Efficacy of urination in alleviating urethral pain associated with flexible cystoscopy - a single-center randomized trial

Abstract Objective: This study aimed to assess whether urethral pain can be alleviated by urination in male patients undergoing flexible cystoscopy. Patient and Methods: Ninety-six male outpatients undergoing flexible cystoscopy were randomly divided into two groups. Patients in the test group urinated during flexible cystoscopy, whilst patients in the control group received no instructions to do so. All patients received 10mL of 2% lidocaine gel prior to assessment. Using 0 (no-pain) to 10 (unbearable severe pain) pain scores (VAS), we assessed patient discomfort prior to anesthesia gel perfusion (baseline), during gel perfusion, during cystoscope insertion through the urethra, and 15minutes post-examination analysis. The entire protocol was completed by a single doctor in our Department of Urology. Results: The groups showed no statistical differences regarding age or examination time. During cystoscope insertion, the test group recorded significantly lower pain scores 2 (IQR 1-3) - compared to the control group 3 (IQR 2-3) , (P = 0.001). No significant differences between other evaluation points were observed between groups. Conclusion: Urethral pain can be significantly alleviated by urination in male patients undergoing flexible cystoscopy through the urethra.

Download Full-text

Efficacy of urination in alleviating man’s urethral pain associated with flexible cystoscopy : a single-center randomized trial

10.21203/rs.2.11112/v3 ◽

2019 ◽

Author(s):

Yingwei Xie ◽

Wei Wang ◽

Wei Yan ◽

Dan Liu ◽

Yuexin Liu

Keyword(s):

Test Group ◽

Control Group ◽

Flexible Cystoscopy ◽

Pain Scores ◽

Examination Time ◽

Lower Pain ◽

Lidocaine Gel ◽

Group 3 ◽

Male Patients ◽

Urethral Pain

Abstract Objective: This study aimed to assess whether urethral pain can be alleviated by urination in male patients undergoing flexible cystoscopy. Patient and Methods: Ninety-six male outpatients undergoing flexible cystoscopy were randomly divided into two groups. Patients in the test group urinated during flexible cystoscopy, whilst patients in the control group received no instructions to do so. All patients received 10mL of 2% lidocaine gel prior to assessment. Using 0 (no-pain) to 10 (unbearable severe pain) pain scores (VAS), we assessed patient discomfort prior to anesthesia gel perfusion (baseline), during gel perfusion, during cystoscope insertion through the urethra, and 15minutes post-examination analysis. The entire protocol was completed by a single doctor in our Department of Urology. Results: The groups showed no statistical differences regarding age or examination time. During cystoscope insertion, the test group recorded significantly lower pain scores 2 (IQR 1-3) - compared to the control group 3 (IQR 2-3) , (P = 0.001). No significant differences between other evaluation points were observed between groups. Conclusion: Urethral pain can be significantly alleviated by urination in male patients undergoing flexible cystoscopy through the urethra.

Download Full-text

Ultrasound-Guided Funicular Block: Ropivacaine Injection into the Tissue around the Spermatic Cord to Improve Analgesia during Orchiectomy in Dogs

Animals ◽

10.3390/ani11051275 ◽

2021 ◽

Vol 11 (5) ◽

pp. 1275

Author(s):

Vincenzo Cicirelli ◽

Pasquale Debidda ◽

Nicola Maggio ◽

Michele Caira ◽

Giovanni M. Lacalandra ◽

...

Keyword(s):

Postoperative Pain ◽

General Anaesthesia ◽

Spermatic Cord ◽

Postoperative Pain Management ◽

Control Group ◽

Ultrasound Guided ◽

Hemodynamic Stability ◽

Pain Scores ◽

Lower Pain ◽

Ropivacaine Hydrochloride

Orchiectomy is a common surgical procedure performed on small animals, and it requires postoperative pain management despite its relative simplicity. This study aimed to evaluate the hemodynamic stability, intraoperative administration of additional hypnotic and/or analgesic drugs, and postoperative pain scores following the combination of ultrasound-guided injection of ropivacaine hydrochloride into the spermatic cord and infiltration by the same anaesthetic of the incisional prescrotal line (ROP) or general anaesthesia. Dogs in the ROP group showed greater intraoperative hemodynamic stability and lower pain scores than the control group. The locoregional approach used in this study proved effective in minimising the responses to the surgical stimulus and ensured adequate analgesia intra- and postoperatively. This method, called ultrasound-guided funicular block, allows orchiectomy to be performed under deep sedation without general anaesthesia.

Download Full-text

Clinical Evaluation of a Novel Technology for Oral Patient-Controlled Analgesia, the PCoA® Acute Device, for Hospitalized Patients with Postoperative Pain, in Pilot Feasibility Study

Pain Research and Management ◽

10.1155/2017/7962135 ◽

2017 ◽

Vol 2017 ◽

pp. 1-12 ◽

Cited By ~ 3

Author(s):

Stefan Wirz ◽

Stefan Conrad ◽

Ronit Shtrichman ◽

Kai Schimo ◽

Eva Hoffmann

Keyword(s):

Postoperative Pain ◽

Elective Surgery ◽

Test Group ◽

Medication Administration ◽

Control Group ◽

Medical Centers ◽

Novel Technology ◽

Pain Scores ◽

Pain Ratings ◽

Pilot Feasibility Study

Background. Acute postoperative pain delays recovery and increases morbidity and mortality. Traditional administration of postoperative analgesics by nurses is often inefficient. The present study evaluated the safety, efficacy, and usability of a novel, patient-controlled analgesic dispenser, the PCoA Acute. Methods. A controlled pilot study was conducted at three medical centers. Patients scheduled for elective surgery were enrolled into two groups, both taking oral analgesics: a control group (n=43), opioids dispensed by nurses, and a test group (n=27), opioids dispensed via the PCoA Acute. Pill intake data were recorded. Pain ratings at rest and during movement were surveyed. Results. No severe adverse events were recorded. Average pill intake time was reduced from 8 : 58 minutes in the control group to 1 : 17 minutes in the test group (P value < 0.05). The test group took 67% more pills than the control group, indicating enhanced compliance. Pain scores were significantly lower for patients in the test group (P value < 0.05). Over 90% of PCoA Acute users were satisfied with its use. Conclusions. The study confirmed that PCoA Acute is safe and effective. It is well accepted by patients and medical staff. Its use can optimize pain medication administration.

Download Full-text

Interpleural Administration of Bupivacaine after Cholecystectomy: A Comparison with Intercostal Nerve Block

Anaesthesia and Intensive Care ◽

10.1177/0310057x8901700305 ◽

1989 ◽

Vol 17 (3) ◽

pp. 269-274 ◽

Cited By ~ 10

Author(s):

D. W. Blake ◽

G. Donnan ◽

J. Novella

Keyword(s):

Local Anaesthetic ◽

Intercostal Nerve ◽

Intercostal Nerve Block ◽

Nerve Blocks ◽

Pain Scores ◽

Lower Pain ◽

Chest X Ray ◽

Group 3 ◽

Group 2 ◽

Group 1

Pethidine requirements and verbal pain scores were recorded in 36 patients after cholecystectomy via subcostal incision. All patients also received 20 ml 0.5% bupivacaine with adrenaline 1/200,000. Group 1 (12 patients) received unilateral intercostal nerve blocks. Interpleural catheters were inserted through the 8th intercostal space in the remaining patients; 12 received local anaesthetic via the catheter immediately after surgery (Group 2) and 12 were given local anaesthetic at three hours (Group 3). Small asymptomatic pneumothoraces were noted on chest X-ray in six of the 24 patients with interpleural catheters. Both types of local anaesthesia produced lower pain scores than pethidine alone (P < 0.05) with 25% of intercostal nerve blocks and 63% of interpleural catheters requiring no pethidine in the following three hours. The provision of catheter ‘top-ups’ between six and 18 hours after surgery also resulted in lower pain scores and a reduction in pethidine requirements (P < 0.05).

Download Full-text

Effects of the Preoperative Administration of Dexketoprofen Trometamol on Pain and Swelling After Implant Surgery: A Randomized, Double-Blind Controlled Trial

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-17-00185 ◽

2018 ◽

Vol 44 (2) ◽

pp. 122-129

Author(s):

Arturo Sánchez-Pérez ◽

Jesús Muñoz-Peñalver ◽

María José Moya-Villaescusa ◽

Carmen Sánchez-Matás

Keyword(s):

Placebo Group ◽

Postoperative Pain ◽

Controlled Trial ◽

Test Group ◽

Control Group ◽

Double Blind ◽

Implant Surgery ◽

Lower Pain ◽

Dexketoprofen Trometamol ◽

Group A

The fear of postoperative pain is often mentioned by patients as one of the factors that is most frequently associated with dental implants. To reduce this factor, a single oral dose of 25 mg dexketoprofen trometamol (DKT) or placebo was administered 15 minutes before implant surgery. One hundred patients who required single-implant treatments were randomly assigned to 1 of 2 blinded groups. The patients in the test group were given 25 mg DKT (DKT group), and those in the control group were given 500 mg vitamin C as a placebo (PLACEBO group). A subjective visual analogue scale of 100 mm in length was used to evaluate pain. Inflammation and complications were assessed using a 5-point Likert scale. An analysis of variance, t-tests, and a Mann-Whitney U test were performed. Among the 100 patients, 83 completed the study (there were 8 dropouts in the PLACEBO group and 9 in the DKT group). The patients who received DKT reported a lower pain intensity during the immediate postoperative period. The inflammatory response was weaker in the DKT group than the control group at 48 hours, but bleeding was greater. There were no other complications in either of the groups. In conclusion, the preemptive use of 25 mg soluble DKT administered orally 15 minutes before implant surgery can reduce the severity of immediate postoperative pain.

Download Full-text

A structured exercise to relieve musculoskeletal pain caused by face-down posture after retinal surgery: a randomized controlled trial

Scientific Reports ◽

10.1038/s41598-021-01182-w ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

A-Young Kim ◽

Sungsoon Hwang ◽

Se Woong Kang ◽

So Yeon Shin ◽

Won Hyuk Chang ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Musculoskeletal Pain ◽

Controlled Trial ◽

Exercise Group ◽

Control Group ◽

Randomized Controlled ◽

Pain Scores ◽

Lower Back ◽

Physical Burden ◽

Lower Pain

AbstractFace-down posture after vitrectomy physically burdens patients. Despite being of significant concern for patients, the intraoperative pain and discomfort has not been of great interest to retinal surgeons or researchers. This randomized controlled trial evaluated the effect of a 3-day novel structured exercise on reducing musculoskeletal pain from the face-down posture in 61 participants (31 in the exercise group) who underwent vitrectomy. Among the subjects, the median age was 62 years, 42 were female, 42 had macular holes, and 19 had retinal detachments. Participants in the exercise group received initial education on the exercise and performed three daily active exercise sessions. After the sessions, the exercise group had median numeric pain scores of 2, 1, and 1 at the back neck, shoulder, and lower back, respectively, while the control group had corresponding scores of 5, 3, and 4, respectively. The exercise group reported significantly lower pain scores (P = .003, .039, and .006 for the back neck, shoulder, and lower back, respectively). Application of the structured exercise would alleviate the patients’ position-induced postoperative physical burden, by reducing pain and discomfort.

Download Full-text

Postoperative Analgesia for Pediatric Craniotomy Patients: A Randomized Controlled Trial

10.21203/rs.2.192/v3 ◽

2019 ◽

Author(s):

Fei Xing ◽

LiXin An ◽

FuShan Xue ◽

ChunMei Zhao ◽

YaFan Bai

Keyword(s):

Postoperative Analgesia ◽

Severe Pain ◽

Pediatric Patients ◽

Group Versus ◽

Pediatric Neurosurgery ◽

Control Group ◽

Morphine Group ◽

Pain Scores ◽

Background Infusion ◽

Lower Pain

Abstract Background: Pain is often observed in pediatric patients after craniotomy procedures, which could lead to some serious postoperative complications. However, the optimal formula for postoperative analgesia for pediatric neurosurgery has not been well established. This study aimed to explore the optimal options and formulas for postoperative analgesia in pediatric neurosurgery. Methods: Three hundred and twenty patients aged 1 to 12-years old who underwent craniotomy were randomly assigned to receive 4 different regimens of patient-controlled analgesia. The formulas used were as follows: Control group included normal saline 100 ml, with a background infusion of 2 ml/h, bolus 0.5 ml; Fentanyl group was used with a background infusion of 0.1-0.2 μg/k·h, bolus 0.1-0.2 μg/kg; Morphine group was used with a background infusion of 10-20 μg/kg·h, bolus 10-20 μg/kg; while Tramadol group was used with a background infusion of 100-400 μg/kg·h, bolus 100-200 μg/kg. Postoperative pain scores and analgesia-related complication were recorded respectively. Comparative analysis was performed between the four groups. Results: In comparison of all groups with each other, lower pain scores were shown at 1 hour and 8 hour after surgery in Morphine group versus Tramadol, Fentanyl and Control groups (P<0.05). Both Tramadol and Fentanyl groups showed lower pain scores in comparison to Control group (P<0.05). Nausea and vomiting were observed more in Tramadol group in comparison to all other groups during the 48 hours of PCIA usage after operation (P=0.020). Much more rescue medicines including ibuprofen and morphine were used in Control group (CI=0.000-0.019). Changes in consciousness and respiratory depression were not observed in study groups. Moderate-to-severe pain was observed in a total of 56 (17.5%) of the study population. Multiple regression analysis for identifying risk factors for moderate-to-severe pain revealed that, younger children (OR=1.161, 1.027-1.312, P=0.017), occipital craniotomy (OR=0.374, 0.155-0.905, P=0.029), and morphine treatment (OR=0.077, 0.021-0.281, P<0.001) are the relevant factors. Conclusions: Compared with other analgesic projects, PCIA or NCIA analgesia with morphine appears to be the safest and most effective postoperative analgesia program for pediatric patients who underwent neurosurgical operations. Trial registration: Chinese Clinical Trial Registry. No: ChiCTR-IOC-15007676. Prospective registration. http://www.chictr.org.cn.

Download Full-text

Several interventions to alleviate pain in male patients undergoing oﬃce-based ﬂexible cystoscopy: a systematic review and meta-analysis

10.31083/jomh.2021.077 ◽

2021 ◽

Keyword(s):

Meta Analysis ◽

Cochrane Collaboration ◽

Pooled Analysis ◽

Mean Difference ◽

Cochrane Library ◽

Flexible Cystoscopy ◽

Standard Mean Difference ◽

Study Heterogeneity ◽

Lower Pain ◽

Male Patients

Background: The purpose of this study was to explore the ability of nonpharmacologic adjuvant interventions to alleviate pain in male patients during ﬂexible cystoscopy (FC) under local anesthesia. Methods: Electronic databases including PubMed, the Cochrane Library, and Embase were searched to identify eligible clinical trials from inception to 31 December 2020, with no language restrictions. Two independent reviewers used Cochrane Collaboration tools to assess the selection criteria, methodological rigor and risk of bias. Statistical analyses were performed using STATA 14.2. Results: In total, 717 studies were initially identiﬁed, and fourteen randomized controlled trials were ultimately included. We observed that patients who underwent FC with higher irrigation pressures had signiﬁcantly lower pain scores on the visual analog scale than their counterparts with lower irrigation pressure during FC (weight mean difference (WMD): −1.43; 95% conﬁdence interval (CI): −1.72 to −1.14) with no between-study heterogeneity (p = 0.661). There were no signiﬁcant differences in pain between immediate or delayed FC groups under the same local anesthetic (standard mean difference (SMD): −0.19; 95% CI: −0.39 to 0.01). A pooled analysis of three studies including 340 male patients showed that men who observed the cystoscopy on the monitor had signiﬁcantly lower pain ratings compared to those who did not view the operation on the monitor (SMD: −0.64; 95% CI: −1.14 to −0.15). Two studies, including a total of 272 patients, assessed the inﬂuence of listening to music on pain and anxiety in male patients during FC. Our meta-analysis found that music signiﬁcantly improved patient pain (WMD: −0.92; 95% CI: −1.29 to −0.54). Hand-holding and urination during FC also relieved pain and anxiety in male patients undergoing FC. Conclusions: We observed that elevated irrigation pressure, real-time cystoscopy visualization, and music therapy alleviated pain in male patients undergoing FC. Well-designed trials are needed to conﬁrm our ﬁndings.

Download Full-text

Evaluation of Cardioprotective action of Suvarna gairik (Redochre) in Indian Cobra Envenomation, Aluminium Phosphide Poisoning and Doxorubicin Cardiotoxicity in Albino Rats- A Protocol

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i60a34500 ◽

2021 ◽

pp. 405-411

Author(s):

Santoshi Mane ◽

Nilima Wadnerwar ◽

Sudhir Ninave ◽

R. D. Wajgi ◽

R. R. Dighade

Keyword(s):

Cardiac Arrest ◽

Disease Control ◽

Test Group ◽

Control Group ◽

Albino Rats ◽

Aluminium Phosphide ◽

Doxorubicin Cardiotoxicity ◽

Group 3 ◽

Hospital Cardiac Arrest ◽

Group 1

Background: Poisoning is major health issue all over the world. Poisoning is one of basic causes for Out Hospital cardiac arrest (OHCA). P-OHCA (Poison induced Out Hospital cardiac arrest) can be prevented by immediate primary management. The agent for poisoning is unknown in most cases, which leads to difficulty deciding the emergency antidote. In Ayurveda Hridyavaranchikitsa (Cardio protection) is one of the treatment modalities mentioned in all types of poisoning as first aid treatment. Suvarna Gairik (Red ochre) is one of drugs mentioned for the cardioprotection. Snake bite and organophosphate poisoning are the threats to life in India. Doxorubicin is commonly used drug for Chemotherapy in malignancies, and its major side effect is cardiotoxicity. Hence these poisonings are included in study. Aim and Objective: Evaluation of cardioprotective activity of Suvarna Gairik (Red ochre) in cardiac biomarker like Lactate dehydrogenase, Creatinine phosphokinase, Alkaline transferase, Cardiac Troponins and Survival Time in Indian Cobra Envenomation, Aluminium phosphide poisoning and Doxorubicin cardiotoxicity in Albino Rats. Methodology: Animal study is designed. 56 wistar rats will be divided in 7 groups as Vehicle Control Group, Disease control Group -1 Indian Cobra envenomation, Disease control Group -2Aluminium Phosphide poisoning, Disease control Group -3 Inj. Doxorubicin induced cardiotoxicity, Test Group -1 Indian Cobra Envenomation and Suvarna gairik Test Group -2 Aluminium Phosphide poisoning and Suvarna gairik Test control Group 3- Inj. Doxorubicin cardiotoxicity and Suvarna gairik. Results: Outcome will be assessed in between groups and among groups. Conclusion: Suvarna Gairik (Red ochre) may show statistical significant cardioprotective activity.

Download Full-text