Predicted Versus Non-Predicted Opioid Administration Using Preoperative Pain Sensitivity in Patients Undergoing Gynecological Surgery: A Randomized-Controlled Trial

Individualized administration of opioids based on preoperative pain sensitivity may improve postoperative pain profiles. This study aimed to examine whether a predicted administration of opioids could reduce opioid-related adverse effects after gynecological surgery. Patients were randomized to the predicted group or control group. Participants received a preoperative sensory test to measure pressure pain thresholds. Patients were treated with a higher or lower (15 or 10 μg/mL) dose of fentanyl via intravenous patient-controlled analgesia. The opioid dose was determined according to pain sensitivity in the predicted group, while it was determined regardless of pain sensitivity in the control group. The primary outcome was the incidence of nausea over the first 48 h postoperative period. Secondary outcomes included postoperative pain scores and opioid requirements. There was no difference in the incidence of nausea (40.0% vs. 52.5% in predicted and control groups, respectively; p = 0.191) and postoperative pain scores (3.3 vs. 3.5 in predicted and control groups, respectively; p = 0.691). However, opioid consumptions were lower in the predicted group compared to the control group (median 406.0 vs. 526.5 μg; p = 0.042). This study showed that offering a predicted dose of opioids according to pain sensitivity did not affect the incidence of nausea and pain scores.

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Cryotherapy Reduced Postoperative Pain in Gynecologic Surgery: A Randomized Controlled Trial

Pain Research and Treatment ◽

10.1155/2019/2405159 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Apisada Chumkam ◽

Densak Pongrojpaw ◽

Athita Chanthasenanont ◽

Junya Pattaraarchachai ◽

Kornkarn Bhamarapravatana ◽

...

Keyword(s):

Postoperative Pain ◽

Statistical Difference ◽

Controlled Trial ◽

Exploratory Laparotomy ◽

Gynecologic Surgery ◽

Control Group ◽

Study Group ◽

Control Groups ◽

Vas Score ◽

And Control

Objective. To examine the effectiveness of cryotherapy for reducing postoperative pain in patients who underwent exploratory laparotomy for gynecologic surgery. Materials and Methods. Patients who had indication for an exploratory laparotomy gynecologic procedure were selected by attending physicians to undergo abdominal surgery via low transverse skin incision. The participants were randomized into study and control groups with simple random sampling methods. Cold packs were applied at two hours after operation for 6 hours. The visual analog scale (VAS) score was recorded at two, 6, and 12 hours after operation. Result. One hundred cases were recruited and then divided into study and control groups equally. The mean age of both groups was 43 years. There was no difference in demographics data of both groups. Half of the participants in both groups underwent hysterectomies. At two hours after surgery, both groups had similar VAS scores. The study group had a lower VAS score at 6 and 12 hours after surgery than the control group with statistical difference. Morphine consumption within 24 hours after surgery in both the study and control groups was 2.8±3.4 and 3.0±4.4 mg, respectively, with no statistical difference. However the registration time of the first morphine requirement in the study group was statistically more prolonged than that of the control group. The lengths of hospital stay in both groups were similar. There was no complication reported in this study. Conclusion. Cryotherapy can reduce postoperative pain. In this presented study the patients who underwent gynecologic surgery had improved pain relief and prolonged time for the first dose of the analgesic drug.

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Single-injection caudal thoracic paravertebral block improves pain control and recovery quality in female dogs undergoing unilateral radical mastectomy: a randomized controlled trial

Journal of the American Veterinary Medical Association ◽

10.2460/javma.21.04.0188 ◽

2021 ◽

Vol 260 (S1) ◽

pp. S53-S58

Author(s):

Francesco Santoro ◽

Pasquale Debidda ◽

Paolo Franci

Keyword(s):

Postoperative Pain ◽

Pain Control ◽

Single Injection ◽

Radical Mastectomy ◽

Cardiovascular Responses ◽

Paravertebral Block ◽

Control Groups ◽

Thoracic Paravertebral Block ◽

Pain Scores ◽

And Control

Abstract OBJECTIVE To test clinical and analgesic effects of a single-injection caudal thoracic paravertebral block (TPVB) after localization of the thoracic paravertebral space with a loss-of-resistance to air injection technique in female dogs undergoing unilateral radical mastectomy. ANIMALS 14 client-owned dogs. PROCEDURES Dogs were premedicated with methadone, anesthetized with propofol and sevoflurane, and randomly assigned to receive a TPVB or no block preoperatively. Rescue analgesia with fentanyl and methadone was provided on the basis of cardiovascular responses during surgery and postoperative pain scores assigned with a validated pain scale. Required dose of rescue opioids; mean end-tidal sevoflurane concentration; episodes of hypotension, bradycardia, and other complications; quality of recovery scores; and postoperative pain scores were compared between groups. RESULTS Median intraoperative fentanyl doses were 0 µg/kg (range, 0 to 2 µg/kg) and 4 µg/kg (range, 2 to 6 µg/kg) for the TPVB and control groups, respectively. Median postoperative methadone doses were 0 mg/kg (range, 0 to 0.2 mg/kg) and 0.6 mg/kg (range, 0.4 to 0.6 mg/kg) for the TPVB and control groups, respectively. Recovery scores and pain scores assigned at the time of and 1 hour after extubation were significantly lower in the TPVB group than in the control group. CONCLUSIONS AND CLINICAL RELEVANCE A single-injection caudal TPVB improved pain control and recovery quality in female dogs undergoing unilateral radical mastectomy. Because the TPVB involves only a single injection, does not take long to perform, and requires only readily available low-cost equipment, the technique may be a valuable option in both referral and first-opinion practice.

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Effect of Foot Reflexology on Postoperative Pain in Patients Undergoing Tibia Plating Surgery: A Randomized Clinical Trial

Complementary Medicine Journal ◽

10.32598/cmja.10.3.1019.1 ◽

2020 ◽

Vol 10 (3) ◽

pp. 258-269

Author(s):

Fatemeh Imani ◽

◽

Ebrahim Nasiri ◽

Houshang Akbari ◽

Mohammad Reza Safdari ◽

...

Keyword(s):

Clinical Trial ◽

Postoperative Pain ◽

Randomized Clinical Trial ◽

Repeated Measures ◽

Intervention Group ◽

Control Group ◽

Control Groups ◽

Chi Square ◽

Chi Square Test ◽

And Control

Objective: One of the major problems of patients after orthopedic surgeries is acute pain. The present study aims to evaluate the effect of foot reflexology massage on postoperative pain in patients undergoing plating surgery for tibia fracture. Methods: This study is a randomized clinical trial conducted on 96 patients who were candidates for tibia plating surgery referred to Imam Ali Hospital in Bojnourd, Iran, randomly divided into intervention and control groups. Foot reflexology massage in the intervention group was performed on patients’ healthy feet for 10 minutes, one hour before surgery. In the control group, the foot sole was touched for one minute without any pressure. Pain intensity was measured using the standard Visual Analog Scale before and immediately after the intervention and 2, 4, 6, 12 and 24 hours after surgery. Data were analyzed using chi-square test, t-test, repeated measures ANOVA, Mann-Whitney U and Friedman tests. Results: The baseline pain scores in the intervention and control groups were reported 8.1±0.9 and 8.4±0.9, respectively. After the intervention, the pain score in these groups was reduced to 6.9±1.1 and 8.1±1.0, respectively (P<0.001). At other times, up to 24 hours after surgery, the pain reduction was higher in the intervention group (P<0.05). Conclusion: Foot reflexology massage reduces postoperative pain of patients undergoing tibia plating surgery. Therefore, this method can be used to reduce pain and anxiety in orthopedic surgery patients.

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Virtual reality distraction decreases pain during daily dressing changes following haemorrhoid surgery

Journal of International Medical Research ◽

10.1177/0300060519857862 ◽

2019 ◽

Vol 47 (9) ◽

pp. 4380-4388 ◽

Cited By ~ 2

Author(s):

Jie Ding ◽

Yanyan He ◽

Lishan Chen ◽

Bili Zhu ◽

Qiuping Cai ◽

...

Keyword(s):

Virtual Reality ◽

Control Group ◽

Control Groups ◽

Open Label ◽

Pain Scores ◽

Significant Difference ◽

The Mean ◽

Baseline Characteristics ◽

Dressing Change ◽

And Control

Objective To investigate whether immersive virtual reality (VR) distraction could decrease pain during postoperative dressing changes. Methods This was a prospective, open-label randomized clinical trial that enrolled patients that had undergone haemorrhoidectomy. Patients were randomly assigned to one of two groups: a control group that received the standard pharmacological analgesic intervention during dressing change and a VR group that received VR distraction during dressing change plus standard pharmacological analgesic intervention. Pain scores and physiological measurements were collected before, during and after the first postoperative dressing change. Results A total of 182 patients were randomly assigned to the control and VR groups. The baseline characteristics of the VR and control groups were comparable. There was no significant difference in mean pain scores prior to and after the dressing change procedure between the two groups. The mean pain scores at the 5-, 10-, 15- and 20-min time-points during the first dressing change were significantly lower in the VR group compared with the control group. Heart rates and oxygen saturation were not significantly different between the two groups. Conclusion Immersive VR was effective as a pain distraction tool in combination with standard pharmacological analgesia during dressing change in patients that had undergone haemorrhoidectomy.

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Comparison of Transcutaneous Electrical Nerve Stimulation and Parasternal Block for Postoperative Pain Management after Cardiac Surgery

Pain Research and Management ◽

10.1155/2016/4261949 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6 ◽

Cited By ~ 9

Author(s):

Nilgun Kavrut Ozturk ◽

Elif Dogan Baki ◽

Ali Sait Kavakli ◽

Ayca Sultan Sahin ◽

Raif Umut Ayoglu ◽

...

Keyword(s):

Cardiac Surgery ◽

Postoperative Pain ◽

Nerve Stimulation ◽

Transcutaneous Electrical Nerve Stimulation ◽

Control Group ◽

Block Group ◽

Control Groups ◽

Electrical Nerve Stimulation ◽

Extubation Time ◽

And Control

Background. Parasternal block and transcutaneous electrical nerve stimulation (TENS) have been demonstrated to produce effective analgesia and reduce postoperative opioid requirements in patients undergoing cardiac surgery.Objectives. To compare the effectiveness of TENS and parasternal block on early postoperative pain after cardiac surgery.Methods. One hundred twenty patients undergoing cardiac surgery were enrolled in the present randomized, controlled prospective study. Patients were assigned to three treatment groups: parasternal block, intermittent TENS application, or a control group.Results. Pain scores recorded 4 h, 5 h, 6 h, 7 h, and 8 h postoperatively were lower in the parasternal block group than in the TENS and control groups. Total morphine consumption was also lower in the parasternal block group than in the TENS and control groups. It was also significantly lower in the TENS group than in the control group. There were no statistical differences among the groups regarding the extubation time, rescue analgesic medication, length of intensive care unit stay, or length of hospital stay.Conclusions. Parasternal block was more effective than TENS in the management of early postoperative pain and the reduction of opioid requirements in patients who underwent cardiac surgery through median sternotomy. This trial is registered with Clinicaltrials.gov numberNCT02725229.

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Effects of Preoperative Parental Pain Management Educational Interventions on the Postoperative Pain Intensity and Duration of Small Children Who Underwent One-Day Surgery: A Prospective Randomized Controlled Trial

10.22514/sv.2020.16.0057 ◽

2020 ◽

Keyword(s):

Pain Management ◽

Postoperative Pain ◽

Pain Intensity ◽

Rating Scale ◽

Educational Interventions ◽

Control Groups ◽

Small Children ◽

Pain Scores ◽

And Control ◽

At Home

Objectives: To evaluate effects of parental pain management educational interventions on postoperative pain assessment, intensity and duration of small children after a one-day-pediatric surgery. Methods: We conducted a prospective randomized, observational study of parental and nurse’s pain assessments in children. The Parents’ Postoperative Pain Management rating scale (PPPM), Wong-Baker FACES Pain Rating Scale (W-B) or the Numerical Rating Scale (NRS) was used. The children’s pain was assessed by parents who were or were not (intervention vs. control groups) preoperatively educated about pain management postoperatively in the hospital and the first three days at home. Nurses who cared for the children postoperatively in the hospital, independently from the parents, assessed the children’s postoperative pain with W-B and NRS. Results: One hundred and fifty-two parents and their children were included in the study. Complete data were available for 142 parents and their children, with one parent, usually the mother (108 (76.1 %)), being involved at all stages of the study. No differences in children’s postoperative pain scores and analgesic use at home were found between the two parental groups (intervention and control groups). Parental pain scores after surgery was strongly positively correlated with pain duration, and analgesic use by their children at home. Pain intensity scores assessed by nurses in the hospital were lower compared to parental pain intensity scores. There was high inter-rater reliability between the PPPM, Wong-Baker, and NRS scales. Conclusions: No differences in postoperative pain in children were found between the intervention and control groups of parents. Parents gave higher scores of pain intensity in children than nurses did.

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Dienogest and the Risk of Reoperation in Endometriosis

Journal of Personalized Medicine ◽

10.3390/jpm11090924 ◽

2021 ◽

Vol 11 (9) ◽

pp. 924

Author(s):

Yong-Soo Seo ◽

Jin-Sung Yuk ◽

Yong-Kyoon Cho ◽

Ji-Yeon Shin

Keyword(s):

Survival Analysis ◽

Gnrh Agonist ◽

Reoperation Rate ◽

Control Group ◽

Gynecological Surgery ◽

Diagnosis Code ◽

Control Groups ◽

Group A ◽

And Control ◽

Reoperation Rates

Background: This retrospective cohort study aimed to determine whether there is a difference in reoperation rates between patients who used dienogest (DNG) and patients who did not use DNG. Methods: Using Health Insurance Review and Assessment Service (HIRA) data generated between 1 January 2010 and 30 June 2018, we identified women with an endometriosis diagnosis code who used GnRH agonists after gynecological surgery. Among them, women prescribed DNG were selected as the DNG group, and those who did not receive DNG were selected as the control group. A survival analysis of the reoperation between the two groups was performed. Results: DNG and control groups were extracted from 9735 people each. The reoperation rates were 0.4% and 0.6% in the DNG and control groups, respectively, without adjusting. In the Cox proportional risk analysis, DNG use increased the reoperation rate {hazard ratio (HR), 1.599; 95% confidence interval (CI), 1.005–2.545}. The site of endometriosis and the number of GnRH agonist injections were not associated with reoperation (HR, 1.008; 95% CI, 0.739–1.374; HR, 1.062; 95% CI, 0.690–1.635). In the subgroup survival analysis, according to the period between the last GnRH agonist injection and the first DNG dose, DNG did not increase the reoperation rates up to 9 months (~3 months: HR, 0.968; 95% CI, 0.551–1.699; 4~6 months: HR, 1.094; 95% CI, 0.58–2.063; 7~9 months: HR, 2.419; 95% CI, 0.735–7.962), but DNG increased the reoperation rate from 10 months onwards (10~12 months: HR, 3.826; 95% CI, 1.164–12.579 and ~13 months: HR, 8.436; 95% CI, 4.722–15.072). Conclusions: Women who used DNG had a higher endometriosis reoperation rate than women who did not use DNG. However, the initiation of DNG treatment within nine months after the last GnRH agonist injection did not affect the endometriosis reoperation rate.

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Conjugated Linoleic Acid Causes a Marked Increase in Liver α-Tocopherol and Liver α-Tocopherol Transfer Protein in C57BL/6 J Mice

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000007 ◽

2010 ◽

Vol 80 (1) ◽

pp. 65-73 ◽

Cited By ~ 10

Author(s):

Pei-Min Chao ◽

Wan-Hsuan Chen ◽

Chun-Huei Liao ◽

Huey-Mei Shaw

Keyword(s):

Antioxidant Enzymes ◽

Linoleic Acid ◽

Conjugated Linoleic Acid ◽

Thiobarbituric Acid ◽

Control Group ◽

Thiobarbituric Acid Reactive Substances ◽

Control Groups ◽

Protein Levels ◽

Transfer Protein ◽

And Control

Conjugated linoleic acid (CLA) is a collective term for the positional and geometric isomers of a conjugated diene of linoleic acid (C18:2, n-6). The aims of the present study were to evaluate whether levels of hepatic α-tocopherol, α-tocopherol transfer protein (α-TTP), and antioxidant enzymes in mice were affected by a CLA-supplemented diet. C57BL/6 J mice were divided into the CLA and control groups, which were fed, respectively, a 5 % fat diet with or without 1 g/100 g of CLA (1:1 mixture of cis-9, trans-11 and trans-10, cis-12) for four weeks. α-Tocopherol levels in plasma and liver were significantly higher in the CLA group than in the control group. Liver α-TTP levels were also significantly increased in the CLA group, the α-TTP/β-actin ratio being 2.5-fold higher than that in control mice (p<0.01). Thiobarbituric acid-reactive substances were significantly decreased in the CLA group (p<0.01). There were no significant differences between the two groups in levels of three antioxidant enzymes (superoxide dismutase, glutathione peroxidase, and catalase). The accumulation of liver α-tocopherol seen with the CLA diet can be attributed to the antioxidant potential of CLA and the ability of α-TTP induction. The lack of changes in antioxidant enzyme protein levels and the reduced lipid peroxidation in the liver of CLA mice are due to α-tocopherol accumulation.

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Sri Lankan Cleft Lip and Palate Study Model Analysis: Clefts of the Secondary Palate

The Cleft Palate-Craniofacial Journal ◽

10.1597/1545-1569_1993_030_0227_slclap_2.3.co_2 ◽

1993 ◽

Vol 30 (2) ◽

pp. 227-230 ◽

Cited By ~ 2

Author(s):

Andrew Mccance ◽

David Roberts-Harry ◽

Martyn Sherriff ◽

Michael Mars ◽

William J.B. Houston

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Model Analysis ◽

Control Group ◽

Tooth Size ◽

Sri Lankan ◽

Control Groups ◽

Secondary Palate ◽

Comparable Control ◽

And Control

The study models of a group of adult Sri Lankan patients with clefts of the secondary palate were investigated. Tooth-size and arch-dimension comparisons were made with a comparable control group. Significant differences were found between the cleft and control groups in tooth sizes, chord lengths, and arch widths. The cleft group dimensions were generally smaller than those of the control group. Overjets were larger in the cleft group.

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THE EFFECT OF APPLYING ANIMAL CARTOON PICTURES ON STUDENTS’ ACHIEVEMENT IN WRITING NARRATIVE TEXT

10.24114/reg.v6i1.5371 ◽

2017 ◽

Vol 6 (1) ◽

Author(s):

Hasanul Arifin Zul And Masitowarni Siregar

Keyword(s):

T Test ◽

Narrative Text ◽

Control Group ◽

First Year ◽

Writing Achievement ◽

Control Groups ◽

Post Test ◽

Written Test ◽

And Control ◽

Experimental Group

This thesis is focused on the investigation of the effect of applying animal cartoon pictures on students’ achievement in writing narrative text. This study aims to find whether applying animal cartoon pictures significantly affect the students’ writing achievement or not. The data in this study were obtained by administering a written test. The population was the 2015/2016 first year (grade XI) of SMA Swasta Nusantara Lubuk Pakam and 66 students were taken as the sample by using random sampling. The sample was divided into two groups, experimental and control groups. The experimental group was taught by applying animal cartoon pictures while the control group without animal cartoon pictures (x = lecturing). The data were taken the scores from the pre-test and post-test to both experimental and control groups. These data were analyzed by using t-test. The result of computing the t-test obviously showed that t-observed is higher than t-table (5.21 >1,67) with the degree of freedom 64 (df =N-2) at the level significance 0,05 one tail test. It showed that the application of animal cartoon pictures significantly affected the students of SMA Swasta Nusantara Lubuk Pakam achievement in writing narrative text.

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