Music Intervention to Orthopedic Patients: A Possible Alternative Solution to Control Pain

Aims and Objective. Pain is a common problem associated with postoperative orthopedic patients; the current study is aimed at evaluating music intervention as an alternative method to control pain. Methodology. The experimental design of the current study was comparative, descriptive, and quasi-experimental. 38 postoperative orthopedic patients were equipped with pocket-size MP3 players with prerecorded music tracks (instrumental and lyrical) in Hindi, English, and Urdu. After that, pre-post-pain scores were recorded with the help of designed brief patient logs. Ultimately, a satisfactory survey was completed at discharge. Major Findings. It was found that during the intervention of music, the pain was significantly reduced from 5.40 to 2.98. There was a slight relationship between listening time and pain relief. It was also found that the feedback was extremely positive and each patient suggested the use of music to others with 96.6% recommendation. Conclusion. From the current study, it was found that music intervention can be beneficial to postoperative patient pain control. Further, it is hoped that the findings of the current experimental work will lead to improvements in the care of postoperative patients.

Tools Are Needed to Promote Sedation Practices for Mechanically Ventilated Patients

Suboptimal sedation practices continue to be frequent, although the updated guidelines for management of pain, agitation, and delirium in mechanically ventilated (MV) patients have been published for several years. Causes of low adherence to the recommended minimal sedation protocol are multifactorial. However, the barriers to translation of these protocols into standard care for MV patients have yet to be analyzed. In our view, it is necessary to develop fresh insights into the interaction between the patients' responses to nociceptive stimuli and individualized regulation of patients' tolerance when using analgesics and sedatives. By better understanding this interaction, development of novel tools to assess patient pain tolerance and to define and predict oversedation or delirium may promote better sedation practices in the future.

PENGARUH RELAKSASI NAPAS DALAM DENGAN AROMATERAPI LAVENDER TERHADAP TINGKAT NYERI POST APENDIKTOMI DI RUANG JANGER RSD MANGUSADA

Appendectomy is a surgical procedure for appendicitis. This action can cause the perception of pain so that it has an impact on the healing process and triggers further complications if left untreated. Deep breathing relaxation techniques combined with aromatherapy is one of the treatments done to help overcome post appendectomy pain. This study purposed to determine the effect of deep breath relaxation with lavender aromatherapy on the level of post appendectomy pain in the Janger Room RSD Mangusada. This study is a pre-experimental research with one group pretest and posttest design involving 32 samples selected through purposive sampling technique. Collecting data using a research instrument in the form of the Numerical Rating Scale observation sheet. The results showed that there was an effect of deep breath relaxation with lavender aromatherapy on the level of post appendectomy pain in the Janger Room at RSD Mangusada (p-value = 0,000). This research can be applied in the provision of nursing services as one of the nursing interventions to reduce post appendectomy patient pain.

Identifying the content and context of pain within paediatric rheumatology healthcare professional curricula in the UK: a summative content analysis

Background The curriculum for professionals working in paediatric rheumatology should include pain but it is unclear to what extent this currently occurs. The aim of this study was to identify pain-related curriculum content and the context in which pain is presented in educational and training documentation for healthcare professionals in this clinical speciality. Methods Core curricula documents from UK based professional organisations were identified in partnership with healthcare professionals. Documents were analysed using a summative content analysis approach. Key pain terms were quantified and weighted frequencies were used to explore narrative pain themes. Latent content was interpreted qualitatively to explore the context within which pain terms were positioned. Results Nine curriculum documents were identified and analysed from doctors, nurses, physiotherapists and occupational therapists specialising in paediatric rheumatology. Pain themes represented a mean percentage of 1.51% of text across all documents. Pain was rarely presented in the context of both inflammatory and non-inflammatory condition types despite being a common feature of each. Musculoskeletal pain was portrayed simply as a ‘somatic’ symptom, rather than as a complex phenomenon involving biological and psychosocial processes. Content around the assessment and management of pain was vague and inexplicit. Conclusion Current educational and training documentation in paediatric rheumatology do not include core pain topics. Curricula for these healthcare professionals would benefit from updates in contemporary pain theories and examples of in-context, evidence-based pain practices. This should be a priority starting point for optimising patient pain care in paediatric musculoskeletal healthcare.

A Retrospective Examination of Home PCA Use and Parental Satisfaction With Pediatric Palliative Care Patients

Introduction: Home Patient-Controlled Analgesia (PCA) is an effective and often preferred therapy for the treatment of chronic pain symptoms in the pediatric palliative care patient. There is little previous research of patient experience with Home PCA. The purpose of this study was to investigate use of home PCA devices in pediatric patients to inform palliative care providers considering an alternative management option for the treatment of end-of-life or chronic pain. Methods: A chart review was performed of patients prescribed home PCA. Surveys were sent to patients’ guardians/caregivers. Questions referred to caregiver impression/satisfaction with information provided regarding use of the PCA machine, the medication used, the benefits and risks of PCA, monitoring of patient pain level and alertness, machine efficacy, and fears and concerns. Results: Thirty-four patients met inclusion criteria, and 18 patient families completed surveys. Demographic data showed that the majority were Caucasian and had a cancer diagnosis. Patient age and duration of home PCA use varied greatly. Overall, participants were satisfied with information received and felt positively about home PCA, albeit expressing concerns. The majority described the machine as easy to use and were satisfied with their child’s pain management and level of alertness. Conclusion: Responses indicated that home PCA is a manageable and effective alternative to traditional analgesic medications for management of chronic pain in the pediatric patient.

THE EFFICACY OF LASER THERAPY AND IBUPROFEN ON PAIN AFTER ELASTOMERIC SEPARATOR PLACEMENT: RAPID REVIEW

Background: Separator placement is the first step in orthodontic treatment, which aims to create space between teeth before molar band placement. This procedure can cause pain for the patient. Pain management after separator placement can be done through pharmacological and non-pharmacological approaches.Method: The aim of this rapid review was to determine the efficacy of laser therapy and ibuprofen for pain management after elastomeric separator placement in orthodontic treatment.Result: Ten articles were included in this review, four articles gave laser therapy interventions and six articles gave ibuprofen therapy interventions. The result of the quality assessment using Strength of Recommendation Taxonomy (SORT) was laser therapy intervention has one good quality articles and three limited-quality articles, while ibuprofen therapy has two good quality articles and four limited-quality articles.Conclusion: The efficacy of laser therapy and the efficacy of ibuprofen on pain after separator placement is good, with the strength of the clinical recommendation of ibuprofen is better than laser therapy.

Multicamera 3D Viewpoint Adjustment for Robotic Surgery via Deep Reinforcement Learning

While robot-assisted minimally invasive surgery (RMIS) procedures afford a variety of benefits over open surgery and manual laparoscopic operations (including increased tool dexterity, reduced patient pain, incision size, trauma and recovery time, and lower infection rates [1], lack of spatial awareness remains an issue. Typical laparoscopic imaging can lack sufficient depth cues and haptic feedback, if provided, rarely reflects realistic tissue–tool interactions. This work is part of a larger ongoing research effort to reconstruct 3D surfaces using multiple viewpoints in RMIS to increase visual perception. The manual placement and adjustment of multicamera systems in RMIS are nonideal and prone to error [2], and other autonomous approaches focus on tool tracking and do not consider reconstruction of the surgical scene [3-5]. The group’s previous work investigated a novel, context-aware autonomous camera positioning method [6], which incorporated both tool location and scene coverage for multiple camera viewpoint adjustments. In this paper, the authors expand upon this prior work by implementing a streamlined deep reinforcement learning approach between optimal viewpoints calculated using the prior method [6] which encourages discovery of otherwise unobserved and additional camera viewpoints. Combining the framework and robustness of the previous work with the efficiency and additional viewpoints of the augmentations presented here results in improved performance and scene coverage promising towards real-time implementation.