McGill Scale Research Articles

Comparison of photobiomodulation with cryotherapy in the immediate postpartum period of parturients with grade I, grade II lacerations and/or episiotomy in reducing perineal and vulvar and edema: A randomized clinical trial

IntroductionVaginal delivery has several benefits for the parturient; however, during labor, some injuries, such as lacerations and/or episiotomy, can occur. Perineal pain may occur in the puerperium and can be aggravated in cases of perineal injury during childbirth, potentially impacting the physical and emotional aspects of the parturient. For this reason, it is necessary to use techniques that can relieve pain and edema in the immediate postpartum period, directly influencing recovery. ObjectiveTo compare the reduction of pain and improvement in healing using two techniques, namely photobiomodulation and cryotherapy, performed in the immediate postpartum period of up to 12 h, in parturients who suffered grade I and II lacerations and/or episiotomy. MethodsData collection was carried out through an evaluation questionnaire. Photobiomodulation was applied using the red and infrared laser from the DMC brand. The EVA and McGill scales were used for pain assessment, and the REEDA scale was used for the evaluation of edema and healing. ResultsThe techniques were evaluated and applied to 56 patients, with 28 in each group (cryotherapy and LBI). Patients who received photobiomodulation showed superior improvement compared to cryotherapy. In the immediate postpartum period, there was a greater reduction in pain in favor of photobiomodulation (p = 0.008); and after 24 h, the difference was even more significant (p < 0.001).

Analysis of modified ilib therapy in patients submitted to plastic surgery.

The sample comprised 44 volunteers who had undergone some surgical procedure and were equally divided into four groups. G1 started the therapy 24h after the surgical procedure with the device off. G2 followed the same time pattern, 24h, but with the device turned on. G3 and G4 started therapy three days after the surgical procedure; in G3, the device was turned off, and in G4, the device remained on during therapy; each session lasted 30min, using 660nm (red), energy 180J. For all groups, the therapy started with daily use for seven days and followed the interval use of three times a week until completed 21days. The revaluation was performed after 7 and 21days.The results found show changes in HR at rest, systolic and diastolic BP, and in peripheral oxygen saturation, which showed a significant difference in the groups that used on-therapy (p < 0.05). In the MCGILL Scale evaluation, the mean total score showed a more accentuated drop in the groups that used ILIB, (p < 0.05). ILIB may have prevented a more significant evolution of firosis levels; however, no changes were observed in the evaluation of sleep and anxiety.The application of the ILIB in patients undergoing plastic surgery was supported in terms of hemodynamics and pain; in addition, starting the ILIB application 24h after the procedure proved to be more advantageous.

Effectiveness of 780 nm photobiomodulation as adjunct treatment for bone exposed fractures: A pilot study on radiograph, pain, and cytokines analysis.

The aim of this study was to evaluate the effectiveness of photobiomodulation with a 780 nm laser as an adjunct to surgical treatment in the regeneration of bone fractures. Twenty patients diagnosed with open fractures in the lower limbs were selected and randomly divided into two groups: control and LLLT. LLLT parameter: 780 nm, 0.04 cm2 of light beam diameter, 40 mW of power, 10 s per point, 0.4 J of energy, fluence of 10 J/cm2 and irradiance of 1 W/cm2. The evaluated data were: pain, using McGill scale, use of analgesics and anti-inflammatories, levels of cytokines TNF-α, IFN-γ, IL-1β, IL-10, and IL-17, and bone level regeneration. Data were analyzed using Wilcoxon and Mann-Whitney tests (5%). We can conclude that LLLT was effective as an adjuvant in the bone fracture regeneration process, altered IL-1β levels, reduced the use of analgesics and anti-inflammatories, reducing the pain pattern throughout the sessions.

Evaluating The Effects of Fine Cooperation Program and Doctor-Nurse Integration on Patients with Chronic Wounds

Objective: This study aimed to evaluate the effects of fine cooperation program of doctor-nurse integration on wound healing, patient???s psychological state and pain degree of patients with chronic wounds. Methods: A total of 100 patients with chronic wounds who were treated with conventional wound management from March 2016 to December 2018 were enrolled as a control group, while another 100 patients with chronic wounds who were treated with the fine cooperation program of doctor-nurse integration during January to October 2020 were selected as an observation group. Nursing satisfaction, general conditions (waiting time for dressing change, hospitalization time, and wound healing time) and wound healing grade were observed, and the pain degree (scored by the simplified McGill scale) and psychological state [evaluated by Self-rating Depression Scale (SDS) and Self-rating Anxiety Scale (SAS)] were compared between before intervention and on Day 5 of intervention. Results: The nursing satisfaction was higher and the waiting time for dressing change, hospitalization time and wound healing time were shorter in the observation group than those in the control group (P&lt;0.05). On Day 5 of intervention, the present pain intensity, Visual Analogue Scale, pain rating index, SDS and SAS scores are seen declined in both groups compared with those before intervention, and they were lower in the observation group than those in the control group (P&lt;0.05). The observation group had a higher wound healing grade than that of the control group (P&lt;0.05). Conclusion: The fine cooperation program of doctor-nurse integration can shorten the waiting time for dressing change and hospitalization time.

Assessment of postoperative pain in patients undergoing temporomandibular joint arthroscopy with infiltration of dexamethasone disodium phosphate in different concentrations. A randomized controlled trial

The main aim of this work was to evaluate the effect of intra-articular, sub-synovial steroid injections (IASSSI) with different doses during temporomandibular joint (TMJ) arthroscopy. Using a single-blind, randomized clinical trial, the investigators enrolled a sample of subjects who underwent TMJ arthroscopy with vs. without IASSSI for treating TMJ disorder (TMD). The predictor variable was the treatment group classified as no treatment (A - without IASSSI) or active treatments (IASSSI (B) with 2 mg or (C) 4-mg dexamethasone). Study medications were randomly assigned. Only subjects were blinded to treatment assignment. The main outcome variables included the following: 1) pain assessed up to postoperative day 30 with the McGill Pain Questionnaire and visual analog scale (VAS); 2) maximum mouth opening (MMO); and 3) analgesic and anti-inflammatory drug consumption. Other variables were demographic (age, sex) or pathologic (disease manifestations and classifications). Descriptive and bivariate statistics were computed. Statistical significance was set at p ≤ 0.5, one-tailed test of hypothesis. The sample comprised 36 patients (n = 12 per study group). In the active group with 4 mg corticosteroids, pain reduction measured by VAS (odds ratio [OR] = 0.18; p = 0.013) and McGill scale scores (OR = 0.15; p = 0.048) was significantly higher than in the control group. The McGill scale scores significantly decreased in both IASSSI groups, compared to the control group, at the final follow-up (all p < 0.012), and IASSSI was significantly associated with reduced analgesic consumption at postoperative days 7 and 14 (p = 0.003). However, there was no significant difference regarding MMO among the three groups. Within the limitations of the study, it seems that intra-articular, sub-synovial steroid injections (IASSSI) with 4 mg dexamethasone should be preferred whenever appropriate when pain relief is the priority of the procedure.Brazilian Registry of Clinical Trials (ReBec)- 28yb2g

ARE THERE DIFFERENCES IN CHRONIC PAIN AFTER LAPAROSCOPIC INGUINAL HERNIA REPAIR USING THE TRANSABDOMINAL TECHNIQUE COMPARING WITH FIXATION OF THE MESH WITH STAPLES, WITH GLUE OR WITHOUT FIXATION? A CLINICAL RANDOMIZED, DOUBLE-BLIND TRIAL.

ABSTRACTBACKGROUND:Regarding postoperative pain, it remains unclear whether non-fixation of the polypropylene prosthesis in transabdominal preperitoneal inguinal hernia repair produces the same outcomes as mesh fixation with glue or tackers. In addition, hernia recurrence is another aspect to be assessed in the comparison between non-fixation and mesh-fixation techniques (tackers and glue).AIMS:This study aimed to evaluate the incidence, quality of pain, and recurrence in patients undergoing laparoscopic inguinal hernioplasty (transabdominal preperitoneal) technique, comparing the fixation of the mesh with tackers versus with glue versus without fixation.METHODS:This is a prospective, double-blind study in which 63 patients presenting with primary unilateral inguinal hernia underwent laparoscopic transabdominal preperitoneal inguinal hernia repair and were randomized into three groups: no mesh fixation (n=21), mesh tacked (n=21), and mesh fixed with fibrin glue (n=21). Patients also responded to questionnaires in order to assess pain and pain quality and were followed up for 2 years.RESULTS:Neither mesh-fixation nor non-fixation techniques were found to affect postoperative chronic pain (p=0.535), but patients undergoing tacker fixation reported more pain descriptors (p=0.0021) and a higher pain index (p=0.002) on the McGill scale in the first 15 postoperative days (T0 and T1). No hernia recurrences were observed.CONCLUSIONS:Both mesh-fixation techniques (tackers and glue) used with the transabdominal preperitoneal approach did not influence the onset of inguinodynia, but tacker fixation was more likely to increase patient sensitivity to pain. Mesh placement without fixation produced the same pain and recurrence outcomes as mesh-fixation techniques. Also, no recurrence was observed in patients without mesh fixation in this study. Consequently, it has become an alternative therapy deserving consideration for hernia repair.

THE ROLE OF COMORBIDITY IN THE CLINICAL COURSE AND QUALITY OF LIFE OF PATIENTS WITH DIABETIC POLYNEUROPATHY

The aim: To identify and substantiate the role of comorbidity in the clinical course and quality of life (QOL) of patients with diabetic polyneuropathy (DP). Materials and methods: We examined 139 patients aged from 19 to 69 years with DP occured as a consequence from type I and II diabetes mellitus (DM). The examined persons were divided into two groups: DP due to type I and II DM with comorbidity (group A,n=93) and without comorbidity (group B,n=46). For the patients was done a comprehensive clinical and neurological examination, laboratory, instrumental methods of examination. Results: We observe hypo- or areflexia much more in group A respect to reflexes on the upper and lower extremities than in group B, where the changes are more noticeable on the lower extremities. The level of QOL in group A is significantly lower than in group B. According to the McGill scale in group A, all indicators of pain characteristics are higher. Quite a high score in group A on the Pain Rating Index(PRI) – 32.17±1.57points. The lowest rates of the nerve conduction velocity (NCV) on the motor fibers were registered in group A, on the sensitive fibers of the upper extremities has got lower rates in groups A and B than in the control group, but in group A it is slightly higher. Conclusions: Clinical manifestations of DP in group A are more pronounced than in the comparison group and a wide range of comorbidity was diagnosed, including cardiovascular, which aggravates the manifestations of DP.

The effect of vulvar lichen sclerosus on sexual dysfunction

Lichen sclerosus (LS) is a chronic inflammatory dermathosis that affects the vulva. Many women with LS complain about pain in the vulva, which usually often affects a patient’s life quality. This study describes the results of comparing the sexual function of patients with vulva lichen sclerosis (VLS) with reports of pain and without, to a control group of healthy people.The objective: a determination of the spread of sexual dysfunction in women with VLS.Materials and methods. On the basis of the gynecological office for routine screening / preventive care of the outpatient department in the National Cancer Institute and the clinic “Verum”, a case-control study was carried out to determine the relationship between VLS and sexual dysfunction. A total of 235 women were included in the study. 140 women with a confirmed by biopsy the diagnosis VLS were compared with a control group. We studied the current health complaints, medical and surgical history, current symptoms such as pain and itching, the type and frequency of sexual intercourse and level of satisfaction with sexual activity. The assessment of the severity of pain was carried out according to the McGill scale, the type and frequency of sexual relations and the level of satisfaction with sexual activity - according to the results of questionnaires.Results. Women with VLS reported less sexual activity than women of the control group (p=0.007). In the study, sexually active women with VLS were significantly less likely to report vaginal intercourse (71.6%) than «healthy» controls (89.0%, p=0.003), although similar proportions of all groups indicated that vaginal contact was important for them. Satisfaction with the quality of sexual activity was significantly lower among the women with VLS compared with the control group of «healthy» patients. 25% of women with VLS reported that sexual activity was rarely or never satisfying, compared with 2,11% of the control group of healthy women (p&lt;0.0001).Conclusion. Women with vulva lichen sclerosis have less frequent and less satisfying sexual activity compared to the control group.

Functional electrical stimulation reduces pain and shoulder subluxation in chronic post-stroke patients?

Background: Shoulder subluxation is a common complication of cerebral vascular accident (stroke) and the use of Functional Electrical Stimulation (FES) within the rehabilitation process is extremely important. Objective: To analyze the therapeutic effects of FES in the treatment of chronic shoulder subluxation in post-stroke patients. Method: This is a case study of patients with radiologically subluxation confirmed, who were randomly divided into two groups: Control Group (CG) and Treatment Group (TG). Patients were assessed before and after treatment and at the 2-month follow-up. The assessment consisted of the modified Ashworth scale; passive goniometry; Fugl-Meyer scale; McGill pain questionnaire and evaluation of shoulder subluxation by radiography. The CG did not receive physiotherapeutic intervention; and TG underwent 20 sessions of motor kinesiotherapy and FES associated with functional exercises with a total duration of 1 hour, three times a week, for 7 weeks. The data were analyzed descriptively. Results: The mean age of CG participants was 82.5 ± 1.5 years and of the TG was 70.5 ± 13.5 years. All of them were retired, sedentary, non-smokers/alcoholics and had hemiparesis on the left side. There was an approximate increase of 10o for most joint movements of the shoulder, improvement in McGill scale scores and reduction of shoulder subluxation in TG patients. Conclusion: FES associated with functional movements was effective in reducing the degree of subluxation of the shoulder joint and decreased pain in subjectsin the chronic phase of the post-stroke.

Effectiveness of gabapentin pharmacotherapy in chemotherapy-induced peripheral neuropathy.

Chemotherapy-induced peripheral neuropathy (CIPN) is a common chemotherapy side effect, but its prevention and treatment remains a challenge. Neurotoxicity may lead to dose limitation or even treatment discontinuation, and therefore potentially affect the efficacy of anticancer treatment and long term outcomes. The practice to administer gabapentin for neuropathy may be applicable, but is limited by insufficient studies. The aim of our study was to assess the presence of chemotherapy-induced peripheral neuropathy in ovarian cancer patients treated with first-line paclitaxel and carboplatin chemotherapy and evaluate the effectiveness of gabapentin in treatment of this condition. 61 ovarian cancer patients treated with first line chemotherapy were included in the study. The first phase of the study was to assess neurological condition of each patient by: neuropathy symptoms scale, McGill's scale, neurological deficit and quality of life, during the chemotherapy. In the second phase of the study we evaluated the response to gabapentin treatment in a group of patients who developed neuropathy. 78.7% of the patients developed chemotherapy related neuropathy. During the course of chemotherapy these patients experienced significant exacerbation of neuropathy symptoms (p < 0.0001), neuropathic pain (p < 0.0001), neurologic deficit (p < 0.0012) and worsening of quality of life (p < 0.0002). Patients who were qualified to undergo the gabapentin treatment observed improvement in symptoms (p < 0.027), pain (p < 0.027) and neurologic deficit (p < 0.019). Quality of life did not change significantly after gabapentin treatment (p < 0.128). Chemotherapy substantially deteriorates the neurologic condition of the patients and the quality of life. Paclitaxel and carboplatin treated patients may benefit from gabapentin therapy in chemotherapy-induced peripheral neuropathy.

Correlation of perceptive temperature threshold of oral mucosa and sympathetic skin response

Objectives: To explore the critical values of temperature perception in various mucosa sites of oral cavity and to draw the perceptive temperature threshold maps in healthy volunteers. To observe the interrelationship between subjective cognitive perception and sympathetic skin response (SSR) under various levels of thermal stimuli. Methods: Forty-two healthy volunteers (recruited from the students of Tianjin Medical University, 16 females and 26 males) were enrolled in the present study. The whole oral mucosa of each subject was divided into multiple partitions according to the mucosa type as well as tooth position. Peltier patch (commodity name) semiconductor chip was placed in the central part of each subarea of the mucosa. The stimulus was increased or decreased at 1 ℃ each time from a baseline temperature of 37 ℃. Warm (WT) and cold (CT) perception thresholds were measured thereafter respectively. A topographic temperature map of the oral mucosa for each subject was drew. Furthermore, the SSR was elicited and recorded at three temperature levels of 50 ℃, 55 ℃, 60 ℃ respectively. Analog test with visual analogue scale (VAS) and McGill scales were also performed. Data were statistically analyzed with variance and generalized estimation equation. Results: The tip of the tongue was the most sensitive area with both WT [(38.8±2.1) ℃, P<0.05] and CT [(23.5±4.2) ℃, P<0.05]. The highest heat threshold of gingival mucosa was in the left lower posterior teeth area [(49.9±3.7) ℃, P<0.05], and the highest cold threshold of gingival mucosa was in the left upper posterior teeth area [(15.9±5.5) ℃, P<0.05]. The perceptive temperature threshold increased gradually from the midline to both left and right sides were observed symmetrically and bilaterally. There was no statistically significant differences in temperature perception threshold between males and females [WT, male (44.8±3.1) ℃, female (44.8±3.2) ℃, OR=1.100, P=0.930; CT, Male (18.4±4.9) ℃, female (20.8±4.8) ℃, OR=0.157, P=0.210]. The SSR amplitude at sites of the tongue tip and the lower lip were increased with the rise of temperature [tongue tip (4.58±4.04) mv, P<0.05, lower lip (2.89±3.01) mv, P<0.05]. However, SSR amplitude values had no significant differences between males and females [tongue tip, male (2.00±2.16) mv, female (1.89±1.20) mv, P=0.890; lower lip, male (0.94±0.82) mv, female (0.85±0.68) mv, P=0.887]. Nevertheless, the amplitude of SSR and the VAS score of subjects showed a similar trend. Conclusions: The temperature perception levels were different amongst sites of lip, buccal mucosa, tongue dorsal mucosa and gingival mucosa. SSR amplitude values could reflect the responses of the mouth to the thermal stimuli.

Functional electrical stimulation reduces pain and shoulder subluxation in chronic post-stroke patients?

Background: Shoulder subluxation is a common complication of cerebral vascular accident (stroke) and the use of Functional Electrical Stimulation (FES) within the rehabilitation process is extremely important. Objective: To analyze the therapeutic effects of FES in the treatment of chronic shoulder subluxation in post-stroke patients. Method: This is a case study of patients with radiologically subluxation confirmed, who were randomly divided into two groups: Control Group (CG) and Treatment Group (TG). Patients were assessed before and after treatment and at the 2-month follow-up. The assessment consisted of the modified Ashworth scale; passive goniometry; Fugl-Meyer scale; McGill pain questionnaire and evaluation of shoulder subluxation by radiography. The CG did not receive physiotherapeutic intervention; and TG underwent 20 sessions of motor kinesiotherapy and FES associated with functional exercises with a total duration of 1 hour, three times a week, for 7 weeks. The data were analyzed descriptively. Results: The mean age of CG participants was 82.5 ± 1.5 years and of the TG was 70.5 ± 13.5 years. All of them were retired, sedentary, non-smokers/alcoholics and had hemiparesis on the left side. There was an approximate increase of 10o for most joint movements of the shoulder, improvement in McGill scale scores and reduction of shoulder subluxation in TG patients. Conclusion: FES associated with functional movements was effective in reducing the degree of subluxation of the shoulder joint and decreased pain in subjectsin the chronic phase of the post-stroke.

THE INFLUENCE OF SINGLE-NUCLEOTIDE POLYMORPHISMS OF CATECHOL-O-METHYLTRANSFERASE GENE ON THE FORMATION OF PAIN SYNDROME AND EFFECTIVENESS OF ANALGESIA IN ONCOLOGICAL PATIENTS

The objective is to study the effect of single-nucleotide polymorphisms (SNPs) of COMT gene on the formation and characteristics of chronic pain, level of anxiety and depression, effectiveness of analgesia in oncological patients. Material and Methods. The study includes 196 patients with oncological pathology. The formation of chronic pain syndrome was estimated in all patients one year after surgery using the assessment of pain intensity by numeric rating scale, pain questionnaire of McGill, PainDetect. Basing on the patients genotyping data the genotypes and haplotypes frequency distribution on SNPs of rs4680, rs740603, rs2097603=rs2070577, rs4633 of COMT gene was estimated. The relationship between different genotypes, haplotypes and chronic pain intensity, severity of ranking index of pain for sensor and affective characteristics on McGill scale, presence of neuropathic component of pain and anxiety was studied in all patients sample. The same analysis was carried out in order to clarify difference in morphine consumption (mg/24h) and severity of adverse side effects such as drowsiness, confusion and hallucinations. Results. It is found that after one year the pain syndrome was developed in 134 patients. It was showed that there is direct relationship between chronic pain intensity, anxiety level and presence of mutant allele on polymorphisms of rs4680 in exon and rs740603 in intron of COMT gene. There was also revealed inverse relationship between morphine requirement and presence of pointed polymorphisms in comparison with the patients who have GG genotype of these markers. Conclusion. The determination of pointed SNPs may be useful for choosing the optimal tactics of analgesia in patients with chronic oncological pain syndrome.

Effect of bloodletting therapy at local myofascial trigger points and acupuncture at Jiaji (EX-B 2) points on upper back myofascial pain syndrome: a randomized controlled trial

ObjectiveTo observe the clinical efficacy of bloodletting therapy and acupuncture at Jiaji points for treating upper back myofascial pain syndrome (MPS), and compare this with lidocaine block therapy. MethodsA total of 66 upper back MPS patients were randomly assigned to either the treatment group or the control group in a 1:1 ratio. The treatment group (n = 33) were treated with bloodletting therapy at local myofascial trigger points and acupuncture at Jiaji (EX-B 2) points; one treatment course consisted of five, single 20-min-treatments with a 2-day break between each treatment. The control group (n = 33) were treated with a lidocaine block at trigger points; one treatment course consisted of five sessions of lidocaine block therapy with a 2-day break between each session. The simplified McGill Scale (SF-MPQ) and tenderness threshold determination were used to assess pain before and after a course of treatment. ResultsAfter the third and fifth treatment, the SF-MPQ values were significantly decreased (P < 0.01) and the tenderness thresholds were significantly increased (P < 0.01) in both groups compared with before treatment. There were no significant differences in pain assessments between the two groups after three and five treatments (P > 0.05). There were five cases with minor adverse reactions reported in the control patients, while no adverse reactions were reported in the treatment group. ConclusionBloodletting therapy at local myofascial trigger points and acupuncture at Jiaji points was effective in treating upper back MPS. Clinically, bloodletting and acupuncture therapy had the same efficacy as the lidocaine block therapy, with fewer adverse reactions.

The Effectiveness of Prenatal Intervention on Pain and Anxiety during the Process of Childbirth-Northern Iran: Clinical Trial Study.

Background:Due to the painful nature of childbirth and its maternal and neonatal complications, the woman needs support in this phase of their life. Increased knowledge and skills during pregnancy prepares pregnant mothers for labor and leads to promoted health.Aim:This study was designed to evaluate the effectiveness of “prenatal education” on the process of childbirth.Subjects and Methods:This clinical trial was conducted on 195 pregnant women, that is, control group (N = 132) and case group (N = 63) attending health centers in Amol-Iran from 20 weeks of gestation age during 2012. Case group members attended in “prenatal education” class and the control group only received routine care. Data were collected through demographic questionnaire, standard hospital anxiety questionnaire, and a checklist related to childbirth information, and intensity of pain based on visual analogue scale and McGill scales. The data were analyzed by Statistical Package for the Social Sciences software using t-test and Chi-square test.Results:The result of this study showed that the parent with a high level of education was more interested to participant in prenatal classes. The anxiety level in case group (who received education) was 14.47 (4.69) and in control group it was 16 (4.86), (P < 0.001) the pain intensity in case group was 85.68 (1.85) and in control group was 90.99 (14.72) (P = 0.03), intervention on labor such episiotomy was 39 %66.1 (39/63) in case group and 80 %72.8 (80/132) in control group (P = 0.01) and cesarean section was 13 %17.1 (13/63) in case group and 58 %32.2 (58/132) in control group (P = 0.01).Conclusions:According to findings of this study, the prenatal education and psychological support are beneficial for mothers during pregnancy and labor. Therefore, it is recommended for educating all the pregnant women.

Effect of Perioperative Electroacupuncture as An Adjunctive Therapy on Postoperative Analgesia with Tramadol and Ketamine in Prostatectomy: A Randomised Sham-Controlled Single-Blind Trial

To study the analgesic effect of electroacupuncture (EA) as perioperative adjunctive therapy added to a systemic analgesic strategy (including tramadol and ketamine) for postoperative pain, opioid-related side effects and patient satisfaction. In a sham-controlled participant- and observer-blinded trial, 75 patients undergoing radical prostatectomy were randomly assigned to two groups: (1) EA (n=37; tramadol+ketamine+EA) and (2) control (n=38; tramadol+ketamine). EA (100 Hz frequency) was applied at LI4 bilaterally during the closure of the abdominal walls and EA (4 Hz) was applied at ST36 and LI4 bilaterally immediately after extubation. The control group had sham acupuncture without penetration or stimulation. The following outcomes were evaluated: postoperative pain using the Numerical Rating Scale (NRS) and McGill Scale (SF_MPQ), mechanical pain thresholds using algometer application close to the wound, cortisol measurements, rescue analgesia, Spielberger State Trait Anxiety Inventory (STAI Y-6 item), patient satisfaction and opioid side effects. Pain scores on the NRS and SF_MPQ were significantly lower and electronic pressure algometer measurements were significantly higher in the EA group than in the control group (p<0.001) at all assessments. In the EA group a significant decrease in rescue analgesia was observed at 45 min (p<0.001) and a significant decrease in cortisol levels was also observed (p<0.05). Patients expressed satisfaction with the analgesia, especially in the EA group (p<0.01). Significant delays in the start of bowel movements were observed in the control group at 45 min (p<0.001) and 2 h (p<0.05). Adding EA perioperatively should be considered an option as part of a multimodal analgesic strategy.

The Effect of Perinatal Education on Iranian Mothers’ Stress and Labor Pain

Lack of sufficient knowledge about the unknowns of pregnancy increases stress and requires more medical interventions. This study was conducted to assess the effects of prenatal education on mothers’ stress and labor. This clinical trial was conducted to study 195 women (132 in the control group and 63 in the experimental group) who had attended healthcare centers in the city of Amol after their 16th gestational week. The experimental group participated in educational classes to learn how to experience a safe childbirth for 6-8 sessions of 1.5 hours almost every three weeks. The control group received only a routine care, pain assessment scales like Visual Analogue Scale (VAS) and McGill questionnaire, and Hospital Anxiety and Depression Scale (HADS) were employed to collect data. The data were analyzed using SPSS software through t-test and Chi Square test to compare the groups. The results of the t-test showed a meaningful difference in levels of stress felt by the experimental group compared to control group (p=0.002). The Visual Analogue Scale suggested that in the transitional stages (8-10 cm cervical dilation), the level of pain felt by the experimental group was meaningfully lower than that felt by the control group (p=0.03). However, this was not significantly different between the two groups at 3-4 cm cervical dilation and the second stage of childbirth. The McGill scale’s results for measuring pain levels, proved a meaningful difference between the experimental group and the control group (p=0.018). Educational and supportive interventions increased mothers’ knowledge during pregnancy and reduced their fear of unknown environment and people. These trained women learned how to effectively overcome their problems and labor pain.

Outcomes Following Hip Fracture Surgery: A 2-Year Prospective Study

To describe the health outcomes in older people following hip fracture surgery. A naturalistic prospective study of people who had undergone hip fracture surgery undertaken in three specialist inpatient orthopaedic units in Manchester, England, with follow-up for 2 years in primary care. One hundred forty-two people, age 60 and older who had undergone hip fracture surgery of whom 74 were interviewed at follow-up. Assessment of mood (using the Geriatric Depression Scale and Hospital Anxiety and Depression Scale), cognitive function (Mini-Mental State Examination), pain (Wong-Baker and McGill scales), tests of function (Up and Go Test, Gait Test and Functional Reach), and Sickness Impact Profile. Twenty-six percent of the original group had died by the time of the 2-year follow-up and associated with increasing age, poorer mobility, and higher levels of support. Sixteen percent of the group were found to be depressed, the only robust predictor of this being depression at entry to the study. There was a consistency in the presence or absence of depressive symptoms over the duration of the study. Forty-nine percent were able to walk independently at 2 years. The presence of depressive symptoms is associated with poor outcomes at 2 years. Few people recover from, or develop, depression over 2 years.

P03-377 - Sexual functioning and pain disorders in depressive women

IntroductionAs the incidence of depression, both in Poland and the world, has increased in recent years, it seems important to consider it in a wider context, including its comorbidities.AimsThe aim of the study was to assess anxiety, sexual functioning and pain disorders in women with depression.MethodsThe study encompassed 41 women, aged 18 - 65 years old, of whom 21 were assigned into the study group and 20 into the control group. The research was based on a two-part questionnaire. The first, general part involved socio-demographic data, basic patient history and sexuality-related questions. The other part was based on standardized tests, such as Beck Depression Inventory (BDI), State Trait Anxiety Inventory (STAI), McGill Pain Questionnaire - short form (SF-MPQ), Beliefs About Pain Control Questionnaire (BPCQ) and Female Sexual Function Index (FSFI).ResultsThe two groups were homogenous with regard to mean age, age at menarche and the BMI. The study group had significantly lower FSFI results than the control group, which implies greater severity of sexual disorders. Moreover, a significant positive correlation between depressive disorders (BDI) and pain disorders (McGill scale) was observed in the study group.ConclusionsTaking into consideration the multitude and severity of sexual functioning disorders and pain disorders in women with depression, careful diagnosis should be attempted in all cases. The participation of a sexologist and doctors of other specialties in both diagnosis and therapy should be considered.

Validating the McGill Revision of the Depressive Experiences Questionnaire

Research has identified important psychometric differences between the original Depressive Experiences Questionnaire (DEQ; Blatt, D'Affliti, & Quinlan, 1976) and two of its most widely used revisions, which have failed to preserve the degree of between-scale orthogonality routinely observed with the original Dependency and Self-Criticism scales. The purpose of this study was (a) to examine construct validity for the recently developed McGill revision of the DEQ (Santor, Zumff, & Fielding, this issue), which preserves between-scale orthogonality; (b) to compare the McGill revision of the DEQ with other existing revisions with respect to measures of personality, motivation, and interpersonal relatedness; and (c) to explore the correlates of items that appear to be responsible for maintaining the degree of orthogonality between measures of Dependency and Self-Criticism. Results suggest that (a) the McGill revision of the DEQ offers more valid estimates of the relations among dependency, self-criticism, and other theoretically relevant constructs, such as depressed mood and agreeableness, than other existing revisions and (b) items differentiating Dependency and Self-Criticism assess broad interpersonal orientations that can be characterized as communal or agentic. Results validate the newer McGill scales, further support the utility of the methods used in their development, and provide insights into the differences between Dependency and Self-Criticism.