The Efficacy of an Intervention Program for Pain Intensity Reduction in Patients Undergoing Arterial Sheath Removal after Coronary Artery Angioplasty

Background: Pain management after sheath removal is one of the most significant points in patient care. The use of a simple, practical, and combined method in this field is essential. The purpose of this study was to evaluate the efficacy of an intervention program for pain intensity reduction in patients undergoing arterial sheath removal after coronary artery angioplasty. Methods: This semi-experimental study was conducted in 2020 on 90 eligible patients selected via the purpose-based method and randomly assigned to experimental and control groups. The intervention program for the experimental group included training to relax the abdominal muscles, deep and slow breathing, and precise pressure on the femoral pulse. Pain intensity was measured before, during, and several times after arterial sheath removal. The independent t, Fisher exact, and χ2 tests were used to analyze the data. Results: Women comprised 66.6% of the study participants, who had a mean age of 58.20±8.70 years. No significant differences were observed concerning pain intensity, bleeding, pseudoaneurysm formation, and hematoma between the 2 groups before the intervention (P=0.531). However, during the intervention and in the fifth and tenth minutes after the intervention, pain intensity was lower in the experimental group (P<0.050), whereas no such differences were observed regarding bleeding, pseudoaneurysm formation, and hematoma. Conclusions: Given the effectiveness of our intervention program in ameliorating pain intensity and vasovagal response after arterial sheath removal, we suggest that this program, along with prescription drugs, be used for the management of patients’ pain.

Hyaluronic acid injections in post-enucleation or evisceration socket syndrome: a case series

Background One of the primary goals of enucleation and evisceration surgery is the restoration of an adequate orbital volume through the use of appropriately sized alloplastic or autogenous tissues. In patients inadequately treated, post-enucleation or evisceration socket syndrome occurs. Fillers are an ideal alternative for eyelid and eyebrow arcade volume enhancement since their injection is easily performed in an outpatient setting avoiding several complications. The aim of this study is to report the use of hyaluronic acid (HA) fillers to treat volume deficits of the upper and lower eyelids, projecting the brow arcade and reducing the asymmetry. Methods Thirteen patients (2 male, 11 female, mean age 32.7 years) were treated from June 2012 to May 2020. Non-surgical treatment by HA filler injection for aesthetic rehabilitation of deep superior sulcus, inferior tear trough deformity, and scleral show was performed. Results No complications as orbital-ache and/or vasovagal response were reported during the injections. Minor complications such as light swelling at the site of injection, self-resolved within 2 days, were recorded. Stable results were observed at follow-ups. In two cases, two successive treatments were required at 3 and 6 years from the first injection. Conclusions Hyaluronic acid fillers offer a versatile and safe method for replacing soft tissue lost from the upper eyelid/brow complex in cases of post-enucleation or evisceration socket syndrome. Level of evidence: Level IV, therapeutic study.

Design of Pulse Oximeter Solution for Conscious Rodents

Neuromodulation can be used to control organ function through exogenous augmentation of neural activity via targeted delivery of an electrical stimulus. Recently, neuromodulation has been a topic of investigation to treat many illnesses and conditions including Parkinson’s disease, epilepsy, obesity, chronic pain, type 1 diabetes, and hypertension. During neuromodulatory treatments, it is important to measure both the physiological response of the target system as well as any off-target systems that may be engaged from the delivered stimulus. Stimulation of the vagus nerve, a common target of neuromodulatory therapies, causes a vasovagal response which results in decreased cardiac rate and arteriolar dilatation. It is possible to measure these physiological parameters in anesthetized rats, but it is a challenge in conscious, moving rats because of motion artifact introduced to the sensors. By creating a noninvasive, stabilized pulse oximeter that measures the blood oxygenation waveform, one can analyze the heart rate in awake behaving animals. This study reports the design of a heart rate monitor used to monitor effects of heart rate variability during neuromodulation experiments. Design of this device included testing different sensors, methods of attaching to the rodent, microcontrollers, and wireless communication modules.