Outcome measures and outcomes of peripheral nerve stimulation of the sacroiliac joint

This chapter focuses on the most commonly used questionnaires and pain assessment scales that are used both clinically and in the research setting, and it compares and contrasts their validity and accuracy. Reliable outcome measures are essential to translate the complex perception of pain into measurable data. Several questionnaires and grading scales have been developed, each with their own inherent advantages and disadvantages. In addition to quantitative measures of pain, this chapter explores what other qualitative measures are useful to understand a patient’s perception of pain, their functional ability, and even potential adverse outcomes. Finally, this chapter demonstrates how some of these measures have already been used in the literature specifically in the context of peripheral nerve stimulation of the sacroiliac joint.

A Comparison of Three Pain Assessment Scales in the Assessment of Pain Among Dental Patients in Port Harcourt

Proper assessment of pain is essential in evaluating the appropriate treatment need of patients presenting with dental conditions. This study aimed to determine the correlation between Short Form McGill pain questionnaire 2 (SF-MPQ-2), Visual analogue Scale (VAS) and Numerical Rating Scale (NRS) for pain assessment among dental patients. A total of 83 patients that presented at the Oral Diagnosis clinic of the University of Port Harcourt Teaching Hospital with various dental conditions over 2 months were recruited for the study. The severity of the different presenting conditions was determined using SF-MPQ-2, VAS and NRS. The mean pain assessment scores for the different dental conditions was compared and Pearson correlation coefficient was evaluated for the three pain assessment scales. P < 0.05 was considered statistically significant. The mean age of the study participants was 38.2 ± 14.0 years with age range of 16 to 83 years. The mean VAS and NRS scores were significantly higher in those diagnosed with acute apical periodontitis with mean scores of 6.68±2.36 and 6.61±2.06 respectively. The participants with cancer had the lowest SF-MPQ-2 mean scores while those with chronic periodontitis have the lowest score using VAS and NRS. There was a significant strong, positive correlation between VAS and NRS pain assessment tools. The correlation between SF-MPQ-2 and either VAS/NRS was however, weak but positive and statistically significant. Severity of pain was highest among those with acute apical periodontitis using the three pain assessment tools. There was a significant positive correlation between SF-MPQ-2, VAS and NRS for dental pain assessment.

Role of L-carnitine in complex treatment for lesions of peripheral nerves of the extremities

The article presents the results of complex treatment with L-carnitine in patients with peripheral nerve damage. The data of dynamic clinical, instrumental and laboratory examination of patients with traumatic neuropathies are presented. Attention is drawn to the possible influence of the content of insulin-like growth factor 1 in blood serum on the persistence of pain syndrome. A correlation between content of insulin-like factor 1 in the blood serum and severity of pain syndrome has been found. Pain has been estimated using different pain assessment scales (VAS, LANSS, NTSS-9, DN4). Data on the content of insulin-like growth factor 1 in blood serum in patients with traumatic neuropathies on the background of complex treatment with the use of L-carnitine are presented.

Assessment and Management of Postoperative Pain among Nurses at a Resource-Constraint Teaching Hospital in Ghana

Background. Postoperative pain remains one of the greatest concerns for patients following surgical procedures. Nurses play an essential role in postoperative pain assessment and management, especially within the first few days after surgery. Objective. The study investigated how nurses in a resource-constraint hospital in Ghana assessed and managed postoperative pain. Methods. This was an explorative qualitative study involving 12 registered nurses practising in the largest referral hospital in Ghana. Data was gathered using a semistructured interview guide. Demographic characteristics of participants were summarized using descriptive statistics. Data were analysed using Kvale’s three phases for analysing qualitative data. First, the entire text was read again to identify meaning units which were then condensed. Second, the condensed texts were read again and interpreted. Finally, the condensed data containing similar meaning were coded and then sorted into subthemes. Results. It was found that some nurses have never used any pain assessment tool due to lack of standard tool for assessing postoperative pain. The majority of nurses reported that managing pain by using medication was the norm especially in the first 24 hours after surgery. Conclusion. Although participants may have some knowledge of assessing and managing postoperative pain, this knowledge was not largely used to manage postoperative pain effectively, partly because of resource constraints. Therefore, there is the need for adequate training and with provision of resources, it is imperative that the use of standardized pain assessment scales could help in the proper assessment and management of postoperative pain in this setting.

Trigeminal Neuropathic Pain

Motor cortex stimulation is a surgical treatment for medically refractory trigeminal neuropathic pain, a syndrome often caused by nerve injury due to trauma, dental work, or previous surgery for trigeminal neuralgia. Preoperative planning includes pain assessment scales, psychological clearance, and functional magnetic resonance imaging (fMRI) to map the motor cortex. The patient undergoes a craniotomy with trial placement of an epidural electrode array, assisted by neuronavigation, phase reversal monitoring, and somatosensory evoked potential recordings. Less commonly, the electrodes are placed in the subdural space. Postoperative seizure is the most common complication, additionally there are risks for infection and hemorrhage. Programming of the device is performed and the patient undergoes permanent implantation of the system if they achieve a greater than 50% reduction in their pain. Further research is necessary to determine which patients will have the best response to therapy.

Perceptions of nursing professionals front the pain of newborns in a neonatal intensive therapy unit

Objective: This study aims to know the perceptions of nursing professionals regarding the identification of pain in the newborn, as well as to assess the level of knowledge of these professionals regarding the existence and applicability of pain assessment scales for newborns and possible nursing interventions to be performed. Methodology: This is a qualitative, exploratory, descriptive and cross-sectional study conducted at the Intensive Care Unit of Hospital Escola in the city of Itajubá, State Minas Gerais. The present study counted on the participation of 20 professionals who answered two instruments to capture the data from March to June 2016. The analysis was done by the statistical program Excel version 2013 and as for the data, it was recorded by means of interview, it has been used the analysis of content proposed by Laurence Bardin. The study was approved by the Research Ethics Committee of Teresa D'Ávila University Center. Results: The following categories were listed: Yes, Venous Puncture, Crying, Non-pharmacological interventions, Yes, NIPS scale and Non-use of scale. Conclusion: This study will enable the critical reflection of professionals involved in the care of the neonate in pain situation, sensitizing them to interpret and minimize pain in the human being who is not yet able to verbalize it.

The Management of Pain In Animals on The Clinic Floor

Most animals presented for veterinary care are suffering or will suffer from some pain during restraint, clinical examination, samples collection, diagnostic imaging, parenteral drug administration or clinical procedures et cetera. The Veterinarian is ethically, morally and professionally enjoined to recognize and alleviate such pain. Although most studies on animal pain have been focused on mostly post surgical pain in dogs and cats, animals afflicted with most common external or internal, infectious and non-infectious disease conditions also suffer from pain. Identifying animals in pain alone is difficult except if a Veterinarian with a penchant for the management of pain in animals actively looks out for it in patients. The measurement of pain in animals poses even more difficulties for the Veterinarian than its identification mainly because animals are unable to communicate the locations, the temporal occurance and the severities of the pain they feel just as they don’t of other clinical manifestations. Therefore, animals in pain rely on their owners, handlers or keepers et cetera who actually don’t know how or where it hurts them to provide such details to the Veterinaruan. To complicate matters, the use of validated pain assessment scales in animals is fraught with serious limitations except to some less extent, for the visual analog and the simple descriptive scales which seem applicable in real clinic situations. A multi-modal mode of management in which opioids, non-steroidal anti-inflammatory drugs, local anesthetics, α 2 – adrenergic agonists, NDMA receptor antagonists and ketamine delivered through a variety of routes, at varied dosages and regimens, is advocated for pain management in animals. The need to regularly review the state of the patient vis-à-vis the need to modify the treatment module and regimen cannot be over emphasized when and if a clinical case is under consideration. This may involve the change of medications, the addition of more medications, the reduction in the number of medication, changes in dosages and the regimen in use from time to time. This discuss is aimed at the general Veterinary practitioner who is presented daily with different species and breeds of animals suffering from varieties of clinical conditions or which will undergo a variety of clinical procedures capable of causing pain in the course of veterinary health care delivery in diverse clinic settings.