scholarly journals Effect of intraoperative use of dexmedetomidine on post-operative analgesia in patients undergoing elective spine surgery under general anaesthesia

2021 ◽  
Vol 12 (5) ◽  
pp. 88-93
Author(s):  
Madhumita Ray ◽  
Chanchal Kumar Dalai ◽  
Shah Newaz Ahmed ◽  
Amita Acharjee
Keyword(s):  
General Anaesthesia ◽  
Visual Analog Scale ◽  
Spine Surgery ◽  
Analgesic Efficacy ◽  
Saline Control ◽  
Analog Scale ◽  
Vas Score ◽  
Post Operative Pain ◽  
Significant Difference ◽  
Efficacy Parameters

Background: Dexmedetomidine is an alpha2 agonist which shows sedative, analgesic and anti-adrenergic effects and is useful as an adjuvant agent in general anaesthesia (GA) in major surgeries. Aims and Objectives: In this study, we evaluated the analgesic efficacy of intra-operative infusion of dexmedetomidine in alleviating post-operative pain in elective spine surgery using multiple efficacy parameters. Materials and Methods: Patients (n=60) scheduled to undergo elective spine surgery under GA were randomised to receive either dexmedetomidine (treatment arm) or normal saline (control arm) in the intra-operative period. The analgesic efficacy of the drug in the post-operative period was assessed using- the time to first rescue analgesic, total requirement of analgesic, Visual Analog Scale (VAS) score and the number of back-up analgesic required. Results: There was no statistically significant difference in the baseline clinical and demographic characteristics between the two groups. The time to first rescue analgesic, total requirement of analgesic, Visual Analog Scale (VAS) score and the number of back-up analgesic required, were all statistically significant in favour of the treatment arm (P<0.001). Conclusion: Dexmedetomidine provides effective postoperative analgesia and reduces tramadol requirements in elective spine surgery performed under general anaesthesia.

scholarly journals Sublingual immunotherapy increases Treg/Th17 ratio in allergic rhinitis

Open Medicine ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. 826-832
Author(s):  
Jiarong Wang ◽  
Liansheng Qiu ◽  
Yimin Chen ◽  
Minyun Chen
Keyword(s):  
T Cells ◽  
Allergic Rhinitis ◽  
Retrospective Study ◽  
Regulatory T Cells ◽  
Visual Analog Scale ◽  
Peripheral Blood ◽  
Sublingual Immunotherapy ◽  
Analog Scale ◽  
Vas Score ◽  
Medication Score

Abstract Background Few studies investigated the effects of sublingual immunotherapy (SLIT) on the peripheral regulatory T cells (Tregs)/Th17 ratio. Objective To investigate the effectiveness of SLIT in children with allergic rhinitis (AR) and the effects on the Tregs/Th17 ratio. Methods This was a retrospective study of children who were treated for AR between April 2017 and March 2018 at one hospital. The patients were grouped according to the treatments they received: SLIT + pharmacotherapy vs pharmacotherapy alone. Results Eighty children (51 boys and 29 girls; 40/group) were included. The visual analog scale (VAS) and medication scores at 1 year in the SLIT + pharmacotherapy group were 2.70 ± 1.08 and 1.1 ± 0.8, respectively, which were lower than at baseline (7.7 ± 1.2 and 3.6 ± 1.0, respectively) (both Ps < 0.05). For the pharmacotherapy group, the VAS score was decreased at 1 year vs baseline (3.3 ± 1.2 vs 7.4 ± 1.0; P < 0.05), but the medication score did not change (P > 0.05). In the SLIT + pharmacotherapy group, the Treg percentage increased, while the Th17 percentage decreased at 1 year (both Ps < 0.01). The percentages of Tregs and Th17s did not change in the pharmacotherapy group (both Ps > 0.05). Conclusions SLIT + pharmacotherapy can increase the Treg percentage and decrease the Th17 percentage in the peripheral blood of children with AR.

scholarly journals The effect of local ketamine infiltration on post tonsillectomy pain scale

2020 ◽  
Vol 50 (1) ◽  
pp. 38
Author(s):  
Ade Asyari ◽  
Novialdi Novialdi ◽  
Elniza Morina ◽  
Rimelda Aquinas ◽  
Nasman Puar ◽  
...  
Keyword(s):  
Visual Analog Scale ◽  
Secondary Infection ◽  
Pain Scale ◽  
Control Group ◽  
Analog Scale ◽  
Noticeable Effect ◽  
Local Infiltration ◽  
Significant Difference ◽  
Post Test ◽  
Test Control

Background: Post tonsillectomy pain is one of the surgery side effects that most disturbing for patient’s comfort and will cause dysphagia, low intake, dehydration, secondary infection and bleeding. Ketamine is an anesthetic drug that has strong analgesic effect and easily available in any hospital at relatively cheap price. Objective: To find out the effect of local ketamine infiltration on the post tonsillectomy pain scale. Method: An experimental study during tonsillectomy with a Post Test Control Group on 12 samples without local infiltration of ketamine and 12 samples with local infiltration of ketamine in peritonsillar pillar. The pain was assessed 2 hours and 24 hours post extubation with pain Visual Analog Scale (VAS). Result: The VAS value from patients who were given local infiltration of ketamine in peritonsillar pillar were lower (5.83 ± 0.72 at 2 hours and 2.83 ± 0.58 at 24 hours post extubation) compared to patients without ketamine infiltration (7.83 ± 0.58 at 2 hours and 3.58 ± 0.51 at 24 hours post extubation). The result showed statistically significant difference (p <0.05) at 2 hours and 24 hours post extubation. Conclusion: The VAS score of the ketamine infiltration group is lower at 2 hours and 24 hours post extubation than the group without ketamine infiltration, showing there was a noticeable effect of local ketamine infiltration on the post tonsillectomy pain scale.Keywords : post tonsillectomy pain, ketamine, local infiltration, visual analog scale ABSTRAKLatar belakang: Nyeri pascatonsilektomi adalah salah satu efek samping operasi yang sangat mengganggu kenyamanan pasien, dan dapat menyebabkan gangguan menelan, kurangnya asupan nutrisi, dehidrasi, infeksi sekunder dan perdarahan. Ketamin merupakan obat anestesi yang memiliki efek analgetik yang kuat dan mudah didapatkan di semua tipe rumah sakit dengan harga yang relatif murah. Tujuan: Mengetahui efek pemberian infiltrasi lokal ketamin terhadap skala nyeri pascatonsilektomi. Metode: Penelitian eksperimental dengan desain Post Test Control Group pada 12 sampel tanpa pemberian infiltrasi lokal ketamin dan 12 sampel dengan pemberian infiltrasi lokal ketamin di pilar peritonsil saat tonsilektomi. Dilakukan penilaian nyeri 2 jam dan 24 jam pascaekstubasi menggunakan skala nyeri Visual Analog Scale (VAS). Hasil: Nilai VAS pasien yang diberi infiltrasi lokal ketamin di pilar peritonsil lebih rendah (5,83±0,72 pada 2 jam dan 2,83 ± 0,58 pada 24 jam pascaekstubasi) dibanding tanpa diberi infiltrasi lokal ketamine (7,83 ± 0,58 pada 2 jam dan 3,58± 0,51 pada 24 jam pascaekstubasi), dan bermakna secara statistik (p<0,05) pada kedua penilaian. Kesimpulan: Terdapat efek nyata infiltrasi lokal ketamin terhadap skala nyeri pascatonsilektomi, dimana nilai VAS kelompok yang diberi infiltrasi ketamin lebih rendah, baik pada 2 jam ataupun 24 jam pascaekstubasi dibanding kelompok yang tidak diberi infiltrasi ketamin.

scholarly journals Spinal cord stimulation for chronic intractable trunk or limb pain: study protocol for a Chinese multicenter randomized withdrawal trial (CITRIP study)

2020 ◽  
Author(s):  
Yang Lu ◽  
Peng Mao ◽  
Guihuai Wang ◽  
Wei Tao ◽  
Donglin Xiong ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Visual Analog Scale ◽  
Spinal Cord Stimulation ◽  
Pulse Generator ◽  
Short Form ◽  
Control Group ◽  
Withdrawal Period ◽  
Analog Scale ◽  
Limb Pain ◽  
Vas Score

Abstract Background: Although effective results of many studies support the use of spinal cord stimulation in the chronic pain patients, no randomized controlled trial has been undertaken in China to date. CITRIP is a multicenter, prospective, randomized, withdrawal study designed to evaluate the clinical effectiveness and safety of spinal cord stimulation plus remote programming management in patients with intractable trunk or limb pain.Method：Participants will be recruited in approximately 10 centers across China. Eligible participants with intractable trunk or limb and an average Visual Analog Scale (VAS) score ≥ 5 will undergo spinal cord stimulation test. Participants with VAS score reduction ≥ 50% could move forward to receive implantation of an implanted pulse generator. In the withdrawal period at 3-months follow-up visit, participants randomized to the experimental group (EG) will undergo continuous stimulation while ceasing the stimulation in the control group (CG). The outcome assessment will occur at baseline and at 1, 3 (pre and post randomization) and 6 months. The primary outcome is the difference of maximal visual analog scale (VAS) score between EG and CG in the withdrawal period compared with baseline before the withdrawal period. Additional outcomes include VAS score change at 1, 3 and 6-month follow-ups, responder rate (VAS score improving by 50%), achievement rate of a desirable pain state (VAS score ≤ 4), awake times during sleep, Beck Depression Inventory for depression evaluation, short-form 36 for quality of life evaluation, drug usage, satisfaction rating of the device. Adverse events will be collected. The primary analysis will follow the intention-to-treat principle. Discussion：The CITRIP study seeks to evaluate the effectiveness and safety of a randomized withdrawal trial of spinal cord stimulation for patients with intractable trunk or limb pain.Trial registration: NCT03858790, clinicaltrials.gov, registered on March 1st, 2019, retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03858790

scholarly journals A comparison of pain registration by Visual Analog Scale and Numeric Rating Scale – a cross-sectional study of primary triage registration

2020 ◽  
Author(s):  
Jofrid Kollltveit ◽  
Malin Osaland ◽  
Marianne Reimers ◽  
Magnus Berle
Keyword(s):  
Emergency Department ◽  
Visual Analog Scale ◽  
Rating Scale ◽  
Emergency Admission ◽  
Numeric Rating Scale ◽  
University Hospital ◽  
Analog Scale ◽  
Cross Sectional ◽  
Significant Difference ◽  
Numeric Rating

BackgroundPain is a subjective sensation; self-reporting is important for quantifying pain intensity. There are several different validated tools for this, such as Visual Analog Scale and Numeric Rating Scale. In the clinic, these terms are often used as equivalent. The objective of this study was to examine correlation and agreement between the pain registration tools in triage in an emergency department.Materials and MethodsThe study was performed in the Department of Emergency Medicine at Haukeland University Hospital in the period June-August 2019. We registered the pain score with two tools in 200 unselected patients in emergency admission with pain. In addition, we registrered gender, age, triage and general department affiliation.ResultsWe found a strong correlation between the pain registration tools by Spearmans correlation test (rho=0,930, p<0,001). There were no significant difference between the pain registration tools within the subgroups. Bland-Altman analysis show agreement between the two pain registration tools.ConclusionsIn an Emergency Department triage is it acceptable to use Visual Analog Scale and Numeric Rating Scale as equivalent, as long as the correct terminology is used.

The Effect of Dry Needling on Pain, Range of Motion of Ankle Joint, and Ultrasonographic Changes of Plantar Fascia in Patients With Plantar Fasciitis

2021 ◽  
pp. 1-6
Author(s):  
Afsaneh Moosaei Saein ◽  
Ziaeddin Safavi-Farokhi ◽  
Atefeh Aminianfar ◽  
Marzieh Mortezanejad
Keyword(s):  
Range Of Motion ◽  
Ankle Joint ◽  
Visual Analog Scale ◽  
Plantar Fasciitis ◽  
Plantar Flexion ◽  
Plantar Fascia ◽  
Trigger Points ◽  
Dry Needling ◽  
Analog Scale ◽  
Significant Difference

Context: Plantar fasciitis (PF) is a common and devastating disease. Despite different treatments, there is no clear evidence for the effect of these treatments on PF. One of the therapy methods used in physiotherapy is dry needling (DN). So the purpose of this study is to investigate the effect of DN on the pain and range of motion of the ankle joint and plantar fascia thickness in subjects with PF who are suffering from the trigger points of the gastrocnemius and soleus muscles. Methods: In this study, 20 volunteer females with PF were randomly assigned into DN treatment and control groups. Measurements were range of motion in dorsiflexion and plantar flexion, plantar fascia thickness, and visual analog scale measured before, immediately, and 1 month after the end of the intervention in both groups. Results: There were significant differences in the plantar fascia thickness and visual analog scale between the 2 groups. Plantar fascia thickness (P = .016) and visual analog scale (P = .03) significantly decreased in the treatment group. However, there was no significant difference in plantar flexion (P = .582) and dorsiflexion range of motion (P = .173) between groups. Conclusion: The result of this study showed that DN can reduce pain and plantar fascia thickness in women with PF who are suffering from trigger points of the gastrocnemius and soleus muscles. Level of evidence: Level 1, randomized controlled trial.

Extracorporeal Pulse-Activated Therapy versus Injection: Treatment of Recalcitrant Plantar Fasciitis

2019 ◽  
Vol 109 (2) ◽  
pp. 108-112
Author(s):  
John Grady ◽  
Yelena Boumendjel ◽  
Kathryn LaViolette ◽  
Trevor Smolinski
Keyword(s):  
Visual Analog Scale ◽  
Treatment Modality ◽  
Functional Outcomes ◽  
Plantar Fasciitis ◽  
Corticosteroid Injection ◽  
Inclusion Criteria ◽  
Analog Scale ◽  
Vas Score ◽  
Clinical Presentations ◽  
American Orthopaedic

Background: Plantar fasciitis is one of the most common clinical presentations seen by podiatric clinicians today. With corticosteroid injection being a classic treatment modality and extracorporeal pulse-activated therapy (EPAT) technology improving, the purpose of this study was to retrospectively compare pain and functional outcomes of patients with plantar fasciitis treated with either injection or EPAT. Methods: Between November 1, 2014, and April 30, 2016, 60 patients who met the inclusion criteria were treated with either corticosteroid injection or EPAT. Patients were evaluated with both the visual analog scale (VAS) and the American Orthopaedic Foot & Ankle Society Hindfoot Score at each visit. Results: The EPAT was found to reduce pain on the VAS by a mean of 1.98 points, whereas corticosteroid injection reduced pain by a mean of 0.94 points. This was a significant reduction in the VAS score for EPAT compared with corticosteroid injection (P = .035). Conclusions: Extracorporeal pulse-activated therapy is as effective as corticosteroid injection, if not more so, for the treatment of recalcitrant plantar fasciitis and should be considered earlier in the treatment course of plantar fasciitis.

scholarly journals Perception and Characterization of Posed Smile: A Photographic Study

2020 ◽  
pp. 030157422096341
Author(s):  
Sukhpal Kaur ◽  
Sanjeev Soni ◽  
Anil Prashar ◽  
and Rajdeep Kaur
Keyword(s):  
Visual Analog Scale ◽  
Digital Camera ◽  
Analog Scale ◽  
Male And Female ◽  
Maxillary Tooth ◽  
Significant Difference ◽  
Smile Esthetics ◽  
Relationship Of ◽  
Buccal Corridor

Aims of the Study: The aims of the study are: (a) to compare the perceptions of dental specialists and laypeople regarding smile esthetics; (b) to compare male and female smile parameters; (c) to find influence of smile parameters on esthetics of smile. Materials and Methods: The study was conducted on 60 subjects (30 males and 30 females) of age 18 to 25 years. Frontal posed photographs of all subjects were taken using a digital camera and rated on a visual analog scale by 10 dental specialists and 10 laypersons. Measurements made on photographs were used to analyze various parameters of smile, such as buccal corridor space, smile arc, modified smile index, anterior height of smile, most posterior maxillary tooth visible, and midline relationship of central incisors to philtrum. Results: Visual analog scale values showed that 6 photographs were rated as very good (3 males, 3 females), 29 as good (11 males, 18 females), 21 as average (13 males, 8 females), and 4 photographs were rated as bad (3 males, 1 female). A high correlation was observed between ratings of dental specialists and layperson’s ratings for both male and female smiles. Most of the subjects had non-consonant smile arc, and a high correlation was found between buccal corridor space on right and left sides in both males and females. Most of the male and female smiles had an average anterior height of smile; permanent maxillary first molar was the last tooth visible during smile (73.3% females, 66.7 males); and 55% subjects had coincident midline relationship of central incisors to philtrum. Conclusion: There was no significant difference in perception of dental specialists and laypersons regarding esthetics of smile. Smile arc and anterior height of smile influenced the esthetics of smile. No significant difference was found between male and female smile parameters except modified smile index.

scholarly journals Hematoma block for distal radius fractures – prospective, randomized comparison of two different volumes of lidocaine

2018 ◽  
Vol 46 (11) ◽  
pp. 4535-4538 ◽  
Author(s):  
Hagay Orbach ◽  
Nimrod Rozen ◽  
Barak Rinat ◽  
Guy Rubin
Keyword(s):  
Distal Radius ◽  
Analgesic Efficacy ◽  
Fracture Site ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Vas Score ◽  
Significant Difference ◽  
Group A ◽  
Vas Scores ◽  
Group B

Objective This study aimed to compare analgesic efficacy and safety of different volumes of lidocaine injected into a fracture hematoma (hematoma block [HB]) for reducing distal radius fractures. Methods Patients were randomly divided into two groups. Group A included patients in whom 10 mL of 2% lidocaine was injected into the fracture site and group B included patients in whom 20 mL of 1% lidocaine was injected. The fracture was manipulated after 15 minutes and the Visual Analogue Scale (VAS) score was recorded during manipulation. Patients were followed up for approximately 1 hour and complications were recorded. Results Twenty patients were enrolled in the study (12 women and eight men), with a mean age of 57 years (range, 32–87 years). Demographic findings were similar between the groups. The mean VAS score of group A was 5.50 ± 3.57 and that in group B was 3.09 ± 2.33, with no significant difference between the groups. Conclusion VAS scores between HB with 20 mL of 1% lidocaine and HB with 10 mL of 2% lidocaine are not significantly different. However, our study suggests that HB with 20 mL of 1% lidocaine has a better analgesic effect than HB with 10 mL of 2% lidocaine.

scholarly journals Efficacy and safety of intrathecal morphine for post cesarean section analgesia

2015 ◽  
Vol 1 (1) ◽  
pp. 13-17
Author(s):  
Rupesh Kumar Gami ◽  
Kumar Jahan ◽  
Chandra Bhushan Jha
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Visual Analog Scale ◽  
Intrathecal Morphine ◽  
Safe Motherhood ◽  
Control Group ◽  
Efficacy And Safety ◽  
Analog Scale ◽  
Morphine Group ◽  
Significant Difference

Background: Government of Nepal has been conducting Cesarean section under “Safe Motherhood” program all over country. The purpose of this study was to evaluate the efficacy and safety of intrathecal morphine for post cesarean analgesia under spinal anesthesia.  Methods: A total of 300 parturients posted for Cesarean section under spinal anesthesia were divided into two groups of 150 each in this prospective randomized case-control study. Morphine group received 0.15 mg of intrathecal morphine mixed in 12 mg of 0.5% bupivacaine heavy while control group received 12 mg of 0.5% bupivacaine heavy alone, after proper preparation of spinal anesthesia. The parturients were assessed for first request of analgesic as per Visual Analog Scale, frequency of analgesics required within 24 hr, nausea, vomiting, pruritus, sedation and respiratory depression.Results: Postoperative analgesia was significantly greater in morphine group as compare to control group (12.1 ± 7.6 vs 3.7 ± 2.9 hr). Frequency of analgesics requirements was also significantly lower in morphine group (1.7 ± 2.0 vs 3.4 ± 8.1). Visual Analog Scale was below 4 at most of time in morphine group. The incidence of nausea, vomiting and pruritus were more in morphine group as compare to control group but without any respiratory depression. There was no significant difference in APGAR score among fetus.  Conclusion: Mixing low dose of intrathecal morphine in standard dose of spinal anesthesia effectively prolongs the duration of post cesarean analgesia and decreases the frequency of analgesics requirement without any major complication in parturients or fetus.Journal of Society of Anesthesiologists 2014 1(1): 13-17

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