Faculty Opinions recommendation of The weight of pain: what does a 10 on the pain scale mean? an innovative use of art in medical education to enhance pain management.

2019 ◽  
Author(s):  
Rajesh Gupta
Keyword(s):  
Medical Education ◽  
Pain Management ◽  
Pain Scale

scholarly journals Equine Discomfort Ethogram

Animals ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 580
Author(s):  
Catherine Torcivia ◽  
Sue McDonnell
Keyword(s):  
Pain Management ◽  
Line Drawing ◽  
Clinical Work ◽  
Pain Scale ◽  
University Of Pennsylvania ◽  
Systematic Evaluation ◽  
Clear Understanding ◽  
Physical Discomfort ◽  
Professional Health ◽  
The University

In recent years, there has been a growing interest in and need for a comprehensive ethogram of discomfort behavior of horses, particularly for use in recognizing physical discomfort in domestically managed horses. A clear understanding of the physical discomfort behavior of horses among caretakers, trainers, and professional health care personnel is important to animal welfare and caretaker safety. This is particularly relevant to pain management for hospitalized equine patients. Various pain scale rubrics have been published, typically incorporating only a few classically cited pain behaviors that, in many cases, are specific to a particular body system, anatomic location, or disease condition. A consistent challenge in using these rubrics in practice, and especially in research, is difficulty interpreting behaviors listed in various rubrics. The objective of this equine discomfort ethogram is to describe a relatively comprehensive catalog of behaviors associated with discomfort of various degrees and sources, with the goal of improving understanding and clarity of communication regarding equine discomfort and pain. An inventory of discomfort-related behaviors observed in horses has been compiled over 35 years of equine behavior research and clinical consulting to medical and surgical services at the University of Pennsylvania School of Veterinary Medicine’s equine hospital. This research and clinical work included systematic evaluation of thousands of hours of video-recordings, including many hundreds of normal, healthy horses, as well as hospitalized patients with various complaints and/or known medical, neurologic, or orthopedic conditions. Each of 73 ethogram entries is named, defined, and accompanied by a line drawing illustration. Links to online video recorded examples are provided, illustrating each behavior in one or more hospitalized equine patients. This ethogram, unambiguously describing equine discomfort behaviors, should advance welfare of horses by improving recognition of physical discomfort, whether for pain management of hospitalized horses or in routine husbandry.

Does meloxicam provide adequate pain management as a post-operative analgesic in canine ovariohysterectomy patients?

2020 ◽  
Vol 11 (4) ◽  
pp. 192-197
Author(s):  
Gavin Goldsbrough ◽  
Helen Reynolds
Keyword(s):  
Pain Management ◽  
Pain Score ◽  
Pain Scale ◽  
Short Term ◽  
Post Surgery ◽  
Pain Scores ◽  
Significant Difference ◽  
Time Frames ◽  
Adequate Pain Management

Background: Meloxicam is an analgesic agent with anti-inflammatory properties, commonly used in veterinary practices to treat a variety of different long-term medical conditions and is also used as a short-term pain relief following particularly traumatic surgeries. Aims: An observational study was conducted to determine whether meloxicam provides adequate pain management as a post-operative analgesic for canine ovariohysterectomies. Methods: 13 canines were admitted for ovariohysterectomy. Each patient was assessed using the Glasgow composite pain scale (CMPS) prior to surgery during the admission procedure, 15 minutes post-operatively, at discharge and at their post-operative check (POC) 3–5 days after surgery. Results: Data were statistically analysed to determine the overall effectiveness of meloxicam in reducing pain following canine ovariohysterectomy. The results showed a statistically significant difference (Kruskal-Wallis test: H3 =12.98, p=0.005) in pain scores between admission, 15 minutes post operatively, discharge and 3–5 days POC. The greatest decrease in pain score was between 15 minutes post-operatively and POC (Mann-Whitney U test: W=236, n=13, 13, p=0.0014) and between discharge and POC (Mann-Whitney U test: W=227, n=13, 13, p=0.0060). Overall, this demonstrated that there was an improvement in pain suggesting meloxicam is effective between these time frames. In addition, 69.2% (n=9) of patients in the study showed a pain score of 0, indicating an absence of pain, on their final POC. Statistical analysis was also used to determine if there was any difference in pain score between the 3, 4 or 5 day POC pain score. The results show there was no significant difference (Kruskal-Wallis test: H2 =0.090, p=0.638) suggesting that meloxicam's effectiveness was similar across this range of time post surgery. Conclusion: The results from the study indicate that meloxicam is an effective post-operative analgesic for canine patients undergoing an ovariohysterectomy.

scholarly journals Penile nerve block at the base of penis in combination with intravenous ketamin plus midazolam versus general anaesthesia(GA) in children undergoing circumcision for post operative pain management in the Eastern Nepal

2014 ◽  
Vol 4 (1) ◽  
pp. 33-36
Author(s):  
NR Sharma ◽  
P Timalsena ◽  
U Rai
Keyword(s):  
Pain Management ◽  
General Anaesthesia ◽  
Nerve Block ◽  
Randomized Study ◽  
Pain Scale ◽  
Single Shot ◽  
Post Operative Pain ◽  
Analgesia Requirement ◽  
Group A ◽  
Group B

Adequate post operative analgesia in children provides satisfactory psychological objective of this study was to compare the post operative analgesia requirement and child satisfaction between two groups, general anaesthesia(GA) alone and GA in combination with penile nerve block. This prospective randomized study was conducted in 50 children aged 6 to 14 years, who underwent circumcision. The boys were randomly allocated into two groups. Group A (n = 25) received GA with Single shot ketamin 2mg/kg IV plus midazolam 0.1 mg/kg and dorsal penile nerve block at the base of penis prior to circumcision with and Group B (n = 25) received GA with ketamine 2mg/kg IV plus midazolam 0.1 mg/kg plus halothane by laryngeal mask. Severity of pain was assessed quantitatively by children’s hospital eastern Ontario pain scale (CHEOPS). The pain intensity was assessed at one hour A1 in group A and B1 for group B and at two hour A2 for group A and B2 for group B during postoperatively period for two hours. Statistical analysis was done by SPSS method. The post operative analgesia was satisfactory with CHEOPS score 6 or <6 in group A 1. In group A 2 twenty two out of twenty five cases had CHEOPS score <6.Where as in group B1 and B2 it was > 6 .Which was statistically 100% significant. In conclu­sion, combined penile nerve block in combination with intravenous ketamine plus midazolam is the satisfactory method of Post operative pain management in children undergoing circumcision. DOI: http://dx.doi.org/10.3126/jcmc.v4i1.10846 Journal of Chitwan Medical College 2014; 4(1): 33-36

scholarly journals Postoperative Analgesic Effects of Laserpuncture and Meloxicam in Bitches Submitted to Ovariohysterectomy

2020 ◽  
Vol 7 (3) ◽  
pp. 94
Author(s):  
Rubia M. Tomacheuski ◽  
Marilda O. Taffarel ◽  
Guilherme S. Cardoso ◽  
Ana A. P. Derussi ◽  
Marcos Ferrante ◽  
...  
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Area Under The Curve ◽  
Postoperative Pain Management ◽  
Pain Scale ◽  
Rescue Analgesia ◽  
Analgesic Effects ◽  
Pain Scores ◽  
Chi Squared ◽  
Perioperative Pain Management

Background: This prospective, randomised and blind study investigated the efficacy of laserpuncture for postoperative pain management in dogs. Method: Sixteen bitches were sedated with acepromazine and randomly treated before ovariohysterectomy with meloxicam 0.2 mg·kg−1 intramuscular or laserpuncture (wavelength 904 mm, frequency 124 Hz, potency 10 Joules, 100 s in each acupoint). Anaesthesia was performed with propofol, isoflurane/O2, and fentanyl. The Glasgow Composite Measure Pain Scale (GCMPS) and Dynamic Interactive Visual Analog Scale (DIVAS) were used to evaluate postoperative pain before and for 24 h after surgery. Morphine was administrated as rescue analgesia when pain scores were ≥3.33 (GCMPS). Differences between treatments, time points, and amount of rescue analgesia between groups were investigated by the Mann–Whitney test and the area under the curve (AUC) for GCMPS, Friedman, and Chi-squared tests, respectively (p < 0.05). Results: Dogs treated with laserpuncture presented lower GCMPS AUC for 24 h and lower GCMPS scores at 2 and 4 h postoperatively (p = 0.04). Three dogs treated with meloxicam required postoperatively rescue analgesia against none treated with laserpuncture. Conclusions: In this preliminary study, laserpuncture mitigated postoperative pain in dogs following ovariohysterectomy, and the technique is a promising adjunct to perioperative pain management in dogs undergoing soft tissue surgery.

Use of a comprehensive survey as a first step in addressing clinical competence of physicians-in-training in the management of pain

2005 ◽  
Vol 1 (2) ◽  
pp. 98 ◽  
Author(s):  
Mark Chaitowitz, MBBCh ◽  
William Tester, MD ◽  
Glenn Eiger, MD
Keyword(s):  
Internal Medicine ◽  
Pain Management ◽  
Residency Program ◽  
Clinical Competence ◽  
Initial Step ◽  
Educational Interventions ◽  
Pain Scale ◽  
Contributing Factors ◽  
Management Interventions ◽  
Comprehensive Survey

Deficiencies in practice, knowledge, and competence among physicians are important contributing factors to the unsatisfactory level of analgesic care in hospitalized patients. By way of a comprehensive survey, we characterized these deficiencies within an internal medicine residency program as an initial step in designing remedial educational strategies. To do so, an anonymous 43-item survey was administered to residents in an internal medicine program. A total of 61 residents (69 percent) responded.The results indicated that patient-controlled analgesia (PCA), a standardized pain scale, and an opioid equivalence table were underused. Competence in opioid conversion was suboptimal, but completion of an oncology rotation and familiarity with the opioid equivalence table predicted greater competence in this area (p = 0.007 and p = 0.001, respectively).Self-perceptions of adequacy of training and painmanagement competence were predictors of knowledge (p = 0.026 and p = 0.038, respectively). Attitudes regarding opioid analgesia were generally satisfactory (i.e., low “opiophobia” score), although the risk of addiction was still overestimated.The characterization of deficiencies in pain management in a residency program is an essential step in the design and implementation of educational interventions. Administration of a comprehensive survey is a simple and effective method of gathering this data and has the additional benefit of promoting awareness of pain management issues. Our experience served to establish, among other findings, the didactic value of experience on an oncology floor; this result substantiates the value of practical experience in the gaining of clinical competence in pain management. Interventions that capitalize on the findings of the survey and the interest in pain management generated by its administration are currently ongoing at our institution.

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