Mean Pain Level Research Articles

Chronic pain among primary fentanyl users: The concept of self-medication.

Chronic pain is among the leading causes of disability worldwide, of which only a small percentage of patients receive adequate treatment for. Non-prescribed opioid analgesics are commonly sought out in effort to alleviate unrelieved pain. This study assesses the prevalence and correlates of chronic pain among primary fentanyl users. A cross-sectional and structured survey was conducted with 200 adults who reported fentanyl as their drug of choice from a Vancouver acute care hospital. Presence and levels of chronic pain were determined through self-report. The majority of participants (n = 130, 72.6%) reported having chronic pain in the past 6 months, with the mean level of pain on a typical day to be 7.6 out of a scale of 10 (SD = 1.9). Majority (n = 85, 65.4%) reported using street opioids to self-medicate, while only 9 (6.9%) reported that their chronic pain was unrelated. Regression analysis indicated that increasing age and co-use of cannabis and opioids were independent associated factors of chronic pain. Higher levels of reported pain on a typical day were further associated with age and self-medication. The findings of this study demonstrate a significant association between self-medication and chronic pain among primary fentanyl users in British Columbia. For these individuals, inadequate pain relief may drive continued opioid use, which in turn may increase risks of treatment discontinuation and overdose. Appropriate pain management strategies are crucial to avoid opioid misuse and decrease the large societal burden caused by chronic pain. Our work points to the high prevalence of self-reported chronic pain among individuals who primarily use fentanyl. Among those with self-reported fentanyl use and chronic pain, self-medication with street opioids was found to be common and associated with higher reported pain levels on a typical day. This highlights the need for pain management strategies to be integrated into opioid dependence treatment and more research in the overlap of pain and fentanyl use.

Effect of Cryotherapy on Pain Intensity for Patients Undergoing Arterial Sheath Removal After Percutaneous Coronary Intervention: A Randomized Controlled Trial

Introduction: Coronary artery disease is the main cause of mortality globally, making up approximately 33% of all deaths Patients with coronary artery disease experience pain and discomfort post-percutaneous coronary intervention after the femoral catheter is removed, which might raise the patient's duration of hospitalisation and the hospital's costs. Aims: The purpose of the study is to evaluate the effect of cryotherapy on the degree of pain that patients who have had their arterial sheath removed after percutaneous coronary intervention felt. Methods: A test-and-retest design in a randomised controlled trial was conducted from January 7, 2024, to February 19, 2024, at Babylon Centre/Imam Al-Sadiq Hospital. A probability (simple random) sampling method was used in a two-group design, with 50 patients in each group as a control and cryotherapy group, and evaluating pain levels utilizing the visual analogue scale. Descriptive and inferential statistics were used in data analysis frequency, percentage, mean, paired sample t-test, standard deviation, and ANOVA. Results: This stated the mean pain level was similar before cryotherapy. However, after cryotherapy, the level of pain in the cryotherapy group was significantly less than that of the control group (2.38± 5.1 vs. 23.34± 11.5), respectively. P = 0.000 (<0.05) demonstrating a statistically significant variation. Conclusions: According to the study, cryotherapy applied to the femoral sheath region assisted the percutaneous coronary intervention patients feel less pain when their femoral catheter was removed. In these situations, a local cold gel bag may be advised as a nursing intervention for pain management.

Carpal tunnel release under local anesthesia with or without distal median nerve block: Double-blind randomized clinical trial

Background: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy of the upper extremity, and its surgical treatment is carpal tunnel release (CTR). It is mostly performed in local anesthesia. There are no clinical randomized controlled trials (RCTs) comparing local infiltration anesthesia with or without a distal median nerve block in CTR. The aim of the PERSONNEL trial (carPal tunnEl ReleaSe lOcal iNfiltratioN mEdian bLockade) is to assess whether a distal median nerve block reduces pain during and after the procedure in addition to local anesthesia. Methods: This is a single-center randomized clinical superiority trial comparing local anesthesia alone and local anesthesia with a distal median nerve block for CTR in patients with CTS. Adult patients will be randomized in one university hospital in Finland, and the intended sample size is 118. The primary outcome is the mean pain level after the procedure during 72 h using a visual analogue scale (VAS). The secondary outcomes include expected pain; pain during the injection of the anesthetic solution caused by pressure, burning, needle sting, and total pain; worst pain during the surgery; duration of anesthesia; number of experienced needle stings; Boston Carpal Tunnel Syndrome Questionnaire (BCTSQ); pain killer consumption;, patient satisfaction using Net Promoter Score (NPS); and complications. Discussion: Patient satisfaction is a crucial factor in modern healthcare. A distal median nerve block may reduce pain during and after CTR, potentially increasing patient satisfaction with the given treatment. It can also be hypothesized that better postoperative pain control may prevent complications, for example, complex regional pain syndrome. However, we lack adequate evidence to justify the use of distal median nerve block, which can itself predispose patients to complications, for example, median nerve injury. Therefore, there is a need for adequate RCTs to assess its efficacy. The results of this study can be used to optimize anesthesia for carpal tunnel surgery, improve patient satisfaction, and possibly prevent complications. Registration: ClinicalTrials.gov NCT05372393.

Preoperative anxiety, postoperative pain tolerance and analgesia consumption: A prospective cohort study.

Anxiety affects the patient's perception of postoperative pain and causes a significant increase in the consumption of analgesia postoperatively. This study assesses the relationship between preoperative anxiety, postoperative pain and postoperative pethidine consumption. A prospective cohort design was used. Data were collected from 100 patients who were undergoing a laparoscopic cholecystectomy at St Joseph Hospital, Jerusalem. Pain-controlled analgesia with pethidine was utilised to manage pain throughout the postoperative period. The visual analogue scale scores and pethidine consumption of all patients were recorded. Participants' mean level of pain was higher in the preoperative period (mean visual analogue scale = 1.3) compared with their mean level of pain in the postoperative period (mean visual analogue scale = 0.5). There is a statistically significant difference between the participants' level of anxiety and postoperative pain level (p < 0.001). Gender, weight, level of education and smoking were predictors of developing preoperative anxiety. Also, gender, smoking and medication were statistically significant predictors of developing postoperative pain. Furthermore, gender, medical history and medication were statistically significant predictors of pethidine consumption postoperatively. The preoperative anxiety reduction intervention should be promoted and implemented as routine care for all surgical patients.

Effectiveness of Low-Level Laser Therapy in reducing postoperative pain after dental implant surgery: A randomized clinical trial

BackgroundA clinical trial was conducted to measure the effectiveness of a combined wavelength of 660 nm and 808 nm Low-Level Laser Therapy (LLLT) in reducing postoperative pain in partially and totally edentulous patients who underwent dental implant surgery. Materials and MethodsThe study included 20 blinded individuals divided in a randomized split-mouth fashion; the experimental group in one hemiarch and the control group in the other hemiarch. The experimental group received a total of 22.5 Joules (J) of LLLT divided into 5 points per implant immediately after surgery. The control group received a placebo treatment. At 24 h, 72 h, and 7 days, a blinded surveyor administered a pain questionnaire using a Numerical Rating Scale (NRS) combined with a Verbal Rating Scale (VRS) to assess pain onset after surgery, duration of the first pain episode, and pain evolution. Group data were analyzed with an ANOVA test for repeated measures and a paired t-test at defined time intervals. ResultsThe experimental group showed a significant decrease in postoperative pain at 24 h and at 72 h for fully edentulous patients. There was a non-significant difference in the duration of the first pain episode. The mean pain levels decreased over time for both the experimental and control treatments, but only statistically significantly for the experimental group in the 24–72 h and 24 h to 7 days intervals. The same was true for the control group when comparing 24 and 72 h and between 24 h and 1 week. The time range between 72 h and 1 week showed no statistically significant differences. ConclusionWithin the limitations of this study, a single dose of 22.5 J LLLT per implant helps to decrease postoperative pain in dental implant surgery at 24 h for partially edentulous patients and at 24 and 72 h for fully edentulous patients.

Virtual reality for interventional radiology patients: a preliminary study.

The aim of this prospective study was to evaluate the tolerance and feasibility of using virtual reality headsets with patients during interventional radiology procedures. In this single-center prospective study, the use of a virtual reality headset in addition to the usual analgesic and anxiolytic treatment was proposed to all patients presenting in the interventional radiology department from December 2020 to June 2022. Exclusion criteria were as follows: (1) patients with whom it was not possible to communicate (2) epileptic patients, (3) non-verbal patients, and (4) pregnant women. The main objective was to evaluate the safety of the procedure by screening complications during and after the procedure. The second objective was to evaluate feasibility, as defined by the number of patients using the helmet until the end of the procedure. Effectiveness (patient's self-evaluation of pain and anxiety), comfort, satisfaction, emotions felt, sense of security, and feeling of immersion were also evaluated. Caregivers completed a feedback questionnaire. Virtual reality headsets were offered to 100 patients, 9 of whom declined. Procedures were achieved in 93.5% of cases: 6/91 patients removed the headset before the end of the procedure. There were minor adverse events in 2/85 (2.3%) procedures (discomfort and nausea) and no major adverse events. 93.9% of patients found an overall benefit, and 90.2% would recommend virtual reality to another patient. 94.4% of caregivers were satisfied with the virtual reality equipment. The mean pain level was 2.5 ± 2.7 before the procedure, 3.3 ± 2.5 during the procedure, and 1.6 ± 2.7 after the procedure. Mean anxiety scores were 4.6 ± 2.9 before the procedure, 3.1 ± 2.7 during the procedure, and 1.1 ± 1.9 after the procedure. The use of virtual reality technology as a complement to traditional therapy for procedures under local anesthesia is feasible and safe in interventional radiology and can be beneficial for pain and anxiety management.

Glued suture-less peritoneum closure in laparoscopic inguinal hernia repair reduces acute postoperative pain

Inguinal hernia repair is performed more than 20 million times per annum, representing a significant health and economic burden. Over the last three decades, significant technical advances have started to reduce the invasiveness of these surgeries, which translated to better recovery and reduced costs. Here we bring forward an innovative surgical technique using a biodegradable cyanoacrylate glue instead of a traumatic suture to close the peritoneum, which is a highly innervated tissue layer, at the end of endoscopy hernia surgery. To test how this affects the invasiveness of hernia surgery, we conducted a cohort study. A total of 183 patients that underwent minimally invasive hernia repair, and the peritoneum was closed with either a conventional traumatic suture (n = 126, 68.9%) or our innovative approach using glue (n = 57, 31.1%). The proportion of patients experiencing acute pain after surgery was significantly reduced (36.8 vs. 54.0%, p = 0.032) by using glue instead of a suture. In accordance, the mean pain level was higher in the suture group (VAS = 1.5 vs. 1.3, p = 0.029) and more patients were still using painkillers (77.9 vs. 52.4%, p = 0.023). Furthermore, the rate of complications was not increased in the glue group. Using multivariate regressions, we identified that using a traumatic suture was an independent predictor of acute postoperative pain (OR 2.0, 95% CI 1.1–3.9, p = 0.042). In conclusion, suture-less glue closure of the peritoneum is innovative, safe, less painful, and possibly leads to enhanced recovery and decreased health costs.

Prospective, multi-centric, international, single-arm, cohort study to assess a synthetic polyamide suture material in oral surgery to close the mucosa - MUCODA study.

ObjectivesThe aim was to collect different clinical parameters systematically and proactively regarding safety, effectiveness, and performance of a nylon monofilament suture under routine clinical practice for oral surgery. MethodsThe study design was prospective, bicentric, international, single-armed, and observational. A non-absorbable suture was applied to close the mucosa after different dental surgical interventions. Main objective was the incidence of combined postoperative complications until suture removal. The 95 % Confidence Interval (Agresti-Coull method) was used to prove the non-inferiority with a pre-specified upper margin of 21.9 %. Secondary variables were intraoperative suture handling, patient pain and satisfaction, wound healing, aesthetic appearance, and bacterial contamination. Results105 patients were enrolled. Complication rate was low (1.9 %), 2 swellings occurred. Pain was present for 1.61 days ± 1.42 after various dental interventions with an average pain level of 20.98 ± 22.60 (VAS). Patients with impacted third molar extraction showed the longest pain duration (6 days) combined with the highest mean pain level of 35.33 ± 30.45 (VAS). Intraoperative suture handling was very good to excellent. Suture removal was done after an average duration of 7.56 ± 2.09 days. Patient's satisfaction was high, and an excellent wound healing was reported by the dentists. Aesthetic appearance only performed in implant patients was rated by oral surgeons with an average of 96.19 ± 3.79 points [min. 80 – max. 100] at 5 months postoperatively. Thread bacterial analysis showed that F. nucleatum was the most present species. ConclusionsOur findings indicate that the non-absorbable, nylon-based monofilament suture used is safe and quite suitable for oral mucosal closure after various dental surgical interventions such as tooth extraction, implant placement and impacted third molar extraction. Clinical significanceThis study showed the safe use of a non-absorbable, nylon-based monofilament suture for different oral surgical interventions under daily routine clinical practice.

Effect of Occlusal Reduction on Alleviating Pain in Symptomatic Apical Periodontitis

OBJECTIVE: To evaluate pain relief in response to occlusal reduction in teeth with symptomatic apical periodontitis METHODOLOGY:A randomized controlled trial was done at department of Operative Dentistry and Endodontics, PIMS Hospital, Islamabad, Pakistan 27th May 2019 to 30th May 2020 on 166 patients suffering from irreversible pulpitis with symptomatic apical periodontitis were included in the study. After consent, Visual Analogue Scale (VAS) was used to document preoperative pain levels. Pulpectomy was done and patients were randomly divided into Group A (without occlusal reduction) and Group B (with 1-1.5mm occlusal reduction). Mean pain scores of Group A and Group B were compared at 24hrs, 72 hours and seventh day using T-test RESULTS: There was a significant difference in mean pain score (p=0.0001) post-pulpectomy between the teeth with and without occlusal reduction. CONCLUSION: The teeth that underwent occlusal reduction after pulpectomy showed lower mean pain levels compared to the non-reduction group. KEYWORDS: Occlusal reduction, apical periodontitis, irreversible pulpitis, pulpectomy, root canal therapy

Effects of inhalation of peppermint oil after lumbar discectomy surgery on pain and anxiety levels of patients: A randomized controlled study

AimThis study was conducted to analyze the effects of the inhalation of peppermint oil after lumbar discectomy surgery on the pain and anxiety levels of patients. Materials and methodThis study was performed as a randomized controlled trial from September 2022 to June 2023 with 68 patients (34 patients in the experimental group and 34 patients in the control group). A Patient Information Form, the Numerical Pain Rating Scale, and the State Anxiety Inventory were used in the data collection process. The researcher administered the Patient Information Form to the patients before they underwent surgery. The State Anxiety Inventory and the Numerical Pain Rating Scale were administered to the patients after the second hour in the postoperative period. Next, for 10 minutes, only the patients in the experimental group inhaled five drops of peppermint oil dripped on a sterile gauze pad whereas no intervention was administered to the patients in the control group. Then, the State Anxiety Inventory and the Numerical Pain Rating Scale were administered again to the patients in both groups successively after the third and fourth hours in the postoperative period. ResultsAfter the second hour in the postoperative period, the difference between the mean pain or state anxiety levels of the two groups were not statistically significant (p > 0.05). On the other hand, after the third and fourth hours in the postoperative period, the differences between the two groups were statistically significant (p < 0.05). ConclusionIt was concluded that the inhalation of peppermint oil after lumbar discectomy surgery reduced pain and anxiety levels.

Time Effect on Acute Postoperative Pain After Total Knee Replacement Surgery: An Exploratory Study Using the Experience Sampling Method.

Acute postoperative pain (APP) is the main cause of postoperative dissatisfaction; however, traditional methods of pain assessment provide limited insights into the dynamics and development of APP. This study used the experience sampling method (ESM) to understand the dynamics of APP over time in relation to various patient factors. Forty patients scheduled to undergo total knee replacement surgery were recruited in this study. Following an initial assessment, a short report questionnaire was sent to the patients via 10 digital alerts per day to assess the pain levels during two preoperative and the first 6 postoperative days. The data were analyzed using multilevel regression including random intercept and slope. Thirty-two patients submitted the pre-specified minimum of 30% of their short reports, yielding 1217 records. The analysis revealed significant (P<0.001) linear and quadratic decreases in APP and a quadratic time effect. The lowest between-days and within-day pain levels were observed on postoperative day 4.8 and during the time slot 3.8 or approximately 19:15, respectively. Significant random intercepts and slopes were noted, indicating variations in the mean pain level between patients and a decrease in pain. None of the 10 patient factors had any confounding effect. Using ESM data combined with multilevel analysis, we were able to evaluate the postoperative pain course while considering inter-individual differences in the baseline pain level and non-linear pain course over time. The findings of this study could aid clinicians in personalizing the treatment for APP.

SHORT SEGMENT VERSUS LONG SEGMENT PEDICLE SCREW FIXATION IN MANAGEMENT OF THORACOLUMBAR BURST FRACTURES: A META-ANALYSIS

This comprehensive meta-analysis evaluates the comparative effectiveness of short-segment pedicle screw fixation (SSF) and long-segment pedicle screw fixation (LSF) in treating thoracolumbar burst fractures. Our study examines various outcomes, including fusion rates, pain relief, functional recovery, and complication rates. Data from studies conducted between January 2018 and January 2022 were reviewed, involving a collective patient cohort of 100 individuals diagnosed with thoracolumbar burst fractures. We conducted an extensive review of the literature, including six investigations, with a total sample size of 100 patients, drawn from studies by Smith et al. (2018), Johnson et al. (2019), Brown et al. (2020), White et al. (2021), Davis et al. (2022), and Wilson et al. (2022). Fusion rates were 90% for SSF and 91% for LSF. The risk difference (RD) between SSF and LSF was -1%, indicating a marginal advantage favoring LSF (RD M-H = -0.95, 95% CI: -4.02 to 2.11). Analysis of postoperative pain scores showed that SSF patients had a mean pain level of 2.4, while LSF patients reported 2.3. With low heterogeneity (T = 12%) and a Z-score of 3.42, our findings demonstrated no statistically significant difference in postoperative pain levels between SSF and LSF. Functional outcomes were assessed using the Oswestry Disability Index (ODI) and Short Form 36, revealing an RD of -1% in favor of LSF. However, this difference was insignificant (RD M-H = -0.82, 95% CI: -3.80 to 2.16). The complication rate for SSF was 12%, and for LSF, it was 11%, with an RD of 1%, suggesting a slightly higher complication rate for SSF, although this difference was not statistically significant (RD M-H = 1.05, 95% CI: -1.38 to 3.48).Our meta-analysis found no statistically significant differences in fusion rates, postoperative pain scores, or complication rates between SSF and LSF in the context of thoracolumbar burst fractures. The choice between SSF and LSF for treating thoracolumbar burst fractures is a pivotal consideration. Our findings indicate that SSF and LSF yield comparable outcomes in fusion, postoperative pain relief, functional recovery, and complication rates. The marginal advantages associated with LSF are of negligible clinical significance. This study underscores the importance of individualized decision-making, emphasizing patient-specific criteria and surgeon expertise in selecting the most appropriate fixation strategy for thoracolumbar burst fracture management. Personalized treatment plans are paramount in optimizing patient outcomes in this clinical scenario.

Clinical and radiological outcome after arthroscopic rotator cuff repair using PEEK-CF anchors

PurposeThe goal of this study was to evaluate the clinical and radiological outcome after arthroscopic rotator cuff repair using new carbonfiber reinforced polyetheretherketone (CF-PEEK) suture anchors. MethodsOne hundred (n=100) patients with rotator cuff tears were enrolled at seven French hospitals between July 2019 and June 2020. Pain levels, Constant score and Subjective Shoulder Value (SSV) were taken preoperatively and 6months postoperatively. Ultrasonography (US) was performed at 6months postoperatively to evaluate tendon healing using the Sugaya classification. Statistical analysis was done with the Student t-test with 95% confidence intervals. ResultsOne hundred patients of the 100 patients were followed at 6months. The mean SSV and Constant score improved from 40.1% preoperatively to 78% at 6months (p<0.0001) and from 43 points preoperatively to 65 points at 6months (p<0.0001), respectively. The mean level of pain, as measured with the visual analogue scale, decreased from 5.9 to 1.6 (p<0.001). There were no postoperative complications that resulted in revision surgery. ConclusionThe study showed good results at 6months follow-up using carbonfiber reinforced PEEK anchors with improved Constant and SSV scores as well as a high ultrasonographic tendon healing rate, making PEEK-CF anchors safe to use, comparable to commonly used anchors. Level of evidenceIV.

Effect of deep tissue massage on reducing back pain in windsurfers

Background. The following paper describes back pain problems among windsurfers at different levels of advancement and a proposal for pain reduction by means of deep tissue massage (DTM). The following research assumption was accepted: windsurfers often suffer from back pain, and deep tissue massage may be a suitable tool for reduction of these complaints. The purpose of this study was to verify wthether deep tissue massage is an effective therapeutic approach for windsurfers.Material and methods. The study took place on the Hel Peninsula in Poland and involved thirty windsurfers in the age range between18 and 27 years at various levels of advancement. One session of deep tissue massage in the study group and a single heat treatment in the control group were carried out; heat therapy was applied in the subjects assuming a supine position on a heated massage table. In order to evaluate the therapeutic effects of the applied procedure, the NRS scale was used to test the level of back pain and the sit and reach test was used to test the range of motion and to evaluate the effects of therapy.Results. After the treatment, the mean level of pain in the control group decreased by 33.9% while in the study group this level decreased by 57.1% relative to the initial pre-treatment value in each group. The average score in the sit&amp;reach test increased by 3.7% in the control group, while in the study group it increased by 10.4% relative to the initial pre-treatment values in these groups. As the level of windsurfer’s advancment increases, the therapeutic effect decreases, and the longer the time of the windsurfing session windsurfing was, the higher increase in back pain was noted. The average analgesic effect was the highest in the beginners, and then it sequentially decreased by 2.2% and 6.3% as the level of advancement increased. It was shown that the differences in the analgesic and relaxation effects between the test and control groups were not statistically significant.Conclusions. Both deep tissue massage and the application of heat had a positive effect on reduction of the back pain level and relaxation of the back muscles after windsurfing. Larger differences were noted in the post-treatment study after DTMapplication. Further studies on a larger study group are needed to confirm the effectiveness of DTM. Attention should be paid to injury prevention in windsurfers by taking breaks after each hour of the windsurfing session.

Durability and efficacy of the ELVeS® Radial® 2ring slim fiber for multiple ablations.

To prove that the ELVeS® Radial® 2ring slim fiber (Biolitec AG, Wien, Austria) is safe and effective, with a reliable fiber durability. This prospective, non-randomized, registry recruited patients with venous incompetence of the great saphenous vein, with or without concomitant incompetence of the small, anterior accessory and posterior accessory saphenous veins. Anatomic success, clinical success and pain were assessed. 150 patients (410 veins) underwent endovenous laser ablation (EVLA). Mean number of veins treated was 2.7 (1-7) with a mean total length of 80.7cm. 98.3% occlusions were observed after 12months. Clinical improvement was significant with reduced venous clinical severity scores at 1 month (1.7 ±1.9; p < .0001) and 12 months (0.7 ±1.3; p < .0001) versus pre-operation (4.4 ± 2.2). Mean pain level after 1-week was 5.8/100. No major surgery- or device-related complications occurred. 1470-nm EVLA with the 2ring slim fiber is a highly effective treatment option well tolerated by patients. Despite intensive use, fiber integrity was preserved. The study protocol was registered in clinicaltrials.gov (NCT03810677).

Standardized Stretching Postural postures to treat low-back pain in pregnancy: the GEMALODO randomized clinical trial

Two-thirds of pregnant women suffer from low-back pain during pregnancy, which leads to negative effects on quality of everyday life. According to the literature, an 8- to 12-week program of adapted physical activity during pregnancy has proven its efficacy in treatment of low-back pain and functional disability. Stretching Postural is a nondynamic technique using muscular contractions and stretches that act mainly on the back and that can be practiced alone. This study aimed to assess the effect of an 8-week program of standardized Stretching Postural postures in low-risk pregnant women suffering from low-back pain. This was an open-label, randomized, controlled trial in 1 French university hospital. Women with a singleton low-risk pregnancy between 15 and 32 weeks of gestation and with back, lumbar, or sacroiliac pain were randomly assigned (1:1) to either undergo an 8-week program of standardized Stretching Postural with basic advice (intervention group) or to receive basic advice only (control group). Both groups received ergonomic advice and encouragement to practice physical activity. The primary endpoint was the pain assessment at 8 weeks (defined by the mean pain level estimated by women in the previous week, scored on a numeric scale from 0 to 10). Secondary endpoints were pain after 4 weeks of follow-up, quality of life (12-item Short Form Survey), satisfaction (Patient Global Impression of Change), and delivery outcomes. The main analysis was intention-to-treat. From January 2019 to August 2020, 60 women were randomized: 30 were assigned to the intervention group and 30 to the control group. The mean level of pain at 8 weeks was significantly lower in the intervention group than in the control group (1.6±1.4 vs 4.1±2.2; P<.01). The mean 12-item Short Form Survey scores were significantly higher in the posture group than in the control group (Physical Component Score, 45.7±7.8 vs 37.4±8.5; P<.01; Mental Component Score, 54.3±5.8 vs 50.4±7.1; P=.04), and the Patient Global Impression of Change score was also significantly higher (6.1±1.5 vs 3.9±2.3; P<.01). No adverse effects were found. Stretching Postural appears to be a safe and efficient nondrug therapy to treat low-back pain during low-risk pregnancy.

Musculoskeletal pain post-COVID-19 in patients undergoing physical therapy in Saudi Arabia: a cross-sectional study

BackgroundThe COVID-19 (coronavirus disease 2019) pandemic has posed a challenge to the physical therapy service. In addition to pandemic-associated treatment interference, many recovered COVID-19 patients developed new or worsening musculoskeletal pain as a sequela of COVID-19, which has been shown to affect the musculoskeletal system. The objective of the study was to examine musculoskeletal pain post-COVID-19 in patients undergoing physical therapy in Saudi Arabia.MethodsThe design of the study was a cross-sectional study. We approached patients attending physical therapy clinics who had COVID-19. Data were collected through an electronic survey consisting of multiple-choice questions related to sociodemographic data and pain. Pain severity was rated on a 10-point numerical rating scale.ResultsA total of 85 recovered COVID-19 patients participated in this study, 30 had musculoskeletal pain prior to getting COVID-19, while 55 acquired it after. The most affected sites for musculoskeletal pain were the lower back and shoulder. Mean pain levels reported increased from 4.48 ± 2.54 pre-COVID-19 to 6.92 ± 8.06 post-COVID-19 (mean difference, 1.61 ± 2.61; t = 5.68; p < 0.0001). Mean pain scores did not associate significantly with demographic or clinical factors. Patient responses skewed toward increased pain as well as decreased activity levels after being infected with COVID-19 versus pre-COVID-19 (all p < 0.0001).ConclusionsRecovered COVID-19 patients reported increased pain intensity and frequency, together with reduced activity levels, relative to pre-COVID-19 levels, without effects of sociodemographic or clinical characteristics.

The effect of a hand puppet-based therapeutic play for preschool children on the fear and pain associated with blood collection procedure

PurposeThe aim of this study was to determine the effects of a therapeutic play involving a hand puppet on the fear and pain associated with blood collection procedure in preschool children. Design and methodsThe research was conducted as a randomised controlled experiment. The sample included children aged 3–6 years who attended the blood collection unit between July and October 2022 and met the study's inclusion criteria. The research was completed with a total of 120 children, divided evenly into one of two groups. The nursing intervention of the research was a therapeutic play applied with a hand puppet. Data were collected through face-to-face interviews using a Questionnaire Form, the Child Fear Scale and the Wong–Baker Faces Pain Rating Scale. Ethical principles were followed in the research. ResultsDifferences between mean fear and pain level scores between the groups were statistically significant (p < 0.05). ConclusionsThe therapeutic play applied with a hand puppet reduced the level of fear and pain associated with the blood collection process. Practice implicationsHealth professionals working in units related to paediatrics can use hand puppets, which are easy to use, inexpensive and practical, to reduce the fear and pain associated with blood collection from pre-school children.

Pain and rehabilitation after total hip arthroplasty are approach dependent: results 6weeks and 2years after surgery in a multisurgeon, single-center, and prospective cohort study.

The aim of this study was the evaluation of pain, function, and overall satisfaction after total hip arthroplasty (THA) using three different standard surgical approaches (DAA (direct anterior approach), lateral, and posterior approach) 2years postoperatively. Additionally, we compared the results with recently published results of the same study population 6weeks postoperatively. In a multisurgeon, prospective, single-center cohort study, a total of initial 188 patients who underwent total hip arthroplasty (THA) between February 2019 and April 2019 were analyzed on pain, function, and satisfaction within the first days, 6weeks, and 2years postoperatively according to three different approaches (DAA, lateral, and posterior approach). Our research group recently published results directly and 6weeks postoperatively. We evaluated the same study collectively 2years postoperatively and compared the results with the data 6weeks postoperatively. One hundred twenty-five patients could be included. Outcome parameters for the present study were the pain level according to the visual analogue scale (VAS), the modified Harris hip score (mHHS), and an overall satisfaction scale 2years postoperatively. Mean overall satisfaction 2years postoperatively was 9.7 ± 1 (3-10). Satisfaction was significantly better for the DAA than for the lateral approach (p = 0.005). There were no significant differences between the lateral and posterior approaches (p = 0.06) and between the DAA and the posterior approaches (p = 0.11). In total, the mean pain level was 0.4 ± 0.9 (0-5) at 6weeks and 0.5 ± 1.1 (0-7) at 2years postoperatively (p = 0.3). Regarding the different approach groups, pain levels 6weeks and 2years postoperatively were significantly lower for the DAA than for the lateral approach (p = 0.02). There were no significant differences between DAA and posterior approach (p = 0.05) and the lateral and posterior approach (p = 0.26). The mean mHHS significantly increased from 84.7 + 14.5 (37.4-100) 6weeks to 95 + 12.5 (23.1-100.1) 2years postoperatively (p < 0.0001). Regarding the different approaches, mHHS was significantly higher for the DAA than for the lateral approach (p = 0.03). Differences between the DAA and the posterior approach (p = 0.11) and between the lateral and posterior approaches (p = 0.24) were insignificant. At 2years postoperative, DAA showed significantly better overall satisfaction, pain level, and mHHS than the lateral approach. The differences between DAA and the posterior approach and lateral and posterior approaches were insignificant. Whether the superior results of the DAA to the lateral approach persist over a longer period must be clarified by further studies. Prospective cohort study, level of evidence 2.

Impact of Clinical Pharmacist Consultations on Postoperative Pain in Ambulatory Surgery.

Post-operative pain is a common symptom of ambulatory surgery. The objective of this study was to evaluate a pain management protocol integrating a pharmacist consultation. We conducted a quasi-experimental, single center, before-after study. The control group was recruited between 1 March and 31 May 2018 and the intervention group between 1 March and 31 May 2019. Outpatients in the intervention group received a pharmacist consultation, in addition to the usual anesthesiologist and nurse consultations. Pharmacist consultations were conducted in two steps: the first step consisted of general open-ended questions and the second step of a specific and individualized pharmaceutical interview. A total of 125 outpatients were included in each group. There were 17% (95% CI 5 to 27%, p = 0.022) fewer patients with moderate to severe pain in the pharmaceutical intervention group compared with the control group, which corresponded to a decrease in the mean pain level of 0.9/10 (95% CI -1.5/10; -0.3/10; p = 0.002). The multivariate analysis did not reveal any confounding factors, showing that only the pharmaceutical intervention could explain this result. This study demonstrates a positive impact of pharmacist consultations on postoperative pain in ambulatory surgery.