scholarly journals Comparative Evaluation of Different Numerical Pain Scales Used for Pain Estimation during Debonding of Orthodontic Brackets

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Mohmed Isaqali Karobari ◽  
Ali A Assiry ◽  
Mubashir Baig Mirza ◽  
Fazlur Rahman Sayed ◽  
Sufiyan Shaik ◽  
...  
Keyword(s):  
Pain Control ◽  
Stress Relief ◽  
Orthodontic Brackets ◽  
Anterior Region ◽  
Control Methods ◽  
Pain Scores ◽  
Pain Scales ◽  
Intergroup Comparison ◽  
Significant Difference ◽  
Finger Pressure

Introduction. Patients experience various levels of discomfort during orthodontic treatment, i.e., after placement of separators, orthodontic implant placement, and archwire placement and during debonding. Various pain control methods have been developed to relive pain during debonding, i.e., finger pressure (FP), elastomeric wafer (EW), and stress relief (SR). Aim. To analyse various pain scales commonly used to determine the effect of different pain control methods during debonding of orthodontic brackets. Study Design. A comparative cross-sectional study performed on a sample of 60 patients (n = 60) including 14 males and 46 females who were ready for debonding and who were divided into three groups, i.e., finger pressure (FP), elastomeric wafer (EW), and stress relief (SR). Materials and Methods. A 100 mm Visual Analog Scale (VAS) was used to record the pain intensity for each tooth. Another scale known as Pain Catastrophizing Scale (PCS) was used to evaluate the patient’s general attitude towards pain perception. The armamentarium and operator were kept same for all the patients. Statistical analysis used was the Kruskal–Wallis test, used for intergroup and intragroup comparison of pain scores. Results. Lowest total pain score was recorded in the FP group ( P = 0.043 ) on intergroup comparison, while on intragroup comparison, higher pain scores were recorded in lower anterior region ( P = 0.02 ) in all three groups. There was no significant difference between the pain scores reported by the male and female subjects. Conclusion. FP is an effective method of pain control. And teeth in the anterior region of lower and upper arches are more sensitive to pain. In terms of cognitive-affective constructs, although the VAS has been widely used in previous studies, the PCS has been detailed to show the most reliable association with physical discomfort and emotional distress.

scholarly journals Comparative Evaluation of Clonidine as an Adjunct to Ropivacaine for Caudal Block Anaesthesia in Children Undergoing Sub-Umbilical Surgeries

2021 ◽  
Vol 10 (44) ◽  
pp. 3785-3790
Author(s):  
Priyash Verma ◽  
Ravishankar R.B.
Keyword(s):  
Epidural Space ◽  
Pain Control ◽  
Motor Blockade ◽  
Pain Scores ◽  
Caudal Analgesia ◽  
Significant Difference ◽  
Key Words Analgesia ◽  
Caudal Epidural

BACKGROUND Studies suggest that clonidine can improve the duration of analgesia, quality of pain control when used with ropivacaine for caudal blocks in children. This study was designed to understand the effects of caudally administered ropivacaine 0.25 % (1ml/kg) alone and ropivacaine 0.25 % (1ml/kg) with clonidine 2 mcg/kg, in children between 2- 10 years. METHODS Sixty children posted for various sub-umbilical surgical procedures were included after written informed consent and ethics committee approval. Children were randomly divided into 2 groups of 30 each: Group R —ropivacaine 0.25 % 1 ml/kg into caudal epidural space and Group RC—ropivacaine 0.25 % 1 ml/kg and clonidine 2 mcg/kg into caudal epidural space. RESULTS The mean age of patients was similar with no statistical difference (4.83 vs 5.36, P = 0.3353). The duration of anaesthesia was significantly longer in the RC group (544.83 minutes vs 268.00 minutes, P < 0.0001). The effect size was very high (Cohen d=23.86). The pain score was comparable up to 1 hour for the two groups. But 2 hours later, the pain scores were significantly lower for the ropivacaine and clonidine groups. The effect on motor blockade was similar in both groups with no motor blockade at 4 hours follow up. 5 cases of urinary retention were seen in the study with no statistically significant difference in terms of complication rate between the two groups. No case of hypotension or bradycardia was seen. There was a significant difference between the two groups in terms of cardiovascular parameters (HR, SBP, DBP) after administration of drugs. CONCLUSIONS The addition of clonidine to ropivacaine for caudal blocks in children was associated with better quality of pain control and a longer duration of analgesia without any additional motor blockade. There was no significant difference seen in terms of complication. KEY WORDS Analgesia Duration, Caudal Analgesia, Clonidine, Pain Control, Ropivacaine.

Celecoxib versus parecoxib versus oxycodone in pain control for transcatheter chemoembolization in patients with hepatocellular carcinoma.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 509-509
Author(s):  
Ming Zhao ◽  
Ning Lyu ◽  
Yanan Kong ◽  
Xiaoxian Li
Keyword(s):  
Hepatocellular Carcinoma ◽  
Clinical Trial ◽  
Analgesic Effect ◽  
Pain Control ◽  
Morphine Consumption ◽  
Pain Scores ◽  
Time Period ◽  
Significant Difference ◽  
Inflammatory Drugs ◽  
Cox 2

509 Background: Abdominal pain is one of the most common side effects of transarterial chemoembolization (TACE) in patients with unresectable hepatocellular carcinoma. Previous studies reported that perioperative controlled-release oxycodone (CRO) intake or administration of parecoxib resulted in adequate pain control after TACE. However, there are currently no studies comparing opioids with nonsteroidal anti-inflammatory drugs (NSAIDs) in controlling postoperative pain. Therefore, we conducted a clinical trial to compare the analgesic effect and safety among celecoxib (oral COX-2 inhibitor), parecoxib (injectable COX-2 inhibitor), and CRO (oral opioids) in patients undergoing TACE. Methods: The study was a prospective, randomized, paralleled trial in which 213 patients were enrolled between September 2016 and March 2019. Patients were randomly assigned at the ratio of 1:1:1 to receive celecoxib, parecoxib or CRO 1 h before TACE (T0) and once every 12 h for 2 days after TACE. Pain level, morphine consumption and adverse events were evaluated and compared among the three regimens. Results: Highest incidence of pain occurred within the first 12 hours (T12) after TACE. Analysis of pain control showed no significant difference among the mean highest pain scores, percentage distribution of pain categories and mean morphine consumption in the three groups at T0, T12, T24, T36, and T48. At T24, 11 patients (15.7%) in oxycodone group had fever, which was higher than parecoxib regimen (1 patient [1.5%], P = 0.003). At T36, 13 patients (18.6%) in oxycodone regimen had fever, which was higher than celecoxib regimen (2 patients [2.9%], P = 0.003) and parecoxib regimen (1 patient [1.5%], P < 0.001). At T48, 11 patients (15.7%) in oxycodone regimen had fever, which was higher than celecoxib regimen (2 patients [2.9%], P = 0.010) and parecoxib regimen (0 patients, P = 0.001). Conclusions: The results suggested that patients obtained celecoxib, parecoxib or CRO once every 12 hours can have the same level of analgesic effect during each time period of TACE. However, body temperature balance in oxycodone regimen was significantly worse than celecoxib regimen and parecoxib regimen. Clinical trial information: NCT03059238.

scholarly journals Comparison of Efficacy of Pain Control Using the Interseptal Injection Technique and Inferior Alveolar Block Accompanied by Long Buccal Infiltration in Mandibular Periodontal Flap Surgery

2018 ◽  
Vol 6 (1) ◽  
pp. 8-12
Author(s):  
Mohammad Taghi Chitsazi ◽  
Reza Pourabbas ◽  
Adileh Shirmohammadi ◽  
Saied Nezafati ◽  
Amin Mousavi
Keyword(s):  
Pain Control ◽  
Statistical Significance ◽  
Inferior Alveolar Nerve ◽  
Anesthetic Technique ◽  
Flap Surgery ◽  
Pain Scores ◽  
Significant Difference ◽  
To Receive ◽  
Buccal Infiltration ◽  
Periodontal Flap Surgery

Background and aims. Pain control ensures patient satisfaction and cooperation. This study aimed to compare the interseptal anesthetic technique (IA) as the initial injection for pain control during periodontal flap surgery with the inferior alveolar nerve block (IANB) accompanied by long buccal infiltration (LBI). Materials and methods. This single-blind randomized clinical trial included 40 periodontitis patients. Pain intensity was evaluated immediately after injection and at the end of surgery. One side was chosen as the control to receive IANB accompanied by LBI and the other side as the test to receive IA. After the injection, the patients were asked to mark their reaction to the pain immediately after the injection on a visual analogue scale, which was repeated to analyze pain the day after surgery. Data were analyzed with independent-samples t-test using SPSS 13. Statistical significance was set at P < 0.05. Results. The mean pain scores immediately after injection in the control and test groups were 20.62 ± 7.62 and 21.47 ± 8.62, respectively, with no statistically significant difference (df = 78, t = −0.466, P = 0.642). Pain scores 24 hours after completion of surgery in the control and test groups were 7.97 ± 3.43, and 9.30 ± 3.24, respectively, with no significant difference (df = 78, t = −1.775, P = 0.080). Conclusion. Based on the results, interseptal anesthetic technique was not shown to be superior to conventional injections.

scholarly journals Intrauterine levobupivacaine for pain control during intrauterine device insertion

2017 ◽  
Vol 6 (3) ◽  
pp. 1117
Author(s):  
Nilufer Akgun ◽  
Esra Keskin ◽  
Muberra Namlı Kalem ◽  
Batuhan Bakirarar
Keyword(s):  
Pain Control ◽  
Controlled Trial ◽  
Intrauterine Device ◽  
Saline Control ◽  
Control Group ◽  
Double Blind ◽  
Pain Scores ◽  
Significant Difference ◽  
Vas Scores

Background: Safe, effective, long term and a reversible contraception method is offered by intrauterine devices (IUDs).  The objective was to determine the potency of intrauterine administration of 5 cc levobupivacain for pain relief with IUD insertion, when compared with saline placebo.Methods: This was a prospective randomized, double blind placebo-controlled trial undergoing İUD insertion. The trial medication was intrauterine anesthesia, either 5 mL 0.9% saline (control group), or 5 mL 0.5% levobupivacaine. Our primary outcome was self-reported pain scores on a 10 cm visual analogue scale (VAS) immediately following IUD insertion.Results: 95 women were enrolled, and data for 88 women were analyzed. In IUD insertion procedure, no difference was observed between groups during teneculum placement and solution administration, in the course of VAS scores (p=0.349, p=0.396). There was a significant difference in the VAS scores measuring pain suffering during and after IUD procedure (p=0.001).Conclusions: Intrauterine instillation of 5 cc of levobupivacaine along with saline solution reduces pain with IUD insertion when compared to intrauterine saline placebo. Broad deviation in pain scores and persistent pain after IUD insertion recommends that patient would benefit from more functioning method of pain control than before at IUD insertion and during the post interval.

scholarly journals Efficacy of different methods to reduce pain during debonding of orthodontic brackets

2016 ◽  
Vol 86 (6) ◽  
pp. 917-924 ◽  
Author(s):  
Nehir Canigur Bavbek ◽  
Burcu Balos Tuncer ◽  
Tuba Tortop ◽  
Bülent Celik
Keyword(s):  
Pain Control ◽  
Control Method ◽  
Pain Catastrophizing ◽  
Linear Regression Analysis ◽  
Rank Correlation ◽  
Stress Relief ◽  
Multiple Linear Regression Analysis ◽  
Pain Experience ◽  
Vas Scores ◽  
Finger Pressure

ABSTRACT Objective: To determine pain during debonding and the effects of different pain control methods, gender, and personal traits on the pain experience. Materials and Methods: Patients who had fixed orthodontic treatment with metal brackets, but no surgical treatment or craniofacial deformity, were included. Sixty-three patients (32 female, aged 17.2 ± 2.9 years; 31 male aged, 17.2 ± 2.5 years) were allocated to three groups (n = 21) according to the pain control method: finger pressure, elastomeric wafer, or stress relief. Pain experience for each tooth was scored on a visual analogue scale (VAS), and general responses of participants to pain were evaluated by Pain Catastrophizing Scale (PCS). Multiple linear regression analysis, the Mann Whitney U-test, and Spearman's rank correlation coefficient analysis were used to analyze the data. Results: When the VAS scores were adjusted, finger pressure caused a 47% reduction overall, 56% in lower elastomer wafer total, 59% in lower right arch, 62% in lower left, and 62% in lower anterior compared with the elastomeric wafer. In the elastomer wafer group, upper and lower anterior scores were higher than posterior scores, respectively. Females had higher VAS (lower left and anterior) and total PCS scores than males. Regardless of the pain control method, total PCS scores were correlated with total (r = .254), upper total (r = .290), right (r = .258), left (r = .244), and posterior (r = .278) VAS scores. Conclusions: The stress relief method showed no difference when compared with the other groups. Finger pressure was more effective than the elastomeric wafer in the lower jaw. Higher pain levels were recorded for the anterior regions with the elastomeric wafer. Females and pain catastrophizers gave higher VAS scores.

scholarly journals Multimodal Pain Management in Older Elective Arthroplasty Patients

2017 ◽  
Vol 8 (3) ◽  
pp. 151-154 ◽  
Author(s):  
Elaine Brooks ◽  
Susan H. Freter ◽  
Susan K. Bowles ◽  
David Amirault
Keyword(s):  
Older Adults ◽  
Pain Management ◽  
Postoperative Analgesia ◽  
Pain Control ◽  
Postoperative Delirium ◽  
Tertiary Care ◽  
Opioid Analgesics ◽  
Multimodal Approach ◽  
Pain Scores ◽  
Significant Difference

Background: Pain management after elective arthroplasty in older adults is complicated due to the risk of undertreatment of postoperative pain and potential adverse effects from analgesics, notably opioids. Using combinations of analgesics has been proposed as potentially beneficial to achieve pain control with lower opioid doses. Objective: We compared a multimodal pain protocol with a traditional one, in older elective arthroplasty patients, measuring self-rated pain, incidence of postoperative delirium, quantity and cost of opioid analgesics consumed. Methods: One hundred fifty-eight patients, 70 years and older, admitted to tertiary care for elective arthroplasty were prospectively assessed postoperative days 1–3. Patients received either traditional postoperative analgesia (acetaminophen plus opioids) or a multimodal pain protocol (acetaminophen, opioids, gabapentin, celecoxib), depending on surgeon preference. Self-rated pain, postoperative delirium, and time to achieve standby-assist ambulation were compared, as were total opioid doses and analgesic costs. Results: Despite receiving significantly more opioid analgesics (traditional: 166.4 mg morphine-equivalents; multimodal: 442 mg morphine equivalents; t = 10.64, P < .0001), there was no difference in self-rated pain, delirium, or mobility on postoperative days 1–3. Costs were significantly higher in the multimodal group ( t = 9.15, P < .0001). Knee arthroplasty was associated with higher pain scores than hip arthroplasty, with no significant difference in opioid usage. Conclusion: A multimodal approach to pain control demonstrated no benefit over traditional postoperative analgesia in elective arthroplasty patients, but with significantly higher amounts of opioid consumed. This poses a potential risk regarding tolerability in frail older adults and results in increased drug costs.

scholarly journals Effects of intraoperative liposomal bupivacaine on pain control and opioid use after pediatric Chiari I malformation surgery: an initial experience

2021 ◽  
Vol 27 (1) ◽  
pp. 9-15
Author(s):  
Victor M. Lu ◽  
David J. Daniels ◽  
Dawit T. Haile ◽  
Edward S. Ahn
Keyword(s):  
Pain Control ◽  
Potential Role ◽  
Chiari I Malformation ◽  
Control Group ◽  
Initial Experience ◽  
Opioid Use ◽  
Liposomal Bupivacaine ◽  
Pain Scores ◽  
Significant Difference ◽  
Chiari I

OBJECTIVEPediatric Chiari I malformation decompression is a common neurosurgical procedure. Liposomal bupivacaine (LB) is a novel formulation that can have an impact on postoperative recovery for particular procedures, but its potential role in pediatric neurosurgery is largely unexplored. The authors sought to describe and assess their initial experience with LB in pediatric Chiari I malformation decompression to better define its potential role as an analgesic agent in a procedure for which the postoperative course is often remarkably painful.METHODSA retrospective review of all pediatric Chiari procedures performed at the authors’ institution between 2018 and 2020 was conducted. Patients were divided into those who were treated with a single intraoperative dose of LB (LB group) and those who were not (control group). Comparisons of total opioid use and pain control were made using chi-square and Wilcoxon rank-sum tests.RESULTSA total of 18 patients were identified, 9 (50%) in the LB group and 9 (50%) in the control group. Overall, there were 13 (72%) female and 5 (28%) male patients with a mean age of 15.9 years. No surgical complications were observed over a mean length of stay of 2.7 days. Within the first 24 hours after surgery, the LB group had significantly lower total opioid use than the control group (17.5 vs 47.9 morphine milligram equivalents, respectively; p = 0.03) as well as lower mean pain scores reported by patients using a 10-point visual analog scale (3.6 vs 5.5 for the LB vs control groups, p = 0.04). However, from the first 24 postoperative hours to discharge, total opioid use (p = 0.51) and mean pain scores (p = 0.09) were statistically comparable between the two groups. There were 2/9 (22%) LB patients versus 0/9 (0%) control patients who did not require opioid analgesia at any point during hospitalization.CONCLUSIONSThe use of a single intraoperative dose of LB in pediatric Chiari I malformation surgery appears to be safe and has the potential to reduce pain scores and opioid use when administered during the first 24 postoperative hours. From that time period to discharge, however, there may be no significant difference in total opioid use or pain scores.

623 Procedural Pain Management in Burn Patients – A Quality Improvement Project

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S167-S167
Author(s):  
Zachary Fleishhacker ◽  
Colette Galet ◽  
Lucy Wibbenmeyer
Keyword(s):  
Quality Improvement ◽  
Pain Control ◽  
Quality Improvement Project ◽  
Procedural Pain ◽  
Burn Patients ◽  
Improvement Project ◽  
Opioid Dose ◽  
Pain Scores ◽  
Post Procedure ◽  
Significant Difference

Abstract Introduction Achieving adequate burn pain control in patients is paramount as inadequate control can lead to PTSD, suicidal ideation, and depression. The pain accompanying hydrotherapy can be extreme and challenging to manage. The purpose of this quality improvement project was to assess our burn center’s current nurse-driven procedural pain control protocol during hydrotherapy. Methods Burn patients admitted from June to August 2020 who underwent hydrotherapy were observed during the procedure. Demographics, comorbidities, injury related data, and pain and sedation medication data were collected. Pain scores (1–10), patient and nurse satisfaction scores (1–10) were collected before, during, and after hydrotherapy. A single patient could be surveyed for up to three times. Paired t-tests and one-way ANOVA were performed to assess significant differences between pre- and post-procedure patient pain scores and satisfaction ratings across encounters, respectively. P &lt; 0.05 was considered significant. Results Twenty-eight patients and 48 hydrotherapy events were surveyed. Patients were predominately male (23, 82.1%), middle aged (44.8 ± 19.6), and had a TBSA of 11.9 ± 10.5%. Analyzing only the first hydrotherapy sessions, time from initial opioid dose to hydrotherapy varied greatly as did the opioid morphine equivalent dose (OME) provided prior to hydrotherapy (Table 1). Only 13 (46.4%) subjects received versed during hydrotherapy. Pain scores post-procedure significantly increased compared to pre-procedure scores (5.39 vs. 6.32; p = 0.035). There was no significant difference in patients’ or nurse’s satisfaction scores regarding pain control nor with nurse’s rating of ease of procedure when comparing scores across the three encounters (Table 1). No adverse events (SaO2 &lt; 92% or deep sedation RAS &lt; 2) were observed across all encounters. Conclusions Our results suggest that procedural pain control during hydrotherapy, while safe, has opportunities for improvement. Pre-procedural medication timing remains imprecise and widely divergent. Satisfaction scores, while high, also have room for improvement. Finally, pre-procedural pain control is unacceptable (mean 5.39) and requires attention.

scholarly journals Mini-Incision Versus Laparoscopic Cholecystectomy

HPB Surgery ◽  
1997 ◽  
Vol 10 (5) ◽  
pp. 338-340 ◽  
Author(s):  
Charles J. Yeo
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Pain Control ◽  
Operating Time ◽  
Wound Dressings ◽  
Control Methods ◽  
Small Incision ◽  
Significant Difference ◽  
American Society ◽  
Mini Incision ◽  
Back To Work

Background: We report a prospective randomised comparison between laparoscopic and small-incision cholecystectomy in 200 patients which was designed to eliminate bias for or against either technique.Methods: Patients were randomised in the operating theatre and anaesthetic technique and pain-control methods were standardised. Four experienced surgeons did both types of procedure. Identical wound dressings were applied in both groups so that carers could be kept blind to the type of operation.Findings: There was no significant difference between the groups for age, sex, body mass index, and American Society of Anaesthesiologists grade. Laparoscopic cholecystectomy took significantly longer than small-incision cholecystectomy (median 65 [range 27-140] min vs 40 [18-142] min, p<0.001). The operating time included operative cholangiography which was attempted in all patients. We found no significant difference between the groups for hospital stay (postoperative nights in hospital, median 3.0 [1-17] nights for laparoscopic vs 3.0 [1-14] nights for small-incision, p=0.74), time back to work for employed persons (median 5.0 weeks vs 4.0 weeks; p=0.39), and time to full activity (median 3.0 weeks vs 3.0 weeks; p=0.15).Interpretation: Laparoscopic cholecystectomy takes longer to do than small-incision cholecystectomy and does not have any significant advantages in terms of hostital stay or 13 ostoperative recovery.

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