scholarly journals Study of pain level control targets after arthroscopic surgery

2021 ◽  
Author(s):  
Xin Wang ◽  
Congying Liu ◽  
Xiaole Zhang ◽  
Hong Wang ◽  
Yan Xu ◽  
...  
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, a lack of significant personality disorders, stable social and psychological factors, the ability to clearly express his or her pain and an agreement to voluntarily cooperate with the investigators. The exclusion criteria were patients who had been using painkillers long-term and those with other acute and chronic pain disorders.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.

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.

scholarly journals Electroacupuncture to alleviate postoperative pain after a laparoscopic appendectomy: study protocol for a three-arm, randomised, controlled trial

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e015286 ◽  
Author(s):  
Seunghoon Lee ◽  
Dongwoo Nam ◽  
Minsoo Kwon ◽  
Won Seo Park ◽  
Sun Jin Park
Keyword(s):  
Postoperative Pain ◽  
Laparoscopic Appendectomy ◽  
Pain Control ◽  
Rating Scale ◽  
Acupuncture Treatment ◽  
Numerical Rating Scale ◽  
Controlled Trial ◽  
Control Group ◽  
Acupuncture Points ◽  
Postoperative Pain Control

BackgroundThe purpose of this study is to evaluate the efficacy and safety of electroacupuncture (EA) for postoperative pain after laparoscopic appendectomy compared with sham electroacupuncture (SEA) and no acupuncture treatment.Methods and analysisThis study is a protocol for a three-arm, randomised, patient-assessor-blinded (to the type of acupuncture treatment), controlled, parallel trial. 138 participants diagnosed with appendicitis and scheduled for laparoscopic appendectomy will be randomly assigned to the EA group (n=46), SEA group (n=46) or control group (n=46). The EA group will receive acupuncture treatment at both regional and distal acupuncture points with electrostimulation. The SEA group will receive sham acupuncture treatment with mock electrostimulation. Both EA and SEA groups will receive a total of four treatments 1 hour preoperative, 1 hour postoperative and during the morning and afternoon the day after surgery with the same routine postoperative pain control. The control group will receive only routine postoperative pain control. The primary outcome is the 11-point Pain Intensity Numerical Rating Scale (PI-NRS) at 24 hours after surgery. The secondary outcomes are the PI-NRS, analgesic consumption, opioid-related side effects, time to first passing flatus, quality of life and adverse events evaluated 6, 12, 24 and 36 hours and 7 days after surgery.Ethics and disseminationThe study was planned in accordance with the Helsinki Declaration and the Korean Good Clinical Practice Guidelines to protect the participants and was approved by the institutional review board (IRB) of Kyung Hee University Medical Center (KMC IRB-1427–02). The results will be disseminated in peer-reviewed journals and presented at international conferences.Trial registration numberClinical Research Information Service (KCT0001328).

scholarly journals Determinants of Pain Severity Changes in Ambulatory Patients With Cancer: An Analysis From Eastern Cooperative Oncology Group Trial E2Z02

2014 ◽  
Vol 32 (4) ◽  
pp. 312-319 ◽  
Author(s):  
Fengmin Zhao ◽  
Victor T. Chang ◽  
Charles Cleeland ◽  
James F. Cleary ◽  
Edith P. Mitchell ◽  
...  
Keyword(s):  
Pain Management ◽  
Pain Score ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Eastern Cooperative Oncology Group ◽  
Pain Severity ◽  
Initial Assessment ◽  
Pain Level ◽  
Ambulatory Patients

Purpose To understand changes in pain severity over time and to explore the factors associated with pain changes in ambulatory patients with solid tumors. Patients and Methods We enrolled 3,106 patients with invasive cancer of the breast, prostate, colon/rectum, or lung from multiple sites. At baseline and 4 to 5 weeks later, patients rated their pain level on a 0 to 10 numerical rating scale. A 2-point change in pain score was defined as a clinically significant change in pain. Multivariable logistic models were fitted to examine the effects of pain management and demographic and clinical factors on change in pain severity. Results We analyzed 2,761 patients for changes in pain severity. At initial assessment, 53.0% had no pain, 23.5% had mild pain, 10.3% had moderate pain, and 13.2% had severe pain. Overall, one third of patients with initial pain had pain reduction within 1 month of follow-up, and one fifth had an increase, and the improvement and worsening of pain varied by baseline pain score. Of the patients without pain at initial assessment, 28.4% had pain (8.9% moderate to severe) at the follow-up assessment. Logistic regression analysis showed that inadequate pain management was significantly associated with pain deterioration, as were lower baseline pain level, younger age, and poor health status. Conclusion One third of patients have pain improvement and one fifth experience pain deterioration within 1 month after initial assessment. Inadequate pain management, baseline pain severity, and certain patient demographic and disease characteristics are associated with pain deterioration.

scholarly journals The Analgesic Efficacy of Nefopam in Patient-Controlled Analgesia after Laparoscopic Gynecologic Surgery: A Randomized, Double-Blind, Non-Inferiority Study

2021 ◽  
Vol 10 (5) ◽  
pp. 1043
Author(s):  
Soomin Lee ◽  
Seounghun Lee ◽  
Hoseop Kim ◽  
Chahyun Oh ◽  
Sooyong Park ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Pain Control ◽  
Primary Outcome ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Nausea And Vomiting ◽  
Gynecologic Surgery ◽  
Patient Controlled Analgesia ◽  
Postoperative Pain Control ◽  
Laparoscopic Gynecologic Surgery

Opioid-sparing effects of nefopam during patient-controlled analgesia (PCA) are well demonstrated. We hypothesized that postoperative pain control with an opioid-equivalent dose of nefopam as a single analgesic agent for PCA would not be inferior to fentanyl in laparoscopic gynecologic surgery. In total, 135 patients were randomly assigned to the N (nefopam 200 mg), NF (fentanyl 500 mcg + nefopam 100 mg), and F (fentanyl 1000 mcg) groups (n = 45 patients per group). The primary outcome was the numerical rating scale (NRS) score at rest at 6 h postoperatively, and the non-inferiority limit was set to 1. Secondary outcomes were pain severity and incidence of nausea and vomiting for 48 h postoperatively. Mean differences (MD) in primary outcome between the N and F groups were 0.4 (95% confidence interval (CI) −0.5 to 1.3). The upper limit of 95% CI exceeded the non-inferiority limit. The N group showed higher pain scores than the NF group (MD, 1.1; 95% CI, 0.3–1.9) in pairwise comparisons. No significant intergroup differences were observed in the cumulative dose of PCA usage and incidence of postoperative nausea and vomiting (PONV). In laparoscopic gynecological surgery, nefopam alone showed limited efficacy for postoperative pain control.

Patient controlled analgesia (PCA) versus non-PCA intravenous hydromorphone titration for severe cancer pain: A randomized, controlled, multicenter, phase III trial, HMORCT09-1.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. TPS11635-TPS11635
Author(s):  
Rongbo Lin ◽  
Jinfeng Zhu ◽  
Shuitu Feng ◽  
Sunzhi Lin ◽  
Jianqian Fu ◽  
...  
Keyword(s):  
Side Effects ◽  
Cancer Pain ◽  
Pain Score ◽  
Pain Control ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Phase Iii ◽  
Opioid Tolerance ◽  
Self Administration ◽  
Opioid Dose

TPS11635 Background: The opioid dose for an individual with cancer pain to provide adequate relief of pain with an acceptable degree of side effects is variable. Opioid titration is a process to obtain the tailored dose. Conventional titration is administered by a clinician or nurse. PCA is that patients control cancer pain by self-administration of intravenous opioids using programmable pump. The aim of our study is to evaluate the efficacy of PCA titration versus conventional titration intravenously for severe cancer pain (10-point numerical rating scale, NRS ≥ 7). Injectable Hydromorphone was selected as pharmaceutical analgesics, which works as well as morphine and oxycodone and had similar side effects. Methods: This is currently enrolling patients (n=230) with severe cancer pain during previous 24 hours. Patients are randomized 1:1 and stratified by opioid intolerance or opioid tolerance into PCA or non-PCA titration. PCA titration using programmable pump: bolus hydromorphone at 0.5mg (for opioid intolerance) or hydromorphone dose equivalent to 10% to 20% of the total opioid taken in the previous 24 hours with a lockout time 15 minutes (for opioid tolerance) was administered by the patients educated. No basal infusion was set in the pump. Non-PCA titration administered by a nurse or clinician: Initial hydromorphone doses were same with PCA titration. Reassess pain at 15 minutes. Increased dose of hydromorphone by 50%-100% if pain unchanged or increased, or repeat same dose if pain decreased to NRS 4-6, or continue at current effective dose as needed over initial 24 hours. The primary endpoint is the time needed to successful titration was defined the time from the first dose of hydromorphone after randomization to achieve satisfied pain control. The satisfied pain control was defined NRS pain score ≤ 3 at rest in at least 2 consecutive assessment (15 minutes interval). The time needed to successful titration was extended to achieve satisfied pain control again if NRS pain score ≥ 7 after satisfied pain control within 24 hours. The failure of successful titration was defined that satisfied pain control does not achieve within 24 hours. Secondary endpoints include the percentage of patients titrated successfully, the mean NRS pain score of 24 hours, the total dose of hydromorphone titrated, and adverse events. Clinical trial information: NCT03375515.

Ultrasound-Guided Pulsed Radio Frequency Treatment in Morton's Neuroma

2015 ◽  
Vol 105 (4) ◽  
pp. 302-306 ◽  
Author(s):  
Suleyman Deniz ◽  
Tarik Purtuloglu ◽  
Sukru Tekindur ◽  
Kadir Hakan Cansız ◽  
Memduh Yetim ◽  
...  
Keyword(s):  
Radio Frequency ◽  
Pain Control ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Pain Level ◽  
Ultrasound Guided ◽  
Morton’S Neuroma ◽  
Open Label ◽  
Morton's Neuroma ◽  
Perineural Fibrosis

Background Morton's neuroma is a perineural fibrosis of an intermetatarsal plantar nerve. Burning, numbness, paresthesia, and tingling down the interspaces of involved toes may also be experienced. Taking into account all of this information, we designed a prospective open-label study to evaluate the efficacy of pulsed radio frequency on Morton's neuroma. Methods Twenty patients with Morton's neuroma were experiencing symptomatic neuroma pain in the foot not relieved by routine conservative treatment. All of the patients had been evaluated by a specialized orthopedist and were offered pulsed radio frequency as a last option before having surgery. Initially, pain level (numerical rating scale), successful pain control (a ≥50% pain decrease was accepted as successful pain control), comfort when walking (yes or no), and satisfaction level (satisfied or not satisfied) were evaluated. Results We found a decrease in the pain level in 18 of 20 patients, successful pain control in 12, and wearing shoes and walking without pain in 16. Overall, satisfaction was rated as excellent or good by 12 patients with Morton's neuroma in this series. Conclusions This evidence indicates that ultrasound-guided pulsed radio frequency is a promising treatment modality in the management of Morton's neuroma pain.

scholarly journals Comparison between circumferential local anesthesia and dorsal penile nerve block in circumcision procedure

2021 ◽  
Vol 42 (1) ◽  
pp. 51-55
Author(s):  
Chawat Angsurak ◽  
Keyword(s):  
Pain Score ◽  
Local Anesthesia ◽  
Nerve Block ◽  
Pain Control ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Ventral Surface ◽  
Controlled Clinical Trial ◽  
Dorsal Penile Nerve Block ◽  
Dorsal Penile Nerve

Objectives: To compare circumferential local anesthesia and dorsal penile nerve block with regard to pain control during adult circumcision. Materials and Methods: A randomized, controlled clinical trial was conducted and 30 men were randomly assigned into one of the following groups: circumferential local anesthesia (LA) and dorsal penile nerve block (DNB). Patients in both groups were injected with 0.2 ml/kg of 2% lidocaine without epinephrine before circumcision using the different techniques. During the operation, pain score was evaluated in accordance with the Numerical Rating Scale (NRS) and the data were compared using the Mann-Whitney test. Results: The patients in the LA group felt more pain than those in the DNB group during anesthetic injection (4.73 vs 3.7, p<0.05) but the pain scores were lower than in the DNB group during the outer prepuce incision (0.47 vs 3.93, p<0.05), inner prepuce incision (0.33 vs 1.47, p<0.05) and incision near/at Frenulum (0.33 vs 4.47, p<0.05). Overall pain score was higher in the dorsal penile nerve block group (1.53 vs 2.6, p <0.05). The circumferential local anesthesia is equally effective through all stages of the circumcision whereas the dorsal penile nerve block was not effective at the ventral surface of penis. Conclusion: For pain control in circumcision, circumferential local anesthesia is more effective than dorsal penile nerve block.

scholarly journals Effectiveness of Tramadol with Bupivacaine Versus Bupivacaine Alone on Postoperative Analgesia at Wolaita Sodo, Southern Ethiopia: Observational Cohort Study

2021 ◽  
Author(s):  
Tsegaye Demeke G/medhin ◽  
Mohammed Suleiman Obsa ◽  
Andualem Asefa Andebirku ◽  
Ashebir Debalike Gemechu ◽  
Kirubel Eshetu Haile
Keyword(s):  
Cohort Study ◽  
Postoperative Pain ◽  
Pain Score ◽  
Postoperative Analgesia ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Statistical Significance ◽  
Pain Severity ◽  
Southern Ethiopia ◽  
P Value

Abstract Background: Postoperative pain can cause immediate and extended consequences of poor outcome and result in extended hospitalization. It also progresses to chronic pain, if not intervening early. Wound site infiltration with a mixture of tramadol and bupivacaine is inexpensive, easy, and useful means of providing desirable analgesia for postoperative pain relief. The purpose of the study was to compare the analgesic effectiveness of bupivacaine with the tramadol combination and bupivacaine alone as part of postoperative pain management.Method: A prospective cohort study was employed on 120 patients who underwent elective lower abdominal surgery under general or spinal anesthesia with a systematic random sampling technique. Pain severity was measured by using a numerical rating scale, and the employment of additional analgesics was recorded for 24 hours between the two groups. The Mann-Whitney test and chi-square test were used to compare the median pain score and total analgesia consumption. Kaplan-Meier survival analysis was used to compare the time to first analgesic request between the two groups. Statistical significance was stated at a p value < 0.05 with a power of 95%.Result: Postoperatively, the median (interquartile range) of pain severity score was 1.0 (0-5) in the BT group compared with 5 (3-6) in the BA group. And, time to first analgesic request with the BT group, was 18 hours, 95% CI: (14.53- 21.47), had longer time compared to patients in the BA group was 6 hours, 95% CI:(4.48 - 7.71).Conclusion and Recommendation: Local wound infiltration with a mixture of Bupivacaine and Tramadol decreases the postoperative pain score, total analgesia consumption and has prolonged time to first analgesia request. Therefore, we recommend using a mixture of 0.25% bupivacaine with tramadol is effective for postoperative analgesia.

Comparison of Analgesic Effect of Levobupivacaine with Dexmedetomidine and Levobupivacaine for Scalp Block before Supratentorial Craniotomy: A Randomized Controlled Trial

2020 ◽  
Vol 103 (10) ◽  
pp. 1028-1035
Keyword(s):  
Postoperative Pain ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Control Group ◽  
Study Group ◽  
Analgesic Requirement ◽  
Supratentorial Craniotomy ◽  
Numerical Rating ◽  
Fentanyl Consumption ◽  
Scalp Block

Background: Craniotomy causes acute and chronic pain. Uncontrolled postoperative pain may lead to adverse events. Perioperative scalp nerves block is not only effective in reducing intraoperative hemodynamic response, but it also reduces postoperative pain and postoperative analgesia requirement. Objective: To compare the benefits of adding dexmedetomidine to levobupivacaine in scalp nerves block before craniotomy for the duration of analgesia in supratentorial craniotomy. Materials and Methods: After approval by the Committee for Research, 50 supratentorial craniotomy patients were randomized into two groups. The control group received 30 mL scalp nerves block with 0.25% levobupivacaine with adrenaline 1:200,000, whereas the study group received 30 mL scalp nerves block with 0.25% levobupivacaine with adrenaline 1:200,000 plus dexmedetomidine 1 mcg/kg. The primary outcome was the time to first analgesic requirement postoperatively. The secondary outcomes included intraoperative fentanyl consumption, verbal numerical rating scale, tramadol consumption, and complications during the first 24 hours postoperatively. Results: Patients in the study group had significantly increase time to the first analgesic requirement in postoperative period and reduced intraoperative fentanyl consumption. The median time to first analgesic requirement was 555 (360 to 1,035) minutes in the study group versus 405 (300 to 520) minutes in the control group (p=0.023). Intraoperative fentanyl consumption 125 (75 to 175) mcg in the study group was significantly lower than 200 (150 to 250) mcg in the control group (p=0.02). The verbal numerical rating scale at 1, 4, 8, 12 and 24 hours postoperatively, tramadol consumption, and complications during the first 24 hours postoperatively were not statistically significant different. Conclusion: Preoperative scalp nerves block with 0.25% levobupivacaine with adrenaline (1:200,000) with dexmedetomidine 1 mcg/kg significantly increased the time to first analgesic requirement and reduced intraoperative fentanyl consumption compared to 0.25% levobupivacaine with adrenaline (1:200,000) without perioperative complications. Keywords: Scalp block, Dexmedetomidine, Post-craniotomy analgesia, Supratentorial tumor, Levobupivacaine

scholarly journals Early postoperative pain as a marker of anastomotic leakage in colorectal cancer surgery

2021 ◽  
Author(s):  
Petrus Boström ◽  
Johan Svensson ◽  
Camilla Brorsson ◽  
Martin Rutegård
Keyword(s):  
Colorectal Cancer ◽  
Postoperative Pain ◽  
Colorectal Surgery ◽  
Anastomotic Leakage ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Population Based ◽  
Colorectal Cancer Surgery ◽  
Increased Risk ◽  
Independent Marker

Abstract Purpose Even though anastomotic leakage after colorectal surgery is a major clinical problem in need of a timely diagnosis, early indicators of leakage have been insufficiently studied. We therefore conducted a population-based observational study to determine whether the patient’s early postoperative pain is an independent marker of anastomotic leakage. Methods By combining the Swedish Colorectal Cancer Registry and the Swedish Perioperative Registry, we retrieved prospectively collected data on 3084 patients who underwent anastomotic colorectal surgery for cancer in 2014–2017. Postoperative pain, measured with the numerical rating scale (NRS), was considered exposure, while anastomotic leakage and reoperation due to leakage were outcomes. We performed logistic regression to evaluate associations, estimating odds ratios (ORs) and 95% confidence intervals (CIs), while multiple imputation was used to handle missing data. Results In total, 189 patients suffered from anastomotic leakage, of whom 121 patients also needed a reoperation due to leakage. Moderate or severe postoperative pain (NRS 4–10) was associated with an increased risk of anastomotic leakage (OR 1.69, 95% CI 1.21–2.38), as well as reoperation (OR 2.17, 95% CI 1.41–3.32). Severe pain (NRS 8–10) was more strongly related to leakage (OR 2.38, 95% CI 1.44–3.93). These associations were confirmed in multivariable analyses and when reoperation due to leakage was used as an outcome. Conclusion In this population-based retrospective study on prospectively collected data, increased pain in the post-anaesthesia care unit is an independent marker of anastomotic leakage, possibly indicating a need for further diagnostic measures.

Sign in / Sign up

Export Citation Format

Share Document