Faces Pain Scale Research Articles

Evaluation of role of peri portal infiltration of ropivacaine in post laparoscopic cholecystectomy pain management: a randomized controlled double-blind study

Background: Laparoscopic cholecystectomy is considered as the treatment of choice for symptomatic cholelithiasis. The present study was conducted to assess the role of peri-portal infiltration of ropivacaine in post laparoscopic cholecystectomy pain management. Methods: A total of 100 eligible cases undergoing laparoscopic cholecystectomy were randomly allocated in two groups: group A (received infiltration of total 20 ml of 0.5% ropivacaine, 5 ml in each port site after removal of trocar, and group B (received placebo i.e., 20 ml normal saline). Postoperative pain was assessed using Wong Baker facial pain scale at 6, 12 and 18 hours and use of rescue analgesics were noted. Results: Group I comprised of 27 males and 23 females and group II had 25 males and 25 females. The mean heart rate in group I was 85.4 and in group II was 86.2. Respiratory rate was 14.2 cycles/minute in group I and 15.2 cycles/minute in group II. The mean blood pressure was 134.2/74.6 mmHg in group I and 136.4/75.2 mmHg in group II and oxygen saturation was 99.2% in group I and in group II was 99.5%. The mean VAS scores were significantly lower in group A cases as compared to group B, throughout the study follow up (p<0.01). 70% in group A and 90% in group B required 1 dose and 10% in group II required 2 doses. Duration of rescue analgesia was 21.49 minutes in group A and 17.3 minutes in group B. Conclusions: Peri-portal infiltration of ropivacaine is effective in reducing post laparoscopic cholecystectomy pain. Mean duration of analgesia was significantly more and requirement of rescue analgesics were significantly less in cases managed by peri-portal infiltration of ropivacaine as compared to control group (using NSAIDs).

Caudal Epidural Block versus Combined Ilioinguinal and Iliohypogastric Nerve Block for Post-Operative Analgesia in Pediatric Surgeries Below the Umbilicus

Objective: To compare the duration and effectiveness of postoperative analgesia provided by caudal block versus combined Ilioinguinal and Iliohypogastric nerve block in pediatric infra-umbilical surgeries.Study Design: Quasi-experimental.Place and Duration of Study: The study was carried out at the Anesthesia Department of Pak Emirates Military Hospital (PEMH) Rawalpindi, Pakistan, from June 2021 to December 2021.Materials and Methods: Sample size was calculated from the WHO sample size calculator using the population size received in 6 months. The sample size was filtered down by purposive sampling to 80 (children aged 5-10 years) using a pre-defined inclusion/exclusion criterion scheduled for below umbilicus surgeries. They were alternatively divided into two equal groups (n=40) where Group-C received a caudal block and Group-I received ultrasound-guided Ilioinguinal and Iliohypogastric nerve block. Both groups underwent the same general anesthesia technique with I-gel and similar medications at inductions. Our primary outcome measure was the duration of analgesia using the Revised Faces Pain Scale, where p-value <0.05 was considered significant. The secondary outcomes measured were motor block and urinary retention.Results: Median revised Faces Pain Score (FPS-R) immediately after surgery was 1.50(1) for Group-C and 0.00(1) for Group I, respectively. At 4 hours postoperatively, the median FPS-R in Group-C was 4.00(2), and in Group I, it was 2.00(0). After 8 hours, Group-C had a median FPS-R of 6.50(1) and Group-I had pain scores of 3.00(1). Median pain scores of Group-C and Group-I at 12 hours postoperatively were 8.00(1) and 5.00(1), respectively. The demographic characteristics of the patients were comparable in both groups with similar duration of surgery. Group-C reported some cases of side effects, such as motor block and urinary retention, while Group-I did not have any of these effects. All anesthetic procedures did not otherwise have any adverse events.Conclusion: Our study demonstrated that combined Ilioinguinal and Iliohypogastric nerve block furnished efficient post-operative analgesia while requiring smaller amounts of local anesthetics and avoiding the adverse effects of the caudal block. It is an ideal regional block technique for infra-umbilical surgeries in pediatric populations at busy centres.

Nevus of Ota: Combination Treatment with Q-Switched Neodymium-Doped Yttrium Aluminum Garnet Laser and Fractional CO2 Laser.

Nevus of Ota is a facial dermal melanocytic hamartoma occurring more commonly in Asians. The mainstay of treatment is 1064-nm Q-Switched neodymium-doped yttrium aluminum garnet (Nd:YAG) laser, which has shown variable results in pigmented skin. The aim of this study was to determine whether Q-Switched Nd:YAG laser treatment combined with fractional CO2 laser is more efficacious than Q-Switched Nd:YAG laser alone. This was a prospective study with 81 patients. The patients were randomly divided into two groups. Group 1 received 1064-nm Q-Switched Nd:YAG laser alone and group 2 in addition received a fractional CO2 laser as well. Both groups received six sittings at monthly intervals. The treatment response was documented with physician global assessment (PGA) and patient's treatment satisfaction on Wong-Baker Facial Pain Scale (WBFPS). Dermoscopic evaluation was done to see subsurface pigment clearance. In the combination group, 25% of patients had more than 50% improvement as compared with 5.71% in group 1. To achieve a mean PGA score of 1.4, it took six sessions for group 1 versus only four for group 2. Dermoscopic evaluation showed faster pigment clearance in the combination group. Combining two lasers shows statistically significant faster and greater degree of improvement as compared with Q-Switched Nd:YAG laser monotherapy in nevus of Ota.

Vibrating toothbrush, ice, or topical anesthetic agent to reduce pain of local anesthetic injection in 5- to 12-year-old children undergoing dental procedures — a randomized controlled trial

BackgroundApplication of topical anesthetic agent prior to injection is the most commonly used method to control initial needle penetration pain of local anesthetic injection. Ice and vibration stimulus application are other nonpharmacologic methods used to reduce painful sensations of injection. The present study aims to verify and compare topical anesthetic, ice pretreatment, and electric toothbrush as a vibratory device, to reduce the pain of local anesthetic injections.The study was conducted on children aged 5–12 years, requiring extraction of a maxillary primary tooth. A randomized control trial design was used wherein each child was randomly assigned by permuted block randomization design method to receive either lignocaine 5% as topical anesthetic or ice pretreatment or motorized toothbrush as a vibratory device during local anesthetic injections. Sound, eye, and motor (SEM) scale was used for objective evaluation of pain during injection, and Faces Pain Scale (FPS) was used for subjective evaluation. For statistical analysis, nonparametric test — Kruskal Wallis/ANOVA test for three groups and between two groups Mann–Whitney U-test, was used to compare SEM and FPS values. Level of significance chosen was p < 0.05.ResultsSEM (palatal) and FPS (palatal) scores were slightly higher in topical anesthetic group as compared to ice pretreatment or vibration group, but the differences were not statistically significant. There were no statistically significant differences among SEM (buccal) and FPS (buccal) scores in all the three groups.ConclusionsIce cooling and electric toothbrush-induced vibration were as effective as topical anesthetic for reduction in pain due to injection.Trial registrationThe CTRI number of the trial is CTRI/2021/03/032046.

Comparison of twice weekly palliative RT versus continuous hypofractionated palliative RT for painful bone metastases.

Palliative hypofractionated radiotherapy (RT) is an effective mode of treating painful bone metastasis. While 8 Gy single fraction radiation is often effective for the same, for complicated bone metastases a protracted fractionated regimen is preferred, of which 30 Gy/10#/2weeks or 20 Gy/5#/1 week are the most common worldwide. However such schedules add to the burden of already overburdened radiation treatment facilities in a busy center, wherein alternative logistic favourable schedules with treatment on weekends are preferred. Here we compare the efficacy of a twice weekly schedule to that of standard continuous 20 Gy/5 #/1 week schedule in terms of pain relief, response and quality of life. A prospective non randomized study was undertaken from Jan 2018 to May 2019, wherein eligible patients of complicated bone metastases received palliative radiotherapy of 20 Gy/5#, either continuously for 5 fractions from Monday to Saturday or twice weekly, Saturday and Wednesday, starting on a Saturday over about 2 weeks. Pain relief was assessed by the Visual Analogue Scale (VAS) and FACES pain scale recorded prior to starting palliative RT and at 4 weeks, 3 months and 6 months. Thirteen patients received continuous Hypofractionated RT while 16 received it in a twice weekly schedule. Spine was the most common site receiving palliative Radiation (27/29), while breast cancer was the most common primary (16/29). The demographic and the baseline characteristics were comparable. The mean pain score decline at 4 weeks was 2.56 ± 1.1 and 2.71 ± 0.52 in the 5-day and the two-week schedule, respectively (p = 0.67). A twice weekly schedule over about two weeks was found to be equivalent in pain control and response to the standard fractionated palliative radiation and, thus, can be safely employed in resource constrained, busy radiotherapy centers.

Therapeutic communication improves patient comfort during venipuncture in children: a single-blinded intervention study

The aim of this study was to examine whether therapeutic communication improves children’s comfort during venipuncture compared to standard communication. This study was registered in the Dutch trial register (NL8221), December 10, 2019. This single-blinded interventional study was carried out in an outpatient clinic of a tertiary hospital. Inclusion criteria were age between 5 and 18 years, use of topical anesthesia (EMLA) and sufficient understanding of the Dutch language. 105 children were included, 51 assigned to the standard communication group (SC group) and 54 patients to the therapeutic communication group (TC group). The primary outcome measure was self-reported pain based on the Faces Pain Scale Revised (FPS-R). Secondary outcome measures were observed pain (numeric rating scale (NRS)), self-reported/observed anxiety in child and parent (NRS), self-reported satisfaction in child, parent and medical personnel (NRS), and procedural time. No difference was found for self-reported pain. Self-reported and observed anxiety (by parents and medical personnel) was lower in the TC group (p-values ranged from p = 0.005 to p = 0.048). Procedural time was lower in the TC group (p = 0.011). Satisfaction level of medical personnel was higher in the TC group (p = 0.014). Conclusion: TC during venipuncture did not result in lower self-reported pain. However, secondary outcomes (observed pain, anxiety and procedural time) were significantly improved in the TC group.What is Known:• Medical procedures, especially needle related procedures, cause anxiety and fear in children and adults.• In adults communication techniques based on hypnosis are effective in reducing pain and anxiety during medical procedures.What is New:• Our study found that with a small change in communication technique (called therapeutic communication or TC), the comfort of children during venipuncture improves.• This improved comfort was mainly reflected by reduced anxiety scores and shorter procedural time. This makes TC suitable for the outpatient setting.

Reducing pain and discomfort associated with rubber dam clamp placement in children and adolescents: a systematic review and meta-analysis of effectiveness

BackgroundThe application of rubber dams is a widely accepted method of tooth isolation in dental practice. Placement of the rubber dam clamp might be associated with levels of pain and discomfort, especially in younger patients. The purpose of the present systematic review is to evaluate the efficacy of the methods for reducing pain and discomfort associated with rubber dam clamp placement in children and adolescents.Materials and methodsEnglish-language literature from inception until September 6th, 2022 was searched in MEDLINE (via PubMed), SCOPUS, Web of Science, Cochrane, EMBASE, and ProQuest Dissertations & Theses Database Global for articles. Randomized controlled trials (RCTs) comparing methods of reducing the pain and/or discomfort associated with rubber dam clamp placement in children and adolescents were retrieved. Risk of bias assessment was performed using a Cochrane risk of bias-2 (RoB-2) risk assessment tool and the certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) evidence profile.Studies were summarized and pooled estimates of pain intensity scores and incidence of pain were calculated. The meta-analysis was conducted in the following groups according to type of interventions (LA, audiovisual (AV) distraction, behavior management (BM), electronic dental anesthesia (EDA), mandibular infiltration, inferior alveolar nerve block (IANB), TA), outcome (intensity or incidence of pain), and assessment tool (face – legs – activity – cry – consolability (FLACC), color scale, sounds – motor – ocular changes, and faces pain scale (FPS)):(a) pain intensity using (LA + AV) vs (LA + BM), (b) pain intensity using EDA vs LA (c) presence or absence of pain using EDA vs LA (d) presence or absence of pain using mandibular infiltration vs IANB (e) Comparing pain intensity using TA vs placebo (f) Presence or absence of pain using TA vs placebo.Meta-analysis was conducted using StataMP software, version 17.0 (StataCorp, College Station, Texas). Restricted maximum-likelihood random effect model (REML), Mean difference (MD) with 95% confidence interval, and log odds ratio (OR) with 95% CI were calculated were calculated.ResultsInitially, 1452 articles were retrieved. Sixteen RCTs were finally included for reviewing and summarizing. Nine articles with a total of 867 patients were included for quantitative meta-analysis. The differences in pain intensity scores were not significant in any comparison groups (group a: [MD = -0.04 (95% CI = − 0.56, 0.47), P = 0.87, I2 = 0.00%], group b: [MD = 0.25 (95% CI = -0.08, 0.58), P = 0.14, I2 = 0.00%], group c [MD = -0.48 (95% CI = -1.41, 0.45), P = 0.31, I 2 = 0.00%], group d: [MD = -0.67 (95% CI = -3.17, 1.83), P = 0.60, I 2 = 0.00%], group e: [MD = -0.46 (95% CI = -l.08, 0.15), P = 0.14, I 2 = 90.67%], and group f: [MD = 0.61 (95% CI = -0.01, 1.23), P = 0.06, I 2 = 41.20%]. Eight studies were judged as having some concern for risk of bias and the remaining studies were considered as low risk for bias. The certainty of evidence was considered medium for all comparison groups.DiscussionIn the present meta-analysis, a considerable difference was obtained between the included studies regarding intervention methods and pain assessment tools and the analysis was performed in groups with small numbers of the studies. Owing to the mentioned variabilities and the small number of studies, the results of the analysis should be interpreted with caution. The indistinguishability of the manifestations of pain/discomfort from fear/anxiety, particularly in children, should also be considered while using the results of the present study.Within the limitations of the current study, no significant differences were found between the proposed methods for reducing pain and discomfort associated with rubber dam clamp placement in children and adolescents. A larger number of more homogenous studies regarding intervention methods and pain assessment tools need to be conducted in order to draw stronger conclusions.Trial registrationThis study was registered in PROSPERO (ID number: CRD42021274835) and research deputy of Mashhad University of Medical Sciences with ID number 4000838 (https://research.mums.ac.ir/).

Validity of simplified self-report methods versus standard use method for pain assessment in preschool-aged children.

Children experience painful invasive procedures very intensely. The aim of health professionals is to help children minimize this traumatic experience. The Simplified Faces Pain Scale (S-FPS) and Simplified Concrete Ordinal Pain Scale (S-COS) tools offer children the possibility of self-assessing their pain. This can then be the basis for tailoring pain relief to the child's individual need. The aim of this study is to present the validation procedure of the S-FPC, S-COS methods. 135 children aged 3-6 years assessed their pain using the self-reported S-FPS and S-COS methods at three consecutive times, and their results were compared with the commonly used Face, Legs, Activity, Cry, Consolability assessment scale. Intra-class correlations (ICC) were used to assess inter-rater agreement. Convergent validity was verified using Spearman's correlation coefficient. This study demonstrated good validity for both the S FPS and S-COS assessment tools. The ICC coefficient showed good inter-rater correlation. Spearman's correlation coefficient showed a strong correlation between the scales. It is not possible to clearly select a best method of pain assessment in preschool children. To choose the most appropriate method, it is necessary to take into account the child's cognitive development and preferences.

Validation of a faces pain scale in postsurgical geriatric patients

Validation of a faces pain scale in postsurgical geriatric patients

Transnasal Neuro-Prolozone for the Management of Trigeminal Neuralgia; Dramatic and Long-Term Relief of a Novel Technique

We report two cases of trigeminal neuralgia, dramatically relieved with transnasal neuro- prolozone infiltration of the sphenopalatine ganglion. To be mentioned, we are the first to describe this technique in the treatment of trigeminal neuralgia. The two cases had a history of trigeminal neuralgia for more than 2 years, refractory to pharmacological treatment. Case one is a 63 year-old female, with a 5-year history of trigeminal neuralgia. This patient reported a history of hypertension and atrial fibrillation. The second patient, a 33 year-old male, had a 2-year history of trigeminal neuralgia, and a reported history of type-1 diabetes and ischemic heart disease (IHD). No side effects were reported, along the 6-month follow- up period. The Penn Facial Pain Scale Revised (Penn-FPS-R) was conducted to assess pain interference with the quality of life in the included patients, 1-week before injection, 5 minutes, 15 minutes, one week, 4 weeks and 6 months after injection. The patients’ satisfaction and pain intensity were assessed using the 11-point numeric rating scale (NRS) at the pre-defined time points. The two cases reported long-term improvement, regarding pain intensity and quality of life. In conclusion, transnasal neuro-prolozone infiltration is emerging as an effective, long-term and immediate-acting treatment modality for mitigating the burden of trigeminal neuralgia.

Comparison of Dexmedetomidine with Midazolam as an adjuvant with Propofol for insertion of ProSeal laryngeal mask airway in Children.

Propofol is required in higher doses for smooth insertion of the ProSeal laryngeal mask airway. The ideal adjuvant drug so as to minimise induction doses of propofol is still not known. Dexmedetomidine and midazolam are equally effective for premedication in children. We have designed this study to compare dexmedetomidine and midazolam as adjuvants with propofol for insertion characteristics of ProSeal laryngeal mask airway. A total of 130 paediatric patients undergoing elective surgery were randomly allocated into 2 groups of 65 each. One group was induced using propofol, fentanyl and midazolam, whereas the other group received propofol, fentanyl and dexmedetomidine. Subsequently, insertion characteristics of ProSeal laryngeal mask airway were documented in terms of number of attempts and by using modified Muzi score. Post-operative sedation was recorded by Ramsay Sedation Scale and pain was assessed by using Wong-Baker Faces pain scale. Out of 130 patients, ProSeal laryngeal mask airway was inserted in a second attempt in only 5 patients of midazolam group. Time taken for insertion was significantly higher among the midazolam group (21 seconds) than the dexmedetomidine group (19 seconds). A total of 93.8% of patients administered dexmedetomidine had excellent Muzi scores in comparison to midazolam group where only 13.8% patients had excellent Muzi scores (P < .001). Dexmedetomidine in a dose of 1 μg kg-1 as compared to midazolam (20 μg kg-1) produces better insertion characteristics for ProSeal laryngeal mask airway when used as adjuvant with propofol in terms of jaw opening, ease of insertion, coughing, gagging, patient movement, and laryngospasm.

COMPARISON BETWEEN SINGLE BUCCAL INFILTRATION VERSUS CONVENTIONAL BUCCAL AND PALATAL INFILTRATION FOR REMOVAL OF MAXILLARY MOLAR TEETH.

Background: Although less painful injection techniques have been developed, most individuals still nd palatal injection to be unpleasant. The purpose of this study was to evaluate the ef Aims: cacy of single buccal inltration versus conventional buccal and palatal inltration for the removal of maxillary molar teeth. Fifty patie Materials and Methods: nts participated in a prospective randomized, split-mouth study, Group 1: 4% Articaine HCL inltration – Only buccal, Group 2: 2% Lignocaine HCL – Buccal and palatal inltration. Checking VAS score and Facial pain scale during Inltration and during extraction. Factor analysis was used to determine the signicance of the difference in mean scores between the two groups using both the independent sample t-test. Even though the Results: difference was not statistically signicant (P &gt; 0.05), patients in the articaine group reported much less discomfort during having their vital maxillary molars extracted compared to the lignocaine group. As was previously m Conclusion: entioned, it is feasible to avoid the palatal injection while removing molars from the maxilla. Specically, the extraction of the upper molars, and buccal inltration with articaine is a viable alternative to the use of traditional local anaesthetic.

COMPARISON BETWEEN SINGLE BUCCAL INFILTRATION VERSUS CONVENTIONAL BUCCAL AND PALATAL INFILTRATION FOR REMOVAL OF MAXILLARY MOLAR TEETH.

Background: Although less painful injection techniques have been developed, most individuals still nd palatal injection to be unpleasant. The purpose of this study was to evaluate the ef Aims: cacy of single buccal inltration versus conventional buccal and palatal inltration for the removal of maxillary molar teeth. Fifty patie Materials and Methods: nts participated in a prospective randomized, split-mouth study, Group 1: 4% Articaine HCL inltration – Only buccal, Group 2: 2% Lignocaine HCL – Buccal and palatal inltration. Checking VAS score and Facial pain scale during Inltration and during extraction. Factor analysis was used to determine the signicance of the difference in mean scores between the two groups using both the independent sample t-test. Even though the Results: difference was not statistically signicant (P &gt; 0.05), patients in the articaine group reported much less discomfort during having their vital maxillary molars extracted compared to the lignocaine group. As was previously m Conclusion: entioned, it is feasible to avoid the palatal injection while removing molars from the maxilla. Specically, the extraction of the upper molars, and buccal inltration with articaine is a viable alternative to the use of traditional local anaesthetic.

A Prospectiv ospective-Randomiz e-Randomized Study: The Impact of F ed Study: The Impact of Four Diff our Different Caries Remo Caries Removal Method on P al Method on Pain and Clinical E ain and Clinical Evaluations aluations

Objective: There are many different methods for removing caries. In this study, to evaluate four caries removal methods in terms of patient comfort and to evaluate the clinical success of restorations according to modified-USPHS criteria. Methods: In 31 patients with at least 4 Class II caries in their posterior teeth, 4 teeth were randomly divided into four groups and 4 different methods (conventional method, Carisolv, Papacarie, Er-Cr:YSGG Laser) were used for caries removal. Pain formation during caries removal was determined by FACE Pain Scale questionnaire. The restorations were controlled with Modified-USPHS criteria in 3-6-12 months period. Mann-Whitney U test for two-group comparisons, Kruskal Wallis H test for comparison of three or more groups, Wilcoxon Sign test was used to examine the changes according to time (p &lt; 0.05). Results: A significant difference was found between conventional methods and alternative methods in terms of pain tolerance. In the 1-year clinical evaluation of the restorations, there was a significant decrease in the postoperative sensitivity in all groups. A significant difference was detected in Carisolv and laser groups between 6-months and 12-months for marginal coloration. A significant difference was found between the conventional and laser groups between 6-months and 12-months in terms of color match. Conclusion: The success of restorations, efficacy and efficiency of the methods used in the evaluation of all groups were found to be successful. In terms of patient comfort, all alternative methods gave positive results.

Post operative pain assessment and pain management among patients undergoing cranioplasty

Pain assessment and pain management is the most crucial job of critical care nurses. Pain assessment and its management in patients undergoing cranioplasty, especially those with communication barriers, continue to present challenges to nurses in the critical care areas. The present study was undertaken to assess the level of post-operative pain suffered by patients after cranioplasty, to identify the activities that increases/relieve pain and to find out association between pain score of patients and selected variables. This study has used the following tools, a self-prepared validated questionnaire and Wong Bakers Faces pain scale. As per the findings, the post-operative pain was mild to moderate and decreased from first to third postoperative day. Patients Pain relief was adequate with the combination therapy of pain medications like non-narcotic analgesics and non-steroidal anti-inflammatory drugs. The study revealed that there was no significant difference between the pain perception and age or gender of the patient. It is found that the activities that increased pain were surgical dressing removal and patient’s position changing. Critical care nursing staff should focus on assessing and managing post-operative pain to improve quality of nursing care in order to improve the comfort of cranioplasty patients.

Evaluation of vincristine-induced peripheral neuropathy in children with cancer: Turkish validity and reliability study

BackgroundThe evaluation of peripheral neuropathy in children receiving Vincristine treatment is challenging. This study examined the Turkish validity and reliability of the Total Neuropathy Score-Pediatric Vincristine (TNS-PV) measurement tool, which can measure Vincristine-induced peripheral neuropathy symptoms in children with cancer. MethodsA total of 53 children aged 5–17 years who received Vincristine treatment in two pediatric hematology-oncology centers participated in the study. Data was collected using the Total Neuropathy Score-Pediatric Vincristine (TNS-PV), the Common Terminology Criteria for Adverse Events (CTCAE), the Wong-Baker FACES Pain Scale, and the Adolescent Pediatric Pain Tool (APPT). The correlation between the TNS-PV total score and other scales and the inter-rater reliability coefficient was evaluated. FindingsOf the children, 81.1% were diagnosed with ALL and 13.2% with Ewing Sarcoma. Cronbach's alpha values of form A and B of the TNS-PV scale were 0.628 and 0.639, respectively. As the cumulative Vincristine dose increased, the children's scores on TNS-PV were higher. A moderate and significant positive correlation was found between the TNS-PV form A total score and the worst subjective symptoms a, b (A), strength, tendon reflexes, and autonomic / constipation (r = 0.441, r = 0.545, r = 0.472, r = 0.536, p < 0.01). DiscussionThe TNS-PV form B total score was found to have a moderate level, significant correlation with CTCAE sensory neuropathy score and Wong-Baker FACES Pain Scale, and a high level, significant positive correlation with CTCAE motor neuropathy score. Application to practiceThe TNS-PV is valid and reliable for measuring Vincristine-induced peripheral neuropathy in practice in Turkish children 5 years and older.

Botulinum Toxin Type A for the Treatment of Auriculotemporal Neuralgia—A Case Series

Auriculotemporal neuralgia is a rare pain disorder in which anesthetic nerve blockade is usually effective but not always resolutive. Botulinum toxin type A has proven to be effective in treating neuropathic pain, and patients with auriculotemporal neuralgia could also benefit from this treatment. We described nine patients with auriculotemporal neuralgia treated with botulinum toxin type A in the territory of auriculotemporal nerve innervation. We compared the basal NRS and Penn facial pain scale scores with those obtained 1 month after BoNT/A injections. Both Penn facial pain scale (96.67 ± 24.61 vs. 45.11 ± 36.70, p 0.004; mean reduction 52.57 ± 36.50) and NRS scores (8.11 ± 1.27 vs. 4.22 ± 2.95, p 0.009; mean reduction 3.89 ± 2.52) improved significantly at one month after treatment. The mean duration of the effect of BoNT/A on pain was 95.00 ± 53.03 days and no adverse effects were reported.

A Descriptive Study to Assess Level of Stress, Anxiety, and Pain Among Hospitalized Children Admitted in the Pediatric Surgery Unit of APC, PGIMER, Chandigarh 2020−2022

Background Hospitalization is stressful for children. Hospitalized children suffer from stress due to the negative change in their life. Children facing medical procedures often experience pain and anxiety. Physical, psychological, social, cultural, and environmental factors all influence child behavior, which is especially challenging for children as compared to adults. Both pharmacological and non-pharmacological approaches can be used to manage distress among children. There are several ways to reduce stress, anxiety, and pain among hospitalized children. Puzzles, books, comics, crossword, video games, televisions, toys, phone, and so on. all are effective ways through which child can be engaged. Aim To assess the level of stress, anxiety, and pain among hospitalized children admitted in the Pediatric Surgery Unit, APC, PGIMER, Chandigarh, India. Methods A descriptive study was conducted on 60 hospitalized children. Purposive sampling was used to recruit the sample. The data were collected through interview schedule consisting of socio-demographic profile, clinical profile, and questionnaire on stress, anxiety and pain. Results The findings of the study revealed that all the children were having moderate stress, whereas majority of the children (91.7%) were having moderate anxiety, and only 8.3% of the children were having severe anxiety. During the assessment it was also found that almost 55% were having pain score 4, that is, Hurts little bit as assessed by Wong baker face pain scale. Conclusion Children who were being hospitalized were having varied degrees of stress, anxiety, and pain. Therefore, some diversional therapy should be planned to reduce their distress.

The effect of simultaneous rhinoplasty and septoplasty on the development of postoperative pain syndrome

Introduction. One of the most difficult goals in facial reconstructive surgery is to eliminate defects in the external nose. Difficulties may arise with simultaneous septo- and rhinopalasty, as there is a need to restore and preserve the structures of the nasal cavity. To date, there are not many studies that would be aimed at assessing the pain syndrome after surgery on the structures of the nose, which was the impetus for studying this problem. The purpose of the study. The purpose of this study was to study the severity of acute pain syndrome after septoplasty, rhinoplasty and rhinoseptoplasty. Materials and methods. A total of 98 patients, 19 men and 79 women, aged from 18 to 45 years, were examined and operated on. The open rhinoplasty group (group 1) included 6 men and 27 women, the open rhinoseptoplasty group (group 2) – 7 men and 26 women, and the septoplasty group (group 3) included 6 men and 26 women. To ensure premedication, all patients were prescribed 2 ml of 0.4% dexamethasone solution, 4 ml of 0.2% ondacetron solution. Preoxygenation of 100% O2 5-6 l/min was carried out with the help of an anesthetic mask. Induction of anesthesia was carried out with 20 ml (200 mg) of 1% propofol emulsion. To achieve myoplegia, a solution of ridelate C (50 mg) was administered. For anesthesia purposes, 2 ml of 0.005% fentanyl solution (0.1 mg) was administered intravenously. Infiltration anesthesia during rhinoplasty was carried out using a 2% solution. Local anesthesia was performed by intramuscular administration of a 50 mg ketoprofen solution before surgery, 24 and 48 hours after manipulation, as well as for 3 days after it, taking into account the severity of the pain syndrome. After performing rhinoplasty, septoplasty and rhinoseptoplasty, the severity of the pain syndrome was assessed using a visual analog scale (VAS), a digital rating scale (DRS) and facial pain scale (FPS 3, 6, 24, 48 hours after the end of surgery. Results. According to the VAS pain syndrome assessment, the pain intensity in group 1 was maximal one hour after rhinoplasty and subsequently had negative dynamics: on the 3rd, 6th (p&lt;0.001), 24th (p&lt;0.05) and 48th (p&lt;0.001) hours after surgery. In groups 2 and 3, the highest pain intensity was recorded at the 3rd hour after surgery (p&lt;0.001), compared with the hour after surgery. According to the DRS, the intensity of pain 3 hours after rhinoplasty in group 1 decreased, compared with his assessment 1 hour after surgery, and continued to decrease on the 3rd, 6th (p&lt;0.001), 24th (p&lt;0.01) and 48th hours (p&lt;0.001). In group 2, 3 hours after surgical manipulation, the intensity of the pain syndrome increased significantly compared to the previous period of its assessment (p&lt;0.05), which was also found in the group of patients after rhinoseptoplasty (p&lt;0.05) at the same time. Assessing the severity of the pain syndrome according to FPS, in group 1, the pain syndrome was insignificant and did not cross the threshold. In patients of groups 2 and 3, compared with the 1st hour after the interventions, pain syndrome significantly increased after 3 hours (p&lt;0.001), but subsequently decreased. Conclusion. Based on the analysis of acute postoperative pain syndrome, this study confirms that septoplasty is a more traumatic intervention compared to rhinoplasty, and surgical operations in the area of the external nose and on the nasal septum in the early postoperative period entail excalation of stress reactions, relative to rhinoplasty and septoplasty.

Psychometric evaluation of the electronic faces thermometer scale for pain assessment in children 8-17 years old: A study protocol.

It is often a challenge for a child to communicate their pain, and their possibilities to do so should be strengthened in healthcare settings. Digital self-assessment provides a potential solution for person-centered care in pain management and promotes child participation when a child is ill. A child's perception of pain assessment differs when it is assessed using digital or analog formats. As we move into the digital era, there is an urgent need to validate digital pain assessment tools, including the newly developed electronic Faces Thermometer Scale (eFTS). This study protocol describes three studies with the overall aim to evaluate psychometric properties of the eFTS for assessing pain in children 8-17 years of age. A multi-site project design combining quantitative and qualitative methods will be used for three observational studies. Study 1: 100 Swedish-speaking children will report the level of anticipated pain from vignettes describing painful situations in four levels of pain and a think-aloud method will be used for data collection. Data will be analyzed with phenomenography as well as descriptive and comparative statistics. Study 2: 600 children aged 8-17 years at pediatric and dental settings in Sweden, Denmark, Iceland, and USA will be included. Children will assess their pain intensity due to medical or dental procedures, surgery, or acute pain using three different pain Scales for each time point; the eFTS, the Faces Pain Scale Revised, and the Coloured Analogue Scale. Descriptive and comparative statistics will be used, with subanalysis taking cultural context into consideration. Study 3: A subgroup of 20 children out of these 600 children will be purposely included in an interview to describe experiences of grading their own pain using the eFTS. Qualitative data will be analyzed with content analysis. Our pilot studies showed high level of adherence to the study procedure and rendered only a small revision of background questionnaires. Preliminary analysis indicated that the instruments are adequate to be used by children and that the analysis plan is feasible. A digital pain assessment tool contributes to an increase in pain assessment in pediatric care. The Medical Research Council framework for complex interventions in healthcare supports a thorough development of a new scale. By evaluating psychometric properties in several settings by both qualitative and quantitative methods, the eFTS will become a well-validated tool to strengthen the child's voice within healthcare.