Comparison Of Visual Analogue Scale Scores Research Articles

The Use of Contralateral Autologous Breast Grafting Tissue In Breast Reconstruction: A New Approach

Background: Breast reconstruction surgery is an exceptionally important tool for repair of defects and asymmetries caused by the various types of surgical breast cancer treatment. Reconstruction is indicated regardless of lesion location in the breast when a quadrantectomy or sector resection has been performed. Although several surgical techniques are available for reconstruction, we propose a method based on contralateral breast graft replacement to preserve shape and symmetry. Methods: This quasi-experimental study was performed with a sample of 42 women who had undergone quadrantectomy or wide resection, followed by radiation therapy, for treatment of breast cancer. The outcomes of interest were breast aesthetics and symmetry in the immediate postoperative period and after 3 months of radiation therapy. All patients were photographed preoperatively, pre-radiation therapy, and 3 months post radiation therapy. Before-and-after photographs were sent to four independent experts in the field, who, in a blinded manner, used a continuous visual analogue scale (VAS) of 0 to 10 to assess breast symmetry and aesthetic appearance. Results: The mean (SD) VAS score was 8.74 (0.75) for symmetry and 8.76 (0.80) for aesthetics (p>0.50 for both). Comparison of VAS scores assigned to preoperative and postoperative images revealed that autologous breast tissue grafting was useful. Conclusion: These findings suggest that, when combined with established techniques, autologous contralateral breast tissue grafting is a feasible alternative for breast reconstruction that provides satisfactory aesthetics and symmetry.

Analgesic Efficiency of Tramadol Administered Prior to Hysteroscopy Procedure

OBJECTIVE: In this study, our objective was to assess the pain scores using the Visual Analogue Scale (VAS) in patients who were given tramadol prior to office hysteroscopy in order to demonstrate its analgesic activity when given before this procedure. STUDY DESIGN: This prospective study conducted in year 2015 included two group of patients undergoing office hysteroscopy that were defined on the basis of the type of analgesia. Patients in the first group (Group 1, n=44) received oral tramadol prior to the procedure, while patients in the other group (Group 2, n=44) received placebo. VAS scores were determined during (0 minutes) and after (15 minutes) the procedure. RESULTS: There were no significant differences between groups in terms of age, parity and body mass index (p>0.05). Comparison of VAS scores at 0 and 15 minutes, lower values were observed in tramadol patients at 0 minutes (p<0.05), while scores at 15 minutes were not significantly different between the groups (p>0.05). CONCLUSION: Although oral tramadol given prior to office hysteroscopy was effective and safe in reducing pain during the procedure, it is not useful for the pain that occurs after processing.

Intraoperative Results and Postoperative Clinical Outcomes of Lumbar Microdiscectomy in Patients who Previously Received a Transforaminal Anterior Epidural Steroid Injection for Lumbar Radiculopathy.

To describe the intra- and postoperative results of patients who received a transforaminal anterior epidural steroid injection (TAESI) prior to lumbar microdiscectomy. Sixty-four patients who did not improve after minimally invasive techniques (MIT) for lumbar radiculopathy were evaluated. Thirty-two of them treated with techniques other than TAESI and those receiving thrombolytic or anticoagulant drugs before microdiscectomy were excluded. We recorded the type of MIT, numbers of levels and injections, time interval between the last MIT and microdiscectomy, duration of surgery, amount of intraoperative blood loss, rate of incidental durotomy, postoperative infection, and visual analogue scale (VAS) scores for leg pain before and after microdiscectomy at 24 hours, and the 1st and 3rd months (Group 1). A total of 35 patients with no history of MIT or lumbar surgery who had undergone unilateral, single-level lumbar microdiscectomy at our clinic were randomly selected to be included in the control group (Group 2) and same parameters were recorded for the comparison of both groups. The mean duration of lumbar discectomy was 140 minutes, and the amount of average intraoperative blood loss was 227 cc in the study group (Group 1), and 65 minutes and 73 cc, respectively in the control group (Group 2)(p > 0.05). The comparison of VAS scores revealed that lumbar discectomy was still effective after TAESI (p=0.00). Although epidural steroid injection is an effective modality for the management of chronic pain, these patients should be informed preoperatively about the relatively long duration of surgery and the possible requirement for blood transfusion.

A Randomized Controlled Trial of Single Point Acupuncture in Primary Dysmenorrhea

Acupuncture is often used for primary dysmenorrhea. But there is no convincing evidence due to low methodological quality. We aim to assess immediate effect of acupuncture at specific acupoint compared with unrelated acupoint and nonacupoint on primary dysmenorrhea. The Acupuncture Analgesia Effect in Primary Dysmenorrhoea-II is a multicenter controlled trial conducted in six large hospitals of China. Patients who met inclusion criteria were randomly assigned to classic acupoint (N = 167), unrelated acupoint (N = 167), or non-acupoint (N = 167) group on a 1:1:1 basis. They received three sessions with electro-acupuncture at a classic acupoint (Sanyinjiao, SP6), or an unrelated acupoint (Xuanzhong, GB39), or nonacupoint location, respectively. The primary outcome was subjective pain as measured by a 100-mm visual analog scale (VAS). Measurements were obtained at 0, 5, 10, 30, and 60 minutes following the first intervention. In addition, patients scored changes of general complaints using Cox retrospective symptom scales (RSS-Cox) and 7-point verbal rating scale (VRS) during three menstrual cycles. Secondary outcomes included VAS score for average pain, pain total time, additional in-bed time, and proportion of participants using analgesics during three menstrual cycles. Five hundred and one people underwent random assignment. The primary comparison of VAS scores following the first intervention demonstrated that classic acupoint group was more effective both than unrelated acupoint (-4.0 mm, 95% CI -7.1 to -0.9, P = 0.010) and nonacupoint (-4.0 mm, 95% CI -7.0 to -0.9, P = 0.012) groups. However, no significant differences were detected among the three acupuncture groups for RSS-Cox or VRS outcomes. The per-protocol analysis showed similar pattern. No serious adverse events were noted. Specific acupoint acupuncture produced a statistically, but not clinically, significant effect compared with unrelated acupoint and nonacupoint acupuncture in primary dysmenorrhea patients. Future studies should focus on effects of multiple points acupuncture on primary dysmenorrhea.

The effect of repetitive transcranial magnetic stimulation on refractory neuropathic pain in spinal cord injury

ObjectiveTo investigate the analgesic effect of repetitive transcranial magnetic stimulation (rTMS) on intractable neuropathic pain in patients with spinal cord injury (SCI).DesignA single center, prospective, randomized, double-blinded, controlled study.SettingSCI rehabilitation unit of university rehabilitation center.ParticipantsSeventeen patients with SCI and chronic neuropathic pain who met the inclusion criteria recruited between April 2010 and January 2012.InterventionsTen daily treatment sessions of real or sham rTMS (30 trains of 10-Hz stimuli for a duration of 5 seconds; a total of 1500 pulses at intensity equal to 110% of the resting motor threshold) was applied over vertex using a figure-of-8-shaped coil.Outcome measuresPain was assessed with visual analog scale (VAS) at baseline and 10 days, 6 weeks and 6 months after the treatment. Patients’ satisfactions obtained using a 5-point Likert scale at 6 months.ResultsBoth real and sham rTMS provided a significant reduction in the VAS scores (real rTMS group, P = 0.004; sham rTMS group, P = 0.020). Post hoc analysis revealed the significant difference was at 10 days and 6 weeks compared to baseline in the real rTMS group and only at 10 days compared to baseline in the sham rTMS group. Comparison of VAS scores and patient satisfaction did not show any significant difference at each assessment point (P > 0.05).ConclusionOur results demonstrated analgesic effect of rTMS on intractable neuropathic pain in SCI was not superior to placebo. However, middle-term (over 6 weeks) pain relief by rTMS is encouraging and suggests the need for future studies with a larger sample size.

Evaluation of analgesic effect of two different doses of fentanyl in combination with bupivacaine for surgical site infiltration in cases of modified radical mastoidectomy: A double blind randomized study.

Background:Limited evidence supports the efficacy of peripheral route fentanyl and local anesthetic combination for postoperative analgesia. Our study was therefore designed to demonstrate the analgesic efficacy of two different doses of fentanyl in combination with bupivacaine for surgical site infiltration in patients undergoing modified radical mastoidectomy (MRM).Materials and Methods:60 patients undergoing MRM under general anesthesia were randomly allocated into two groups, first group receiving 0.5% bupivacaine at a dose of 2 mg/kg body weight with 50 μg fentanyl and second group receiving bupivacaine 0.5% at a dose of 2 mg/kg body weight with 100 μg fentanyl as infiltration of operative field in and around the incision site, after the incision and just before completion of surgery. In postoperative period pain, nausea-vomiting and sedation was recorded at 0 hr, 2, 4, 6, 12 and 24 hrs.Results:Both the combinations of bupivacaine and fentanyl (Group I and Group II) were effective for postoperative analgesia. In both the groups the Visual Analogue Scale (VAS) score was less than 3 at each time interval. None of the patients required rescue analgesia. The comparison of VAS scores at different intervals showed that group II had lower VAS scores at all time points.Conclusions:Fentanyl and bupivacaine combinations in doses of 50 and 100 μg along with 0.5% bupivacaine at a fixed dose of 2 mg/kg body weight are effective in the management of postoperative pain. Patients who received 100 μg fentanyl (Group II) had lower VAS scores as compared to the patients who received 50 μg fentanyl (Group I) with similar side effects.

Immediate Analgesia Effect of Single Point Acupuncture in Primary Dysmenorrhea: A Randomized Controlled Trial

Acupuncture is often used for primary dysmenorrhea. To assess the efficacy of a single point of acupuncture in the management of primary dysmenorrhea compared with sham acupuncture and no acupuncture. Patients with primary dysmenorrhea were randomly assigned to acupoint group (n=50), unrelated acupoint group (n=50), nonacupoint group (n=46), or no acupuncture group (n=48). Acupuncture and sham acupuncture were administered once-daily for 3 days with electro-acupuncture at Sanyinjiao (SP6) that was specifically designed to treat primary dysmenorrhea, or an unrelated acupoint (Xuanzhong, GB39), or nonacupoint location. The primary outcome was pain intensity as measured by a 100-mm visual analog scale (VAS) at baseline; 5, 10, 30, and 60 minutes following the start of the first intervention. Cox retrospective symptom scale (RSS), verbal rating scale (VRS), pain total time, and proportion of participants using analgesics were also recorded during three menstrual cycles. The primary comparison of VAS scores demonstrated that patients receiving acupuncture (-15.56 mm, 95% CI -22.16 to -8.95, P<0.001), unrelated acupoint (-18.14 mm, 95% CI -24.81 to -11.47, P<0.001), and nonacupoint (-10.96 mm, 95% CI -17.62 to -4.30, P=0.001) treatment presented significant improvements compared with no acupuncture group. There were no significant differences among the four groups with respect to secondary outcomes. Acupuncture was better than no acupuncture for relieving the pain of dysmenorrhea following a single point of acupuncture, but no differences were detected between acupoint acupuncture and unrelated acupoint acupuncture, acupoint acupuncture and nonacupoint acupuncture.