Degree Of Pain Research Articles

Analysis of acupoint massage combined with touch on relieving anxiety and pain in patients with oral implant surgery.

Oral implant surgery is an effective procedure for artificial implants in missing tooth areas under local anesthesia. Because patients under local anesthesia are conscious during this procedure, compared with general anesthesia-related operations, they are more likely to experience negative emotions, such as anxiety and tension. These emotional reactions result in shivering and chills in the limbs, leading to poor doctor-patient cooperation and even avoidance of treatment. In traditional Chinese medicine, it is believed that acupoint massage regulates blood and Qi, dredge menstruation, and relieve pain, which is beneficial for patients' emotional adjustment; however, there are few related clinical studies. To observe the changes in anxiety and pain in patients with oral implant after acupoint massage combined with touch therapy. One hundred patients undergoing oral implantation in our hospital between May 2020 and May 2023 were randomly divided into control and study groups, according to a random number table, with 50 patients in each group. The control group received routine intervention, and the study group received acupoint massage combined with touch on the basis of the control group. Anxiety [assessed using the Modified Dental Anxiety Scale (MDAS)], pain severity, blood pressure, heart rate, and satisfaction were compared between the two groups. Before intervention, the difference in MDAS score between the two groups was not significant (P > 0.05), while after the intervention, the MDAS scores decreased in both groups compared with those before the intervention (P < 0.05); the MDAS score of the study group was lower than that of the control group, with a statistically significant difference (P < 0.05). The degree of pain in the intervention group was significantly lower than that in the control group (P < 0.05). Before the intervention, there were no significant differences in systolic and diastolic blood pressures or heart rate between the two groups (P > 0.05). The systolic and diastolic blood pressures and heart rate in the intervention group, during and after the intervention, were significantly lower than those in the control group (P < 0.05). The total degree of satisfaction in the study group was significantly higher than that in the control group (P < 0.05). Acupoint massage combined with touch better relieves anxiety and pain in patients undergoing dental implant surgery, improving the perioperative comfort of these patients and ensuring safety and a smooth operation.

The effect of apical patency on postoperative pain following endodontic therapy: A systematic review and meta-analysis.

This systematic review and meta-analysis aimed to determine whether apical patency increases postoperative pain after endodontic therapy. This study explored the degree and incidence of postoperative pain during root canal therapy, as well as the number of required analgesic doses. We searched PubMed, Scopus, Embase, Web of Science, Cochrane Library, and gray literature from the date of database inception until May 2023. RevMan 5.4 software was used for data analysis. Twelve studies were considered eligible for meta-analysis. The mean pain scores on days 1 (mean difference [MD] = -1.69) and 2 (MD = -0.85) differed significantly between the apical patency and non-patency groups. The odds for pain after 24 h were significantly lower (OR 0.59) in the apical patency group than in the non-patency group. Furthermore, the mean number of required analgesic doses was not significantly different between the two groups. In conclusion, apical patency significantly alleviated postoperative pain (low-quality evidence) and reduced the incidence of pain (moderate evidence). However, high-quality randomized controlled trials are required to validate these findings.

Clinical application of anatomical locking plate in treatment of Rockwood type Ⅰ- Ⅲpatella fractures

To investigate the effectiveness of anatomical locking plate in the treatment of Rockwood type Ⅰ-Ⅲ patella fractures. The clinical data of 16 patients with patella fractures who were admitted between November 2021 and January 2023 and met the selection criteria was retrospectively analyzed. There were 14 males and 2 females, with an average age of 44.5 years (range, 19-72 years). Causes of injuries included tumble in 12 cases and traffic accident in 4 cases. The fractures were rated as type Ⅰ in 2 cases, type Ⅱ in 9 cases, and type Ⅲ in 5 cases according to Rockwood classification criteria. The time from injury to operation ranged from 6 to 15 days, with an average of 9 days. After fracture reduction, an appropriate anatomical locking plate was selected for internal fixation. The operation time, intraoperative blood loss, and incision healing were recorded; the Lysholm score, Böstman patella fracture efficacy score, knee joint mobility, and visual analogue scale (VAS) score were used to evaluate the knee joint function and pain degree; X-ray films were used to review the fracture reduction and healing. The operation time was 65-100 minutes (mean, 75.3 minutes); the intraoperative blood loss was 10-35 mL (mean, 25.6 mL). All incisions healed by first intention after operation. All patients were followed up 11-26 months (mean, 19.7 months). X-ray films showed that the fractures were reduced satisfactorily, and all achieved bony healing with healing time of 3-5 months. At last follow-up, the Lysholm score was 90-95 (mean, 93.0); the Böstman patella fracture efficacy score was 27-30 (mean, 28.8), of which 12 cases were excellent and 4 were good; the VAS score was 0-1 (mean, 0.3). There was no significant difference in the range of motion of the knee joint between the healthy and affected sides [145° (140°, 150°) vs 145° (140°, 145°); Z=1.890, P=0.059]. Choosing anatomical locking plates for Rockwood typeⅠ-Ⅲ patella fractures can achieve strong fixation with minimal surgical trauma, rapid recovery of knee joint function, and mild pain after operation.

Comparison of the safety and efficacy of robotic natural orifice specimen extraction surgery and conventional robotic colorectal cancer resection: a propensity score matching study.

Robotic resection is widely used to treat colorectal cancer. Although the novel natural orifice specimen extraction surgery (NOSES) results in less trauma, its safety and effectiveness are relatively unknown. In the present study, we used propensity score matching to compare the effectiveness and safety of NOSES and robotic resection for treating colorectal cancer. Present retrospective cohort study included patients who underwent robotic colon and rectal cancer surgery between January 2016 and December 2019 at the Department of Gastrointestinal Surgery, the Second Xiangya Hospital of Central South University. The intraoperative time, intraoperative bleeding, postoperative recovery, postoperative complications, and survival status of the conventional robotic colorectal cancer resection (CRR) (78 patients) and NOSES (89 patients) groups were compared. These results showed that no significant differences were observed between the two groups in terms of early postoperative complications, operation time, and the number of lymph nodes dissected. Compared with the CRR group, NOSES group had shorter postoperative exhaust time [3.06 (0.76) vs. 3.53 (0.92)], earlier eating time [4.12 (1.08) vs. 4.86 (1.73)], lesser intraoperative bleeding [51.23 (26.74) vs. 67.82 (43.44)], lesser degree of pain [80.8% vs. 55.1%], and shorter length of hospital stay [8.73 (2.02) vs. 9.50 (3.45)]. All these parameters were statistically significant (P < 0.05). However, no significant differences were observed in the 3-year overall survival rate and disease-free survival rate between both groups (P > 0.05). Collectively, robotic NOSES is a safe and effective approach for treating rectal and sigmoid colon cancers, could decrease intraoperative bleeding and postoperative complications, and accelerate the speed of intestinal function recovery.

Role of submucosal injection in radiofrequency ablation of gastric low-grade dysplasia: Effects on symptoms and outcomes.

To date, there is still a lack of standardized management strategies for gastric low-grade dysplasia (LGD), which is a direct neoplastic precancerous lesion and requires specifically superficial destruction. Radiofrequency ablation (RFA) is expected to be an effective method for gastric LGD, but post-RFA pain may affect patients' satisfaction and compliance. The current study aimed to evaluate the value of a submucosal injection prior to RFA (SI-RFA) for postoperative pain and treatment outcomes. Between October 2014 and July 2021, gastric LGDs without risk factors (size >2cm, unclear boundary, and abnormal microsurface and microvascularity) undergoing regular RFA and SI-RFA were retrospectively analyzed. Postoperative pain scores, wound healing, and clinical efficacy were compared. Propensity score matching, stratified analysis, and multivariable logistic regression were performed to control the confounding variables. One hundred and ninety-seven gastric LGDs in 151 patients received regular RFA. Forty-nine gastric LGDs in 36 patients received SI-RFA. Thirty-six pairs of patients were selected for the assessment of postoperative pain by propensity score matching. Compared to regular RFA, SI-RFA significantly decreased the degree and duration of postoperative pain (OR, 0.32; 95% CI, 0.13-0.84; P =0.020), improved wound healing rate (80.0% [36/45] vs . 58.9% [89/151], P =0.012), increased the complete ablation rate (91.8% [45/49] vs . 86.3% [170/197], χ2 = 1.094, P =0.295), but correlated with higher rates of local recurrence and progression (25.6% [10/39] vs . 13.2% [18/136], χ2 = 3.471, P =0.062; 8.3% [3/36] vs . 0.9% [1/116], P =0.042). The multivariable logistic regression model confirmed that submucosal injection was associated with local recurrence (OR, 2.93; 95% CI, 1.13-7.58; P =0.027). Submucosal injections prior to RFA may reduce postoperative pain and scar formation while ensuring complete ablation of gastric LGD. However, local recurrence and progression should be considered seriously.

The Effect of Depth of Anesthesia on Postoperative Pain in Laparoscopic Sleeve Gastrectomy: A Randomized Controlled Trial

BackgroundPatients with obesity are more sensitive to pain and more likely to have acute postoperative pain (APP). Studies have shown that the depth of anesthesia may affect the incidence of APP. The purpose of the study was to look into the connection between APP and depth of anesthesia in patients with obesity undergoing laparoscopic sleeve gastrectomy.MethodsThis is a prospective, double-blinded randomized clinical trial, 90 patients undergoing laparoscopic sleeve gastrectomy were randomly divided into two groups: the light anesthesia group (Bispectral Index of 50, BIS 50) and the deep anesthesia group (BIS 35). The degree of pain was evaluated by the visual analogue scale (VAS) at 0, 12, 24, 48, and 72 h after surgery. The use of analgesics, grade of postoperative nausea and vomiting (PONV), and the Quality of Recovery-15 (QoR-15) score were recorded.ResultsThe VAS scores at rest or coughing at 0, 12, and 24 h after surgery in the BIS 35 group were lower than those in the BIS 50 group (P < 0.05). Fewer patients in the deep anesthesia group needed analgesia during the recovery period, and patient satisfaction was higher on the 3rd day after surgery (P < 0.015, P < 0.032, respectively).ConclusionsFor patients with obesity, maintaining a deeper depth of anesthesia during surgery is beneficial to reduce APP causes less need for additional analgesic drugs, and improves patient satisfaction.Graphical

Comparative study of pregabalin and carbamazepine in painful diabetic peripheral neuropathy at the tertiary care hospital

This study aimed to examine the effectiveness of carbamazepine as well as pregabalin in lowering the degree of pain associated with diabetic peripheral neuropathy. The results revealed noteworthy insights into the comparative effectiveness of these medications. Pregabalin, as a calcium channel modulator, has demonstrated efficacy in numerous neuropathic pain conditions. Beyond pain reduction, these drugs influence various aspects of daily functioning, emotional well-being, and social interactions is crucial for tailoring treatment approaches. The discussion explores Pregabalin medication stands out in improving overall quality of life of the patients. The results presented here indicated that among diabetic patients, age, HbA1c, DR, and the duration of their diabetes are related to considerably higher risks of DPN; however, BMI, smoking, TG, as well as TC did not show any evidence of an increased risk of DPN. The results of the study offer a scientific foundation for a deeper comprehension of the causes of peripheral neuropathy-complicated type 2 diabetes and the outcomes of preventative measures.Bottom of Form

The Effects of Dexmedetomidine As an Adjuvant with Levobupivacaine To Epidural Analgesia on The Outcomes of Patients Undergoing Total Abdominal Hysterectomy Surgery

Background: Total abdominal hysterectomy (TAH) characterizes as major surgery with increased risk of morbidity. It depends on adequate pain management intra- and postoperatively. Anesthesia management of TAH widely uses a regional approach with the epidural technique which administers a local anesthesia agent into the epidural space.Objective: This study aims to determine the effectiveness of epidural levobupivacaine with fentanyl versus levobupivacaine with dexmedetomidine for epidural anesthesia in patients undergoing TAH.Methods: This is a prospective, single-blinded trial conducted among 20 patients aged 18 to 40 years who underwent elective TAH with American Society of Anesthesiologist (ASA) class I and II status. The control group received epidural levobupivacaine 0.5% with fentanyl as an adjuvant, while the dexmedetomidine group received levobupivacaine 0.5% with dexmedetomidine as an adjuvant. We then compared the degree of pain using a numeric rating scale (NRS) 24 hours after surgery, duration of analgesia, and incidence of postoperative nausea and vomiting (PONV) in both groups.Result: Duration of analgesia was 89.60 + 7.6332 min in group dexmedetomidine, while it was 78.0 + 10.4562 min in group fentanyl, respectively (P &lt; 0.05). The means of NRS was 3.00 + 1.88562 in group dexmedetomidine and 4.80 + 1.1352 in group fentanyl (p=0.019). The incidence of PONV in group dexmedetomidine was three, while in group fentanyl was eight (p=0.025).Conclusion: Dexmedetomidine is preferred over fentanyl when added to levobupivacaine for epidural analgesia in TAH procedures. Dexmedetomidine offers superior quality with a prolonged duration of analgesia, lower NRS values, and a lower incidence of PONV rather than fentanyl.

Analysis of factors impacting postoperative pain and quality of life in patients with mixed hemorrhoids: A retrospective study.

Hemorrhoids are among the most common and frequently encountered chronic anorectal diseases in anorectal surgery. They are venous clusters formed by congestion, expansion, and flexion of the venous plexus in the lower part of the rectum. Mixed hemorrhoids bleed easily and recurrently, and this can result in severe anemia. Hence, they may have a negative effect on the health of the patient and surgical treatment is required. Milligan-Morgan hemorrhoidectomy has been widely used since 1937 for the treatment of grade III and IV hemorrhoids. However, most patients experience different degrees of postoperative pain that may cause anxiety. To assess the factors influencing pain scores and quality of life (QoL) in patients with mixed hemorrhoids post-surgery. The clinical data of patients with mixed hemorrhoids who underwent Milligan-Morgan hemorrhoidectomy were collected retrospectively. The basic characteristics of the enrolled patients with mixed hemorrhoids were recorded, and based on the Goligher clinical grading system, the hemorrhoids were classified as grades III or IV. The endpoint of this study was the disappearance of pain in all patients. Quantitative data were presented as mean ± SD, such as age, pain score, and QoL score. Student's t-test was used to compare the groups. A total of 164 patients were enrolled. The distribution of the visual analog scale pain scores of all patients at 3, 7, 14 and 28 d after surgery showed that post-surgery pain was significantly reduced with the passage of time. Fourteen days after the operation, the pain had completely disappeared in some patients. Twenty-eight days after the surgery, none of the patients experienced any pain. Comparing the World Health Organization Quality of Life - BREF self-reporting questionnaire scores of patients between 14 and 28 d after surgery, we observed that the quality-of-life scores of the patients post-surgery had significantly improved. There were six items that were compared at 14- and 28-d post-surgery. The mean QoL score 28 d after surgery (4.79 ± 0.46) was higher than that at 14 d post-surgery (3.79 ± 0.57). The mean health condition score 28 d after surgery (4.80 ± 0.41) was also higher than that at 14 d post-surgery (4.01 ± 0.62). The mean physical health score 28 d after surgery (32.10 ± 2.96) was significantly higher than that at 14 d post-surgery (23.41 ± 2.85). The mean psychological health score 28 d after surgery (27.22 ± 1.62) was significantly higher than that at 14 d post-surgery (21.37 ± 1.70). The mean social relations score 28 d after surgery (12.21 ± 1.59) was significantly higher than that at 14 d post-surgery (6.32 ± 1.66). The mean surrounding environment score 28 d after surgery (37.13 ± 2.88) was significantly higher than that at 14 d post-surgery (28.42 ± 2.86). The differences in quality-of-life scores at day 14 and day 28 post-surgery were observed to be statistically significant (P < 0.001). Milligan-Morgan hemorrhoidectomy can significantly improve the postoperative QoL of patients. Age, sex, and the number of surgical resections were important factors influencing Milligan-Morgan hemorrhoidectomy.

Impact of Musculoskeletal Pain on Health-Related Quality of Life Among Adults in Saudi Arabia.

Background Musculoskeletal pain (MSP) is widely recognized as a prevalent public health issue that affects individuals of various genders and age groups. The aim of this study is to assess the influence of musculoskeletal pain on the quality of life (QoL)of adult individuals living in Saudi Arabia. Method This is a cross-sectional study using an online-administered questionnaire that was distributed via online platforms in Saudi Arabia for the duration between January and August 2023. Three questionnaire instruments were used in this study. The 36-item Short Form Health Survey questionnaire (SF-36), The 5-level EQ-5D version (EQ-5D-5L), and Roland-Morris Disability Questionnaire. Binary logistic regression analysis was used to identify predictors of better QoL and having mild to moderate disability. Results A total of 8359 participants were involved in this study. The most commonly reported sites of musculoskeletal pain were the lower back, neck, and shoulder, accounting for 36.8% (n= 3072), 30.5% (n= 2549), and 30.1% (n= 2514), respectively. The mean pain score for the study participants was 4.3 (SD: 2.3), which indicates mild degree of pain. The median EQ-5D-5L index value for the study participants was 0.827 (0.756-1.00), which demonstrates a high quality of life. The mean SF-36 score for the study participants was 63.11 (17.4), which demonstrates moderate quality of life. The median Roland-Morris Disability score for the study participants was 1.00 (0.00-7.00), which demonstrates a low level of pain-related disability. Male gender, younger age (30-39 years), having higher education attainment, having higher monthly income (more than SAR 20000), and having lower BMI (less than 25.8 kg/cm2) were predictors of better QoL (p<0.05). Conclusion Musculoskeletal pain is a multifactorial condition influenced by structural, physical, psychological, social, lifestyle, and comorbid health elements. It ranges from acute to chronic pain and, despite rarely being fatal, has a significant impact on QoL. Musculoskeletal discomfort varies in terms of intensity, affected regions, and demographic and lifestyle factors. This study sheds light on the multifaceted nature of MSP, its impact on QoL, and the significance of early intervention and individualized management strategies to improve the QoLof those affected.

Choosing the optimal target area for repeated transcranial magnetic stimulation in treating neuropathic pain in spinal cord injury patients: a comparative analysis.

The specific target area of repeated transcranial magnetic stimulation (rTMS) in treating neuropathic pain resulting from spinal cord injury (SCI-NP) remains uncertain. Thirty-four participants with SCI-NP were allocated into three groups, namely, the motor cortex (M1, A) group, the left dorsolateral prefrontal cortex (LDLPFC, B) group, and the control (sham stimulation, C) group. The intervention was administered totally 10 times. Outcome measures assessed pre-(T0) and post-(T1)intervention, including Numerical Rating scale (NRS), anxiety (SAS), depression (SDS), sleep quality (PSQI), brief pain inventory (BPI), and impression of change. All outcomes in groups A and B significantly changed after intervention (p < 0.05), and the delta value (T1-T0) also significantly changed than group C (p < 0.05). The delta value of SDS in the group B was better than the group A, and the change of pain degree in the group B was moderately correlated with the change in PSQI (r = 0.575, p < 0.05). Both patients in the groups A and B showed significant impression of change about their received therapy (p < 0.05). Both targets are effective, but LDLPFC is more effective in reducing depression in SCI-NP. Healthcare providers might select the suitable area according to the specific attributes of their patients.

The effect of primary closure versus secondary closure techniques on postoperative wound pain in patients undergoing mandibular surgery: A meta-analysis.

This research is intended to explore the influence of second and first degree closure methods on the degree of wound pain and swelling of the face following the removal of the mandible. For the purpose of this study, three data sets, including PubMed and Embase, were selected. A separate statistical analysis was conducted on the choice of the trial, the collection of data and the risk of bias. Differences between trials were analysed with a chi-square approach, with data analyses dependent on I2. A sensitivity analysis was conducted, and a possible publication bias was evaluated. Ultimately, nine qualifying trials were chosen out of an original pool of 1922 related trials following an in-depth evaluation under the eligibility and exclusion criteria, as well as a follow-up screening. The results indicated that there was no statistically significant change in the degree of post-operation pain after 1 day operation between one or secondary closures of treatment (MD, -0.46; 95% CI, -0.93, 0.01, p = 0.06); the results showed that there were no statistically significant differences in post-operation wound pain after 3 days in two group (MD, -0.15; 95% CI, -0.68, 0.37, p = 0.56); the results showed that there were no statistically different effects on the post-operation wound pain after the 7th day in two groups (MD, -0.14; 95% CI, -0.31, 0.03, p = 0.1). The results showed that there were no statistically different effects on the post-operation wound pain after the 1 day in two groups (MD, -0.26; 95% CI, -0.38, -0.13, p < 0.0001); on the 3rd day after surgery, the face was significantly smaller swelling in the secondary closure of closure compared with the first-stage closure group (MD, -0.70; 95% CI, -1.40, -0.00, p = 0.05). While there is no obvious effect on post-operation wound pain in patients with mandibular surgery, there is significant difference in post-operation face swelling. The findings do not support a preference for any of these methods.

The Effect of Rehabilitative Exercises in Improving (the range of motion, muscle strength, and the degree of pain) for Football Players After ACL Surgery

Objective: This study aims to prepare rehabilitative exercises for football players following anterior cruciate ligament surgery and to determine the impact of such exercises on the functional ability of the anterior cruciate ligament (muscle strength, range of motion, and level of pain) in advanced football players following surgery. Method: A sample of (6) injured, from Al-Kut club, (age = 27.33 ± 1.98 years, height = 174.7 ± 2.99 cm, mass 60.6 0.68 kg) participated in the study. The participants in the experimental group (n=6) completed pre-tests and post-tests. Results: The results of the experimental sample show that there was a significant improvement in the mean scores for Muscular strength on the post-test compared to the pre-test. The mean score for muscular strength increased from 18.50 to 33.33, p&amp;lt;0.001), the mean score for the range of motion increased (extension) from 163.50 to 177.33, (flexion) 68.83 to 21, p&amp;lt;0.001), and the mean score for pain decreased from 7.125 to 1.12, p&amp;lt;0.001). conclusion: following surgery, rehabilitation exercises improve the strength of the muscles that operate on the knee joint, increase the range of motion of the knee joint, and decrease pain degree.

Clinical study on the treatment of postoperative recurrence of lumbar disc herniation with intervertebral fusion

To explore clinical effect of different intervertebral fusion devices (cage) in treating postoperative recurrent lumbar disc herniation (LDH). One hundred and forty-two LDH patients with recurrence after simple intervertebral disc nucleus pulpoideectomy from January 2019 to January 2021 were retrospectively analyzed. All patients were treated with combined underchannel fixation and interbody fusion and divided into a single anatomical group,two-anatomical group and a single banana group according to types and numbers of implanted cage. There were 51 patients in a single anatomical group,included 29 males and 22 females,aged from 39 to 65 years old with an average of (53.74±5.68) years old;body mass index (BMI) ranged from 18.62 to 28.13 kg·m-2 with an average of (22.08±2.15) kg·m-2;the interval between operation and recurrence ranged from 0.5 to 4.0 years with an average of (2.7±0.8) years;5 patients with L3,4,35 patients with L4,5 and 11 patients with L5S1;a single anatomical cage was implanted. There were 46 patients in two-anatomical group,included 25 males and 21 females,aged from 37 to 66 years old with an average of (54.52±6.02) years old;BMI ranged from 18.25 to 28.44 kg·m-2 with an average of (21.74±1.83) kg·m-2;the interval between operation and recurrence ranged from 0.5 to 5.0 years with an average of (2.7±0.9) years;4 patients with L3,4,32 patients with L4,5 and 10 patients with L5S1;two-anatomical cages were implanted. There were 45 patients in a single banana group,included 22 males and 23 females,aged from 38 to 65 years old with an average of (54.49±6.45) years old;BMI ranged from 18.85 to 28.20 kg·m-2 with an average of (21.63±1.59) kg·m-2;the interval between operation and recurrence ranged from 0.5 to 5.0 years with an average of (2.6±1.0) years;3 patients with L3,4,36 patients with L4,5 and 16 patients with L5S1;a single banana cage was implanted. Operation time,intraoperative blood loss,incision length,postoperative incision drainage volume,hospital stay and complications among 3 groups were observed and compared. The height of intervertebral space before and after operation,curvature of lordosis and the postoperative intervertebral fusion were compared. Visual analogue scale (VAS) and Oswestry disability index (ODI) were used to evaluate degree of lumbar pain and lumbar function before operation,1 and 6 months after operation,respectively. All patients among 3 groups were followed up at least 6 months,and no cases were fell out. There were no significant difference in operation time,intraoperative blood loss,incision length,postoperative incision drainage volume and hospital stay among 3 groups (P>0.05). At 6 months after operation,the height of intervertebral space in two-anatomical group and a single group were [(11.08±1.78) mm,(10.95±1.62) mm],curvature of lordosis were [(12.05±1.86) °,(11.63±1.57) °],which were higher than those in a single dissection group (10.14±1.54) mm,(10.92±1.45) °,and the difference were statistically significant (P<0.05). The interbody fusion rate between two-anatomical and a banana group (95.65%,95.56%) were higher than that in a single anatomical group (78.43%) at 6 months after operation (P<0.05). VAS and ODI of lumbar among 3 groups were decreased at 1 and 6 months after operation (P<0.05). There was no significant difference in complications among 3 groups (P>0.05). The three fusion devices could achieve significant results in treating postoperative recurrence of LDH,but the implantation of two-anatomical cage and a single banana cage are more helpful to maintain the height of intervertebral space and lordosis curvature of patients with postoperative recurrence of LDH,and obtain good intervertebral fusion results.

Prevalence of Hamstring Strain and Association with Fatigue among Domestic Cricketers in Lahore Pakistan

Background: Hamstring strains are a common injury among athletes, particularly affecting those involved in sports requiring high-speed running and abrupt movements, such as cricket. The association between these injuries and factors like fatigue has been of particular interest within the sports medicine community, aiming to enhance injury prevention and management strategies. Objective: This study aimed to investigate the prevalence of hamstring strains and their association with fatigue among domestic cricketers in Lahore, Pakistan, providing insights into effective strategies for injury prevention and management in this athletic population. Methods: A cross-sectional study was conducted from December 2022 to May 2023 among 82 domestic cricketers in Lahore, using non-probability convenient sampling. Participants underwent assessments including the Functional Assessment Scale for Acute Hamstring Injuries (FASH) and the Fatigue Assessment Scale (FAS), alongside demographic and physical fitness data collection. Data were analyzed using IBM SPSS Statistics Version 25, with the chi-square test applied to evaluate the association between hamstring strain and fatigue. Results: The average age of participants was 26.68±1.395 years, with the majority (81.7%) having a normal BMI. About 28.0% of the athletes reported hamstring strains, with varying degrees of pain from mild to severe. The chi-square test indicated a significant association between hamstring strains and fatigue (p&lt;0.001), highlighting fatigue as a key factor in the occurrence of hamstring injuries among cricketers. Conclusion: The study underscores the significant prevalence of hamstring strains among domestic cricketers in Lahore and their association with fatigue. These findings emphasize the necessity for targeted interventions focusing on fatigue management to mitigate the risk of such injuries, thereby enhancing athlete health and performance sustainability.

Comparison between Retroperitoneal Laparoscopic Nephrectomy and Traditional Open Nephrectomy to Treat Polycystic Kidney Disease before Kidney Transplantation.

To compare the efficiency and safety between retroperitoneal laparoscopic nephrectomy and traditional open nephrectomy to treat autosomal-dominant polycystic kidney disease before kidney transplantation. A total of 57 patients diagnosed with huge autosomal-dominant polycystic kidney disease between 2000 and 2020 at our center were included in this study. Patients were divided into a retroperitoneal laparoscopic (RL; n=23) group and traditional open (TO; n = 34) group. We retrospectively analyzed and compared preoperative and perioperative variables between the two groups. Patients in the RL group showed a longer operation time (201.09±83.76min) compared to patients in the TO group (113.38 ± 51.84min, p < 0.001). The RL group also showed significantly less intraoperative blood loss (p = 0.025) and less intraoperative blood transfusion volume (p = 0.016) compared to the TO group. Meanwhile, time of gastrointestinal function recovery, bed leave, catheter indwelling and postoperative hospitalization in the RL group were 2.13 ± 0.63, 1.30 ± 1.0, 5.22 ± 2.09, 7.35±2.48 days, respectively, which were significantly shorter than the TO group (p < 0.05). Pain degree of patients during the first 48 hours after operation was similar between the RL and TO groups, but the opioid use percentage in the RL group was 8.70% (2/23) and was lower than the 26.47% (9/34) in the TO group (p = 0.022). Meanwhile, 5 and 23 patients exhibited postoperative complications in the RL and TO groups, respectively (p < 0.001). Both retroperitoneal laparoscopic nephrectomy and traditional open surgery are feasible to treat huge polycystic nephrectomy. However, patients who undergo retroperitoneal laparoscopic nephrectomy experience higher levels of safety and recover more rapidly.

IPACK Block Efficacy for Acute Pain Management after Total Knee Replacement: A Review.

Patients often experience a significant degree of knee pain following total knee replacement (TKR). To alleviate this pain, nerve blocks may be performed such as the adductor canal block (ACB). However, ACBs are unable to relieve pain originating from the posterior region of the knee. A new type of nerve block known as the IPACK block may be used in conjunction with ACBs as it is designed to inhibit nerve branches innervating this area. In this article, we examine the rationale behind the IPACK procedure, how it is performed, and clinical trials examining its efficacy. 5 of the 7 clinical trials examined in this article showed the IPACK + ACB block to show superior efficacy in treating pain following TKR compared to other blocks. These blocks included PMDI+ACB, SPANK+ACB, PAI+ACB, ACB alone, and SCAB. 2 of the 7 clinical trials showed the IPACK + ACB to be less effective in managing patients pain following TKR compared to other blocks which included the CACB and 4 in 1 block. In most instances, the IPACK + ACB showed superior efficacy in managing patients' pain following TKR when compared to other types of nerve blocks. This was determined by measuring usage of opioids, reported postoperative pain, and length of hospital stays following TKR. Thus, we suppose the IPACK block may be used in conjunction with the ACB to effectively reduce patient's pain following TKR.

Effectiveness of wearing glasses with green lenses on dental anxiety for third-molar surgery: A randomized clinical trial

BackgroundDental anxiety is a common problem for oral surgeries. This study investigated the effectiveness of wearing glasses with green lenses in reducing dental anxiety, blood pressure, heart rate, and intraoperative pain in patients undergoing first-time third-molar surgery. MethodsThe authors planned this study as a randomized and parallel-group clinical trial. Patients’ dental anxiety was measured with the use of a visual analog scale and a State-Trait Anxiety Inventory for baseline measurement purposes. At the same time, blood pressure, oxygen saturation, and heart rate values were recorded. Patients were given glasses with clear or green lenses, depending on their group. After 10 minutes, all parameters were measured again for preoperative measurement. Patients wore glasses with either green or clear lenses throughout the operation. After the operation, patients were asked to estimate the degree of intraoperative pain using the visual analog scale. ResultsThe study included 128 patients. On the basis of the change between baseline and preoperative measurements, the authors found a statistically significant difference in anxiety and heart rate. Intraoperative pain showed a significant difference between groups. No significant changes were found in blood pressure and oxygen saturation. ConclusionsPatients with anxiety could wear low-cost, easy-to-use glasses with green lenses for 10 minutes before an operation to reduce anxiety and heart rate. In addition, wearing glasses during the surgical procedure can reduce intraoperative pain. Practical ImplicationsBy means of using glasses with green lenses throughout the procedure, existing anxiety and pain can be reduced. An operation can be performed more comfortably for both the patient and the dentist. This clinical trial was registered at ClinicalTrials.gov. The registration number is NCT05584696.

Effect of recombinant human epidermal growth factor on neuropathic pain associated with radiotherapy for head and neck malignancies and nursing strategy

Objective To evaluate the effect of recombinant human epidermal growth factor (rhEGF) on radiotherapy-related neuropathic pain in patients with head and neck malignancies, and to explore comprehensive nursing strategies. Methods In this retrospective study, a total of 80 patients diagnosed with head and neck malignancy and receiving radiotherapy were divided into 2 groups according to treatment. Patients in the control group received conventional radiation therapy and postoperative care, and those in the trial group received rhEGF in addition to conventional radiation therapy and care. Visual analogue scale (VAS) was used to evaluate the pain degree of patients before and after treatment, EORTC QLQ-C30 scale was used to evaluate the quality of life of patients before and after treatment, and the skin and mucosal reactions of patients after radiotherapy were observed. Results Baseline characteristics were similar between the two groups. VAS scores in the trial group were significantly lower than those in the control group during and after radiotherapy (p < 0.001), and skin and mucosal reactions were less severe (p < 0.05). In addition, compared with the control group, the quality of life and symptom scores of the trial group were significantly improved after treatment (p < 0.05). Conclusion rhEGF can effectively alleviate neuropathic pain during and after radiotherapy in patients with head and neck malignancies, improve skin and mucosal response, and improve quality of life.

Comparison of side effects of different steroids used in intratympanic injections

ObjectivesThis study aimed to compare the side effects of different steroids used in the intratympanic injections (IT). MethodsOne hundred and sixty patients diagnosed with sudden sensorineural hearing loss and undergoing IT were assigned to four groups based on the type or concentration of steroids administered (Group DM5: 5 mg/ml Dexamethasone sodium phosphate; Group DM10: 10 mg/ml Dexamethasone sodium phosphate; Group MP: 40 mg/ml Methylprednisolone sodium succinate; Group BM: 4 mg/ml Betamethasone sodium phosphate). Each group comprised 40 patients, and all participants received IT six times. The study assessed and compared the degrees and duration of pain, dizziness, and tympanic membrane damage following IT. Patients were asked to report the pain they felt using the numeric rating scale (NRS). ResultsNRS scores for pain after IT showed significant differences among the four groups (p < 0.001). The average NRS scores for pain in each group were as follows: Group DM5: 1.53 ± 1.04; Group DM10: 1.45 ± 1.30; Group MP: 4.33 ± 2.22; Group BM: 6.03 ± 1.46. The durations of pain after IT also exhibited significant differences among the four groups (p < 0.001), with the longest duration observed in Group MP at 31.93 ± 15.20 min. ConclusionDifferent types of steroids could lead to varying degrees of pain when used in IT. Betamethasone could cause the most severe pain, and methylprednisolone could result in the longest duration of pain.