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.

Is Postoperative Chronic Pain Syndrome Higher with Mesh Repair of Inguinal Hernia?

2010 ◽  
Vol 76 (10) ◽  
pp. 1115-1118 ◽  
Author(s):  
Kristin Masukawa ◽  
Samuel E. Wilson
Keyword(s):  
Chronic Pain ◽  
Inguinal Hernia ◽  
Postoperative Pain ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Mesh Repair ◽  
Pain Syndrome ◽  
Chronic Pain Syndrome ◽  
Chronic Postoperative Pain ◽  
Anatomic Repair

Chronic postoperative pain has been associated with mesh repair in meta-analysis of clinical trials. We compared the incidence of early complications, recurrence, and chronic pain syndrome in anatomic and mesh repairs in 200 patients. We defined chronic pain syndrome as pain in the inguinal area more than 3 months after inguinal hernia repair, patient referral to pain management, or necessity of a secondary procedure for pain control. The mean follow-up time was 4 years and 2 months for anatomic repair and 3 years and 7 months for mesh repair. The clinical outcomes did not reveal a significant disparity between the 100 consecutive patients who had mesh repair versus the 100 patients who had anatomic repair with regard to the incidence of superficial wound infection (0 vs 2%, P = 0.497), testicular swelling (12 vs 7%, P = 0.335), hematoma (1 vs 0%, P = 0.99), recurrence (3 vs 2%, P = 0.99), or chronic postoperative pain (4 vs 1%, P = 0.369). The anatomic procedure without mesh should continue to be offered to patients who have an initial inguinal hernia repair.

Chronic postoperative pain syndrome - «a pitfall» of modern surgery

2016 ◽  
Vol 10 (1) ◽  
pp. 5-18
Author(s):  
Alexei M. Ovechkin
Keyword(s):  
Chronic Pain ◽  
Postoperative Pain ◽  
Pain Syndrome ◽  
Early Postoperative Period ◽  
Current Data ◽  
Main Role ◽  
Chronic Pain Syndrome ◽  
Preventive Action ◽  
Chronic Postoperative Pain ◽  
Perioperative Analgesia

The overview is devoted to the problem of chronic postoperative pain. At the moment every fifth patient undergone elective or emergency surgery suffers from chronic postoperative pain. The paper presents current data on epidemiology of chronic pain syndrome following different operations, as well as diagnostic criteria and pathophysiological mechanisms of transformation of acute postoperative pain into chronic pain syndrome. Risk factors responsible of formation of chronic postoperative pain are described in details, among which the most valuable are presence of pain before surgery, trauma of the surgery, intensity of pain in early postoperative period. The article discusses modern methods of prophylaxis of chronic postoperative pain. The most perspective drugs for preventive action include gabapentinoids and ketamine in subanesthetic doses. The main role in prophylaxis belongs to regional anesthesia and analgesia. The role of multimodal approach to perioperative analgesia is presented in the work as well.

scholarly journals EMLA- AN EFFECTIVE TOOL FOR TOPICAL ANALGESIA IN SPLIT SKIN GRAFT HARVEST

2020 ◽  
pp. 1-4
Author(s):  
Lalit Agrawal ◽  
Fahud Khurram ◽  
Naveen Khubchandani
Keyword(s):  
Visual Analogue Scale ◽  
Skin Graft ◽  
Analogue Scale ◽  
Skin Grafting ◽  
Split Skin Graft ◽  
Emla Cream ◽  
Graft Harvest ◽  
Group 2 ◽  
Split Skin ◽  
Group 1

Background: Many patients require general anesthesia merely for skin grafting. EMLA cream which is aeutectic mixture of Lignocaine and Prilocaine provides surface anesthesia when applied on intact skin. Its role in venepuncture or IV cannula insertion in children is well documented. Aim and Objective: To compare effectiveness of EMLA over inltrative local anaesthesia in split skin graft harvest. Method: A prospective study was conducted on 64 patients who required skin grafting. Various indications for grafting were noted. The patients were randomly allocated to two groups. In one group 32 patients, graft was harvested after application of EMLA cream whereas in another group of 32 patients, graft was harvested by inltrating local anesthesia. Pain perceived during donor area preparation, graft harvesting and post-operative pain was recorded and compared between the two groups on Visual analogue scale and Likert scale. Results: Total 64 patients were included in the study with 32 patients in either group. Traumatic loss of skin was the most common indication in either group for skin graft harvest. As per visual analogue scale during the graft harvest, most of the patients were in the range of 4-7 score in either group (71.87% vs 53.12%). 75% of the patients were in the 4-7 score in both groups. As per likert scale during the graft harvest score of 4 was noted in 62.5% in group 1 vs 53.12% in group 2 patients. 81.25% patients in group 1 reported procedure as excellent versus 53.12% patients in group 2. Patients experienced more pain during inltration of local anesthesia. Whereas more bleeding was noted in EMLA group immediately after harvest of graft. Conclusions: EMLA cream can be effectively used as an alternative to local anaesthetic inltration for harvest of split thickness skin graft

scholarly journals Comparison of Four Different Pain Relief Methods during Hysterosalpingography: A Randomized Controlled Study

2015 ◽  
Vol 20 (2) ◽  
pp. 107-111 ◽  
Author(s):  
Bekir Serdar Unlu ◽  
Mehmet Yilmazer ◽  
Gulengul Koken ◽  
Dagistan Tolga Arioz ◽  
Ebru Unlu ◽  
...  
Keyword(s):  
Pain Relief ◽  
Visual Analogue Scale ◽  
Analogue Scale ◽  
Cervix Uteri ◽  
Controlled Study ◽  
Group 4 ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

BACKGROUND: Hysterosalpingography (HSG) is the most commonly used method for evaluating the anatomy and patency of the uterine cavity and fallopian tubes, and is an important tool in the evaluation of infertility. The most frequent side effect is the pain associated with the procedure.OBJECTIVES: To evaluate four analgesic methods to determine the most useful method for reducing discomfort associated with HSG.METHODS: In the present prospective study, 75 patients undergoing HSG for evaluation of infertility were randomly assigned to four groups: 550 mg of a nonsteroidal anti-inflammatory drug (NSAID) (group 1); 550 mg NSAID + paracervical block (group 2); 550 mg NSAID + paracervical analgesic cream (group 3); or 550 mg NSAID + intrauterine analgesic instillation (group 4). A visual analogue scale was used to assess the pain perception at five predefined steps.RESULTS: Instillation of the liquids used for HSG was found to be the most painful step of HSG, and this step was where the only significant difference among groups was observed. When comparing visual analogue scale scores, group 2 and group 3 reported significantly less pain than the other groups. Group 1 reported significantly higher mean ( ± SD) scores (7.2 ± 1.6) compared with groups 2 and 3 (4.7 ± 2.5 and 3.8 ± 2.4, respectively) (P<0.001). In addition, group 2 reported significantly less pain than group 4 (4.7 ± 2.5 versus 6.7 ± 1.8, respectively) (P<0.02).CONCLUSIONS: For effective pain relief during HSG, in addition to 550 mg NSAID, local application of lidocaine cream to the posterior fornix of the cervix uteri and paracervical lidocaine injection into the cervix uteri appear to be the most effective methods.

Exploring the impact of pain management programme attendance on complex regional pain syndrome (CRPS) patients’ decision making regarding immunosuppressant treatment to manage their chronic pain condition

2020 ◽  
Vol 20 (4) ◽  
pp. 707-716
Author(s):  
Calum Murray ◽  
Samantha Harrison ◽  
Andreas Goebel ◽  
Hannah Twiddy
Keyword(s):  
Decision Making ◽  
Chronic Pain ◽  
Pain Management ◽  
Treatment Options ◽  
Pain Syndrome ◽  
Management Programme ◽  
Chronic Pain Condition ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

AbstractObjectivesComplex regional pain syndrome (CRPS) is a rare chronic pain condition for which no curative treatment exists. Patients in tertiary centres are often required to make decisions about treatment options. This study was conducted to explore how prior attendance of a pain management program might alter patients’ decision making processes.MethodsThis qualitative study uses focus groups to gather patient views on an immunosuppressant drug treatment (mycophenolate) for the management of CRPS. Participants were allocated to one of three focus groups based on their treatment journey; Group 1 (n=3) were involved in a recent mycophenolate drug trial; Group 2 (n=5) were neither involved in the trial nor attended a Pain Management Programme (PMP); Group 3 (n=6) were not involved in the trial but had attended a PMP. Outcomes were considered within the framework of Leventhal’s Common Sense Model (CSM) in relation to the decision making process.ResultsThematic analysis identified differing themes for each group. Group 1: (1) Medication as a positive form of treatment, (2) The trial/drug and (3) Pacing. Group 2: (1) Medication as form of treatment, (2) Other forms of support/treatment and (3) Side effects of mycophenolate. Group 3: (1) Varied view of medication, (2) Consideration of other forms of support and (3) Side effects.ConclusionsAttendance on a PMP might provide patients with skills to better manage uncertainty when faced with various treatment options. Leventhal’s model goes some way to explaining this. The specific importance of, and benefit from understanding pacing when commencing an effective drug treatment for chronic pain became apparent.

scholarly journals Chronic pain in children with oncopathology: ways of solving the problem

2020 ◽  
pp. 6-7
Author(s):  
N.M. Adamchuk ◽  
O.Yu. Sorokina
Keyword(s):  
Blood Pressure ◽  
Gastrointestinal Tract ◽  
Visual Analogue Scale ◽  
Acute Leukemia ◽  
Emotional Disorders ◽  
Analogue Scale ◽  
Face Scale ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Objective. Pain is one of the complications in children with acute leukemia, which requires timely and effective analgesic therapy. We decided to determine the effectiveness and tolerability of analgesia in children with acute leukemia depending on the method of analgesia. Materials and methods. There was a survey of 60 children (3 groups of 20 children each). In group 1 conducted morphine analgesia, in group 2 – morphine in combination with gabapentin, in group 3 – paracetamol with gabapentin. Investigated performance of the cardiovascular system, gastrointestinal tract. The questionnaire “Feeling. Activity. Mood” was used to determine psycho-emotional disorders, visual-analogue scale and face scale was used to determine the intensity of pain. Results and discussion. In group 1, all children had dysfunction of the gastrointestinal tract and lability of blood pressure. In group 2, only 11 children had disorders of the digestive system, there were no cardiovascular complications. In group 3, only 5 children had lability of blood pressure. Averages activity in all three groups are almost identical and reflect favorable condition. The average health indicators are the lowest in the 1st group – 3.78±0.11 (p<0.05), in the 2nd group – 3.84±0.06 (p<0.05), and in the 3rd group – 4.01±0.09 (p<0.05). Mood indicators in groups 2 and 3 are almost the same – 4.04±0.12 (p<0.05) and 4.42±0.04 (p<0.05), respectively, and the worst in 1st group – 3.94±0.07 (p<0.05). The pain intensity according to visual-analogue scale on day 30 was in the 1st group ≤5 points, in the 2nd group ≤4 points and in the 3rd group ≤3 points. On day 78, the intensity of pain in group 1 was ≤5 points, in 2nd and 3rd groups – ≤3 points. Severe asthenia was observed only in 6 children (10 %) of the group 1, moderate asthenia – in 45 children (75 %) and the fatigue reaction – in 9 children (25 %). Conclusions. The best tolerability of analgesia in children, receiving paracetamol with gabapentin, the worst – in children receiving only opiates. Children who combined opiates with gabapentin had better health and significantly fewer complications than children who received opiates alone.

scholarly journals Analgesic Efficiency of Tramadol Administered Prior to Hysteroscopy Procedure

2016 ◽  
pp. 4
Author(s):  
Pınar Kadiroğulları ◽  
Kerem Doğa Seçkin ◽  
Burak Yücel ◽  
Berna Aslan Çetin ◽  
Sibel Arslan Barut ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Visual Analogue Scale ◽  
Prospective Study ◽  
Analogue Scale ◽  
The Other ◽  
Office Hysteroscopy ◽  
Pain Scores ◽  
Vas Scores ◽  
Group 2 ◽  
Group 1

<p><strong>OBJECTIVE:</strong> In this study, our objective was to assess the pain scores using the Visual Analogue Scale (VAS) in patients who were given tramadol prior to office hysteroscopy in order to demonstrate its analgesic activity when given before this procedure. <br /><strong>STUDY DESIGN:</strong> This prospective study conducted in year 2015 included two group of patients undergoing office hysteroscopy that were defined on the basis of the type of analgesia. Patients in the first group (Group 1, n=44) received oral tramadol prior to the procedure, while patients in the other group (Group 2, n=44) received placebo. VAS scores were determined during (0 minutes) and after (15 minutes) the procedure. <br /><strong>RESULTS:</strong> There were no significant differences between groups in terms of age, parity and body mass index (p&gt;0.05). Comparison of VAS scores at 0 and 15 minutes, lower values were observed in tramadol patients at 0 minutes (p&lt;0.05), while scores at 15 minutes were not significantly different between the groups (p&gt;0.05). <br /><strong>CONCLUSION:</strong> Although oral tramadol given prior to office hysteroscopy was effective and safe in reducing pain during the procedure, it is not useful for the pain that occurs after processing.</p>

scholarly journals THE DIFFERENCES OF PROPRIOCEPTIVE NEUROMUSCULAR FACILITATION (PNF) STRETCHING AND ICE MASSAGE IN PREVENTING DELAYED ONSET MUSCLE SORENESS (DOMS) IN ADOLESCENT IN DENPASAR

2018 ◽  
Vol 6 (3) ◽  
pp. 37
Author(s):  
Made Wahyu Cahyadi ◽  
Ni Wayan Tianing ◽  
I Made Krisna Dinata
Keyword(s):  
Visual Analogue Scale ◽  
Analogue Scale ◽  
Muscle Soreness ◽  
Hypothesis Test ◽  
Sampling Technique ◽  
Simple Random Sampling ◽  
Significant Difference ◽  
Proprioceptive Neuromuscular Facilitation ◽  
Group 2 ◽  
Group 1

ABSTRACT             The purpose of this study was to determine the aim of this research the difference between proprioceptive neuromuscular facilitation (PNF) stretching and ice massage in preventing the occurrence of delayset onset muscle soreness (DOMS). This research is an experimental study with post test two group desaign and using simple random sampling technique. The sample of the study were 20 male students selected based on the inclusion and exclusion criteria, which were then divided into two groups. Group 1 was given treatment of pnf stretching and group 2 was given ice massage treatment. DOMS pain was measured using visual analogue scale (VAS) at 48 h after treatment. Hypothesis test of this research using Mann-Whitney U-test, where got result p = 0,027 (p <0,05). These results show that there is a significant difference between pnf stretching and ice massage. Mean of DOMS pain value in group 1 was 2,560 and mean of DOMS pain value in group 2 was 1,200. This shows that ice massage group results in lower DOMS pain value compared to pnf stretching group. Based on the results of this study, it is concluded that ice massage is better than pnf stretching in preventing DOMS.   Keyword: delayet onset muscle soreness (DOMS), PNF Stretching, Ice Massage, visual analogue scale (VAS)

scholarly journals Percutaneous resonance stimulation in complex correction of intraabdominal hypertension and dynamic intestinal obstruction in patients with severe acute pancreatitis

2018 ◽  
Vol 23 (3) ◽  
pp. 23-30
Author(s):  
O. K. Khalidov ◽  
V. S. Fomin ◽  
A. N. Gudkov ◽  
G. O. Zayratyants ◽  
G. P. Dmitrienko ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Visual Analogue Scale ◽  
Intestinal Obstruction ◽  
Severe Acute Pancreatitis ◽  
Analogue Scale ◽  
Disease Onset ◽  
Abdominal Pressure ◽  
Abdominal Hypertension ◽  
Group 2 ◽  
Group 1

Aim. To evaluate an effectiveness of non-invasive stimulation of gastrointestinal peristaltic activity in complex correction of motor-evacuation disorders and intra-abdominal hypertension in patients with severe acute pancreatitis.Material and methods. There were 85 patients with severe acute pancreatitis. Patients were divided into two groups: group 1 (n = 43) – percutaneous resonance stimulation; group 2 (n = 42) – routine treatment of acute pancreatitis with intraperitoneal hypertension syndrome and dynamic intestinal obstruction according to normative documents. Intra-abdominal pressure was measured in 1, 3, 5, 7 days after disease onset. Abdominal perfusion pressure and filtration gradient were additionally calculated. Moreover, outcomes were assessed after 1, 3, 5, and 7 days according to visual-analogue scale.Results. There were faster regression of intraperitoneal hypertension followed by normalization of abdominal pressure after 7 days in group 1 compared with group 2 (p ≤ 0.05). Data of visual-analogue scale confirmed patients’ good tolerability of resonance stimulation including absent local discomfort during electrodes deployment and better state of health compared with group 2 (p ≤ 0.05). Infectious complications rate was 20.9% in group 1, 38.1% – in group 2. Sepsis developed in 3 (7%) patients of group 1 and in 7 (16.6%) patients of group 2. Overall mortality was 7% and 14.3% in both groups, respectively. Сonclusion. Percutaneous resonance stimulation is able to improve outcomes in patients with severe acute pancreatitis.

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.

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