at three months after treatment, and from 0 to 10 (median, 0) at the end of treatment. Pain intensity after treatment improved significantly. Conclusion. There was a significant reduction in pain after our combination of therapies as nonpharmacological treatments, and therefore this treatment could be useful in the management of NPDP patients.

Download Full-text