scholarly journals Trained and dedicated staff appears to be the main factor in decreasing anxiety and improving overall satisfaction during urodynamic testing: A prospective, randomized trial

2016 ◽  
Vol 10 (5-6) ◽  
pp. 187 ◽  
Author(s):  
Rose Khavari ◽  
Cindy Gu ◽  
Anastasia C. Tran ◽  
Robert Chan
Keyword(s):  
The State ◽  
State Trait Anxiety Inventory ◽  
Urodynamic Testing ◽  
Pain Scores ◽  
Lower Pain ◽  
The Mean ◽  
Group 2 ◽  
State Score ◽  
Main Factor ◽  
Group 1

Introduction: We sought to determine whether listening to patientselected music during urodynamic study (UDS) reduced pain and anxiety while increasing overall patient satisfaction and willingness to repeat the procedure.Methods: Fifty-one (51) patients who underwent UDS from March to July 2014 were randomized into two groups: Group 1 with patient-selected music during the procedure (n=27) and Group 2 without music (n=24). Standard multichannel filling cystometry was performed. Anxiety was self-assessed using the State Trait Anxiety Inventory, while overall pain, satisfaction, and willingness to undergo the procedure again were self-measured using a visual analogue scale.Results: Demographic characteristics and reasons for testing were similar between the two groups. The state score for Groups 1 and 2 were 27.04 and 29.5, respectively (p=0.3225) and 31.78 and 33.86, respectively (p=0.4970) for the trait score. The mean pain scores were 1.04 and 1.57, respectively (p=0.2047); the mean satisfaction scores were 0.65 and 0.52, respectively (p=0.8169); and the scores for willingness to undergo the procedure again were 0.77 and 0.74, respectively (p=0.9442). While there were no significant differences between the two groups in anxiety and satisfaction scores, pain, and willingness to undergo the procedure again, both groups commented on the nurse as the most important factor in their overall comfort.Conclusions: Music during UDS did not appear to lower pain and anxiety, nor increase overall satisfaction and willingness to repeat the procedure. The most important aspect in alleviating patients’ pain and anxiety was the person actually performing the testing, highlighting the importance of having trained and dedicated staff.

scholarly journals Interpleural Administration of Bupivacaine after Cholecystectomy: A Comparison with Intercostal Nerve Block

1989 ◽  
Vol 17 (3) ◽  
pp. 269-274 ◽  
Author(s):  
D. W. Blake ◽  
G. Donnan ◽  
J. Novella
Keyword(s):  
Local Anaesthetic ◽  
Intercostal Nerve ◽  
Intercostal Nerve Block ◽  
Nerve Blocks ◽  
Pain Scores ◽  
Lower Pain ◽  
Chest X Ray ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Pethidine requirements and verbal pain scores were recorded in 36 patients after cholecystectomy via subcostal incision. All patients also received 20 ml 0.5% bupivacaine with adrenaline 1/200,000. Group 1 (12 patients) received unilateral intercostal nerve blocks. Interpleural catheters were inserted through the 8th intercostal space in the remaining patients; 12 received local anaesthetic via the catheter immediately after surgery (Group 2) and 12 were given local anaesthetic at three hours (Group 3). Small asymptomatic pneumothoraces were noted on chest X-ray in six of the 24 patients with interpleural catheters. Both types of local anaesthesia produced lower pain scores than pethidine alone (P < 0.05) with 25% of intercostal nerve blocks and 63% of interpleural catheters requiring no pethidine in the following three hours. The provision of catheter ‘top-ups’ between six and 18 hours after surgery also resulted in lower pain scores and a reduction in pethidine requirements (P < 0.05).

scholarly journals Transseptal Suturing Reduce Patient Anxiety after Septoplasty Compared to Nasal Packing

2016 ◽  
Vol 59 (4) ◽  
pp. 133-136 ◽  
Author(s):  
Kamran Sari ◽  
Ali Irfan Gul ◽  
Yunus Kantekin ◽  
Ozgul Karaaslan ◽  
Zeliha Kapusuz Gencer
Keyword(s):  
Trait Anxiety ◽  
Clinical Assessment ◽  
Operating Time ◽  
The State ◽  
Nasal Packing ◽  
State Trait Anxiety Inventory ◽  
Patient Anxiety ◽  
The Difference ◽  
Group 2 ◽  
Group 1

Background: We measured postoperative anxiety in patients who underwent transseptal suturing or nasal packing after septoplasty. Materials and Methods: Transseptal suturing was performed on Group 1 patients and nasal splints with airway were placed after septoplasty in Group 2 patients. Postoperative 48-h anxiety levels of both groups were measured using the State-Trait Anxiety Inventory (STAI) clinical assessment scale, prior to removal of nasal packing in Group 2. Results: Transseptal suturing was performed after septoplasty in 28 patients and nasal packing in 34 patients. The State-Trait Anxiety Inventory clinical assessment state (STAI-S) and trait (STAI-T) instruments were used to measure postoperative anxiety. The STAI-S scores were found 35.00 in the transseptal suturing group and 43.8 in the nasal packing group; the difference was found significant (p < 0.05). The STAI-T scores were found 42.6 in the transseptal suturing group and 45.7 in the nasal packing group; the difference was not found significant (p > 0.05). The rate of minor hemorrhage was found 10.7% in Group 1 patients. Conclusions: Transseptal suturing is simple and reliable when performed after septoplasty. The technique is painless and comfortable, and reduces patient anxiety (compared to that associated with nasal packing) with only a minor increase in operating time and hemorrhage.

Spielberger's State-Trait Anxiety Inventory: Measuring Anxiety with and without an Audience during Performance on a Stabilometer

1983 ◽  
Vol 57 (1) ◽  
pp. 15-18 ◽  
Author(s):  
R. Ferreira ◽  
J. Murray
Keyword(s):  
Trait Anxiety ◽  
State Anxiety ◽  
The State ◽  
State Trait Anxiety Inventory ◽  
Orthogonal Contrasts ◽  
Trait And State Anxiety ◽  
Pre Treatment ◽  
Group 2 ◽  
Faculty Group ◽  
Group 1

Half of the 56 subjects ( n = 28) performed 15 pre-treatment trials on a stabilometer, then six more with an audience of three faculty (Group 1), the other half performed the same task with no audience (Group 2). Subjects completed the State-Trait Anxiety Inventory prior to and after the treatments. Orthogonal contrasts indicated that Group 1 (audience) post-State-anxiety was significantly different from its own pre-State-anxiety and significantly different from Group 2 (no audience) on post-State-anxiety. It was concluded that the State-Trait Anxiety Inventory is an appropriate measure of trait and state anxiety in studies of motor performance.

scholarly journals RATIONAITY AND INTERVENTION EFFICIENCY OF CLINICAL PHARMACIST IN USAGE PAINKILLERS AFTER OPERATION

2021 ◽  
Vol 62 (3) ◽  
Author(s):  
Bui Dang Phuong Chi ◽  
Bui Dang Minh Tri ◽  
Bui Tung Hiep ◽  
Tran Nhat Anh
Keyword(s):  
Adverse Effects ◽  
General Surgery ◽  
Pain Treatment ◽  
Pain Scores ◽  
Post Operative Pain ◽  
The Mean ◽  
Group 2 ◽  
Surgery Department ◽  
Mean Time ◽  
Group 1

Objectives: To evaluate the rationality and effectiveness of clinical pharmacist’s intervention in the use of painkillers for post-operative pain treatment at the General Surgery Department of Cai Nuoc General Hospital. Objects and methods: Cross-sectional descriptive study on 172 patients (patients) undergoing surgery at General Surgery Department, Cai Nuoc General Hospital. Results: There were 38.95% of patients studied with adverse effects when using painkillers. The average duration of painkiller use after surgery was 5.6 ± 4.0 days. The differences in the mean time to take the drug between the 2 groups were statistically significant. VAS pain scores of the study samples tended to decrease gradually over 1, 3, 5, 7 days after surgery. On 2 research groups, in general, the average VAS score after 1 day surgery was 4.2 ± 1.9 points and after 7 days was 1.1 ± 0.8 points. Increase the reasonable rate in choosing drugs group 2 with reasonable rate was had a reasonable rate of 68.18%, much higher than group 1 with 46.43%. Conclusion: The incidence of adverse effects was low. The differences in the mean time to take the drug 70.45%, much higher than group 1 with 42.86%; drug dose, group 2 had reasonable rate was 82.95%, much higher than group 1 with 55.95%; the rationality of drug use, group 2 between the 2 groups were statistically significant. VAS pain scores of the study samples tended to decrease gradually over 1, 3, 5, 7 days after surgery. Increase the rationality of drug selection, drug dosage, and general rationality of post-operative pain treatment.

scholarly journals Lack of association between the ICIQ-SF questionnaire and the urodynamic diagnosis in men with post radical prostatectomy incontinence

2013 ◽  
Vol 28 (suppl 1) ◽  
pp. 37-42 ◽  
Author(s):  
Rodolfo Borges dos Reis ◽  
Adauto Jose Cologna ◽  
Roberto Dias Machado ◽  
Marcos Tobias Machado ◽  
Lucas Nogueira ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Bladder Dysfunction ◽  
Short Form ◽  
Urodynamic Testing ◽  
International Consultation ◽  
Significant Difference ◽  
Group 3 ◽  
The Mean ◽  
Group 2 ◽  
Group 1

PURPOSE: To analyze the correlation between the "International Consultation on Incontinence Questionnaire-Short Form" (ICIQ-UISF) survey and the urodynamic findings in men with urinary incontinence (UI) following radical prostatectomy (RP). METHODS: 88 men who presented post-RP UI for a minimum of 1 year were enrolled prospectively. All answered the ICIQ-UISF survey and underwent urodynamic testing. Patients were divided in 3 Groups according to their urodynamic diagnosis: Group 1, patients with sphincteric incontinence (SI) alone; Group 2, patients with mixed UI (SI + Bladder Dysfunction (BD)); and Group 3, patients with BD alone. Data were analyzed using SPSS v16.0 software. RESULTS: There were 51 men in Group 1 (57.9%); 30 in Group 2 (34%); and 7 (7.9%) in Group 3. BD was found in 37/88 patients (42%), but it was the main cause of UI in only 14 patients (15.9%). There was no statistically significant difference among the mean ICIQ-UISFs values from groups 1, 2, or 3 (p>0.05). The symptoms of stress incontinence correlated with the urodynamic finding of SI (r = 0.59), and complaints of urinary urgency correlated with the presence of detrusor overactivity (DO) (r = 0.37), but these complaints did not predict the main cause of UI. CONCLUSION: The etiology of UI following RP cannot be predicted by the ICIQ-UISF survey. Symptoms of stress and urge incontinence predict the findings of SI and DO on urodynamic tests, but they cannot ascertain the main cause of UI. Urodynamic testing remains the gold standard to assess the etiology of post-RP UI.

Creation of physiologic rhythm by closed loop stimulation in heart failure patients with severe chronotropic incompetence: worldwide first results of a pilot study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J Proff ◽  
B Merkely ◽  
R Papp ◽  
C Lenz ◽  
P.J Nordbeck ◽  
...  
Keyword(s):  
Heart Rate ◽  
Closed Loop ◽  
Funding Source ◽  
Chronotropic Incompetence ◽  
First Results ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Abstract Background The prevalence of chronotropic incompetence (CI) in heart failure (HF) population is high and negatively impacts prognosis. In HF patients with an implanted cardiac resynchronisation therapy (CRT) device and severe CI, the effect of rate adaptive pacing on patient outcomes is unclear. Closed loop stimulation (CLS) based on cardiac impedance measurement may be an optimal method of heart rate adaptation according to metabolic need in HF patients with severe CI. Purpose This is the first study evaluating the effect of CLS on the established prognostic parameters assessed by the cardio-pulmonary exercise (CPX) testing and on quality of life (QoL) of the patients. Methods A randomised, controlled, double-blind and crossover pilot study has been performed in CRT patients with severe CI defined as the inability to achieve 70% of the age-predicted maximum heart rate (APMHR). After baseline assessment, patients were randomised to either DDD-CLS pacing (group 1) or DDD pacing at 40 bpm (group 2) for a 1-month period, followed by crossover for another month. At baseline and at 1- and 2-month follow-ups, a CPX was performed and QoL was assessed using the EQ-5D-5L questionnaire. The main endpoints were the effect of CLS on ventilatory efficiency (VE) slope (evaluated by an independent CPX expert), the responder rate defined as an improvement (decrease) of the VE slope by at least 5%, percentage of maximal predicted heart rate reserve (HRR) achieved, and QoL. Results Of the 36 patients enrolled in the study, 20 fulfilled the criterion for severe CI and entered the study follow-up (mean age 68.9±7.4 years, 70% men, LVEF=41.8±9.3%, 40%/60% NYHA class II/III). Full baseline and follow-up datasets were obtained in 17 patients. The mean VE slope and HRR at baseline were 34.4±4.4 and 49.6±23.8%, respectively, in group 1 (n=7) and 34.5±12.2 and 54.2±16.1% in group 2 (n=10). After completing the 2-month CPX, the mean difference between DDD-CLS and DDD-40 modes was −2.4±8.3 (group 1) and −1.2±3.5 (group 2) for VE slope, and 17.1±15.5% (group 1) and 8.7±18.8% (group 2) for HRR. Altogether, VE slope improved by −1.8±2.95 (p=0.31) in DDD-CLS versus DDD-40, and HRR improved by 12.9±8.8% (p=0.01). The VE slope decreased by ≥5% in 47% of patients (“responders to CLS”). The mean difference in the QoL between DDD-CLS and DDD-40 was 0.16±0.25 in group 1 and −0.01±0.05 in group 2, resulting in an overall increase by 0.08±0.08 in the DDD-CLS mode (p=0.13). Conclusion First results of the evaluation of the effectiveness of CLS in CRT patients with severe CI revealed that CLS generated an overall positive effect on well-established surrogate parameters for prognosis. About one half of the patients showed CLS response in terms of improved VE slope. In addition, CLS improved quality of life. Further clinical research is needed to identify predictors that can increase the responder rate and to confirm improvement in clinical outcomes. Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Biotronik SE & Co. KG

Epidural Clonidine or Bupivacaine as the Sole Analgesic Agent during and after Abdominal Surgery 

1999 ◽  
Vol 90 (5) ◽  
pp. 1354-1362 ◽  
Author(s):  
Marc De Kock ◽  
Philippe Gautier ◽  
Athanassia Pavlopoulou ◽  
Marc Jonniaux ◽  
Patricia Lavand'homme
Keyword(s):  
High Dose ◽  
General Anesthetics ◽  
Visual Analogue Pain ◽  
Pain Scores ◽  
Arterial Blood ◽  
Sedation Scores ◽  
Group 3 ◽  
Group 2 ◽  
High Doses ◽  
Group 1

Background The rationale of this study was to compare high-dose epidural clonidine with a more commonly used agent, such as bupivacaine. This was performed to give a more objective idea of the relative analgesic potency of epidural clonidine. Methods Sixty patients undergoing intestinal surgery during propofol anesthesia were studied. At induction, the patients received epidurally a dose of 10 micrograms/kg [corrected] clonidine in 7 ml saline followed by an infusion of 6 micrograms [corrected] x kg(-1) x h(-1) (7 ml/h) (group 1, n = 20), a dose of 7 ml bupivacaine, 0.5%, followed by 7 ml/h bupivacaine, 0.25% (group 2, n = 20), or a dose of 7 ml bupivacaine, 0.25%, followed by 7 ml/h bupivacaine, 0.125% (group 3, n = 20). Intraoperatively, increases in arterial blood pressure or heart rate not responding to propofol (0.5 mg/kg) were treated with intravenous alfentanil (0.05 mg/kg). Additional doses of propofol were given to maintain an adequate bispectral index. The epidural infusions were maintained for 12 h. In cases of subjective visual analogue pain scores up to 5 cm at rest or up to 8 cm during coughing, the patients were given access to a patient-controlled analgesia device. Results During anesthesia, patients in group 1 required less propofol than those in groups 2 and 3 (78 [36-142] mg vs. 229 [184-252] mg and 362 [295-458] mg; P &lt; 0.05) and less alfentanil than patients in group 3 (0 [0-0] mg vs. 11 [6-20] mg; P &lt; 0.05). Analgesia lasted 380 min (range, 180-645 min) in group 1 versus 30 min (range, 25-40 min) in group 2 and 22 min (range, 12.5-42 min) in group 3 (P &lt; 0.05). There was no suggestion of a hemodynamic difference among the three groups except for heart rates that were significantly reduced in patients in group 1. Sedation scores were significantly higher in this group during the first 2 h postoperatively. Conclusion Our results show that high doses of epidural clonidine potentiate general anesthetics and provide more efficient postoperative analgesia than the two bupivacaine dosage regimens investigated.

Comparison of the ATRIA, CHA2DS2-VASc, and Modified Scores ATRIA-HSV, CHA2DS2-VASc-HS, for the Prediction of Coronary Artery Disease Severity

Angiology ◽  
2021 ◽  
pp. 000331972199141
Author(s):  
Arafat Yildirim ◽  
Mehmet Kucukosmanoglu ◽  
Fethi Yavuz ◽  
Nermin Yildiz Koyunsever ◽  
Yusuf Cekici ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Vascular Disease ◽  
Operating Characteristics ◽  
Coronary Artery Disease Severity ◽  
Group 3 ◽  
The Mean ◽  
Group 2 ◽  
Artery Disease ◽  
Group 1

Many parameters included in the Anticoagulation and Risk Factors in Atrial Fibrillation (ATRIA) and CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, stroke, vascular disease, age 65-74 years, sex category) scores also predict coronary artery disease (CAD). We modified the ATRIA score (ATRIA-HSV) by adding hyperlipidemia, smoking, and vascular disease and also male sex instead of female. We evaluated whether the CHA2DS2-VASc, CHA2DS2-VASc-HS, ATRIA, and ATRIA-HSV scores predict severe CAD. Consecutive patients with coronary angiography were prospectively included. A ≥50% stenosis in ≥1epicardial coronary artery (CA) was defined as severe CAD. Patient with normal CA (n = 210) were defined as group 1, with <50% CA stenosis (n = 178) as group 2, and with ≥50% stenosis (n = 297) as group 3. The mean ATRIA, ATRIA-HSV, CHA2DS2-VASc, and CHA2DS2VASc-HS scores increased from group 1 to group 3. A correlation was found between the Synergy between PCI with Taxus and Cardiac Surgery score and ATRIA ( r = 0.570), ATRIA-HSV ( r = 0.614), CHA2DS2-VASc ( r = 0.428), and CHA2DS2-VASc-HS ( r = 0.500) scores ( Ps < .005). Pairwise comparisons of receiver operating characteristics curves showed that ATRIA-HSV (>3 area under curve [AUC]: 0.874) and ATRIA (>3, AUC: 0.854) have a better performance than CHA2DS2-VASc (>1, AUC: 0.746) and CHA2DS2-VASc-HS (>2, AUC: 0.769). In conclusion, the ATRIA and ATRIA-HSV scores are simple and may be useful to predict severe CAD.

Does Presurgical Nasoalveolar Molding Have a Long-Term Effect on Nasal and Upper Airway Dimensions?

2020 ◽  
pp. 105566562098023
Author(s):  
Ashwina S. Banari ◽  
Sanjeev Datana ◽  
Shiv Shankar Agarwal ◽  
Sujit Kumar Bhandari
Keyword(s):  
Upper Airway ◽  
P Value ◽  
Airway Patency ◽  
The Mean ◽  
Group 2 ◽  
Acoustic Pharyngometry ◽  
Nasoalveolar Molding ◽  
Area And Volume ◽  
Group 1

Objectives: To compare nasal and upper airway dimensions in patients with cleft lip and palate (CLP) who underwent nasoalveolar molding (NAM) with those without NAM during infancy using acoustic pharyngometry and rhinometry. Materials and Methods: Eccovision acoustic pharyngometry and rhinometry (Sleep Group Solutions) was used for assessment of mean area and volume of nasal and upper airway in patients with complete unilateral CLP (age range 16-21 years) treated with NAM (group 1, n = 19) versus without NAM (group 2, n = 22). Results: The mean nasal cross-sectional areas and volume were higher in group 1 compared to group 2 on both cleft ( P value <.001) and noncleft side ( P value >.05). The mean area and volume of upper airway were also significantly higher in group 1 compared to group 2 ( P value <.05). Conclusions: Nasoalveolar molding being one of the first interventions in chronology of treatment of patients with CLP, its long-term outcome on nasal and upper airway patency needs to be ascertained. The results of the present study show that the patients with CLP who have undergone NAM during infancy have better improvement in nasal and upper airway patency compared with those who had not undergone NAM procedure. The basic advantages of being noninvasive, nonionizing and providing dynamic assessment of nasal and upper airway patency make acoustic pharyngometry and rhinometry a diagnostic tool of choice to be used in patients with CLP.

scholarly journals Comparison of Bite Force in Patients After Treatment of Mandibular Fractures With 3-Dimensional Locking Miniplate and Standard Miniplates

2019 ◽  
Vol 1 (1) ◽  
pp. 7-10
Author(s):  
Gaurav Singh ◽  
Madan Mishra ◽  
Amit Gaur ◽  
Dhritiman Pathak
Keyword(s):  
Treatment Strategies ◽  
Bite Force ◽  
Mandibular Fractures ◽  
Time Intervals ◽  
Experimental Conditions ◽  
3 Dimensional ◽  
The Mean ◽  
Group 2 ◽  
Drilling Conditions ◽  
Group 1

Background: Fractures of the mandible can be studied and described in anatomic terms, functional considerations, treatment strategies, and outcome measures. The performance of any fixation system depends on multiple factors including plate adaptation, screw placement, bone quality, drilling conditions, and postoperative patient compliance. Bite force assesses masticatory muscle function under clinical and experimental conditions. Method: 30 patients with isolated, noncomminuted mandibular fractures were randomly divided into two equal groups. Group 1 patients were treated using 3-dimensional locking miniplates and group 2 patients were treated with standard miniplates. The bite forces were recorded at definite time intervals: preoperatively, and second week, sixth week, third month, and sixth month postoperatively. Result: At 6 weeks postoperative, 3 month postoperative, and 6 month postoperative, the mean bite force was found to be significantly higher among group 1 patients as compared to those in group 2 in all the sites. While at 2 week postoperative, the mean bite force was found to be significantly higher in Group 2 as compared to Group 1 at incisor region. Conclusion: The overall results of the present study show better performance in bite force for the 3-dimensional locking miniplate when compared with standard miniplates.

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