Measuring Chronic Pain in Children, an Exploration

1997 ◽  
Vol 84 (3_suppl) ◽  
pp. 1176-1178 ◽  
Author(s):  
J. A. M. Hunfeld ◽  
E. S. G. den Deurwaarder ◽  
J. C. van der Wouden ◽  
L. W. A. van Suijlekom-Smit ◽  
A. J. J. M. Hazebroek-Kampschreur
Keyword(s):  
Chronic Pain ◽  
Postoperative Pain ◽  
Visual Analogue Scale ◽  
Medical Treatment ◽  
Pain Intensity ◽  
Analogue Scale ◽  
Limb Pain ◽  
Optimal Period

The study focused on the feasibility and validity of pain instruments and the optimal period of diary registration for measuring chronic pain intensity of 13 children. Highly positive associations were found between the registration of pain on a Visual Analogue Scale and on the Postoperative Pain Measure for Parents. For children under medical treatment for chronic limb pain a one-week diary registration suffices.

scholarly journals NEUROTRANSMITTER IMBALANCES AND PSYCHOLOGICAL DYSFUNCTIONS AS PREDICATIVE FACTORS OF POSTOPERATIVE CHRONIC PAIN SYNDROME IN OPERATIVE GYNECOLOGY CENTER

2020 ◽  
pp. 48-56
Author(s):  
L.N. Gumenyuk ◽  
L.I. Seytumerova ◽  
A.A. Serafimova ◽  
A.V. Yatsiv
Keyword(s):  
Chronic Pain ◽  
Postoperative Pain ◽  
Visual Analogue Scale ◽  
Analogue Scale ◽  
Depressive Disorders ◽  
Pain Syndrome ◽  
Chronic Pain Syndrome ◽  
Chronic Postoperative Pain ◽  
Group 2 ◽  
Group 1

Chronic postoperative pain is one of the urgent medical and social problems of operative gynecology. The problem is preconditioned by a high prevalence rate, a significant impact on the outcomes of operative therapy and, as a consequence, patients’ quality of life. The goal of the paper is to study the role of preoperative neurotransmitter and psychoemotional dysfunctions in the development of postoperative chronic pain syndrome in an operative gynecology center. Materials and Methods. The study enrolled 156 patients aged 18–45 years who underwent planned surgical treatment for gynecological pathology. Patients were subsequently divided into 2 groups: Group 1 – women with postoperative chronic pain syndrome; Group 2 – women without chronic postoperative pain syndrome. The authors conducted general clinical examination, and also determined the levels of g-aminobutyric acid and β-endorphin in serum of patients using enzyme-linked immunosorbent assay. A visual analogue scale was used to assess quantitative characteristics of pain syndrome. Qualitative characteristics of pain syndrome were assessed according to the McGill Pain Questionnaire. HAM-A and HDRS were used to assess psychoemotional state. Results. Postoperative chronic pain was observed in 39.7 % of patients 12 months after surgery. In the preoperative period, a pain syndrome was registered in all patients. However, there were no significant intergroup differences in its severity. Statistically significant predominance of the affective scale indicators was revealed in the pain syndrome structure in Group 1, while Group 2 demonstrated predominance of the sensory scale indicators (p=0.003). Group 1 demonstrated more pronounced changes in GABA and β-endorphin levels. An inverse correlation was found between the level of β-endorphin and the affective and evaluative McGill questionnaire scales. Various affective pathologies were verified in Group 1. However, depressive disorders dominated. Group 2 demonstrated only subdepression and individual clinically unformed anxiety symptoms. The authors found out depressive disorder correlation with the severity of preoperative pain syndrome according to visual-analogue scale, McGill questionnaire affective scale, and β-endorphin concentration. Conclusion. Neurotransmitter disorders and psychological dysfunctions affect the formation of postoperative chronic pain syndrome. There is a correlation between chronic postoperative pain syndrome, preoperative β-endorphin concentration (r=-0.70; p=0.028), and the severity of depressive disorders (r=0.65; p=0.012), which confirms their role as non-specific prognostic markers while monitoring the postoperative chronic pain syndrome. Keywords: gynecological pathology, postoperative chronic pain syndrome, neurotransmitters, affective disorders. Хроническая послеоперационная боль – одна из актуальных медико-социальных проблем оперативной гинекологии, что обусловлено высоким уровнем распространенности, значительным влиянием на исходы хирургического лечения и, как следствие, качество жизни пациентов. Цель – изучение роли предоперационных нейромедиаторных и психоэмоциональных дисфункций в формировании хронического послеоперационного болевого синдрома в клинике оперативной гинекологии. Материалы и методы. В исследовании приняли участие 156 больных в возрасте от 18 до 45 лет, которым выполнено плановое хирургическое лечение по поводу гинекологической патологии. Пациенты в последующем были разделены на 2 группы: 1-я – женщины с хроническим послеоперационным болевым синдромом; 2-я – пациентки без хронического послеоперационного болевого синдрома. Наряду с общеклиническим обследованием c помощью иммуноферментного анализа определяли уровень кислоты и β-эндорфина в сыворотке крови. С целью оценки количественной характеристики боли применяли визуальную аналоговую шкалу, качественной – болевой опросник McGill, для оценки психоэмоционального статуса – клиническую шкалу HAM-A и HDRS. Результаты. Спустя 12 мес. после оперативного вмешательства хронический послеоперационный болевой синдром наблюдался у 39,7 % обследованных. В предоперационном периоде у всех обследованных отмечался болевой синдром, при этом достоверных межгрупповых различий его интенсивности не выявлено. В структуре болевого синдрома у пациенток 1-й группы выявлено статистически значимое преобладание показателей аффективной шкалы, у женщин 2-й группы – сенсорной (p=0,003). У пациенток 1-й группы изменения уровней ГАМК и β-эндорфина носили более выраженный характер. Установлена обратная корреляционная связь уровня β-эндорфина с показателями аффективной и эвалюативной шкал опросника McGill. Аффективная патология различной степени выраженности верифицирована у всех больных 1-й группы. В структуре преобладали депрессивные нарушения. У пациенток 2-й группы наблюдались лишь субдепрессивные состояния и отдельные, клинически не оформленные симптомы тревоги. Установлены корреляции депрессивных расстройств c выраженностью предоперационного болевого синдрома по визуально-аналоговой шкале, аффективной шкалой опросника McGill, концентрацией β-эндорфина. Выводы. Нейромедиаторные и психологические дисфункции влияют на формирование послеоперационного хронического болевого синдрома. Установлена связь между хроническим послеоперационным болевым синдромом и предоперационными значениями концентрации β-эндорфина (r=-0,70; p=0,028), выраженностью депрессивных расстройств (r=0,65; p=0,012), что подтверждает их роль как неспецифических прогностических маркеров при мониторинге формирования послеоперационного хронического болевого синдрома. Ключевые слова: гинекологическая патология, хронический послеоперационный болевой синдром, нейромедиаторы, аффективные расстройства.

scholarly journals Coccygectomy can be a option for coccydynia which is refractory to medical treatment

2018 ◽  
Vol 11 (4) ◽  
pp. 282-285
Author(s):  
Md. Anowarul Islam ◽  
Santosh Batajoo ◽  
Md. Sayeed Al Mahmud ◽  
Manish Shrestha
Keyword(s):  
Visual Analogue Scale ◽  
Conservative Treatment ◽  
Clinical Outcome ◽  
Antibiotic Therapy ◽  
Medical Treatment ◽  
Pain Intensity ◽  
Analogue Scale ◽  
Daily Activities ◽  
Sitting Position

The aim of this study was to evaluate the clinical outcome of coccygectomy those who were refractory to conservative treatment. Twenty patients (5 males, 15 females) underwent total coccygectomy when coccygodynia did not responding to medical treatment July 2013 to September 2018. All the patients timely attended with non-traumatic (n = 12) and traumatic (n = 8) cause with mean follow-up visits of 24 months (range 18-28 months). The outcome pain intensity was evaluated by visual analogue scale (VAS) in sitting position and during daily activities. Three patients had infection which improved after antibiotic therapy. The VAS improved from 6.4 ± 0.9 to 2.1 ± 0.9 for sitting and from 5.8 ± 0.9 to 1.6 ± 0.6 for daily activities. Improvement in pain and daily activities were significant at the final follow-up. Ninety percent patients were satisfied with the operation.

Type lll internal hemipelvectomy for primary bone tumours with and without allograft reconstruction

2021 ◽  
Vol 103-B (6) ◽  
pp. 1155-1159
Author(s):  
Khodamorad Jamshidi ◽  
Farshad Zandrahimi ◽  
Abolfazl Bagherifard ◽  
Fatemeh Mohammadi ◽  
Alireza Mirzaei
Keyword(s):  
Postoperative Pain ◽  
Visual Analogue Scale ◽  
Functional Outcome ◽  
Surgical Complications ◽  
Analogue Scale ◽  
Allograft Reconstruction ◽  
Internal Hemipelvectomy ◽  
Type Iii ◽  
The Mean ◽  
Reconstruction Group

Aim There is insufficient evidence to support bony reconstruction of the pubis after a type III internal hemipelvectomy (resection of all or part of the pubis). In this study, we compared surgical complications, postoperative pain, and functional outcome in a series of patients who had undergone a type III internal hemipelvectomy with or without bony reconstruction. Methods In a retrospective cohort study, 32 patients who had undergone a type III hemipelvectomy with or without allograft reconstruction (n = 15 and n = 17, respectively) were reviewed. The mean follow-up was 6.7 years (SD 3.8) for patients in the reconstruction group and 6.1 years (SD 4.0) for patients in the non-reconstruction group. Functional outcome was evaluated using the Musculoskeletal Tumor Society (MSTS) scoring system and the level of postoperative pain with a visual analogue scale (VAS). Results The mean MSTS score of the patients was significantly better in patients after reconstruction (26 (SD 1.7) vs 22.7 (SD 2.0); p < 0.001). The mean visual analogue scale score for pain was significantly less in the reconstruction group (2.1 (SD 2) vs 4.2 (SD 2.2); p = 0.016). One infection occurred in each group. Bladder herniation occurred in three patients (17.6%) in the non-reconstruction group but none in the reconstruction group. Five patients (29.4%) in the non-reconstruction group and one (7%) in the reconstruction group had a limp. Graft displacement occurred in two patients in the reconstruction group. Conclusion We recommend reconstruction of the bony defect after a type III hemipelvectomy: it gives a better functional result, less postoperative pain, and fewer late surgical complications. Cite this article: Bone Joint J 2021;103-B(6):1155–1159.

scholarly journals Comparative analysis of different methods of anesthesia in patients with acute pancreatitis using pain scales

2016 ◽  
Vol 97 (2) ◽  
pp. 217-221
Author(s):  
V N Shilenok ◽  
E V Nikitina
Keyword(s):  
Acute Pancreatitis ◽  
Comparative Analysis ◽  
Visual Analogue Scale ◽  
Pain Intensity ◽  
Epidural Anesthesia ◽  
Analogue Scale ◽  
Pain Syndrome ◽  
Opioid Analgesics ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Aim. To conduct a comparative analysis of used anesthesia methods in patients with acute pancreatitis in intensive care units settings using pain scales.Methods. Depending on the anesthesia type, 44 patients with acute pancreatitis were divided into three groups: the first group received intramuscular injections of nonsteroidal anti-inflammatory drugs and spasmolytics, the second group - intramuscular injections of non-steroidal anti-inflammatory drugs and opioid analgesics, the third group - epidural anesthesia with local anesthetics. Comparative analysis of pain character, intensity was conducted, its dynamics in patients of all groups amid anesthesia was evaluated using a visual analogue scale, verbal rating scale, verbal descriptor scale, McGill pain questionnaire.Results. Baseline pain intensity in patients of all groups was high. Patients estimated this pain as «very strong». The time and the level of pain intensity reduction for various anesthesia types had differences. Pain syndrome was eliminated slower in patients of the second group. By the end of the 1st day, patients of this group continued to complain of «strong» pain. Pain intensity decreased only on the 2nd day - patients reported «moderate» pain. Pain syndrome was not completely eliminated in these patients for 2 days of anesthesia. 97.7% of patients reported that the visual analogue scale is the most acceptable pain assessment scale for them.Conclusion. In patients with acute pancreatitis, the most optimal anesthesia types are intramuscular nonsteroidal anti-inflammatory drugs with spasmolytics and prolonged epidural anesthesia with local anesthetics; intramuscular administration of opioid analgesics with non-steroidal anti-inflammatory drugs is less effective in relieving pain.

scholarly journals Is Intra-Articular Magnesium Effective for Postoperative Analgesia in Arthroscopic Shoulder Surgery?

2015 ◽  
Vol 20 (1) ◽  
pp. 35-38 ◽  
Author(s):  
Tuba Berra Saritas ◽  
Hale Borazan ◽  
Selmin Okesli ◽  
Mustafa Yel ◽  
Seref Otelcioglu
Keyword(s):  
Postoperative Pain ◽  
Visual Analogue Scale ◽  
Postoperative Analgesia ◽  
Analogue Scale ◽  
Serum Magnesium ◽  
Diclofenac Sodium ◽  
Saline Group ◽  
Shoulder Surgery ◽  
Pain Scores ◽  
Arthroscopic Shoulder Surgery

BACKGROUND: Various medications are used intra-articularly for postoperative pain reduction after arthroscopic shoulder surgery. Magnesium, aN-methyl-D-aspartate receptor antagonist, may be effective for reduction of both postoperative pain scores and analgesic requirements.METHODS: A total of 67 patients undergoing arthroscopic shoulder surgery were divided randomly into two groups to receive intra-articular injections of either 10 mL magnesium sulphate (100 mg/mL; group M, n=34) or 10 mL of normal saline (group C, n=33). The analgesic effect was estimated using a visual analogue scale 1 h, 2 h, 6 h, 8 h, 12 h, 18 h and 24 h after operation. Postoperative analgesia was maintained by intra-articular morphine (0.01%, 10 mg) + bupivacaine (0.5%, 100 mL) patient-controlled analgesia device as a 1 mL infusion with a 1 mL bolus dose and 15 min lock-out time; for visual analogue scale scores >5, intramuscular diclofenac sodium 75 mg was administered as needed during the study period (maximum two times).RESULTS: Intra-articular magnesium resulted in a significant reduction in pain scores in group M compared with group C 1 h, 2 h, 6 h, 8 h and 12 h after the end of surgery, respectively, at rest and with passive motion. Total diclofenac consumption and intra-articular morphine + bupivacaine consumption were significantly lower in group M. Postoperative serum magnesium levels were significantly higher in group M, but were within the normal range.CONCLUSIONS: Magnesium causes a reduction in postoperative pain in comparison to saline when administered intra-articularly after arthroscopic shoulder surgery, and has no serious side effects.

Pre-emptive triple analgesia protocol for tonsillectomy pain control in children: double-blind, randomised, controlled, clinical trial

2013 ◽  
Vol 127 (4) ◽  
pp. 383-391 ◽  
Author(s):  
A M A El-Fattah ◽  
E Ramzy
Keyword(s):  
Postoperative Pain ◽  
Visual Analogue Scale ◽  
Analogue Scale ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Double Blind ◽  
Post Surgery ◽  
Scale Scores ◽  
Randomised Controlled ◽  
At Home

AbstractIntroduction:This double-blind, controlled, parallel-group study was designed to determine the efficacy of pre-emptive triple analgesia for paediatric post-tonsillectomy pain management.Materials and methods:One hundred and thirty-five children were randomised into two groups: pre-emptive triple analgesia (n = 55) and control (n = 80). Pain was assessed using a visual analogue scale (in hospital) and the Parent's Postoperative Pain Measure (at home), and scores recorded.Results:Visual analogue scale scores on awakening and for 6 hours post-surgery were significantly better in the study group than the control group (p < 0.05). The Parent's Postoperative Pain Measure scores of control group children were significantly higher within the first 3 post-operative days (p = 0.000), with a greater percentage of children experiencing significant pain and requiring more analgesia.Conclusion:The proposed multimodal, pre-emptive analgesia protocol for paediatric post-tonsillectomy pain results in less post-operative pain, both in hospital or at home.

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