Lower Pain Levels Research Articles

Postoperative Pain Comparison Between Alcohol-Assisted and Transepithelial Photorefractive Keratectomy Using Nepafenac Treatment: A Novel Study.

The study aimed to compare postoperative pain between alcohol-assisted and transepithelial photorefractive keratectomy in patients who received the novel analgesic preoperative nepafenac treatment 2days preoperatively and 3days postoperatively. Pain, stinging, tearing, light sensitivity, and stress levels were evaluated. The study included a retrospective analysis of 55 patients divided into two groups: bilateral alcohol-assisted photorefractive keratectomy (aa-PRK) and transepithelial photorefractive keratectomy (transepithelial-PRK). Nepafenac was administered for pain control for all patients, with patients receiving four drops for 2 days before the surgery and 3 days postoperatively per clinical instructions. Patients completed questionnaires on the day of the surgery and for the first 5 days postoperatively. Statistical analysis was performed using XLSTAT (version 2023.1.2). t-Test was used to analyze and compare pain and symptom levels and Fisher's exact test for categorical data. p-Values less than 0.05 were considered statistically significant. The study examined 55 patients (49% female) with a mean age of 25.11 ± 6.81years who had undergone bilateral surface refractive surgery to correct myopic errors. The mean baseline standard error (SE) was -3.16 ± 2.20 D. Among these patients, 27 patients underwent aa-PRK and 28 patients underwent transepithelial-PRK. Higher levels of pain were significant in the aa-PRK group (p = 0.003). However, there was no significant difference between the groups in the average levels of stinging, tearing, or light sensation. Additionally, stress levels decreased over time in both groups, with levels becoming almost equal after 5 days, and there was no significant difference in the average stress levels between the two groups. The study found that patients who underwent the transepithelial-PRK procedure had significantly lower pain levels compared with those who underwent aa-PRK after being treated with nepafenac per protocol. However, there was no significant difference between the two groups in terms of stinging, tearing, light sensation, and stress levels.

The functional outcomes of tibia fractures treated with intramedullary tibia nail: A retrospective study

Background: The tibia nailing system is a type of implant used to stabilize a broken tibia bone. It is intended for long bone fracture fixation of tibia fractures, which include transverse, oblique, spiral, segmental, comminuted fractures, open and closed fractures etc. There is different nailing system available each with its own advantages and limitation. The type of system that is used will depends on the severity of the fracture, location of the fracture and the patient individual anatomy. In this study the Tibia Nail was to treat the fracture. Materials and Methods: Total 14 patients having age ranging from 26-57 years were treated by Tibia nails. Retrospective analysis of patients who underwent Tibia nail fixation having tibial shaft fractures was performed. Clinical evaluation was done for all patients with a mean follow-up of 1.5 years. Radiological images taken at the follow up after surgery were utilised to assess the outcome. VAS Score was used for analysis. Results: The patients that are included in the current study were available for evaluation after a mean of 12 months of follow-up. Radiological union in all patients were achieved in 6.1-7.2 weeks. Apart from this, the patients stay in clinical hospital for the 12.2 days of mean duration. The result reveals that overall, VAS Score at the final follow up was satisfactory. In addition, the full weight-bearing with low level of pain was reported after 9-12 month of surgery. Conclusion: The tibia nail is an effective treatment of fractures of the tibia bone.

Evaluating the Success of Revision Spine Surgery in Patients with Failed Back Surgery Syndrome: A Prospective Study

Background: Failed Back Surgery Syndrome poses a significant challenge due to persistent pain following spinal surgery, greatly affecting patient quality of life and healthcare resources. Objective: This study aims to evaluate the effectiveness of revision spine surgery in FBSS patients, identifying key predictors for improved clinical outcomes. Method: A prospective study was conducted at a tertiary-level hospital in Bangladesh, involving 98 FBSS patients undergoing revision spine surgery from June 2020 to June 2023. Outcome measures included pain reduction (Visual Analog Scale), functional improvement (Oswestry Disability Index), and patient-reported quality of life. Result: Six months post-surgery, 74% of patients experienced clinically significant pain reduction (>50% on VAS), while 63% showed notable functional improvement with a reduction in ODI scores of over 40%. Quality of life improved for 68% of patients, with 25% reporting a complete return to daily activities. Among surgical types, decompression led to a 58% improvement in mobility, while fusion procedures resulted in a 70% pain reduction. However, 12% of patients reported little to no improvement, and 5% experienced worsened symptoms, underscoring the variability in outcomes. Predictive success factors included shorter intervals between surgeries and lower initial pain levels (p < 0.05). Overall, revision surgery was beneficial for the majority, but not all patients achieved desired outcomes. Conclusion: Revision spine surgery in FBSS patients can lead to significant improvements, though outcomes vary. Identifying predictive factors is essential to guide surgical planning and enhance patient selection.

Assessment of Clients' Perceptions and Satisfaction With Eyebrow Mesotherapy Treatment.

Eyebrows significantly influence facial aesthetics and are often linked to attractiveness and personality. Eyebrow loss and alopecia impact physical and psychological well-being. Several treatments, including mesotherapy (MT), aim to enhance eyebrow density and quality. Despite the availability of MT for hair growth, its application in eyebrow revitalization is less explored. This study evaluates clients' perceptions and satisfaction with eyebrow MT (EB MT) using AQ skin solutions' growth factor-based MT cocktail serum. Thirty-two healthy women (ages 21-55) with thin or weakened eyebrows underwent three EB MT sessions spaced 2-4 weeks apart. Exclusion criteria included chronic diseases, allergies, and conditions like pregnancy. Each session lasted about 40 min, and "point by point" and "nappage" techniques were employed. Satisfaction and pain levels were assessed through a Numeric Rating Scale for Satisfaction (NRSS) and Pain scale, while photographic analysis and the Global Aesthetic Improvement Scale (GAIS) evaluated effectiveness. The average GAIS score was 8.28, while the NRSS satisfaction score was 8.06. Pain levels were moderately low, averaging 4.0. A high majority (90.6%) were satisfied and willing to continue treatment, with 100% recommending EB MT to others. Notable improvements in overall appearance were reported by participants. EB MT demonstrated high satisfaction and low pain levels, with significant improvements in eyebrow density and appearance. This treatment is a practical option for eyebrow enhancement with a strong safety profile, motivating further clinical application.

Pain Relief Survivorship: A Comparison of Exactech Equinoxe Anatomic and Reverse Total Shoulder Arthroplasty for Primary Osteoarthritis

BackgroundPain-relief plays a major deterministic role when assessing postoperative patient satisfaction; however, whether anatomic total shoulder arthroplasty (aTSA) or reverse total shoulder arthroplasty (rTSA) provides the most durable pain-relief has not been studied. The purpose of this study was to evaluate the durability of pain-relief after aTSA compared to rTSA in patients undergoing surgery for rotator cuff-intact glenohumeral osteoarthritis (RCI-GHOA). MethodsA retrospective review of a multicenter shoulder arthroplasty database (Exactech Equinoxe) was performed. We included 1,848 aTSAs and 1,464 rTSAs performed for RCI-GHOA between 2007 and 2023. Pain after surgery was assessed postoperatively at 3-months, 6-months, and yearly thereafter. Average postoperative pain on a daily basis and pain at worst were compared between aTSA and rTSA up to 8-years postoperatively. Kaplan-Meier survivorship analysis for pain-relief maintenance was performed to compare the maintenance of clinically-relevant pain-relief defined as pain scores that achieved the minimal clinically important difference (MCID), substantial clinical benefit (SCB), and patient acceptable symptomatic state (PASS). Maintenance of favorable patient satisfaction over time was also evaluated. Multivariable cox regression was performed to determine whether the type of prosthesis (aTSA vs. rTSA) was independently associated with pain recurrence. ResultsMaintenance of achievement of the MCID and SCB for both daily pain and pain at worst as well as favorable patient satisfaction was similar between aTSAs and rTSAs. However, aTSA had longer maintenance of average daily pain below the PASS compared to rTSA (P=.024). This was confirmed on multivariable cox regression analysis which found that rTSAs had a 34% greater likelihood of recurrence of postoperative average daily pain exceeding the PASS (VAS rating 1/10) compared to aTSAs. ConclusionPatients that undergo either aTSA or rTSA for RCI-GHOA and achieve initial pain-relief postoperatively can expect to maintain their clinically-relevant pain improvement at similar rates up to 8-years postoperatively. However, recurrence of low levels of daily pain was significantly higher after rTSA.

Assessing The Impact Of Surgical Approaches On Total HIP Replace-ment Outcomes: A Systematic Review

Total hip replacement is one of the most common and effective orthopedic surgical procedures to reduce pain and improve hip function in patients with severe conditions. This procedure has undergone many advances in the past few decades. However, there is debate among surgeons about which surgical approach is the most optimal to apply. This study aims to systematically assess and compare the outcomes of different surgical approaches in total hip replacement (THR) procedures. The method used in this study was a systematic literature review, in which literature was searched through academic databases such as PubMed, Scopus, and Google Scholar using relevant keywords. The collected data were then analyzed through three stages, namely data reduction, data presentation, and conclusion drawing. The results of this study show that each surgical method for total hip replacement has different advantages and disadvantages. The choice of surgical approach should be tailored to each patient's specific condition. Based on a review of the available literature, the anterior approach is often considered superior to the other approaches. The advantages include less surgical trauma, better postoperative pain reduction and a faster rehabilitation process. The anterior approach is considered safe, reliable and effective, and results in lower pain levels compared to other methods

Sling Results in Better Sleep Quality and Less Anxiety Early After Arthroscopic Rotator Cuff Repair: A Randomized Single-Blinded Trial.

Sleep disturbance is commonly reported by patients wearing an abduction brace after arthroscopic rotator cuff repair (ARCR). Although a sling has been proven noninferior to an abduction brace for function and repair integrity, there is no evidence-based medical support for the advantage of the sling in improving sleep quality compared with a brace. This study aimed to compare the effects of a sling and an abduction brace on sleep quality and clinical outcomes after ARCR. It was hypothesized that immobilization in a sling would result in better sleep quality while not deteriorating clinical outcomes and bone-tendon healing compared with an abduction brace. Randomized controlled trial; Level of evidence, 1. A total of 142 consecutive patients with rotator cuff tears were randomly assigned to 2 groups: (1) the brace group, receiving abduction brace immobilization for 6 weeks, and (2) the sling group, receiving sling immobilization after ARCR for 6 weeks. The primary outcome was the Pittsburgh Sleep Quality Index at 6 weeks postoperatively. Secondary outcomes-American Shoulder and Elbow Surgeons score, Self-rating Anxiety Scale, pain, satisfaction, and tendon healing (using ultrasonography)-were evaluated until 1 year postoperatively. Complete outcome measurements were obtained for 131 patients. The Pittsburgh Sleep Quality Index at 6 weeks was 11.1 ± 2.7 for the brace group and 9.2 ± 2.3 for the sling group (P < .001), indicating a statistically significant advantage for the sling group. The sling group also reported significantly lower Self-rating Anxiety Scale, lower pain level, and higher satisfaction scores at 6 weeks. No significant difference was observed in outcome measures between groups at 1 year. The tendon healing rates (91% vs 88%, respectively) were comparable between the brace and sling groups within the first 1 year (risk ratio, 1.03 [95% CI, 0.92-1.16]; P = .59). The use of a sling resulted in better sleep quality, less anxiety, and higher satisfaction compared with an abduction brace in the first 6 weeks after ARCR; nevertheless, functional outcomes and repair integrity were similar at 1 year postoperatively between the 2 groups. These findings indicate that a sling is appropriate for the postoperative care of ARCR. However, caution should be used when interpreting these results because the clinical relevance of sling-related benefits warrants further investigation. ChiCTR2200059967 (Chinese Clinical Trial Registry).

Applications of flexible ureteroscope lithotripsy with negative pressure suction and percutaneous nephrolithotomy in the treatment of 2-3cm diameter renal calculi.

Renal calculus, or kidney stone disease, presents a significant healthcare challenge globally, necessitating diverse therapeutic interventions. Percutaneous nephrolithotomy (PCNL) and flexible ureteroscope lithotripsy (FURL) are prominent among these interventions, with PCNL favored for stones > 2cm and FURL for smaller stones and applications of flexible ureteroscope lithotripsy with negative pressure suction for stones 1.5-2.5cm have some benefit. From June 2019 to January 2024, 310 patients undergoing FURL with negative pressure suction or PCNL for 2-3cm renal calculi were retrospectively analyzed. The demographic and clinical data were collected, and outcomes including stone-free rates (SFR), postoperative complications, and surgical parameters were compared. Comparable SFR were observed between FURL and PCNL groups at 1-month follow-up, although PCNL was superior to FURL after immediately post-surgery. FURL exhibited significantly fewer complications overall (5.7% vs. 19.3%, p = 0.044), shorter hospital stays, and lower postoperative pain levels. The surgical parameters favored FURL, showing lower bleeding volumes, shorter catheter removal times, and less hemoglobin decrease postoperatively. Despite similar stone clearance efficacy at 1-month follow-up, FURL demonstrated superior safety and postoperative outcomes compared to PCNL for 2-3cm renal calculi. These findings highlight the potential advantages of FURL in reducing complications, enhancing recovery, and optimizing patient care pathways.

Laparoscopic access is the modern standard for extended liver resection

Objective. To evaluate the safety and early results of laparoscopic extended liver resection in case of focal liver pathology by retrospective comparison with the relevant parameters of a similar open intervention. Materials and methods. The study involved 162 patients who were divided into two groups: Group 1 – 50 patients who underwent laparoscopic extended liver resection, and Group 2 – 112 patients who underwent open extended liver resection. The groups were compared by age structure, sex, body mass index, type of pathology (benign/malignant), as well as by characteristics of surgical intervention and postoperative period. Statistical analysis included a t–test for independent samples, Pearson's chi–square test, and other appropriate methods with the calculation of the confidence level p (parametric criterion). The difference in indicators was considered statistically significant at p &lt; 0.05. Results. Laparoscopic osshire for liver resection was longer (p = 0.0012), but was associated with a lower level of pain according to the visual analog scale (p = 0.02) and fewer bed days to discharge (p = 0.0007) than a similar open intervention. There was no statistically significant difference between the groups in terms of age structure, body mass index, number of liver tumors, blood loss, complication rate, and degree of ischemic liver damage. Conclusions. Laparoscopic extended liver resection is a less invasive method than open liver resection, and patients recover faster after it, although its duration is longer. At the same time, laparoscopic and open intervention had a similar incidence of complications, which indicates acceptable safety and high clinical efficacy of the laparoscopic approach in the treatment of patients with liver disease.

Kratom (Mitragyna speciosa) use for self-management of pain: Insights from cross-sectional and ecological momentary assessment data

Kratom (Mitragyna speciosa) is increasingly used in the US for self-management of pain, despite limited research on its efficacy and safety. To better understand how and why people use kratom for pain self-management, we analyzed baseline survey data (N = 395) and 15-day ecological momentary assessment (EMA) data (N = 357) from kratom consumers across the US. Although we recruited participants based on their kratom use, not on whether they used it for pain management, nearly half (49.1 %) met criteria for chronic pain, with many reporting substantial pain relief and high effectiveness of kratom in managing pain. A majority (69.2 %) reported difficulties in obtaining adequate pain treatment, and most indicated that these challenges impacted their decision to try kratom. Most participants did not report concerns about overuse or significant side effects. EMA data showed that, regardless of chronic-pain status, pain relief was the most frequently endorsed primary motivation for daily kratom use. There were no significant association between daily pain levels and kratom use frequency, and no difference in the daily kratom use between those with vs. without chronic pain. Recent kratom use was associated with lower current pain levels. Stronger subjective effects of kratom were associated with lower pain levels. This effect was significantly moderated by chronic-pain status: those with chronic pain showed a stronger link between subjective kratom effects and pain reduction. These findings underscore the urgent need for systematic, rigorous research on long-term implications, efficacy, and safety of kratom in pain management to guide informed clinical practices and regulatory policies. PerspectiveThis study reveals that chronic pain is common among kratom consumers, who frequently use it for pain self-management and report significant relief, as shown by ecological momentary assessment. There is an urgent need for research into kratom's safety, efficacy, and mechanisms to guide clinical practice and inform policies.

Comparison of Samfilcon A and Balafilcon A Bandage Contact Lenses in Reducing Postoperative Symptoms After Pterygium Surgery.

To compare differences in postoperative pain, foreign body sensation, photophobia, and lacrimation between balafilcon A and samfilcon A bandage contact lenses (BCLs) in the early stage following pterygium surgery. A total of 66 eyes with pterygium conjunctival grafts fixed with sutures were included in this study, comprising 32 eyes fixed with samfilcon A and 34 eyes fixed with balafilcon A. Demographic data, postoperative corneal epithelialization time, and subjective discomfort, such as pain (using the visual analog scale [VAS]), were recorded and compared. Significant differences were noted in VAS scores between the first day (P<0.01) and the second day post-surgery (P=0.03), suggesting that patients experienced less pain after wearing samfilcon A. However, no significant differences were observed in corneal epithelialization time, VAS score before lens removal, foreign body sensation, photophobia, lacrimation, insomnia, and demographic data between the two groups. Finally, only two balafilcon A patients required nonsteroidal analgesics. After pterygium surgery, samfilcon A BCL was associated with lower pain levels compared with balafilcon A BCL and could assist in reducing postoperative discomfort in patients and concurrently improving patient satisfaction.

Bromelain based enzymatic debridement in burn patients, its outcome, advantages and disadvantages

The aim of this study is to evaluate the outcomes, advantages, and disadvantages of bromelain-based enzymatic debridement in the management of burn wounds. Ours is a study in which we have selected 10 patients with deep dermal and full thickness burns admitted in SMS hospital, Jaipur. These patients underwent bromelain based enzymatic debridement applied as per the manufactures protocol. The patients were then observed for bromelain’s efficacy in debridement, wound healing, pain, duration of hospital stay, superadded bacteraemia and cosmetic outcome. Complete removal of burn eschar was observed in 9 out of 10 patients. Bromelain-based enzymatic debridement effectively removed necrotic tissue within a shorter timeframe compared to traditional methods. Patients treated with bromelain-based enzymatic debridement showed significantly faster wound healing, reduced infection rates, and lower pain levels during debridement. Improved cosmetic outcomes, such as reduced scarring and better skin texture, were also observed. Bromelain-based enzymatic debridement offers notable advantages in burn care, including expedited healing and enhanced patient comfort. Despite these benefits, the treatment's higher cost and the risk of allergic reactions are important considerations. The limited availability of bromelain-based products also poses a challenge. These factors suggest that while bromelain is a promising alternative, its use should be carefully evaluated based on individual patient needs and resource availability.

Factors Associated with Axial Spondyloarthritis Remission in a Cohort of Saudi Patients with Longstanding Disease: A Multicenter Prospective Cohort Study.

Earlier treatment in axial spondyloarthritis (axSpA) was proposed to alter disease prognosis in this often-challenging condition. We aimed to assess the proportion of patients and prognostic factors associated with axSpA remission. The aim was to determine the number of patients with Ankylosing Spondylitis Disease Activity Score with C-reactive protein (ASDAS-CRP) of <2.1 (inactive/moderate disease activity). We also evaluated global functioning and health using the Assessment of Spondyloarthritis International Society-Health Index (ASAS-HI). Patients with axSpA who were receiving targeted synthetic/biological disease- modifying anti-rheumatic drug (ts/bDMARDs) treatments and visited the rheumatology units at two tertiary-care centers between December 2021 and December 2022 were prospectively interviewed. Data regarding patient demographics, disease features, active and previous ts/bDMARDs treatments, and disease activity scores were obtained. Patients were assessed using the ASDAS- CRP, ASDAS-erythrocyte sedimentation rate (ASDAS-ESR), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and ASAS-HI. Overall, 60 patients with axSpA were included in this study (women, n = 35); 25 (41.7%) and 36 (62.1%) achieved an ASDAS-CRP of <2.1 and an ASAS-HI of ≤5 (good health), respectively. Out of the 60 patients, 75% (n = 45) were treated with anti-tumor necrosis factor. Factors associated with achieving the target ASDAS-CRP included age (p = 0.019), sex (p = 0.015), employment status (p = 0.015), education level (p = 0.030), and the number of previous ts/bDMARDs treatments (p = 0.019). Additionally, the ASDAS-CRP strongly correlated with spinal pain and moderately correlated with the ASAS-HI, BASDAI, and the number of previous ts/bDMARDs treatments. Remission was observed in 41.7% of patients, indicating a challenge in achieving target disease activity. However, 62.1% attained good health. Achieving remission was associated with younger age, male sex, a higher level of education, lower level of spinal pain, better global function by ASAS-HI, employment, and receiving their first ts/bDMARDs treatment. Our findings may potentially improve disease prognosis with the earlier use of ts/bDMARDs in those without favorable features by implementing an early axSpA intervention strategy.

Comparison of Preoperative and Postoperative Ultrasound-Guided Caudal Block Analgesia for Lower Limb Surgeries in Pediatrics: A Randomized Controlled Trials

Background: Evaluating pain after surgery is particularly important in children due to their limited ability to communicate effectively. The intensity, duration, and threshold of pain make it challenging to assess in this age group. Objectives: The aim of this study was to compare the effects of ultrasound-guided caudal block at different timings on children's pain and drug consumption during unilateral knee osteotomy surgery. Methods: In a randomized clinical trial, fifty patients were randomly included in the study. The patients were children aged 2 - 6 years, candidates for unilateral osteotomy surgery under general anesthesia with total IV anesthesia (TIVA). The patients were divided into two groups based on the timing of the caudal block: The first group received the block after induction, and the second group received it after surgery and before extubation. Results: There was no statistically significant difference between the two groups in terms of the average amount of Propofol and narcotic consumption during recovery at different time points (P &gt; 0.05). However, significant differences in pain levels were observed during the operation at 60 minutes (P-value &lt; 0.001) and 120 minutes (P-value = 0.006) between the two groups. Pain scores at the start of recovery and at 2, 4, 6, 12, and 24 hours postoperatively were significantly lower in the second group than in the first group. Additionally, the mean difference in Bispectral Index (BIS) at 60 minutes between the two groups was significant (P-value = 0.003), but there was no significant difference at 120 minutes (P-value = 0.896). The second group consistently had significantly lower pain levels than the first group at all times. Conclusions: Based on the results of this study, patients who received a caudal block had lower pain scores, and performing the block before extubation had more beneficial effects on postoperative pain management in children undergoing osteotomy surgery than performing it after induction.

Impact of computed tomography/magnetic resonance imaging registration on rehabilitation after percutaneous endoscopic decompression for lumbar stenosis: Retrospective study.

Percutaneous endoscopic lumbar decompression (PELD) shows promise for lumbar spinal stenosis (LSS) treatment, but its use is limited by the disease's complexity and procedural challenges. In this study, the effects of preoperative planning and intraoperative guidance with computed tomography (CT)/magnetic resonance imaging (MRI) registration techniques on PELD for LSS and postoperative rehabilitation outcomes were evaluated. This retrospective study was conducted with data from patients who underwent PELD for LSS between January 2021 and December 2023. Patients were assigned to preoperative CT/MRI registration and control groups. Data collected included the operative time, length of hospital stay, visual analog scale (VAS) scores for low back and leg pain, and the Japanese Orthopaedic Association (JOA) lumbar spine score. Differences between groups were assessed using Student's t test. Data from 135 patients (71 in the CT/MRI registration group, 64 in the control group) were analyzed. The operative time was significantly shorter in the CT/MRI registration group (P = 0.007). At 2 months postoperatively, both groups showed significant reductions in VAS leg and low back pain scores (all P < 0.001) and improvements in the JOA score (both P < 0.001). No complication or death occurred. Preoperatively, pain and JOA scores were similar between groups (P = 0.830, P = 0.470, and P = 0.287, respectively). At 2 months postoperatively, patients in the CT/MRI registration group reported lower leg and low back pain levels (P < 0.001 and P = 0.001, respectively) and had higher JOA scores (P = 0.004) than did patients in the control group. Preoperative CT/MRI registration for PELD for LSS reduced the operative time and VAS pain scores at 2 months and improved JOA scores, demonstrating enhanced effectiveness and safety.

Efficacy and safety of multidrug cocktail injections in postoperative pain management for lumbar microendoscopic decompression surgery: a prospective randomized controlled trial.

This study aimed to evaluate the analgesic effects and safety of multidrug cocktail injections for postoperative pain management in patients undergoing lumbar microendoscopic decompression surgery. A prospective randomized controlled trial was conducted with 70 patients who underwent lumbar microendoscopic decompression surgery between December 2023 and May 2024. Patients were randomly assigned to receive either a multidrug cocktail injection (cocktail group, n = 35) or no cocktail injection (non-cocktail group, n = 35). Primary outcomes included scores of the numerical rating scale (NRS) for pain from postoperative days 1 to 7 and the number of analgesics used within the first 3 postoperative days. Secondary outcomes included sex, age, body mass index, preoperative diagnosis, surgical levels, duration of surgery, blood loss, C-reactive protein (CRP) levels on postoperative day 1, and drain output. The cocktail group experienced significantly lower pain levels from postoperative days 1 to 7 (p < 0.05) and used fewer analgesics within the first 3days (p = 0.01) compared with the non-cocktail group. Additionally, the cocktail group had significantly lower CRP levels (p < 0.001) and a shorter hospital stay (p = 0.01). No significant differences were observed in the duration of surgery, blood loss, or drain output between the groups. Multidrug cocktail injections are effective and safe for postoperative pain management in lumbar microendoscopic decompression surgery, significantly reducing pain, analgesic use, CRP levels, and hospital stay. These findings suggest that incorporating multidrug cocktail injections into postoperative care protocols can enhance patient recovery and outcomes.

Comparison of spring ankle braces versus splints and casts in treating ankle sprains in patients diagnosed with ankle sprains

BackgroundVarious treatment approaches for individuals with ankle sprains can reduce treatment costs and enhance recovery. This study aimed to compare the efficacy of spring ankle braces with splints and casts in treating ankle sprains.Materials and methodsThis cross-sectional study involved 60 patients diagnosed with ankle sprains at the orthopedic clinic of Imam Khomeini Hospital in Jiroft in 2022. Following diagnosis confirmation through additional examinations and imaging, patients with ankle sprains not requiring surgery were selected and placed in two groups: one treated with spring ankle braces and the other with splints or casts. Both groups underwent a 4-week treatment regimen, comprising 30 individuals each. Data were collected and analyzed using SPSS version 26.ResultsThe average age of patients was 32.5 ± 13.4 years. Of the ankle sprain patients, 56.7% were male. Patients reported the highest satisfaction levels with the plaster cast treatment method. A statistically significant relationship was found between patient satisfaction and the treatment methods of spring ankle braces and plaster casting (P < 0.05). Patients treated with plaster casts reported the lowest pain levels, with a significant relationship between pain levels and the two treatment methods (P < 0.05). Range of motion results were similar for both treatment methods, while the cast treatment showed the highest incidence of skin complications. A significant relationship was observed between spring ankle braces and plaster casts regarding skin complications (P < 0.05).ConclusionTreating ankle sprains with plaster casts leads to higher satisfaction and lower pain levels compared to using spring ankle braces.

Associations between pain-related fear and lumbar movement variability during activities of daily living in patients with chronic low back pain and healthy controls

Low back pain (LBP) is a global issue involving biological, psychological, and social factors. Pain-related fear has been shown to influence movement behavior, however, its association with some measures of movement behavior, such as spinal movement variability, remains inconclusive. To further investigate this, spinal kinematics during various activities of daily living (i.e., walking, running, lifting, and stair climbing) of 49 patients with chronic LBP and a group of 51 sex-, age-, and BMI-matched healthy controls were used to calculate lumbar spine movement variability which was quantified using different indices (i.e., coefficient of variation, coupling angle variability in vector coding, deviation phase of the continuous relative phase and an angle-angular velocity variability). General and task-specific pain-related fear was assessed using the Tampa Scale of Kinesiophobia and the Photograph Series of Daily Activities—Short Electronic Version, respectively. Linear regression analyses showed no significant association between movement variability and pain-related fear, however, the sample consisted of younger individuals with moderate disability and with low levels of pain and pain-related fear. In addition, the different variability indices were weakly correlated and varied greatly depending on the method used and the task performed. Therefore, comparisons between studies with different movement variability calculation methods or different activities should be treated with caution.

Examining the relationships between pain, activities of daily living, and perceptions of overall health in older adults with breast cancer: Results from a brief geriatric screening.

273 Background: Geriatric assessment has been identified as an essential component to caring for patients with cancer who are over 65 years old. Prior research suggests that physical pain and illness perceptions each impact important health behaviors. This retrospective study utilized a brief geriatric screen to examine the relationships between pain levels, activities of daily living (ADLs), and perceptions of overall health for older adults with breast cancer. Implications for methods to improve the patient experience for this population are considered. Methods: The Senior Adult Oncology Program (SAOP) screening tool was administered to 429 patients age 65 or older at a breast oncology clinic. A total ADL score was computed by summing patient-reported responses to 13 ADL items, such as ability to dress oneself, feed oneself, and remember to take medications. A higher ADL score indicates greater difficulty with these responsibilities. Pain was assessed using a 10-point scale; scores were dichotomized to form a low-pain group (scores 0-4) and high-pain group (scores 5-10). Overall Health was assessed on a 1-10 scale, with higher scores indicating perceptions of greater health. Demographic and medical information was abstracted from patients’ electronic health records. Independent samples t-tests examined differences between the high-pain and low-pain groups in total ADL score and self-assessed Overall Health. Results: The average age of the sample was 76 years old (range = 65-89 years). Approximately half of the sample identified as White (48%); 20% identified as Black. In comparing the high-pain and low-pain groups, the high-pain group reported significantly greater difficulty with ADLs (M score = 3.25, 1.41, respectively; p=.026). Additionally, patients endorsing high pain levels reported significantly worse Overall Health as compared to patients endorsing low levels of pain (M= 7.50, 6.11, respectively; p=.001). Conclusions: Older adults with breast cancer experiencing high levels of pain demonstrated greater difficulty with ADLs and worse perceptions of overall health. It is critical that pain is assessed early and often for older adults with breast cancer. Early identification of high pain levels in this population could allow those in need to receive pharmacological and/or behavioral treatments for pain, which may maintain stability or promote improvement in ADLs and perceptions of one’s health. Incorporating brief pain assessments into future geriatric screening tools could improve the process of aging during and after breast cancer.

Pain Perception, Knowledge, Attitude, and Diet Diversity in Patients Undergoing Fixed Orthodontic Treatment: A Pilot Study.

This study aimed to determine the correlation between pain perception and knowledge, attitude, and diet diversity in patients undergoing fixed orthodontic treatment. A total of 103 patients (15-40 yrs.; 67 females, 36 males) undergoing orthodontic treatment with a 0.022-inch slot (MBT prescription) in both arches were recruited. Information on pain perception, knowledge, attitude, and diet diversity scores was collected through validated questionnaires using visual analogue scale and close-ended questions at one time point. The correlation between variables was analyzed using the Pearson's correlation coefficient. Of the patients, 48.5% were aged 15 to 19 years old, with 65% females and 73.8% of Chinese ethnicity. Approximately 90% of the orthodontic patients perceived low levels of pain from orthodontic treatment, and 98% had a positive attitude toward orthodontic treatment. The patients had a good level of knowledge (Mean: 6±0.65). Approximately 49.5% of patients reported having moderate diet diversity. No significant correlation was found between pain perception and knowledge, or pain perception and diet diversity (r=0.062, p=0.534). However, a significant weak negative correlation (r=-0.289, p<0.05) between pain perception and attitude was observed. Patients undergoing fixed orthodontic treatment presented with overall low pain perception, a positive attitude, and good knowledge about their treatment with moderate diet diversity. Informing the patient in advance about different orthodontic procedures encourages a positive attitude and facilitates patient cooperation. An interprofessional approach involving nutritionists can provide a holistic patient approach during orthodontic treatment.