scholarly journals Comparison of Pregabalin and Placebo Effects in Treating Eye Pain Following Cataract Surgery by Phacoemulsification Method

2021 ◽  
Author(s):  
Fardin Yousefshahi ◽  
Hossein Majedi Ardakani ◽  
Mehdi Sanatkar ◽  
Reza Atef Yekta ◽  
Alireza Takzare ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Pain Score ◽  
Rating Scale ◽  
Brief Pain Inventory ◽  
Numeric Rating Scale ◽  
Double Blind ◽  
Eye Pain ◽  
Double Blind Clinical Trial ◽  
Corneal Damage ◽  
The Impact

Cataract surgery sometimes is associated with adverse effects, such as dryness, burning, and patient discomfort. This study evaluates the treatment of dry eye syndrome and pain caused by corneal damage following cataract surgery with pregabalin compared to placebo. In our double-blind clinical trial, a total of 60 cases were divided into two groups. The pain score was assessed by the Numeric Rating Scale (NRS), and the impact of pain and dryness on the patient's performance was evaluated by the Brief Pain Inventory (BPI). The patient's pain score was evaluated postoperatively and followed for six weeks after the procedure. After the sixth week of the study, NRS, BPI, and photophobia in the pregabalin group were significantly different from the placebo group. Pregabalin can significantly reduce chronic and resistant eye pain after cataract surgery.

scholarly journals Evaluating Time to Pain Progression in Multiple Myeloma

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 2299-2299
Author(s):  
Jessica K Roydhouse ◽  
Vishal Bhatnagar ◽  
Mallorie H. Fiero ◽  
Bellinda L King-Kallimanis ◽  
Daniel L. Suzman ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Pain Score ◽  
Rating Scale ◽  
Palliative Radiotherapy ◽  
Brief Pain Inventory ◽  
Numeric Rating Scale ◽  
Lower Threshold ◽  
Opioid Analgesia ◽  
Threshold Levels ◽  
Patient Reported

Abstract Patient-reported outcomes (PROs) are increasingly assessed as part of trials for new medical treatments for multiple myeloma. Pain, particularly bone pain, is an important symptom for patients with myeloma. Although time to pain progression has been evaluated as an endpoint in prostate cancer trials, this endpoint has yet to be applied in multiple myeloma despite the importance of this symptom. We sought to evaluate key issues for defining time to pain progression endpoints using two trials of anti-myeloma products submitted to the FDA. We combined data from two trials, each of which used the 0-10 point worst pain intensity numeric rating scale (0=best, 10=worst) from the Brief Pain Inventory (BPI). We evaluated changes of +1 to +5 points from pre-treatment baseline as deterioration thresholds. We considered deterioration events to be durable if patient scores did not improve by the threshold at the next visit. Event timing and frequency were evaluated using descriptive statistics. Opioid analgesia and pain-relieving procedures such as palliative radiotherapy were also assessed. We evaluated data from 1,368 patients in the pooled intention-to-treat (ITT) populations. At lower threshold levels (+2 to +3 points), 37 - 49% of patients experienced deterioration events. Of the patients with deterioration at lower threshold levels (+2 to +3 points), 39% - 44% had durable deterioration. Deterioration was less durable at higher threshold levels (+4 to +5 points), where 28% - 33% of patients with deterioration had durable deterioration. Additionally, fewer patients had deterioration events at higher threshold levels (16% - 25%). However, even if patients improved by the next visit and did not have durable deterioration, they often deteriorated again at a later timepoint; at a threshold of +5 points, >40% of patients experienced a second deterioration of +5 points after improving. Among those patients who deteriorated but then subsequently improved, pain relief through either opioid analgesia or pain-relieving procedures was used by 52% - 63% in the ITT population. For patients with minimal pain (score of <=4) or no pain (score of 0) at baseline, pain-relieving measures were used less frequently at lower deterioration thresholds (<50% of patients in either population for thresholds of +1 to +3), but more frequently at higher deterioration thresholds (47% - 62%). In conclusion, lower deterioration thresholds result in more frequent and durable events. However, patients often deteriorate, improve, and then deteriorate again. As patients may remain on clinical trials for long periods, researchers interested in assessing time to the first (durable) deterioration should clearly justify this approach. Additionally, the assessment of deterioration durability may be complicated by measures such as the use of opioid analgesia, vertebroplasty, and palliative radiotherapy. As pain is an important myeloma symptom and capturing the patient's experience while on therapy is critical, further research to better characterize patient pain while on trial is needed. Disclosures King-Kallimanis: Pharmerit International: Employment.

Ultrasound-Guided Injection of Dextrose Versus Corticosteroid in Chronic Plantar Fasciitis Management: A Randomized, Double-Blind Clinical Trial

2021 ◽  
pp. 193864002098092
Author(s):  
Gholamreza Raissi ◽  
Amin Arbabi ◽  
Maryam Rafiei ◽  
Bijan Forogh ◽  
Arash Babaei-Ghazani ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Plantar Fasciitis ◽  
Rating Scale ◽  
Corticosteroid Injection ◽  
Treatment Options ◽  
Plantar Fascia ◽  
Numeric Rating Scale ◽  
Therapeutic Effects ◽  
Ultrasound Guided ◽  
Double Blind

Design Chronic plantar fasciitis (PF) is a common cause of chronic heel pain, with different conventional treatment options. In this randomized clinical trial, the effect of ultrasound-guided injection of dextrose versus corticosteroid in chronic PF was evaluated and compared. Methods A total of 44 patients suffering from chronic PF who visited the physical medicine and rehabilitation clinic were enrolled in the study. Two table-randomized groups were formed. They received an ultrasonography-guided, single injection of either 40 mg methylprednisolone or 20% dextrose. Numeric Rating Scale (NRS), Foot and Ankle Ability Measure questionnaire with 2 subscales, Activities of Daily Living (FAAM-A) and Sports (FAAM-S), along with ultrasonographic parameters were evaluated before and at 2 and 12 weeks after the injection. Results. A total of 40 participants completed the study. Both interventions significantly improved pain and function at 2 and 12 weeks postinjection. After 2 weeks, compared with the dextrose prolotherapy, the corticosteroid group had significantly lower daytime and morning NRS scores (2.55 vs 4.1, P = .012, and 2.75 vs 4.65, P = .004), higher FAAM-S (66.84 vs 54.19; P = .047), and lower plantar fascia thickness at insertion and 1 cm distal to the insertion zone (3.89 vs 4.29 mm, P = .004, and 3.13 vs 3.48 mm, P = .002), whereas FAAM-A was similar in both groups ( P = .219). After 12 weeks, all study variables were statistically similar between corticosteroid and dextrose prolotherapy groups. No injection-related side effects were recorded in either group. Conclusion Both methods are effective. Compared with dextrose prolotherapy, our results show that corticosteroid injection may have superior therapeutic effects early after injection, accompanied by a similar outcome at 12 weeks postinjection. Levels of Evidence: Level II

scholarly journals Publisher Correction to: BRAINSTORMING: A study protocol for a randomised double-blind clinical trial to assess the impact of concurrent brain stimulation (tDCS) and working memory training on cognitive performance in Acquired Brain Injury (ABI)

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Sara Assecondi ◽  
Rong Hu ◽  
Gail Eskes ◽  
Michelle Read ◽  
Chris Griffiths ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Working Memory ◽  
Brain Injury ◽  
Cognitive Performance ◽  
Acquired Brain Injury ◽  
Working Memory Training ◽  
Memory Training ◽  
Double Blind ◽  
Double Blind Clinical Trial ◽  
The Impact

Following publication of the original article [1], the authors flagged that the article had published with the Acknowledgements erroneously excluded from the declarations at the end of the article.

Modulation of Remifentanil-induced Analgesia and Postinfusion Hyperalgesia by Parecoxib in Humans

2006 ◽  
Vol 105 (5) ◽  
pp. 1016-1023 ◽  
Author(s):  
Andreas Tröster ◽  
Ruth Sittl ◽  
Boris Singler ◽  
Martin Schmelz ◽  
Jürgen Schüttler ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Rating Scale ◽  
Control Level ◽  
Numeric Rating Scale ◽  
Cyclooxygenase 2 ◽  
Controlled Study ◽  
Double Blind ◽  
Antinociceptive Effects ◽  
Current Densities ◽  
Mu Opioids

Background Numerous experimental and clinical studies suggest that brief opioid exposure can enhance pain sensitivity. It is suggested that spinal cyclooxygenase activity may contribute to the development and expression of opioid tolerance. The aim of the investigation was to determine analgesic and antihyperalgesic properties of the cyclooxygenase-2 inhibitor parecoxib on remifentanil-induced hypersensitivity in humans. Methods Fifteen healthy male volunteers were enrolled in this randomized, double-blind, placebo-controlled study in a crossover design. Transcutaneous electrical stimulation at high current densities was used to induce spontaneous acute pain (numeric rating scale 6 of 10) and stable areas of pinprick hyperalgesia. Pain intensities and areas of hyperalgesia were assessed before, during, and after a 30-min intravenous infusion of remifentanil (0.1 microg x kg x min) or placebo (saline). Parecoxib (40 mg) was administered intravenously either with onset of electrical stimulation (preventive) or in parallel to the remifentanil infusion. Results Remifentanil reduced pain and mechanical hyperalgesia during the infusion, but upon withdrawal, pain and hyperalgesia increased significantly above control level. Preventive administration of parecoxib led to an amplification of remifentanil-induced antinociceptive effects during the infusion (71.3 +/- 7 vs. 46.4 +/- 17% of control) and significantly diminished the hyperalgesic response after withdrawal. In contrast, parallel administration of parecoxib did not show any modulatory effects on remifentanil-induced hyperalgesia. Conclusion The results confirm clinically relevant interaction of mu opioids and prostaglandins in humans. Adequate timing seems to be of particular importance for the antihyperalgesic effect of cyclooxygenase-2 inhibitors.

scholarly journals Study of Pain Level Control Targets After Arthroscopic Surgery

2021 ◽  
Author(s):  
Wang Xin ◽  
Liu Congying ◽  
Zhang Xiaole ◽  
Wang Hong ◽  
Xu Yan ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Pain Score ◽  
Pain Control ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Arthroscopic Surgery ◽  
Daily Activities ◽  
Pain Level ◽  
Convenience Sampling ◽  
The Impact

Abstract Objective: To explore the goal of pain control in patients after arthroscopic surgery.Design: Investigation. Postoperative pain, pain control satisfaction and the effect of pain on daily activities were investigated and evaluated.Setting: Department of Sports Medicine,Peking University 3rd Hospital,Beijing, P.R.ChinaSubjects: 514 patients selected by convenience sampling from patients hospitalized in a level A hospital in Beijing from 2020.06-2020.11. The patient inclusion criteria were an age of at least 18 years, no history of diagnosis of mental illness, the ability to clearly express his or her pain and an agreement to voluntarily cooperate with the investigators. The exclusion criteria were patients who were unable to complete follow-up.Methods: Postoperative pain, pain control satisfaction and the effect of pain on daily activities were investigated and evaluated by administering a homemade questionnaire to 514 patients selected by convenience sampling from patients hospitalized in a level A hospital in Beijing from 2020.06-2020.11. Pain was assessed using a digital pain numerical rating scale (NRS) (0-10), and a digital score ranging from 0 to 10 was used for satisfaction with pain control and the impact of pain on aspects of daily living.Results: The pain level was most severe in patients 6-24 hours after arthroscopic surgery, during which pain control satisfaction was at its worst. The pain score was significantly related to the effects of pain on aspects of daily life, and the degree of these effects changed significantly for pain scores greater than 2 points.Conclusion: Pain control 6 to 24 hours after surgery is not satisfactory. It is recommended that a pain score of 2 points is used as the goal for pain control after arthroscopic surgery to guide both doctors and patients to effectively control postoperative pain.

Baseline endometriosis-associated pain burden: Data from 1600+ women enrolled in elagolix clinical trials

2019 ◽  
Vol 11 (3) ◽  
pp. 117-125 ◽  
Author(s):  
Nicholas Leyland ◽  
Stephanie J Estes ◽  
Samantha Eichner ◽  
Ahmed M Soliman ◽  
Yabing Mai ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Pelvic Pain ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
Phase 3 ◽  
Double Blind ◽  
Scale Range ◽  
Study Participants ◽  
Numeric Rating Scale Score ◽  
Numeric Rating

Background: The daily pain burden experienced by women with endometriosis has not been well studied. Objective: To characterize baseline pain among women with moderate-to-severe endometriosis-associated pain enrolled in phase 3 studies of elagolix, an oral, nonpeptide gonadotropin-releasing hormone antagonist. Study design: Data were pooled from the screening phase of two randomized, double-blind, placebo-controlled clinical trials. After cessation of endometriosis medications, patients entered the screening phase during which symptoms (dysmenorrhea, nonmenstrual pelvic pain, and dyspareunia) and rescue medication use were recorded daily in electronic diaries. Endometriosis-associated pain was also scored using the Numeric Rating Scale (range 0–10). Baseline was defined as the last 35 days during the screening period. Results: Endometriosis-associated pain was reported by the 1686 study participants on most days during the baseline interval. Pain was often moderate or severe, with a mean Numeric Rating Scale score of 5.6 ± 1.7. Women reported dysmenorrhea an average of 8.1 ± 3.0 days (97.9% ± 7.0% of menstruating days), nonmenstrual pelvic pain on 20.5 ± 5.4 days (90.3% ± 15.8% of nonmenstruating days), and dyspareunia on 8.7 ± 8.0 days (81.7% ± 29.7% of sexually active days). When they occurred, dysmenorrhea, nonmenstrual pelvic pain, and dyspareunia were frequently moderate or severe in intensity. Women were free of pelvic pain for an average of 2.4 ± 3.9 days during the 35-day evaluation interval. Conclusion: Among women with untreated moderate-to-severe endometriosis pain, the daily burden of pain was extensive, both during menstruation and on nonmenstruating days.

scholarly journals Effects of Intraoperative Nefopam on Catheter-Related Bladder Discomfort in Patients Undergoing Robotic Nephrectomy: A Randomized Double-Blind Study

2019 ◽  
Vol 8 (4) ◽  
pp. 519
Author(s):  
Chi-Bum In ◽  
Young-Tae Jeon ◽  
Ah-Young Oh ◽  
Se-Jong Jin ◽  
Byeong-Seon Park ◽  
...  
Keyword(s):  
Postoperative Period ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
Control Group ◽  
Double Blind Study ◽  
Analgesic Agent ◽  
Double Blind ◽  
Robotic Nephrectomy ◽  
Male Patients ◽  
Numeric Rating

Catheter-related bladder discomfort (CRBD) is one of the most difficult symptoms during the postoperative period. Nefopam is a non-narcotic analgesic agent, which also has anticholinergic action. This study was performed to evaluate the effects of nefopam on CRBD in male patients undergoing robotic nephrectomy. A total of 109 male patients were randomly divided into two groups: the control group (n = 55) received 20 mL of normal saline, and the nefopam group (n = 54) received 20 mg of nefopam 1 h before the end of the operation. At postoperative times of 20 min, 1 h, 2 h, and 6 h, the severity of CRBD was measured using an 11-point numeric rating scale, respectively. The severity of CRBD in the nefopam group was significantly lower than that in the control group at 20 min (4.8 ± 1.3 vs. 2.3 ± 1.0, respectively, p = 0.012) and at 1, 2, and 6 h (3.5 ± 1.2, 2.7 ± 0.9, and 2.5 ± 1.0 vs. 4.1 ± 0.8, 1.6 ± 0.8, and 1.3 ± 0.6, respectively, p < 0001). Intraoperative nefopam administration reduced the severity of CRBD in patients undergoing robotic nephrectomy.

Exploration of pain management following implementation of WHO pain guidelines

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 19646-19646
Author(s):  
S. Subongkot ◽  
S. Khounnikhom ◽  
N. Pratheepawanit Johns ◽  
A. Sookprasert
Keyword(s):  
Pain Management ◽  
Pain Score ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
Cross Sectional Study ◽  
P Value ◽  
Cross Sectional ◽  
Daily Life Activities ◽  
Naive Group ◽  
Who Guideline

19646 Background: Pain is among the most common symptoms encountered in cancer patients and remains the first priority of care. Methods: This cross sectional study aimed to explore a pattern of pain management at KKU Hospital by utilizing a numeric rating scale (0–10). Cancer pain patients were categorized based on prior analgesic exposure into two groups; Naïve group, and Routine group. Treatments were defined according to WHO as 1) drug treatment relevant to pain severity, 2) analgesics being prescribed as around-the- clock and 3) analgesics used for break-through pain for patients receiving strong opioid. Results: From Dec 2005 to Jul 2006, 261 patients were enrolled. 93.1% (n=243) were in advanced stages and 88.5% (n=231) were in moderate to severe pain. This pain interfered with patient’s daily life activities mildly to moderately as each pain score increased (p-value<0.01). In Naive group (n=159), 32.7% (n=52) were given analgesics following the WHO on both days 1 and day 3 of admission whereas 40.2% (n=64) patients were not. A decreased pain score was greater (2.61, SD±1.5) in a group following the WHO on day 1. Additionally, a decreased pain score was greater (3.91, SD±1.8) in a group following the WHO on day 3 (p-value <0.0001). This pain score decreased was also clinically significant as pain score reduced more than 3 points. In Routine group (n=102), 32 (31.4%) were given analgesics following the WHO guideline on both day 1 and day 3 of admission. In contrast, 36 (35.3%) were not. A decreased pain score was greater (2.59, SD±1.8) in a routine group following the WHO on day 1. Moreover, a decreased pain score was greater (3.95, SD±1.8) in a group following the WHO on day 3. The clinical significance of pain score reduced was also found on day 3. Of the 261 evaluable patients, the pattern of analgesics usage following the WHO guideline was increased in both groups comparing to at the beginning of the study. Conclusions: The results demonstrated that patients who received pain management following the WHO guideline reported significantly lower pain intensity than those not following the WHO. No significant financial relationships to disclose.

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