Incidence and management of inguinodynia after inguinal plasty

Background: Hernia is defined as a defect of fascial and muscle-aponeurotic structures, allowing the protrusion of elements. The most frequent is inguinal region, prevailing in men 3:1 vs female. The most frequent complications are persistent chronic pain.Methods: A descriptive, prospective and cross-sectional study was performed in postoperative inguinal plasty patients, using a laparoscopic approach and open approach, the presence or absence of inguinodynia was studied using the visual analogue pain scale (VAS) and the Semmes-Weinstein monofilament, in addition to a systematic investigation in the following PubMed, Medline, Clinical Key and Index Medicus databases, with articles from July 2019 to April 2020.Results: Inguinodynia was present in laparoscopic surgery and open approach, 58 patients had inguinodynia at two weeks associated with the inflammatory response of the tissues and the presence of a foreign body (mesh), 77% of the patients with persistence of pain at 3 months reported mild pain (VAS 1-4), 21% moderate pain that did not limit their daily activities (VAS 5-8) and 2% of the patients reported severe pain which limited physical activity and effort (VAS 9-10).Conclusions: Inguinodynia has an impact on hospital costs and quality life, we consider it is essential to domain the anatomical variants of the region. We propose an extensive follow-up of this group of patients, to make a comparison of diagnostic methods, as well as conservative management vs. modern techniques for pain control.

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Late follow-up of peripheral neural decompression in leprosy: functional and clinical outcomes

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x-anp-2020-0032 ◽

2021 ◽

Vol 79 (8) ◽

pp. 716-723

Author(s):

Liliane Marques de Pinho Tiago ◽

Maria Fernanda Ferreira Barbosa ◽

Diogo Fernandes dos Santos ◽

Adelmo Divino Faria ◽

Maria Aparecida Gonçalves ◽

...

Keyword(s):

Functional Results ◽

Complementary Therapy ◽

Pain Scale ◽

Surgical Decompression ◽

Visual Analogue Pain Scale ◽

Neural Function ◽

Cross Sectional ◽

Visual Analogue Pain ◽

Assessment Protocol

ABSTRACT Background: Peripheral neural surgical decompression (PNSD) is used as a complementary therapy to the clinical treatment of neuritis to preserve neural function. Objective: To evaluate the long-term (≥ 1 year) clinical and functional results for PNSD in leprosy neuritis. Methods: This cross-sectional study included leprosy patients who were in late postoperative period (LPO) of surgical decompression of ulnar, median, tibial, and fibular nerves. Socioeconomic, epidemiological, and clinical data were collected. The following instruments were used in this evaluation: visual analogue pain scale (VAS), Douleur Neuropathique en 4 Questions (DN4), SALSA scale, and simplified neurological assessment protocol. The preoperative (PrO) and 180-day postoperative (PO180) results were compared. Results: We evaluated 246 nerves from 90 patients: 56.6% were on multidrug therapy (MDT) and 43.3% discharged from MDT. Motor scores and pain intensity showed statistically significant improvement (p<0.01). There was an increase in sensory scores only for bilateral ulnar nerves (p<0.05). Of the operated cases, 26.0% of patients were referred for surgery of ulnar neuritis and 23.6% of tibial neuritis. Neuropathic pain was reported in 41% of cases. Daily dose of prednisone reduced from 39.6 mg (±3.0) in PrO, 16.3 mg (±5.2) in PO180, to 1.7 mg (±0.8) in LPO. The SALSA scale results showed mild activity limitation in 51% and moderate in 34% of patients. Eighty percent of individuals reported that the results reached their expectations. Conclusions: PNSD in leprosy was effective in the long term to decrease the prevalence and intensity of pain, improve motor function, and reduce the dose of corticosteroids, which is reflected in the patients’ satisfaction.

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Assessment of pain in chronic renal failure patients going through hemodialysis

Rev Rene ◽

10.15253/2175-6783.20202143685 ◽

2020 ◽

Vol 21 ◽

pp. e43685

Author(s):

Fabiana Larissa Barbosa da Silva ◽

Geórgia Alcântara Alencar Melo ◽

Regilane Cordeiro dos Santos ◽

Renan Alves Silva ◽

Letícia Lima Aguiar ◽

...

Keyword(s):

Renal Failure ◽

Chronic Renal Failure ◽

Family Income ◽

Pain Scale ◽

The Body ◽

Mcgill Pain Questionnaire ◽

Visual Analogue Pain Scale ◽

Cross Sectional ◽

Income Source ◽

Visual Analogue Pain

Objective: to assess the pain and the differences of this assessment with social, economic and clinical variables in individuals with chronic kidney disease. Methods: cross-sectional study, with 90 patients with hemodialysis clinics. Three instruments were used clinical/sociodemographic, visual analogue pain scale and McGill pain questionnaire. Mann-Whitney and Kruskal-Wallis U tests were used. Results: the most frequent kind of pain was musculoskeletal (35.6%), which was classified as moderate by using the visual analogue pain scale. In McGill’s questionnaire, the most selected categories were sensory and affective, which characterize pain as acute and thin. Significant statistical differences in medians of pain were found with family income, source of income, use of analgesics/anti-inflammatories, use of acupuncture and impaired sleep. Conclusion: pain was a recurrent result in various regions of the body among patients with chronic renal failure.

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The catastrophization of pain is related to the patient and not to the migraine

10.5327/1516-3180.318 ◽

2021 ◽

Author(s):

Eduardo Almeida Guimarães Nogueira ◽

Flávia Rodrigues de Oliveira ◽

Vitor Martinez de Carvalho ◽

Carina Tellaroli ◽

Yara Dadalti Fragoso

Keyword(s):

Online Survey ◽

Depression Scale ◽

Pain Scale ◽

Anxiety And Depression ◽

Visual Analogue Pain Scale ◽

Depression And Anxiety ◽

Cross Sectional ◽

Visual Analogue Pain ◽

One Year ◽

The Individual

Background: Catastrophization is a psychological aspect of pain that alters its perception and expression. Objective: Assess catastrophization in migraine. Design and setting: Cross-sectional observational study conducted by online survey, 2020. Method: Online survey of individuals suffering from migraine attacks at least twice a month, for at least one year. Confidentiality was assured. The participant gave details of his/her headache (including via a visual analogue pain scale) and answered the Hospital Anxiety and Depression Scale and the Catastrophization Scale questionnaires. Results: The survey identified 242 individuals with migraine attacks at least twice a month. The median scores observed in this group of individuals were 7 for pain, 11 for anxiety, 7 for depression and 2 for catastrophization. Catastrophization had no correlation with the duration or intensity of migraine pain. There was no correlation between catastrophization and headache frequency or the monthly amount of headache medication taken. High scores for catastrophization were identified in one third of the participants. High scores were not associated with age, headache duration, pain severity, frequency of attacks or traits of depression or anxiety. There was a moderate association between both depression and anxiety traits with catastrophization. Conclusion: Catastrophization seems to be a trait of the individual and appears to be unrelated to the characteristics of the migraine.

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A comparative study of open preperitoneal versus laparoscopic mesh hernioplasty in cases of incisional hernia repair

International Surgery Journal ◽

10.18203/2349-2902.isj20204137 ◽

2020 ◽

Vol 7 (10) ◽

pp. 3360

Author(s):

Ashish Kharadi ◽

Vikas Makwana ◽

Pranav Patel

Keyword(s):

Incisional Hernia ◽

Laparoscopic Repair ◽

Laparoscopic Approach ◽

Incisional Hernia Repair ◽

Cross Sectional Study ◽

Open Approach ◽

Cross Sectional ◽

Routine Work ◽

Bowel Movements ◽

Pain Duration

Background: Incisional hernias repair being done in large numbers there is still not a consensus about the best repair. Very few studies have been done on comparison open and laparoscopic incisional hernia repair.Methods: A prospective, cross-sectional study was undertaken in Department of Surgery of Civil Hospital. The study included total 50 patients, out of which 25 patients underwent open approach and rest of 25 patients, underwent laparoscopic approach. Patients were assigned to both the groups randomly.Results: Pain, duration of post-operative stay, and return to routine work is earlier in patients with laparoscopic repair mainly due to decreased pain, fewer complications, early mobility and faster return of bowel movements. Laparoscopic repair is more expensive and operative time is more as compared to open method.Conclusions: Keeping in view the advantages and limitations of laparoscopic repair, the choice among two surgical modalities should be made on a case to case basis depending on patient preference and characteristics.

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Buccal Mucosal Grafts for Urethroplasty: Comparison of Postoperative Oral and Perineal Morbidity

Annals of The Royal College of Surgeons of England ◽

10.1308/003588409x391875 ◽

2009 ◽

Vol 91 (2) ◽

pp. 116-117 ◽

Cited By ~ 4

Author(s):

Khalid Abdel-Galil ◽

Ian Eardley ◽

Richard Loukota

Keyword(s):

Donor Site ◽

Pain Scale ◽

Perineal Pain ◽

Visual Analogue Pain Scale ◽

Urethral Reconstruction ◽

Visual Analogue Pain ◽

Buccal Mucosa Graft ◽

Buccal Mucosal Graft ◽

Graft Harvest ◽

Scale Scores

INTRODUCTION A prospective study of postoperative oral and perineal pain experienced by a group of patients undergoing buccal mucosal graft harvest for urethral reconstruction. PATIENTS AND METHODS A consecutive group of 24 male patients undergoing buccal mucosa graft harvest for urethral recon8truction of stricture disease was prospectively studied between June 2006 and December 2008. All patients were examined pre-operatively and entered into the study prospectively. After surgery, all patients were reviewed at 24 h and 48 h. On both occasions, they were asked to complete a proforma containing visual analogue pain scales for both the oral donor site as well as the perineum. RESULTS A statistically significant higher level of pain was experienced from the perineum than the oral donor site on both the first and second postoperative days. CONCLUSIONS Comparative analysis of visual analogue pain scale scores between oral donor site and perineum showed that patients experience significantly more pain from the latter postoperatively.

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Point: Open Radical Prostatectomy Should Not Be Abandoned

Journal of the National Comprehensive Cancer Network ◽

10.6004/jnccn.2007.0058 ◽

2007 ◽

Vol 5 (7) ◽

pp. 685-688 ◽

Cited By ~ 10

Author(s):

William J. Ellis ◽

Paul H. Lange

Keyword(s):

Prostate Cancer ◽

Radical Prostatectomy ◽

Hospital Costs ◽

Laparoscopic Approach ◽

Open Approach ◽

Open Technique ◽

Extensive Lymphadenectomy ◽

Open Radical Prostatectomy ◽

History Of ◽

Treat Prostate Cancer

Robotic-assisted laparoscopic radical prostatectomy is now one of the most common ways to treat prostate cancer. Although it is undoubtedly an outstanding procedure, in many contexts the advantages of the laparoscopic approach are overstated. The authors believe that open radical prostatectomy will continue to have an important role. For example, an extensive lymphadenectomy is more easily accomplished with the open technique and may be important in staging and possibly curing patients at high risk for prostate cancer. Also, tactile sensation is a valuable asset in assessing the extent of local tumor, and this cannot yet be replicated with a robotic approach. Furthermore, obese patients, those with a history of extensive prior surgical procedures, and men with extremely large prostates may experience advantages with the open technique. Finally, the open approach has a significant advantage in terms of hospital costs.

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Transcutaneous Electrical Stimulation and Postoperative Total Knee Arthroplasty Pain

Pain Research and Management ◽

10.1155/1998/683535 ◽

1998 ◽

Vol 3 (2) ◽

pp. 101-104

Author(s):

Mohamed N Mahomed ◽

Gianni L Maistrelli ◽

Ayoob Mossanen ◽

Derek Glazier

Keyword(s):

Electrical Stimulation ◽

Total Knee Replacement ◽

Range Of Motion ◽

Pain Scale ◽

Control Group ◽

Visual Analogue Pain Scale ◽

Transcutaneous Electrical Stimulation ◽

Visual Analogue Pain ◽

Total Knee ◽

Analgesic Use

OBJECTIVE: To determine the efficacy of the Synaptic 2000 in reducing total knee replacement postoperative pain in a prospective randomized controlled trial.DESIGN: Patients were prospectively randomly assigned to two groups, one receiving seven days of transcutaneous electrical stimulation (TES) therapy in addition to standard postoperative care, and the other receiving standard postoperative care. Both groups received postoperative patient-controlled analgesia and were switched to oral opiates.SETTING: Patients were treated at a university teaching hospital for elective primary unilateral total knee replacement.PATIENTS: All patients consented to enter the study. All had primary osteoarthritis. Fifteen patients were entered into each arm of the study, and all patients completed the study. The mean age of patients was 64 years for treatment and 71 years for controls.OUTCOME MEASURES: Outcome measures were analgesic consumption, return of knee range of motion and score on a visual analogue pain scale.RESULTS: No significant differences were noted in postoperative analgesic use, knee range of motion, length of stay or visual analogue pain scale score. Mean total analgesic use of morphine was 148 mg in the TES group and 108 mg in the control group. The TES group mean knee range of motion on postoperative day 7 was 75.3°; it was 73.6° in the control group. Group mean length of stay was 9.5 days in the TES group and 8.3 days in the control group.

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

Journal of International Medical Research ◽

10.1177/030006059502300309 ◽

1995 ◽

Vol 23 (3) ◽

pp. 211-217 ◽

Cited By ~ 6

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.

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EndoTech® minimally invasive trigger thumb release

International Journal of Science and Research Archive ◽

10.30574/ijsra.2021.3.2.0154 ◽

2021 ◽

Vol 3 (2) ◽

pp. 157-160

Author(s):

Michael J Fitzmaurice

Keyword(s):

Minimally Invasive ◽

Pain Scale ◽

Minimally Invasive Technique ◽

Endoscopic Technique ◽

Invasive Technique ◽

Visual Analogue Pain Scale ◽

Trigger Thumb ◽

Visual Analogue Pain ◽

Minimal Incision

We describe a novel minimally invasive technique for the treatment of trigger thumb. 37 patients with a total of 41 thumbs were included in the study. A visual analogue pain scale was used before surgery and also at 2 week and 6 month follow up visits. The pain was significantly improved from a pre op of 7.92 (+/- 1.6) to .65 (+/- .8) at the 2 week follow up and finally .29 (+/- 1.8) at the 6 month follow up. All of the patients had relief of triggering and only 1 patient required any therapy. This endoscopic technique for trigger thumb allows the surgeon to perform a trigger release with a minimal incision and provides excellent relief without any complications.

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Effect of unicornuate uterus on women's reproductive health

The Journal of V. N. Karazin Kharkiv National University, Series "Medicine" ◽

10.26565/2313-6693-2019-38-08 ◽

2019 ◽

Keyword(s):

Quality Of Life ◽

Reproductive Health ◽

Clinical Symptoms ◽

Normal Karyotype ◽

Pain Scale ◽

Control Group ◽

Visual Analogue Pain Scale ◽

Visual Analogue Pain ◽

Unicornuate Uterus

Objectives. The effect of the unicornuate uterus on the reproductive health and quality of life of woman has been analyzed. Materials and methods. The study included 26 patients with unicornuate uterus aged 25 to 42 years and 20 women without gynecological pathology. Diagnosis of uterine abnomalies was based on patient complaints, medical history and life history, as well as clinical and laboratory and instrumental examinations. The severity of dysmenorrhea was determined using a visual analogue pain scale, women's quality of life was assessed using a short SF-12 health questionnaire. Results. The average age of the surveyed women was 30.2 ± 3.9 years. All patients with unicornuete uterus by subclasses were distributed as follows: subclass U4a (unicornuate uterus with rudimentary cavity) – 69.2% of patients, subclass U4b (unicornuate uterus without rudimentary cavity in the contralateral horn or with its aplasia) – 30.8%. In all patients was confirmed normal karyotype – 46XX. The combination of a unicornuate uterus with a defect of the urinary system (aplasia, doubling, or kidney dystopia) occurred in 23.1% of women. It has been found that in women with unicornuate uterus, clinical symptoms in 76.9% of cases are accompanied by dysmenorrhea. The unicornuate uterus in 69.2% of cases causes negative reproductive outcomes, among which 26.9% – early spontaneous abortions, 11.5% – ectopic pregnancy. In 46.2% of cases the unicornuate uterus is combined with other gynecological pathology, whereby the incidence of concomitant gynecologic pathology is significantly more frequent in U4a patients than in the U4b subclass (˂0.01). The severity of dysmenorrhea in the main group was 5.8 ± 1.8 points (the difference was significant compared with the control group, p = 0.0032). Conclusions. Due to the low physical subunit, the unicornuate uterus significantly impairs the quality of life of women, which was significantly lower in the group of patients with unicornuate uterus compared to the control group (total SF-12 score: 85.4 ± 11.2 vs. 95.8 ± 12.1; p = 0.002).

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