scholarly journals Artrodese posterolateral vs artrodese circunferencial no tratamento da espondilolistese degenerativa: avaliação clínica e impacto do IMC nos resultados

2013 ◽  
Vol 12 (3) ◽  
pp. 204-208
Author(s):  
Filipe Rodrigues Duarte ◽  
António Manuel Santos Nogueira de Sousa ◽  
Frederico José Antunes Raposo ◽  
Luís Filipe Almeida Valente ◽  
António Moura Gonçalves ◽  
...  
Keyword(s):  
Pain Score ◽  
Oswestry Disability Index ◽  
Visual Analogue Pain Score ◽  
Visual Analogue Pain

OBJETIVO: O tratamento cirúrgico da espondilolistese degenerativa (ED) apresenta vantagens quando comparado com o tratamento conservador. As técnicas cirúrgicas evoluíram no sentido de optimizar a fixação vertebral após descompressão, com o intuito de aumentar a taxa de artrodese. A fixação pedicular associada à fusão intersomática permite aumentar a área de contacto ósseo e assim a taxa de fusão, mas serão os resultados clínicos e funcionais superiores? MÉTODOS: Estudo retrospectivo incluindo 51 indivíduos (idade média de 61,2 anos) submetidos a artrodese posterolateral (APL) (19) e artrodese circunferencial (360º) (32) de 1996 até 2009 com acompanhamento médio de 5,8 anos (2 a 14 anos). Incluídas apenas descompressões de um nível. Avaliação clínica (VAS - Visual Analogue Pain Score), satisfação global e avaliação funcional (Oswestry disability Index modificado). Cálculo do IMC (índice de massa corporal) - avaliação clínica e funcional IMC ≥30 vs IMC <30. Estudo estatístico com SPSS®. RESULTADOS: Os resultados mostram franca melhoria clínica e funcional no tratamento cirúrgico da espondilolistese degenerativa, independentemente das técnicas estudadas. A taxa de satisfação é igualmente elevada. No confronto entre as duas técnicas de fixação não houve diferenças estatisticamente significativas. Relativamente ao IMC, os pacientes não obesos tiveram melhores resultados clínicos (p<0,05), não havendo diferenças relativas à função entre os dois grupos. CONCLUSÃO: A descompressão seguida de instrumentação vertebral é um tratamento eficaz para os pacientes com espondilolistese degenerativa. A técnica de artrodese utilizada não influencia os resultados clínicos e funcionais

One visual analogue pain score is sufficient after laparoscopic cholecystectomy

2002 ◽  
Vol 89 (1) ◽  
pp. 114-115 ◽  
Author(s):  
W. Schwenk ◽  
J. W. Mall ◽  
J. Neudecker ◽  
J. M. Müller
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Pain Score ◽  
Visual Analogue Pain Score ◽  
Visual Analogue Pain

Treatment with Buttress Plate Technique for Symptomatic Ulnar Styloid Base Nonunion

2021 ◽  
Author(s):  
Ömer Faruk Kümbüloğlu ◽  
Necmi Cam ◽  
Hacı Mustafa Özdemir
Keyword(s):  
Pain Score ◽  
Mean Value ◽  
Dash Score ◽  
Visual Analogue Pain Score ◽  
Ulnar Styloid ◽  
Level Of Evidence ◽  
Visual Analogue Pain ◽  
Plate Technique ◽  
Buttress Plate

Abstract Background Surgical treatment options for symptomatic ulnar styloid base nonunion can be divided into two groups: styloid excision and styloid fixation methods. Styloid fixation is commonly performed using tension band wiring or distal ulna hook plate. However, these methods are more suitable for large styloids than small ones. For this reason, fixation of small styloids still remains a problem. Purpose To present the surgical details and results of patients operated using the buttress plate technique, due to the symptomatic ulnar styloid base nonunion. Patients and Methods In this study, 11 patients who underwent surgery for symptomatic ulnar styloid base nonunion using buttress plate technique were evaluated retrospectively. The patients were evaluated with the help of forearm and wrist range of motion, grip strength, disabilities of the arm, shoulder, and hand (DASH) score and visual analogue pain score. Results The mean follow-up period was 15 months (range: 13–21 months). Union was achieved in 10 patients. At the final follow-up, the forearm supination and pronation active range of motions were significantly higher than those in the preoperative period, the visual analogue pain score mean value was 0.7 (range: 0–5), and the DASH score mean value was 7 (range: 1–32). Conclusion We conclude that good results can be achieved with the buttress plate technique in patients with both large and small fragmented ulnar styloid base nonunions and no distal radioulnar joint instability. Level of Evidence This is a Level IV, therapeutic study.

Intravenous Magnesium – Lidocaine - Ketorolac Cocktail for Postoperative Opioid Resistant Pain: A Case Series of Novel Rescue Therapy

2020 ◽  
Vol 15 ◽  
Author(s):  
Christian Zanza ◽  
Yaroslava Longhitano ◽  
Edwin Lin ◽  
Jerry Luo ◽  
Marco Artico ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Pain Score ◽  
Rescue Therapy ◽  
Visual Analogue Pain Score ◽  
Visual Analogue Pain ◽  
Pain Scores ◽  
Intravenous Magnesium ◽  
Severe Postoperative Pain ◽  
Opioid Induced Hyperalgesia ◽  
Antinociceptive Tolerance

Background: Severe postoperative pain is principally managed by opioids. While effective, opioids do not provide adequate relief in many patients and cause many side effects including antinociceptive tolerance and opioid-induced hyperalgesia. To evaluate if a combination of intravenous Magnesium, Lidocaine, Ketorolac (MLK cocktail) is a useful rescue therapy through synergistic pharmacological mechanisms for acute pain relief. We present the intravenous combination of magnesium, lidocaine, and ketorolac (MLK cocktail) as a possible rescue for opioid insensitive severe postoperative pain. Materials and Methods: The principal settings were the post-operative care unit (PACU) and the surgical ward. We retrospectively analyzed the electronic medical record and anesthesia documents of 14 patients experiencing severe postoperative pain, >7/10 visual-analogue pain score (VAS), despite receiving at least 8 mg of intravenous morphine milligram equivalents (MME) after arrival in the LAC+USC Medical Center PACU between September 2012 and January 2013. The data reviewed included patients’ demographics, disease etiology, surgical procedure, opioids received perioperatively, and visual-analogue pain scores before and after each analgesic received, and after the MLK cocktail. The a priori primary outcome and a posteriori secondary outcome of this study is mean visual-analogue pain score and morphine milligram equivalent dose administered per hour, respectively. The main tool evaluated has been VAS score. Results: In patients who failed to respond to opioid analgesics, administration of the MLK cocktail improved the VAS pain scores immediately from 9.4 ± 1.0 to 3.6 ± 3.5. The MLK cocktail also decreased the MME doses/hour in the immediate 12 hours postoperative period from 12.4 ± 5.6 to 1.1 ± 0.9. Conclusions: In patients experiencing opioid-resistant severe postoperative pain, the magnesium, lidocaine, and ketorolac combination may be an effective non opioid rescue therapy. Additionally, magnesium, lidocaine, and ketorolac may be utilized in cases complicated by either antinociceptive tolerance or opioid-induced hyperalgesia, and can restore opioid responsiveness.

scholarly journals Effectiveness of Transversus Abdominis Plane Block for Postoperative Analgesia in Obstetric Cases Undergoing Caesarean Section

2019 ◽  
Vol 4 (2) ◽  
pp. 755-758
Author(s):  
Roshan Pradhan ◽  
Seema Kumari Mishra ◽  
Lalit Kumar Rajbanshi ◽  
Kanak Khanal ◽  
Batsalya Arjyal ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Pain Score ◽  
Postoperative Analgesia ◽  
Transversus Abdominis ◽  
Control Group ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Rescue Analgesia ◽  
Visual Analogue Pain ◽  
Significant Difference

Introduction: Transversus abdominis plane (TAP) block is a regional anesthesia that involves the infiltration of local anesthetic in between the internal oblique and transversus abdominis muscle plane. This block provides post-operative analgesia and reduces the requirement of opioids consumption. Objective: To assess the effectiveness of TAP block in providing postoperative analgesia in women undergoing caesarean section. Methodology: This was a hospital based prospective, comparative, cross sectional study conducted in 70 patients from 17th September 2018 to 17th February 2019 undergoing caesarean section under spinal anesthesia. Patients were divided into two groups. Group A patients received TAP block with 0.5% Ropivacaine versus Group B patients received injection paracetamol 1gm intravenous every 8 hourly as a standard and routine analgesic. At the end of the surgery, TAP block was performed by anesthesiologist and assessment of postoperative pain using a visual analogue pain score at every 1 hour, 3 hour, 6 hour, 12 hour and 24 hour by trained staffs at postoperative ward. Then, depending upon the severity of the pain injection fentanyl 1mcg/kg intravenous was given as rescue analgesia. Short assessment of patient satisfaction (SAPS) score was also assessed 24 hours postoperatively. Results: Compared to control group, in women who received TAP block, there was statistically significant reduction in pain at 3 hr, 6 hr, 24 hrs. However at 12 hrs there was no significant difference in the pain score. The cumulative fentanyl requirement was also significantly less in the TAP block group at all the time points.  Conclusion: The TAP block provided highly effective postoperative analgesia following caesarean section and reduces the fentanyl requirement in the first 24 hour.

Epidural Morphine plus Bupivacaine for Relief of Postoperative Pain following Harrington Rod Insertion for Correction of Idiopathic Scoliosis

1995 ◽  
Vol 23 (3) ◽  
pp. 211-217 ◽  
Author(s):  
Y Adu-Gyamfi
Keyword(s):  
Side Effects ◽  
Idiopathic Scoliosis ◽  
Pain Score ◽  
Epidural Catheter ◽  
Epidural Morphine ◽  
Pain Scale ◽  
Injection Pain ◽  
Visual Analogue Pain Scale ◽  
Visual Analogue Pain ◽  
Harrington Rod

The aim of this study was to assess the efficacy of epidural morphine plus bupivacaine for post-operative pain control following Harrington rod insertion. In 22 scoliotic patients, studied prospectively, the epidural catheter was positioned under direct vision, intra-operatively before wound closure. Post-operatively, the patients received 2 mg morphine in 4 ml of 0.25% bupivacaine through the epidural catheter whenever they complained of pain. The pain score was assessed before and after every injection, using the Visual Analogue Pain Scale, and side-effects were monitored. All patients had adequate pain relief following analgesic administration. The mean (± SD) pre-injection pain score decreased from 2.5 ± 0.15 on the first post-operative day to 0.7 ± 0.2 by the fourth day. The side-effects, including nausea, vomiting and pruritus, were minimal. It is concluded that morphine, in 0.25% bupivacaine administered through an intra-operatively placed epidural catheter, provides a safe and effective post-operative analgesia in patients undergoing Harrington rod insertion for idiopathic scoliosis.

scholarly journals ADHESIVE CAPSULITIS; MANAGEMENT BY PHYSIOTHERAPY VERSUS INTRA-ARTICULAR CORTICOSTEROID INJECTION

2021 ◽  
Vol 71 (5) ◽  
pp. 1824-27
Author(s):  
Muhammad Umair Hashmi ◽  
Babar Bakht Chughtai ◽  
Muhammad Nadeem Ahsan
Keyword(s):  
Pain Score ◽  
Steroid Injection ◽  
Corticosteroid Injection ◽  
Adhesive Capsulitis ◽  
Frozen Shoulder ◽  
Sampling Technique ◽  
Visual Analogue Pain Scale ◽  
Visual Analogue Pain ◽  
Group A ◽  
Group B

Objective: To determine outcomes of intra-articular corticosteroids injection versus physiotherapy for the treatment of adhesive capsulitis using mean pain score on the visual analogue scale. Study Design: Comparative prospective study. Place and Duration of Study: Orthopedic outpatient department, Bahawal Victoria Hospital Bahawalpur from Jan to Jun 2021. Methodology: A total of 120 cases having adhesive capsulitis (frozen shoulder) were included in the study according to inclusion criteria. Non-probability consecutive sampling technique was used for the selection of cases. Patients were divided into two groups, group-A and group B, each containing 60 cases. Patients in group-A were given intra-articular steroid injection (2ml triamcinolone 40mg ± 2ml of bupivacaine). Patients in group B received ten sessions of physiotherapy by a welltrained physiotherapist under the supervision of an orthopaedic surgeon on alternate days. After six weeks, outcomes were measured in terms of pain score using a visual analogue pain scale. Results: Significant improvement was seen among patients in group-A with mean pain score from 7.32 ± 0.89 measured initially to 5.44 ± 1.37 measured after six weeks (p<0.001). No significant improvement was found among patients in group B with a mean pain score of 7.58 ± 0.94 measured initially to 7.12 ± 0.88 measured after six weeks (p>0.05). Conclusion: Significant improvement in pain relief can be achieved using intra-articular steroid injection administered in the shoulder as compared to supervised sessions of physiotherapy among patients with adhesive capsulitis.

scholarly journals Efficacy and safety of Sahastara remedy for pain relief: A systematic review and meta-analysis of randomized controlled trials

2021 ◽  
Vol 10 (4) ◽  
pp. 375-382
Author(s):  
Wiraphol Phimarn ◽  
Chatmanee Taengthonglang ◽  
Kritsanee Saramunee ◽  
Bunleu Sungthong
Keyword(s):  
Pain Relief ◽  
Adverse Events ◽  
Pain Score ◽  
Oswestry Disability Index ◽  
Global Assessment ◽  
Meta Analysis ◽  
Womac Score ◽  
Index Score ◽  
Efficacy And Safety ◽  
Oswestry Disability Index Score

The Sahastara (SHT) remedy is an herbal medicine that can be used as an alternative treatment for improving pain symptoms. The aim of this study was to evaluate the efficacy and safety of the SHT remedy for pain relief. PubMed, Scopus, ScienceDirect, TCI, and ThaiLis were systematically searched for relevant articles from inception to April 2021. We only included randomized clinical trials (RCTs) in which the efficacy and safety of the SHT remedy were compared with those of non-steroidal anti-inflammatory drugs (NSAIDs). Study selection, data extraction, and quality assessment were independently performed by two reviewers. The clinical therapeutic outcomes were the pain score, WOMAC score, Oswestry Disability Index score, 100 meters walk result, global assessment, and adverse events of the SHT remedy. The outcomes were assessed and pooled using a random-effects model. Heterogeneity was assessed using the I2 test. Four studies with 213 participants were included in the analysis. The efficacy of the SHT remedy was not different from that of NSAIDs in terms of the pain score (standardized mean difference [SMD] = -0.31; 95% CI = -1.26, 0.65; I2 = 91%), WOMAC score (SMD = 0.05; 95% CI = -0.30, 0.41; I2 = 0.0%), Oswestry Disability Index score (SMD = -0.41, 95% CI = -1.18, 0.35), 100 meters walk result (SMD = 0.31; 95% CI = -0.25, 0.87; I2 = 0.0%), and global assessment (relative risk = 0.85; 95% CI = 0.62, 1.16; I2 = 0.0%). Moreover, there were no statistically significant differences between the SHT remedy and NSAID treatment groups in terms of adverse events or liver function. This meta-analysis demonstrated that the SHT remedy is not different from NSAIDs in terms of clinical therapeutic efficacy and adverse events. However, larger and well-designed studies are needed to confirm this conclusion.

scholarly journals COMPARISON OF LOCAL METHYLCOBALAMINE INJECTION VERSUS LOCAL BUPIVACAINE INJECTION FOR THE TREATMENT OF ACUTE HERPETIC NEURALGIA

2022 ◽  
Vol 71 (6) ◽  
pp. 2228-2231
Author(s):  
Ghazala Yasmin ◽  
Naeem Raza ◽  
Arfan -Ul- Bari ◽  
Farah Yousaf ◽  
Summaya Saleem ◽  
...  
Keyword(s):  
Pain Score ◽  
Subcutaneous Injection ◽  
Visual Analogue Score ◽  
Military Hospital ◽  
Visual Analogue Pain ◽  
Significant Difference ◽  
Quasi Experimental ◽  
Group A ◽  
The Mean ◽  
Group B

Objective: To compare the reduction in mean pain score with local Methylcobalamin injection versus local Bupivacaine injection in patients with acute herpetic neuralgia. Study Design: Quasi experimental study. Place and Duration of Study: Dermatology Outpatient Department, Pak Emirates Military Hospital, Rawalpindi, from Jun to Dec 2019. Methodology: Total 100 patients, having pain score more than 3, fulfilling the selection criteria were divided into two groups. Group A was treated with daily subcutaneous injection Bupivacaine, whereas Group B was treated with daily subcutaneous injection Methycobalamin at the site of neuralgia. Patients were followed up for 4 weeks. The pain score was noted. All the data was entered and analyzed on SPSS version 21. Results: In this study mean age of patients in group A was 43.82 ± 15.76 years and in group B was 44.76 ± 16.92 years. The mean visual analogue pain score at 4th week in the group A patients was 1.14 ± 0.32 and in group B was 1.90 ± 0.97. Statistically significant difference was found in group A (local Bupivacaine) with visual analogue score (VAS) at 4th week (pvalue=0.002). Conclusion: The local Bupivacaine injection showed significant reduction in mean pain score than local Methylcobalamin injection in patients with acute herpetic neuralgia.

scholarly journals Clinical Efficacy of Selective Nerve Root Block in Lumbar Radiculopathy due to Disc Prolapse

2019 ◽  
Vol 17 (2) ◽  
pp. 242-246 ◽  
Author(s):  
Gaurav Raj Dhakal ◽  
Pawan Kumar Hamal ◽  
Siddhartha Dhungana ◽  
Yoshiharu Kawaguchi
Keyword(s):  
Nerve Root ◽  
Index Score ◽  
Lumbar Radiculopathy ◽  
Disc Prolapse ◽  
Visual Analogue Pain Score ◽  
Visual Analogue Pain ◽  
Nerve Root Block ◽  
Oswestry Disability Index Score ◽  
One Year ◽  
Selective Nerve Root Block

Background: Selective Nerve Root Block using steroid is a proven technique for management of lumbar radiculopathy. The aim of the study was to determine the effectiveness of selective nerve root block in lumbar radiculopathy.Methods: A prospective observational study was conducted for duration of one year in patients diagnosed with lumbar radiculopathy. Patients with leg pain, positive straight leg raising test and single level disc prolapse were included in the study. The procedure was performed under fluoroscopic guidance and Visual Analogue Pain rating scale and Oswestry Disability Index score was used for assessment pre-injection, 1 week, 1 month, 6 months and 1-year post injection.Results: Total 35 patient with mean age of 37.7± 9.31 years were included in the study. The pre-injection Visual Analogue Pain Score(Mean ± S.D:7.8±0.7) was significantly reduced at one week (4.2±1.47, p <0.00001), one month (2.74±1.06, p <0.00001), six months (2.31±0.75, p <0.00001) and one year (2.62±0.84, p <0.00001). Similarly, pre-injection Oswestry Disability Index score (Mean ± S.D: 32.09±5.95) was significantly reduced at one week (19.51±7.26, p <0.00001), one month (12.71±4.56, p <0.00001), six months (9.8±2.87, p <0.00001) and one year (10.09±2.97, p <0.00001) but not significantly improved when compared at 6 months and 1 year (p < 0.44).Conclusions: Selective Nerve Root Block in lumbar radiculopathy significantly reduces Visual Analogue Pain Score up to a year, however, the reduction in pain plateaus around six months.Disability index score only reduces for first 6 months but doesn’t significantly reduce from six months to one year.Keywords: Lumbar; radiculopathy; selective nerve root block; steroid.

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