scholarly journals Comparison between circumferential local anesthesia and dorsal penile nerve block in circumcision procedure

2021 ◽  
Vol 42 (1) ◽  
pp. 51-55
Author(s):  
Chawat Angsurak ◽  
Keyword(s):  
Pain Score ◽  
Local Anesthesia ◽  
Nerve Block ◽  
Pain Control ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Ventral Surface ◽  
Controlled Clinical Trial ◽  
Dorsal Penile Nerve Block ◽  
Dorsal Penile Nerve

Objectives: To compare circumferential local anesthesia and dorsal penile nerve block with regard to pain control during adult circumcision. Materials and Methods: A randomized, controlled clinical trial was conducted and 30 men were randomly assigned into one of the following groups: circumferential local anesthesia (LA) and dorsal penile nerve block (DNB). Patients in both groups were injected with 0.2 ml/kg of 2% lidocaine without epinephrine before circumcision using the different techniques. During the operation, pain score was evaluated in accordance with the Numerical Rating Scale (NRS) and the data were compared using the Mann-Whitney test. Results: The patients in the LA group felt more pain than those in the DNB group during anesthetic injection (4.73 vs 3.7, p<0.05) but the pain scores were lower than in the DNB group during the outer prepuce incision (0.47 vs 3.93, p<0.05), inner prepuce incision (0.33 vs 1.47, p<0.05) and incision near/at Frenulum (0.33 vs 4.47, p<0.05). Overall pain score was higher in the dorsal penile nerve block group (1.53 vs 2.6, p <0.05). The circumferential local anesthesia is equally effective through all stages of the circumcision whereas the dorsal penile nerve block was not effective at the ventral surface of penis. Conclusion: For pain control in circumcision, circumferential local anesthesia is more effective than dorsal penile nerve block.

scholarly journals Study of Pain Level Control Targets After Arthroscopic Surgery

2021 ◽  
Author(s):  
Wang Xin ◽  
Liu Congying ◽  
Zhang Xiaole ◽  
Wang Hong ◽  
Xu Yan ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Pain Score ◽  
Pain Control ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Arthroscopic Surgery ◽  
Daily Activities ◽  
Pain Level ◽  
Convenience Sampling ◽  
The Impact

Abstract Objective: To explore the goal of pain control in patients after arthroscopic surgery.Design: Investigation. Postoperative pain, pain control satisfaction and the effect of pain on daily activities were investigated and evaluated.Setting: Department of Sports Medicine,Peking University 3rd Hospital,Beijing, P.R.ChinaSubjects: 514 patients selected by convenience sampling from patients hospitalized in a level A hospital in Beijing from 2020.06-2020.11. The patient inclusion criteria were an age of at least 18 years, no history of diagnosis of mental illness, the ability to clearly express his or her pain and an agreement to voluntarily cooperate with the investigators. The exclusion criteria were patients who were unable to complete follow-up.Methods: Postoperative pain, pain control satisfaction and the effect of pain on daily activities were investigated and evaluated by administering a homemade questionnaire to 514 patients selected by convenience sampling from patients hospitalized in a level A hospital in Beijing from 2020.06-2020.11. Pain was assessed using a digital pain numerical rating scale (NRS) (0-10), and a digital score ranging from 0 to 10 was used for satisfaction with pain control and the impact of pain on aspects of daily living.Results: The pain level was most severe in patients 6-24 hours after arthroscopic surgery, during which pain control satisfaction was at its worst. The pain score was significantly related to the effects of pain on aspects of daily life, and the degree of these effects changed significantly for pain scores greater than 2 points.Conclusion: Pain control 6 to 24 hours after surgery is not satisfactory. It is recommended that a pain score of 2 points is used as the goal for pain control after arthroscopic surgery to guide both doctors and patients to effectively control postoperative pain.

Changing Attitudes and Practices Regarding Local Analgesia for Newborn Circumcision

PEDIATRICS ◽  
1994 ◽  
Vol 94 (2) ◽  
pp. 230-233
Author(s):  
C. Anthony Ryan ◽  
Neil N. Finer
Keyword(s):  
Local Anesthesia ◽  
Regional Anesthesia ◽  
Nerve Block ◽  
Educational Program ◽  
Physician Attitudes ◽  
Local Analgesia ◽  
Study Objective ◽  
Attitudes And Practices ◽  
Dorsal Penile Nerve Block ◽  
Dorsal Penile Nerve

Study objective. To change physician attitudes and practices regarding the routine use of local and regional anesthesia for newborn circumcision. Design. Interventional study, followed by an audit of physician practice over a 1-month period, 1 year following interventions. Setting. The newborn nurseries of the Womens' Pavilion, Royal Alexandra Hospital, Edmonton. Interventions. A broad range of awareness and educational programs were directed at physicians who perform newborn circumcisions, including posters, newsletters, presentations at grand rounds, video recordings, and practical "hands-on" demonstration of the techniques of local anesthesia to the prepuce and dorsal penile nerve block. Results. Only one physician was using local analgesia for newborn circumcision prior to the introduction of the educational program. The audit, performed 12 months later, documented 46 circumcisions performed by 22 physicians, each performing between 1 and 6 circumcisions (median = 1). Sixteen of the 22 physicians (73%) used either local anesthesia to the prepuce (19 cases) or dorsal penile nerve block (13 cases) during circumcisions. Thus, local analgesia was used in 66% (32/48) of all circumcisions. Six physicians, performing 16 circumcisions, did not use any form of analgesia. Conclusions. This simple educational program has been associated with a remarkable change in attitudes and practice regarding local analgesia for neonatal circumcision. Our ideal objective, which we hope to achieve through repeated education and practical demonstrations of the techniques to interested physicians, is that all newborn circumcisions are performed under local or regional anesthesia in our institution.

Patient controlled analgesia (PCA) versus non-PCA intravenous hydromorphone titration for severe cancer pain: A randomized, controlled, multicenter, phase III trial, HMORCT09-1.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. TPS11635-TPS11635
Author(s):  
Rongbo Lin ◽  
Jinfeng Zhu ◽  
Shuitu Feng ◽  
Sunzhi Lin ◽  
Jianqian Fu ◽  
...  
Keyword(s):  
Side Effects ◽  
Cancer Pain ◽  
Pain Score ◽  
Pain Control ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Phase Iii ◽  
Opioid Tolerance ◽  
Self Administration ◽  
Opioid Dose

TPS11635 Background: The opioid dose for an individual with cancer pain to provide adequate relief of pain with an acceptable degree of side effects is variable. Opioid titration is a process to obtain the tailored dose. Conventional titration is administered by a clinician or nurse. PCA is that patients control cancer pain by self-administration of intravenous opioids using programmable pump. The aim of our study is to evaluate the efficacy of PCA titration versus conventional titration intravenously for severe cancer pain (10-point numerical rating scale, NRS ≥ 7). Injectable Hydromorphone was selected as pharmaceutical analgesics, which works as well as morphine and oxycodone and had similar side effects. Methods: This is currently enrolling patients (n=230) with severe cancer pain during previous 24 hours. Patients are randomized 1:1 and stratified by opioid intolerance or opioid tolerance into PCA or non-PCA titration. PCA titration using programmable pump: bolus hydromorphone at 0.5mg (for opioid intolerance) or hydromorphone dose equivalent to 10% to 20% of the total opioid taken in the previous 24 hours with a lockout time 15 minutes (for opioid tolerance) was administered by the patients educated. No basal infusion was set in the pump. Non-PCA titration administered by a nurse or clinician: Initial hydromorphone doses were same with PCA titration. Reassess pain at 15 minutes. Increased dose of hydromorphone by 50%-100% if pain unchanged or increased, or repeat same dose if pain decreased to NRS 4-6, or continue at current effective dose as needed over initial 24 hours. The primary endpoint is the time needed to successful titration was defined the time from the first dose of hydromorphone after randomization to achieve satisfied pain control. The satisfied pain control was defined NRS pain score ≤ 3 at rest in at least 2 consecutive assessment (15 minutes interval). The time needed to successful titration was extended to achieve satisfied pain control again if NRS pain score ≥ 7 after satisfied pain control within 24 hours. The failure of successful titration was defined that satisfied pain control does not achieve within 24 hours. Secondary endpoints include the percentage of patients titrated successfully, the mean NRS pain score of 24 hours, the total dose of hydromorphone titrated, and adverse events. Clinical trial information: NCT03375515.

scholarly journals Study of pain level control targets after arthroscopic surgery

2021 ◽  
Author(s):  
Xin Wang ◽  
Congying Liu ◽  
Xiaole Zhang ◽  
Hong Wang ◽  
Yan Xu ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Pain Score ◽  
Pain Control ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Arthroscopic Surgery ◽  
Daily Activities ◽  
Pain Level ◽  
Convenience Sampling ◽  
The Impact

Abstract Objective: To explore the goal of pain control in patients after arthroscopic surgery.Design: Investigation. Postoperative pain, pain control satisfaction and the effect of pain on daily activities were investigated and evaluated.Setting: Department of Sports Medicine,Peking University 3rd Hospital,Beijing, P.R.ChinaSubjects: 514 patients selected by convenience sampling from patients hospitalized in a level A hospital in Beijing from 2020.06-2020.11. The patient inclusion criteria were an age of at least 18 years, a lack of significant personality disorders, stable social and psychological factors, the ability to clearly express his or her pain and an agreement to voluntarily cooperate with the investigators. The exclusion criteria were patients who had been using painkillers long-term and those with other acute and chronic pain disorders.Methods: Postoperative pain, pain control satisfaction and the effect of pain on daily activities were investigated and evaluated by administering a homemade questionnaire to 514 patients selected by convenience sampling from patients hospitalized in a level A hospital in Beijing from 2020.06-2020.11. Pain was assessed using a digital pain numerical rating scale (NRS) (0-10), and a digital score ranging from 0 to 10 was used for satisfaction with pain control and the impact of pain on aspects of daily living.Results: The pain level was most severe in patients 6-24 hours after arthroscopic surgery, during which pain control satisfaction was at its worst. The pain score was significantly related to the effects of pain on aspects of daily life, and the degree of these effects changed significantly for pain scores greater than 2 points.Conclusion: Pain control 6 to 24 hours after surgery is not satisfactory. It is recommended that a pain score of 2 points is used as the goal for pain control after arthroscopic surgery to guide both doctors and patients to effectively control postoperative pain.

scholarly journals Ultrasound-guided superficial cervical plexus block for analgesia in patients undergoing craniotomy via suboccipital retrosigmoid approach: study protocol of a randomised controlled trial

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e034003
Author(s):  
Kun Peng ◽  
Min Zeng ◽  
Jia Dong ◽  
Xiang Yan ◽  
Dexiang Wang ◽  
...  
Keyword(s):  
Nerve Block ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Controlled Trial ◽  
Control Group ◽  
Cervical Plexus ◽  
Ethics Review ◽  
Superficial Cervical Plexus Block ◽  
Cervical Plexus Block ◽  
Plexus Block

IntroductionScalp nerve block has been proven to be an alternative choice to opioids in multimodal analgesia. However, for the infratentorial space-occupying craniotomy, especially the suboccipital retrosigmoid craniotomy, scalp nerve block is insufficient.Methods and analysisThe study is a prospective, single-centre, randomised, paralleled-group controlled trial. Patients scheduled to receive elective suboccipital retrosigmoid craniotomy will be randomly assigned to the superficial cervical plexus block group or the control group. After anaesthesia induction, superficial cervical plexus nerve block will be performed under the guidance of ultrasound. The primary outcome is the cumulative consumption of sufentanil by the patient-controlled intravenous analgesia pump within 24 hours after surgery. Secondary outcomes include the cumulative consumption of sufentanil at other four time points and numerical rating scale pain severity score.Ethics and disseminationThe protocol (version number: 2.0, 10 April 2019) has been approved by the Ethics Review Committee of China Registered Clinical Trials (Ethics Review No. ChiECRCT-20190047). The findings of this study will be disseminated in peer-reviewed journals and at scientific conferences.Trial registration numberNCT04036812

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