scholarly journals Patients' Perceptions Regarding Microimplant as Anchorage in Orthodontics

2008 ◽  
Vol 78 (2) ◽  
pp. 228-233 ◽  
Author(s):  
Tony C. K. Lee ◽  
Colman P. J. McGrath ◽  
Ricky W. K. Wong ◽  
A. Bakr M. Rabie
Keyword(s):  
Postoperative Pain ◽  
Family Member ◽  
Visual Analog Scale ◽  
Orthodontic Treatment ◽  
Tooth Extraction ◽  
Area Under The Curve ◽  
Analog Scale ◽  
Structured Questionnaire

Abstract Objective: To determine patients' expectations, acceptance, and experience of pain with microimplant surgery compared to other orthodontic procedures. Materials and Methods: Seventy-eight microimplants were placed in 37 patients as an anchorage unit for orthodontic treatment. Patients were asked to rate anticipated pain and pain experienced with various orthodontic procedures (tooth extraction, insertion of separators, initial tooth alignment, and microimplant surgery) on a visual analog scale (VAS) over a 7-day period. One month after insertion of microimplants, patients were asked to rate their acceptance of the procedure using a structured questionnaire. Results: Unlike other orthodontic procedures, patients expected to experience a significantly higher level of pain with microimplant surgery than they experienced (P < .001). The postoperative pain experienced decreased continuously from day 1 to day 7 for all orthodontic procedures (P < .05). The total area under the curve (AUC) of pain experienced over the 7-day period was significantly larger for initial tooth alignment than for microimplant surgery (P < .05). Most patients were satisfied with the microimplant surgery (76%) and would recommend it to a friend or family member (78%). Conclusions: Patients tended to overestimate the pain anticipated with microimplant surgery. Patients were accepting of the surgery and would recommend it to others.

scholarly journals Effect of Addition of Dexamethasone or Clonidine to Ropivacaine on Postoperative Analgesia in Ultrasonography Guided Transversus Abdominis Plane Block for Inguinal Hernia Repair: A Prospective Double Blind Randomized Control Trial

2020 ◽  
Vol 5 (1) ◽  
pp. 74-77
Author(s):  
Sweta Bharadiya ◽  
Neelam Meena ◽  
Ram Nivas ◽  
R.K. Solanki
Keyword(s):  
Inguinal Hernia ◽  
Postoperative Pain ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Visual Analog Scale ◽  
Transversus Abdominis ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Analog Scale ◽  
Rescue Analgesia

Background: A hernia repair surgery commonly induces moderate to severe postoperative pain for 48 hours. Aim of the study was to compare 0.5% Ropivacaine with dexamethasone and 0.5% Ropivacaine with clonidine for ultrasonography guided transversus abdominis plane (TAP) block as post-operative analgesia in patients undergoing Inguinal hernia repair surgery.Subjects and Methods:A randomized prospective controlled clinical study was conducted in 64 patients undergoing Inguinal Herneoplasty. Participants were divided into two groups in which group RD (n=32) received 0.5% Ropivavacaine with Dexamethasone 8mg and those in group RC (n=32) received 0.5% Ropivacaine with Clonidine 75mcg as USG guided TAP block at the end of surgery. The postoperative pain was evaluated by visual analog scale (VAS) for pain scoring at every 2 hours for 24 hours postoperatively. Subjective assessment of duration of analgesia was done.Results:Time to first rescue analgesia was significantly less in group RC (424.53±34.13) compared to group RD (616.09±31.36min) (P < 0.001). Total tramadol consumed in 24 h was significantly higher in group RC than group RD (P < 0.001). Visual analog scale scores for both somatic and visceral pain were significantly higher in group RC than group RD at 6h, 8 h and 12 h postoperatively.Conclusion:TAP block is a safe and effective way of relieving postoperative pain in inguinal herneoplasty patients. Addition of dexamethasone to Ropivacaine significantly enhances its effect in terms of block quality and analgesia duration as compared to clonidine addition.

scholarly journals Harmonic scalpel® hemorrhoidectomy: A painless procedure?

2007 ◽  
Vol 60 (9-10) ◽  
pp. 421-426 ◽  
Author(s):  
Dejan Ivanov ◽  
Sinisa Babovic ◽  
Dora Selesi ◽  
Mirjana Ivanov ◽  
Radovan Cvijanovic
Keyword(s):  
Surgical Treatment ◽  
Postoperative Pain ◽  
Visual Analog Scale ◽  
Surgical Approach ◽  
Surgical Procedure ◽  
Thermal Damage ◽  
Harmonic Scalpel ◽  
Hemorrhoidal Disease ◽  
Disease Stage ◽  
Analog Scale

Since the surgical treatment of hemorrhoidal disease has been characterized by intense postoperative pain, recent studies have tried to modify the standard Milligan-Morgans technique. The up-to-date literature, in the experience of authors, has confirmed that the new method of Harmonic Scalpel? hemorrhoidectomy reduces postoperative pain. The aim of our study was to statistically evaluate, based on our experience, the efficacy of this surgical approach in terms of reducing postoperative pain and establishing a stable hemostasis. Seventy-seven (77) patients suffering from hemorrhoid disease, stage III and IV, underwent surgery in our clinic during the last five years. The postoperative pain was determined using the visual analog scale on the 1st, 2nd and 7th postoperative days. Patients were divided into two groups in regard to the surgical procedure applied. The data were statistically processed using the Statistica 7.0 software. We concluded that Harmonic Scalpel? hemorrhoidectomy, due to less thermal damage, statistically significantly reduced postoperative pain with better hemostasis, compared with Milligan-Morgan's method of treating hemorrhoidal disease. .

Pharmacokinetics and Analgesic Effect of Ropivacaine during Continuous Epidural Infusion for Postoperative Pain Relief

1996 ◽  
Vol 84 (4) ◽  
pp. 834-842. ◽  
Author(s):  
Carl-Johan Erichsen ◽  
Jan Sjovall ◽  
Henrik Kehlet ◽  
Cecilia Hedlund ◽  
Torbjorn Arvidsson
Keyword(s):  
Postoperative Pain ◽  
Pain Relief ◽  
Visual Analog Scale ◽  
Plasma Concentrations ◽  
Epidural Infusion ◽  
Postoperative Pain Relief ◽  
Total Plasma ◽  
Analog Scale ◽  
Continuous Epidural Infusion ◽  
Unbound Fraction

Background The pharmacokinetics and clinical efficacy of ropivacaine (2.5 mg/ml) during a 24-h continuous epidural infusion for postoperative pain relief in 20 patients scheduled for abdominal hysterectomy were characterized using an open-label, increasing-dose design. Methods Through an epidural catheter inserted at T10-T12, a test dose of 7.5 mg ropivacaine was given 3 min before a bolus dose of 42.5 mg and immediately followed by a 24-h continuous epidural infusion with either 10 or 20 mg/h. Peripheral venous plasma samples were collected up to 48 h after infusion, and urinary excretion was followed up to the end of infusion. Postoperative pain at rest, on coughing, and at mobilization was assessed by means of a visual analog scale 2,4,6,8,12, and 24 h after the end of surgery. Sensory (pinprick) and motor block (modified Bromage scale) were assessed at the same intervals. Results The total plasma concentrations of ropivacaine increased markedly and consistently during the 24-h epidural infusion, in contrast to stable unbound concentrations. Both total and unbound plasma concentrations at the end of infusion were proportional to the total dose, although only the latter was proportional to the infusion rate. The total and unbound plasma clearance was independent of dose. Total mean clearance decreased on average by 21% (P &lt; 0.001) during the last 12 h of epidural infusion, i.e., from 539 +/- 191 ml/min to 418 +/- 138 ml/min, indicating time-dependent kinetics. The unbound clearance also varied between estimates after 8 h of infusion and the end of treatment, i.e., a 5.3% decrease from 10.4 +/- 5.3 l/min to 9.5 +/- 3.9 l/min (P &lt; 0.05). The unbound fraction of ropivacaine in plasma decreased during treatment, and this was related to the increase in alpha1-acid glycoprotein concentration. Pain was generally well controlled, and median visual analog scale scores during mobilization were less than 30 mm in patients receiving ropivacaine at 20 mg/h. Conclusions The pharmacokinetics of ropivacaine were independent of dose, but total clearance decreased with time over 24 h. The consistent increase in total plasma concentration during the postoperative epidural infusion contrasted to much less variation in the unbound plasma concentrations of ropivacaine.

Continuous Interscalene Analgesia with Ropivacaine 2 mg/ml after Major Shoulder Surgery

2003 ◽  
Vol 98 (1) ◽  
pp. 143-150 ◽  
Author(s):  
Georgios Ekatodramis ◽  
Alain Borgeat ◽  
Gunilla Huledal ◽  
Lennart Jeppsson ◽  
Lars Westman ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Pain Relief ◽  
Visual Analog Scale ◽  
Plasma Concentrations ◽  
Shoulder Surgery ◽  
Interscalene Block ◽  
Postoperative Pain Relief ◽  
Analog Scale ◽  
Threshold Levels ◽  
Continuous Interscalene

Background In this open, randomized study, the pharmacokinetics, clinical efficacy, and safety of a 48-h continuous interscalene infusion of 2 mg/ml ropivacaine for postoperative pain relief were investigated in patients undergoing open major shoulder surgery. Methods An initial interscalene block with 30 ml ropivacaine, 7.5 mg/ml (225 mg), was performed. After completion of interscalene block, all patients (n = 24) received general anesthesia, and 6 h after interscalene block, a 48-h continuous interscalene infusion of 12 or 18 mg/h using 2 mg/ml ropivacaine was started. Total and unbound plasma concentrations of ropivacaine and 2.6-pipecoloxylidide (PPX; a major active metabolite) were determined during and up to 6 h after the interscalene infusion. Postoperative pain at rest was assessed by a visual analog scale. Supplementary analgesics and adverse events were recorded. Results Plasma concentrations of total and unbound ropivacaine were proportional to the total dose. At the end of the interscalene infusion of 9 ml/h, the mean +/- SD plasma concentrations of total and unbound ropivacaine were 1.40 +/- 0.54 and 0.03 +/- 0.01 mg/l, respectively, and of total and unbound PPX were 0.70 +/- 0.38 and 0.30 +/- 0.20 mg/l, respectively. Plasma concentrations of unbound ropivacaine and unbound PPX, added together, remained well below threshold levels for systemic central nervous system toxicity. There were no significant differences between the groups for postoperative pain (median maximum of about 20 mm on the visual analog scale in both groups), analgesic consumption, or quality of pain relief assessed by the patient. No signs or symptoms of systemic local anesthetic toxicity were observed. Conclusion A 48-h continuous interscalene infusion of 6 or 9 ml/h ropivacaine, 2 mg/ml, started 6 h after an initial interscalene block of 30 ml ropivacaine, 7.5 mg/ml, provided satisfactory postoperative pain relief after major shoulder surgery and was well tolerated. Unbound plasma concentrations of ropivacaine and PPX remained well below threshold levels for systemic central nervous toxicity.

scholarly journals BUCCAL CORRIDOR YANG LEBIH MENARIK PADA ESTETIK SENYUM

2017 ◽  
Vol 4 (1) ◽  
pp. 1
Author(s):  
Nety Trisnawaty
Keyword(s):  
Visual Analog Scale ◽  
Orthodontic Treatment ◽  
Dental Students ◽  
Dental School ◽  
Analog Scale ◽  
Dental Aesthetics ◽  
Smile Esthetics ◽  
Smile Aesthetics ◽  
Buccal Corridor

Background: The objectives of orthodontic treatment are not only to obtain functional occlusion but also to improve facial and dental aesthetics. Three aspects of smile aesthetics have recently received great attention: the amount of gingival display, the presence of the smile arc, and buccal corridor spaces.The purpose of this study was to evaluation that the amount of buccal corridor on smile esthetics of dentists and dental students.Method: The population and subjects this study were dentists and dentalstudents of dental school from Faculty of Dentistry University Prof. Dr. Moestopo (Beragama). Using a Visual Analog Scale (VAS), dentists and  dental students rated the attractiveness of six smiles with altered buccal corridors.Result: There was no significant different in judging the effect of buccal  corridors on the smile attractiveness between dentists and dental students.Conclusion: Both the dentists and dental students preferred medium sizes of buccal corridor (buccal corridor 15%).

Efficacy of the Morphine-Adcon-L Compound in the Management of Postoperative Pain after Lumbar Microdiscectomy

Neurosurgery ◽  
2002 ◽  
Vol 50 (3) ◽  
pp. 518-525 ◽  
Author(s):  
Luciano Mastronardi ◽  
Marco Pappagallo ◽  
Fabrizio Puzzilli ◽  
Carlo Tatta
Keyword(s):  
Postoperative Pain ◽  
Visual Analog Scale ◽  
Pain Control ◽  
Control Group ◽  
Postoperative Pain Control ◽  
Analog Scale ◽  
Work Time ◽  
Long Term Outcome ◽  
Lumbar Microdiscectomy ◽  
Straight Leg Raising

Abstract OBJECTIVE: Epidural analgesia is a pharmacological technique for operative and postoperative pain control. It has been used with lumbar microdiscectomy to facilitate management of surgical pain, shorten patient recovery time, and increase patient satisfaction with the procedure and the hospital stay. Adcon-L (Gliatech, Inc., Cleveland, OH) (adhesion control in a barrier gel) has been demonstrated to act as a barrier to the development of epidural fibrosis after lumbar procedures, minimizing the formation of fibrotic scar and improving the long-term outcome. In this study, we used Adcon-L as a vehicle to administer 1 mg of morphine epidurally to patients who underwent lumbar microdiscectomy. Our objective was to evaluate the safety and analgesic efficacy of this compound . METHODS: A randomized, controlled, double-blind study was conducted in 100 patients. Patients were randomized to two groups: the morphine-Adcon-L (M-ADL) group (n = 51 patients) or the Adcon-L control group (n = 49 patients). Outcome measures included: 1) a visual analog scale to assess the intensity of spontaneous low back and radicular pain, 2) a straight leg-raising maneuver to assess the degree of leg elevation in relation to evoked sciatic pain, 3) postoperative time to comfortable walking, 4) duration of postoperative hospitalization, 5) required amount of postoperative analgesics, and 6) postoperative work time loss. RESULTS: No intraoperative or postoperative complications were observed. No clinically relevant adverse events, such as urinary retention, respiratory disturbances, or wound infections were reported in the M-ADL group. At the time of hospital discharge, results were as follows: 1) the M-ADL group had significantly lower pain intensity scores (mean value of postoperative visual analog scale, 12.3 mm ± 0.9 in the M-ADL group versus 24.7 mm ± 11.5 in the control group [P &lt; 0.0001]); 2) the M-ADL group consumed significantly less analgesics: 57.4% of M-ADL patients versus 95.9% of controls received analgesics in the hospital, and 23.5% of M-ADL patients versus 55.1% of controls used analgesics at home (P &lt; 0.0001); 3) the M-ADL group had significantly shorter hospital stays (1.37 ± 0.07 d versus 2.53 ± 0.12 d in the control group [P &lt; 0.0001]); 4) the M-ADL group had a significantly higher degree of symptomatic leg elevation in the straight leg raising (mean postoperative straight leg-raising test, 64.41 degrees ± 1.59 versus 57.77 degrees ± 1.85 in the controls [P = 0.02]); and 5) the M-ADL group lost significantly less postoperative work time (21.67 ± 0.92 d versus 29.47 ± 1.18 d in the control group). In addition, at 1 year of follow-up, there was no clinical evidence of late-onset neurological complications. CONCLUSION: The epidural application of the compound M-ADL after lumbar microdiscectomy was found to be safe and effective, and it significantly improved postoperative pain control and return to function.

scholarly journals Comparative study of tramadol and ketorolac in the pain management of third molar tooth extraction

1970 ◽  
Vol 6 (1) ◽  
pp. 35-43 ◽  
Author(s):  
MM Shaik ◽  
J Kumar ◽  
S Mobina ◽  
N Satyanarayana ◽  
P Sunitha
Keyword(s):  
Side Effects ◽  
Pain Intensity ◽  
Visual Analog Scale ◽  
Tooth Extraction ◽  
Third Molar ◽  
Molar Tooth ◽  
Analog Scale ◽  
Duration Of Action ◽  
Group A ◽  
Group B

Objective: Clinical comparison of efficacy, duration of action, onset of action, side effects of two most commonly used analgesics tramadol and ketorolac after the third molar tooth extraction. Materials and methods: The present study was carried out at department of oral surgery, Mamata Dental Hospital, Khammam, India. 150 patients were randomly selected and divided into two groups. Group A received 50 mg of tramadol orally and Group B received 10 mg of ketorolac orally. In both groups dose was repeated for next 24 hrs. Visual scale analog was used for the collection of pain intensity from the patients. Results: In Group A, the analgesia started within 1hour and at the end of 24 hours, pain intensity was 2.12 out of 10 on visual analog scale. In Group B, analgesia started within 30 mins and at the end of 24 hours, the pain intensity was 2.98 on visual analog scale. Sedation associated with dizziness and muscle relaxation was observed with tramadol in 5% of patients and sweating in 8% patients. While in case of ketorolac, 33% of patients suffered with side effects. Among them 33% patients suffered with bleeding at the site of tooth extraction and 20% patients suffered with epigastric pain. The analgesic effect of 50 mg tramadol lasted up to 6 hours and that of ketorolac lasted for 5 hour. Conclusion: The study shows that tramadol is a suitable and safe analgesic for the relief of post-extraction pain and is more effective than ketorolac with prolonged analgesia and minimal side effects. Key Words: Tramadol; ketorolac; third molar tooth extraction DOI: 10.3126/jcmsn.v6i1.3600 Journal of College of Medical Sciences-Nepal, 2010, Vol. 6, No. 1, 35-43

scholarly journals EFEK KOMBINASI PARASETAMOL DAN KODEIN SEBAGAI ANALGESIA PREEMPTIF PADA PASIEN DENGAN ORIF EKSTREMITAS BAWAH

2017 ◽  
Vol 13 (1) ◽  
pp. 97
Author(s):  
Sahurrahmanisa Sahurrahmanisa ◽  
Kenanga Marwan Sikumbang ◽  
Istiana Istiana
Keyword(s):  
Postoperative Pain ◽  
Visual Analog Scale ◽  
Severe Pain ◽  
Preemptive Analgesia ◽  
P Value ◽  
Moderate Pain ◽  
Analog Scale ◽  
Cross Sectional ◽  
Mild Pain ◽  
Consecutive Sampling

Abstract: Postoperative pain is a complex pain response which often occurred in post-operative patient. Effective pain management is conducted by giving preemptive analgesia, preventive analgesia and multimodal. The purpose of this study was to analyze the effect combination of paracetamol 325 mg and codeine 10 mg in a patient with ORIF inferior extremity. This was an observational analytic study with a cross sectional method and 32 respondents were included by consecutive sampling method. The result of this study, in group with the combination of paracetamol and codeine there are 4 respondents (25.0%) of mild pain, 12 respondents (75.0%) of moderate pain, and there’s none had severe pain, and the group without combination therapy there’s no mild pain, 7 respondents (43.8%) of moderate pain, and 9 respondents (56.2%) of severe pain. The statistic analyses with Kolmogorov Smirnov p-value <0.05, it can be concluded that in this study a combination of paracetamol and codeine are effective as a preemptive analgesia. Keywords: postoperative pain, preemptive analgesia, visual analog scale (VAS), paracetamol, codeine Abstrak: Nyeri pasca bedah merupakan respon nyeri yang sering dirasakan pasien setelah pembedahan dengan respon yang kompleks. Penanganan nyeri yang efektif dilakukan dengan pemberian analgesia preemptif, analgesia preventif, dan analgesia multimodal. Tujuan penelitian ini untuk menganalisi efek kombinasi parasetamol 325 mg dan kodein 10 mg sebagai analgesia preemptif pada pasien dengan ORIF ekstremitas bawah. Penelitian ini menggunakan rancangan observasional analitik cross sectional dengan teknik consecutive sampling didapatkan 32 sampel. Hasil penelitian, pada kelompok yang diberikan kombinasi parasetamol dan kodein sebanyak 4(25.0%) nyeri ringan, 12 (75.0%) nyeri sedang dan tidak didapatkan nyeri berat, sedangkan pada kelompok yang tidak diberikan kombinasi parasetamol dan kodein tidak ditemukan nyeri ringan, sebanyak 7 (43.8%) nyeri sedang dan 9 (56.2%) nyeri berat. Analisa statistik menggunakan Komogorov Smirnov didapatkan perbedaan yang signifikan antara kedua kelompok dengan nilai p value < 0,05 sehingga dapat disimpulkan pada penelitian ini kombinasi parasetamol dan kodein dapat digunakan sebagai analgesia preemptif. Kata-kata kunci: nyeri paska bedah, analgesia preemptif, visual analog scale (VAS) , parasetamol, kodein.

scholarly journals A Prospective Case-control Study on the Comparison of Postoperative Pain Relief with Transdermal Diclofenac Patch and Injection Diclofenac

2015 ◽  
Vol 6 (4) ◽  
pp. 129-133
Author(s):  
Subbhabrata Das
Keyword(s):  
Postoperative Pain ◽  
Pain Relief ◽  
Visual Analog Scale ◽  
Case Control Study ◽  
Case Control ◽  
Postoperative Pain Relief ◽  
Analog Scale ◽  
Group A ◽  
Group B ◽  
Control Study

ABSTRACT Aim This is a randomized case-control study to know the efficacy of postoperative pain relief with transdermal diclofenac patch 200 mg and comparison with injection diclofenac sodium 75 mg. Materials and methods A total of 100 patients with head and neck cancer were included in the study and were randomly divided into two groups (A and B). Anesthetic procedure was standardized. A transdermal diclofenac diethylamine patch of 200 mg was applied to group A, just before the skin closure. And in group B, injection diclofenac was given 8 hourly. In group A, injection diclofenac was given on an as-needed basis whenever patient had visual analog scale (VAS) of pain > 5. Visual analog scale at 2nd, 4th, 8th, 12th, and 24th hour postoperatively was recorded for 5 days. Injection diclofenac needed in groups A and B was recorded for five postoperative days and the mean number of injections of diclofenac per patient per day needed in both groups was calculated. Results In group A, we needed only 0.96 injections (diclofenac 75 mg)/patient on the first day and no injection was needed further, while in group B, we had to use three injections/day/ patient. Visual analog scale and pain relief were more steady and better in group A as compared with group B. Conclusion Transdermal patch of diclofenac diethylamine 200 mg is very effective in providing postoperative analgesia and is better than intravenous injection diclofenac 75 mg. How to cite this article Singh SP, Jain DK, Das S, Jain S. A Prospective Case-control Study on the Comparison of Postoperative Pain Relief with Transdermal Diclofenac Patch and Injection Diclofenac. Int J Head Neck Surg 2015;6(4):129-133.

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