Mean Pain Level Research Articles

Effectiveness of Virtual Reality (VR) technology towards pain management during initial fixed orthodontic procedures: A case-control study

The goal of this research is to see how effective virtual reality (VR) is in reducing discomfort during early fixed orthodontic operations. The research comprised 70 individuals, all of whom were between the ages of 15 to 18 years randomly divided into two groups- research group (n=35) and the control group (n=35). Patients in the experimental group received a virtual reality headset and watched interesting movies during orthodontic procedures, while those in the control group received regular care. The VR headgear was placed over the patient's eyes as the dental procedure began in the study group, whereas the controls group's eyes were kept open as they viewed the clinic and dental procedures going on around them. After adopting virtual reality movies before and after dental treatments, there was a statistically significant difference in pain levels between the control and study groups. The mean pain ratings during orthodontic treatment were 8.6 and 6.3 in the control and study groups, respectively. Following orthodontic treatment, the control and study groups reported mean pain levels of 7.4 and 6.7, respectively. VR is found to be an effective method in pain alleviation during initial fixed orthodontic procedures.

Post-COVID-19 pain syndrome: a descriptive study in Turkish population.

BackgroundThe new type of corona virus has a wide range of symptoms. Some people who have COVID-19 can experience long-term effects from their infection, known as post-COVID conditions. The authors aimed to investigate prolonged musculoskeletal pain as a symptom of the post-COVID-19 condition.MethodsThis is a descriptive study on the patients who were diagnosed with COVID-19 in a university hospital, between March 2020 and March 2021. Patient records and an extensive questionnaire were used to obtain relevant demographic and clinical characteristics, including hospitalization history, comorbidities, smoking history, duration of the pain, the area of pain, and the presence of accompanying neuropathic symptoms.ResultsOf the diagnosed patients, 501 agreed to participate in the study. Among the participants, 318 had musculoskeletal pain during COVID-19 infection, and 69 of them reported prolonged pain symptoms as part of their a post-COVID condition which could not be attributed to any other cause. The mean duration of pain was 4.38 ± 1.73 months, and the mean pain level was 7.2 ± 4.3. Neuropathic pain symptoms such as burning sensation (n = 16, 23.2%), numbness (n = 15, 21.7%), tingling (n = 10, 14.5%), stinging (n = 4, 5.8%), freezing (n = 1, 1.4%) were accompanied in patients with prolonged musculoskeletal pain.ConclusionsPatients with COVID-19 may develop prolonged musculoskeletal pain. In some patients, neuropathic pain accompanies it. Awareness of prolonged post-COVID-19 pain is crucial for its early detection and management.

Pediatrik Anestezi Sonrası Çocukların Ağrı Düzeyleri ve Hemşirelik Girişimlerinin Değerlendirmesi: Retrospektif Tanımlayıcı Çalışma

Çalışmanın amacı, pediatrik anestezi sonrası 3-18 yaş grubundaki çocuk hastaların ağrı düzeylerinin ve uygulanan hemşirelik girişimlerinin retrospektif olarak belirlenmesidir.
 Retrospektif, tanımlayıcı türde bir çalışmadır. Araştırma Konya ili bir kamu hastanesinin çocuk cerrahi servisinde yapıldı. Araştırmanın örneklemini, 01 Ocak 2019-31 Aralık 2020 tarihleri arasında hastanede çocuk cerrahi kliniğinde yatan, cerrahi girişim geçiren 3-18 yaş grubundaki toplam 2420 çocuk hastalar oluşturdu. Araştırma verilerinin toplanmasında Çocuk Bilgi Formu, hastane otomasyon sisteminde kayıtlı ağrı tanılama sistemi kullanıldı. Verilerin analizi sayı, yüzdelik hesaplamalar ve ortalamalar analizleri kullanılarak değerlendirildi.
 Çalışmaya katılan 2420 çocukların %56,5’i 3-6 yaş grubunda, %96,4’ünün erkek, %92,9’una günübirlik cerrahi ameliyatı yapıldığı, %97,6’sına analjezik uygulanmadığı, %78’ine dikkati başka yöne çekme uygulamasının yapıldığı ve ağrı düzey ortalamalarının 2,17±0,71 olduğu saptandı. 
 Çalışma sonucunda postoperatif dönemde çocuklarda ağrı düzeyinin düşük olduğu ve hemşirelerin ağrı yönetiminde nonfarmakolojik yöntemler aracılıyla hemşirelik girişimlerini yaygın olarak çocuğun yaş özelliği dikkate alınarak uyguladıkları belirlendi.

Pain Levels Did Not Differ Following Uncomplicated Third Molar Extractions Utilizing Liposomal Bupivacaine Versus Standard Bupivacaine

Operations in the oral cavity are often characterized by an acute period of postoperative pain historically mitigated via opioids and other analgesics. The purpose of the study was to determine if liposomal bupivacaine infiltration (LBI) following uncomplicated extraction of bilateral, mandibular third molars will significantly reduce postoperative pain when compared to standard bupivacaine. The study was designed as a parallel-arm randomized clinical trial. The sample size was calculated for the primary outcome variable: postoperative pain levels measured at 48-hours. Using a power analysis, a sample size of n=13 for each group was required. Patients meeting the inclusion/exclusion criteria requiring exodontia from November 4, 2018, to June 16, 2022, were recruited out of the oral and maxillofacial surgery clinic. The patients were randomized and divided into 2 groups. Group A was administered 0.50% bupivacaine (with 1:200,000 epinephrine) via infiltration while group B underwent LBI. The primary outcome of interest was postoperative pain levels followed by the secondary outcomes of postoperative narcotic analgesic use, return to oral function, and satisfaction. Patient demographics and characteristics were analyzed as potential covariates utilizing the Fisher exact test and t test for continuous outcomes, respectively. Thirty patients were recruited for the study. The average age of patients receiving the third molar operation was 24.1 ± 5.8 years. Of the 30, 62.5% were female, and 37.5% were male. Seventy-five percent of the patients were Caucasian, 20.8% were African American, and 4.2% were Asian. Forty-eight-hour postoperative interviews revealed mean pain levels of 2.5±2.8 in the control group and 2.9±2.3 in the LBI group (P=.730) as measured on a visual analog scale. The 48-hour postoperative interview identified a mean of 1.9±2.1 narcotic pills used in the control group and 2.5±5.0 pills used in the LBI group (P=.693). Mandibular LBIs following bilateral mandibular third molar extractions showed no statistically significant advantage over the standard bupivacaine at either time point analyzed. Furthermore, no statistically significant difference was found regarding narcotic use between the 2 groups.

Pengaruh Aromaterapi Bitter Orange Terhadap Nyeri Postpartum Sectio Caesarea di RSUD Panembahan Senopati Bantul

Postpartum sectio cesarea pain (pain experienced by a mother after birth delivery) will usually increase on the first postoperative day and will be more painful if the effect of the analgesic disappears. Bitter orange is one among other aromatherapy treatments that can be used to treat pain. This research aims to determine the effect of bitter orange aromatherapy on postpartum sectio caesarea pain. The research method is quantitative that uses a quasi-experimental design with a pre-test and post-test approach without a control group with a bitter orange aromatherapy intervention conducted from June-July 2021. The sampling technique was purposive sampling with a total of 25 postpartum sectio caesarea mothers in the Alamanda 3 Ward at RSUD Panembahan Senopati, Bantul. The pain measuring instrument used was NRS (Numeric Rating Scale). The data analysis used the paired t-test method. The results show that there is a difference in the mean level of pain in postpartum sectio caesarea mothers before and after treated with bitter orange aromatherapy with a mean value of 0.680, standard deviation of 0.476 and p-value of 0.000 (p-value <0.05). There is an effect before and after implementing bitter orange aromatherapy on postpartum sectio caesarea pain in Alamanda 3 Ward RSUD Panembahan Senopati Bantul.

The Effect Of The Use Of Birth Ball On Intensity Of Labor Pain I Active Phase In Primigravidal Mothers In Pmb Bekasi City In 2022

Childbirth is a natural process.Discomfort, fear and pain is a problem for mothers in labor. Pain in the first stage of the active phase of labor is severe pain with a longer time, therefore it is necessary to pay attention to handling to overcome pain in the first stage of labor. This study aims to determine the effect of the use of birth balls on the intensity of labor pain in the active phase of the first stage of primigravida mothers in PMB Bekasi City 2022. This study uses a quasi-experimental approach. The sample in this study was 30 respondents, namely 15 mothers in the control group and 15 mothers in the intervention group. The instrument used is an observation sheet on the implementation of the use of a birth ball. The analysis used is univariate analysis and bivariate analysis using Independent T test and Paired T - Test. HThe results of the univariate analysis showed that in the intervention group the average level of pain before the birth ball was done the average pain level was 7.46 and after it was done it was 4.46. The mean level of pain in the control group on examination 1 was 7.06 and on examination 2 was 6.80. The results of the bivariate analysis showed that there was an effect of using a birth ball on the pain of labor in the first stage of the active phase in primigravida mothers with a p value of 0.000. There is no effect of not using a birth ball on the pain of labor in the first stage of the active phase of primigravid mothers with a p value of 3.64. There was a difference in the decrease in pain level in the first stage of the active phase in primigravida mothers in the intervention group and the control group with a p value of 0.000. The results of this study can be concluded that the use of birth balls is effectively used to reduce labor pain in the first stage of the active phase of primigravida mothers

The effect of aromatherapy and Su Jok interventions on post-cesarean pain

ObjectiveThe aim of this study was to determine the effect of aromatherapy and Su Jok interventions as nonpharmacological methods of relieving pain after cesarean section. Materials and methodsThis randomized controlled trial was conducted with 120 women who had cesarean delivery in the gynecology and obstetrics department of a training and research hospital between February 9 and October 2, 2019. The participants were allocated to the aromatherapy group, Su Jok group, Su Jok and aromatherapy group, or control group using block randomization based on parity. Su Jok was performed using buckwheat seed; aromatherapy was applied using lavender, eucalyptus, or rose oil. Data were collected using a participant information form and pain was assessed using the Visual Analog Scale. ResultsThere was no significant difference between the groups in mean pain levels before or after the intervention, although the control group had less initial pain compared to the intervention groups. However, all three intervention groups showed significant decreases in pain levels immediately and 30 min after the intervention compared to pre-intervention levels (p < 0.05). The intervention in all three groups reduced the level of pain. In particular, the pain level of the Su Jok group reached from moderate to mild. There was no significant change in the control group. ConclusionsAromatherapy and Su Jok interventions performed separately and simultaneously in addition to routine hospital care were more effective in reducing post-cesarean pain than routine care alone.

Evaluation of Pain-Relieving Effect of Menthol and Benzocaine Patches in Orthodontic Patients: A Triple-Blind Randomized Controlled Trial

Purpose: This study aimed to compare the effect of benzocaine and menthol patches on pain alleviation following elastomeric separator placement.Patients and Methods: This triple-blind split-mouth trial was conducted on healthy 14-25 years old patients of orthodontic department. Eligibility criteria included presence of second premolar, first and second molars in both sides of the mandible, no chronic pain in oral cavity, or chronic consumption of analgesic drugs. Elastomeric separators were placed mesial and distal of first mandibular molars and patients were randomized into two groups: 1) menthol/ placebo patches, 2) benzocaine/ placebo patches. The mucosal patches were placed randomly on the buccal area of mandibular first molars on both sides. Main outcome was pain level reported by patients on the Visual Analogue Scale (VAS) in seven-time intervals in three following days. Data were analyzed by linear mixed model. P-value was set to be 0.05. Results: Sixty-four patients were randomized in a 1:1 ratio with no loss to follow-up. Both benzocaine and menthol patches significantly reduced mean pain level compared to placebo patch (P< 0.001). Benzocaine patch had more analgesic effect; however, the difference was not statistically significant (P=0.115). Time interval had a significant effect on recorded pain except the first time interval. Age and gender had no significant effect on pain. No adverse event was reported in patients. Conclusions: Both benzocaine and menthol patches were effective in alleviating pain. Therefore, they can be recommended to be used for reducing pain following orthodontic elastomeric separator placement.

Is it worth the risk? Clinical and radiographic outcomes 24 months after reverse shoulder arthroplasty in an advanced geriatric population

BackgroundThe application of reverse shoulder arthroplasty (RSA) has risen in the past decades especially due to its excellent long-term outcomes. With this positive trend, the indications for RSA have gradually extended to a broader age spectrum. The objective of this study was to identify the benefits of primary RSA in an advanced geriatric population with considerable comorbidity burden and higher perioperative risk.MethodsFor this observational study using data collected from our local RSA register, we identified 73 patients (77% female) with a minimum age of 85 years (range: 85-93 years) at the time of surgery and a complete 24-month postoperative follow-up. Clinical evaluations of pain, Subjective Shoulder Value, Constant score, Shoulder Pain and Disability Index, quality of life (European Quality-of-Life 5-Dimension 5-Level utility), and patient satisfaction were made. Radiographic evaluation followed an international consensus core set. Adverse events were documented according to a core event set.ResultsPreexisting medical conditions categorized following the American Society of Anesthesiologists physical status classification system indicated only 22% of patients with mild comorbidities (American Society of Anesthesiologists I-II), whereas severe (American Society of Anesthesiologists III-IV) comorbidities were common (78%). Indications for surgery were rotator cuff deficiency (72%), post-traumatic conditions (18%), and primary arthrosis (10%). There was significant improvement in all clinical evaluations up to 24 months post RSA: mean pain levels decreased from 6.2 to 1.6 points, where 0 indicates no pain (P < .001) and Subjective Shoulder Value, Constant score, Shoulder Pain and Disability Index, and European Quality of Life 5 Dimensions 5 Level increased from 36% to 76%, 26 to 61 points, 29 to 74 points, and 0.58 to 0.79, respectively (P < .001). Most patients (88%) opted in favor of undergoing the same surgery again based on their personal outcome. There were no signs of early loosening, migration or dislocation at 24 months postsurgery. However, 6 periprosthetic fractures were identified, 5 of which were treated conservatively. Adverse events were reported for 39% of patients, yet rarely led to the need for revision surgery (1.8%) or hospital readmission (3.6%).ConclusionDespite an advanced age over 85 years and numerous associated comorbidities, our geriatric population showed a distinct clinical improvement in their daily activities with high rates of patient satisfaction. Radiographic analysis at 24 months after surgery identified adequate implant stability. RSA is a safe procedure, even in these elderly patients, with an acceptable risk of unfavorable medical and surgical events.

Treatment of First Carpometacarpal Osteoarthritis with Arthroscopy: A Systematic Review.

Background First carpometacarpal (CMC) osteoarthritis or trapeziometacarpal osteoarthritis is a common debilitating hand condition. No one surgical technique has demonstrated superiority in managing this disease. Purpose This study performed a systematic review of arthroscopic techniques for treating first CMC arthritis to assess the effectiveness of different arthroscopic techniques. Methods Grip strength, pinch strength, visual analog scale, the Disability of Arm, Shoulder, and Hand (DASH) score, range of motion (ROM), and complications were recorded. Two subgroup analyses were performed, comparing outcomes of (1) trapeziectomy of any type versus debridement alone and (2) trapeziectomy alone versus interposition versus suspension techniques. Results Preoperative and postoperative scores significantly improved for DASH scores and pain at rest and with activity with variable improvements in ROM. Complications occurred in 13% of cases in publications that reported complications. When comparing studies that utilized techniques with any type of trapeziectomy to debridement alone, only the trapeziectomy subgroup showed significant improvements in pain. When comparing trapeziectomy alone to interposition and suspension techniques, mean DASH scores and pain levels significantly improved in interposition and suspension subgroups. Conclusions The existing literature describes a predominantly female population with Eaton-Littler stage II and III disease. In the subgroup analysis, arthroscopic techniques involving a trapeziectomy seem to be more effective at lowering pain scores compared to techniques involving debridement alone. Likewise, interposition and suspension techniques may show improved outcomes compared to techniques involving trapeziectomy alone. Level of evidence This is a Level III study.

ISIS trapeziometacarpal arthroplasty: What are the outcomes in male patients?

Trapeziometacarpal arthroplasty is a well-known treatment of thumb basal joint arthritis. However, only a few studies have been done on its use specifically in men, with one of the most recent showing a high implant failure rate. Our study was a retrospective analysis of the ISIS prosthesis exclusively in men. Our hypothesis was that it is a viable therapeutic solution. Between 2010 and 2020, 23 ISIS prostheses were implanted in 19 patients. A radiological and functional analysis was done, combined with a self-evaluation by multiple validated outcome scores (visual analog scale for pain, QuickDASH, PRWE, SF36, and Kapandji scores). The median follow-up was 76 months (13–134) with a median age of 69 years. The mean pain level was 1/10, the QuickDASH was 22.7, the PRWE was 14.2, the SF-36 was 61.1 and the Kapandji score was 8.9. One dislocation occurred in one patient; two patients had to be reoperated for periprosthetic ossifications. Radiolucency was found around the cup in one patient and around the metacarpal shaft in one patient. There was no implant failure and only one case of asymptomatic loosening, with a survival rate of 94% at 111 months. In the medium-term, clinical, and functional outcomes were satisfactory with pain relief similar to that of published studies, with a low rate of complications. ISIS arthroplasty appears to be a suitable treatment for thumb basal joint arthritis in men, although a non-negligible rate of periprosthetic ossifications required revision surgery in half of the cases.

IDENTIFYING PATIENTS WITH DIFFERENT PAIN TRAJECTORIES IN HAND OSTEOARTHRITIS

Purpose: Hand pain is a common symptom in hand osteoarthritis (OA). Pain is not clearly associated with structural joint damage. Joint damage shows progression in hand OA, but previous cohort studies did not report an increase in mean pain levels on the short to midterm. This does not preclude the existence of groups of hand OA patients with different pain trajectories. Such groups have previously been found in knee OA patients. Knowledge of similar patient populations in hand OA may help guide pain treatment decisions.

Effect of expressed breast milk administration on pain response among newborns during heel lance procedure in a tertiary care hospital — A randomized controlled trial

Newborn’s pain is a great challenge to health professionals as well as to parents. Newborns are especially vulnerable to pain. The primary objective was to evaluate the effectiveness of expressed breast milk administration on pain response among newborns during heel lance procedure and the secondary objective was to find out association between selected sociodemographic variables and pain response among newborns during heel lance procedure. The research approach adopted was quantitative and the design was experimental - A randomized controlled trial. Sixty newborns after 48 to 72 hours of life who came to the Shalabham newborns screening unit for metabolic screening were selected according to the inclusion criteria. Samples were selected by using block randomization with fixed block size 4 and newborns divided into two groups, experimental and control group. Allocation concealment was done by using an opaque sealed envelope. The investigator, clinical data collected from the case record of the newborns and caregiver who came with newborns to Shalabham unit. After collecting clinical data, pain was measured by NIPS score 3 minutes before heel lance procedure for getting baseline data by an observer in both the groups by an observer. The investigator knows the newborns whether included in experimental or control group. Then for the experimental group, 5 ml expressed breast milk was given through gokarnam by the investigator and routine care was given by the staff nurse. For control group routine care given by staff nurse. After 1 minute performed heel lance procedure by a staff nurse who had adequate experience in neonatal care to minimize the variation in pain during the heel lance procedure, heel lance procedure was done using all sterile precautions and blood collected in the screening card and kept for drying process. The observer assessed the pain level of newborns by using NIPS score during heel lance procedure both experimental group and control group. After 30 minutes, pain level was reassessed by observer using NIPS score on experimental and control group and recorded. Results showed that the mean pain level was significantly improved in the experimental group (p&amp;#60;0.00) compared to the control group. Thus, it can be concluded that expressed breast milk administration is found to be effective in reducing pain during heel lance procedures.

Investigation of the Effect of Time to Ambulation on Patient Outcomes, Anxiety and Depression

Purpose: The aim of the study was to investigation of the effects of time to ambulation on patient outcomes, anxiety and depression.&#x0D; Method: This is a descriptive cross-sectional study. The study was conducted on 157 patients in the general surgery clinic of a training and research hospital in western Turkey. The data were collected using a Descriptive Form, Patient Outcomes Follow-up Form, Brief Pain Inventory, Hospital Anxiety and Depression Scale (HADS) and analysed by number, percentage, Mann–Whitney U test, Spearman correlation method using the Statistical Package for Social Science software version 24.&#x0D; Results: The mean age of the patients who participated in the study was 49.5±18.1 years. The mean time to ambulation of the patients was 12.45±9.07 hours. The mean pain level of the participants in the last 24 hours, mean HADS-anxiety score and mean HADS-depression score were 3.7±1.7, 4.0±2.6 and 4.4±3.0, respectively. &#x0D; Conclusions: In our study, we found that the time to ambulation was increased as the patients' age, duration of anaesthesia and depression scores increased. Additionally, the ambulation of patients with drains and catheters delayed. Furthermore, it was found that the duration of hospitalisation increased with the increase in the time to ambulation of patients.

Platelet-rich plasma outcomes do not correlate with patient satisfaction or perceived cost-effectiveness

ABSTRACT Background As platelet-rich plasma injection for knee osteoarthritis (OA) has increased in popularity, it has become more important to assess its effectiveness and satisfaction with its use in the context of its high cost. The purpose of this study was to determine satisfaction, commercial appeal, and effectiveness of platelet-rich plasma (PRP) for the treatment of knee OA. Methods A retrospective review of patients who underwent PRP injection in the knee from 2016 to 2019 was performed. Various patient-reported outcomes were collected, including: satisfaction with the PRP injection (out of 100), whether the patient would want to undergo PRP injection again, whether they would recommend the injection and whether they felt that the injection was worth the cost was collected. VAS pain scores were collected and measured out of 100. Demographics and radiographical information were obtained via chart review. Statistical analyses were conducted including descriptive statistics and binary logistic and linear regressions. Results Overall, 114 patients were included. The mean pre-injectionpain score was 70.4, and the mean pain level decreased after injection to 36.8. Patients rated their satisfaction on average as neutral along the aforementioned continuous scale (49.2), , 50.9% stated that they would get the PRP injection again, 60.5% would recommend to a friend, and 50.9% felt the injection was worth the cost. Younger age and improved post-injection pain correlated with increasing likelihood of desiring further PRP injection. Conclusions Patients on average rated satisfaction slightly below average, indicating net neutrality in terms of satisfaction with their injection. Furthermore, only half of the patients indicated that it was worth the cost and that they would receive it again. Younger age and post-injection pain relief increased desire for further injection, but pain-relief did not correlate with patients saying that the injection was worth the cost.

Posterior hinge fixation for the treatment of unstable traumatic sacroiliac joint injuries

IntroductionPosterior hinge fixation (PHF) is a sacroiliac joint fixation method indicated for the surgical treatment of unstable pelvic ring fractures (tile C). HypothesisPHF yields good functional outcomes based on the Majeed score at more than 1 year of follow-up. MethodsA single-center, retrospective study of patients who had a Tile C pelvic ring fracture, who were operated by PHF and who were evaluated at a minimum follow-up of 1 year. The functional outcome was determined using the Majeed score and pain was evaluated by the patients using a visual analog scale (VAS). The preoperative, intraoperative and postoperative data, complications and sequelae were documented. A CT-scan was done at least 1 year after the surgical treatment to determine the SI joint's reduction and fusion. ResultsIncluded were 22 patients (59% men) who had a mean age of 37.3±11.9 years; 21 of these patients were reviewed at a mean of 4.8±4 years. The mean Majeed score at the final assessment was 76.4 points±15.3, with 24% of patients having excellent results (n=5), 53% having good results (n=11), 19% having average results (n=4) and 5% having poor results (n=1). The mean pain level on VAS was 28±23mm. Of the eight surgical site infections, seven occurred in the PHF (88%). CT-scans taken at 1 year postoperative were compared to the preoperative scans. The pelvic opening was reduced by −9±6 (p<0.01), SI diastasis by −11mm±9 (p<0.001), vertical displacement by–7mm±8 (p<0.001), symphysis opening by −15mm±15 (p<0.001), median transverse diameter by −10mm±9 (p<0.001) and bispinal diameter by −5mm±7 (p<0.001). SI fusion was confirmed in 43% of patients (n=9). ConclusionPHF is a surgical instrumentation method that provides satisfactory long-term reduction of Tile C pelvic ring fractures. The clinical outcomes are good or excellent in 77% of cases. The perioperative morbidity is marked by surgical site infections, all of which healed. Level of evidenceIV; retrospective, non-comparative cohort study.

Capillary blood glucose measurements at lateral and median fingertips in patients with type 2 diabetes mellitus in Malang: comparison of pain levels

Introduction: Self-monitoring of blood glucose is one of the ways to treat type 2 diabetes mellitus, which is a chronic disease that affects many people. Blood glucose is measured by taking a sample from a capillary blood vessel, such as a finger. To decrease the pain, it is vital to learn more about the exact position of the puncture on the finger. The aims of this study is compare the location of the capillary blood collection at the median and lateral fingertips to the level of pain experienced by patientsMethods: With a sample of 50 participants, the lateral area of the finger and the median finger were separated into two groups. The Visual Analog Scale is the tool used to assess pain (VAS).Results: The lateral group's mean pain level was low. The median group had the greatest pain scale among 50 responders whose pain level was assessed using the VAS instrument. Based on the Mann-Whitney test results, there were differences in the level of pain in blood glucose in the lateral and median fingers (p = 0.036).Conclusion: The lateral and median fingertips in the capillary blood sample have different levels of pain. Although the location lateral to the fingertip is a less painful site for capillary blood collection than the median fingertip location, it still needs to be validated in bigger clinical trials.

The IBTIS score; a new prognostic score for arthroscopic biceps tenotomies

IntroductionShoulder pain associated with tendinopathy of the long head of biceps (LHB) is common. Surgical treatment with arthroscopic tenotomy of the LHB has been shown to be effective. However, it's efficacy is inconsistent. The objective of this study was to assess the pre-operative clinical and radiological prognostic factors of arthroscopic tenotomy of the long head of biceps, and to establish a predictive score for good responses to treatment; the IBTIS score (Isolated Biceps Tenotomy Index Score). HypothesisPrognostic factors representing a good response to treatment of LHB tendinopathy by arthroscopic tenotomy exist. Materials and methodsWe conducted a retrospective monocentric study including 64 patients who underwent surgery of the LHB by arthroscopic tenotomy (with or without tenodesis) between January 2018 and March 2020. We identified 2 patient groups (good responder group and poor responder group) from a 3-month post-operative clinical assessment, which included a subjective assessment comprising Single Shoulder Value (SSV), Constant score, C-Test, and pain level. Prognostic factors of a good response were then sought from the 2 groups using interviews, clinical examinations and pre-operative imaging. Based on these findings, a predictive score for a good response was established. ResultsAll evaluation criteria demonstrated post-operative improvement: mean SSV (72.2 vs 50.7; p<0.001), relative constant (78.2 vs 64.3; p<0.001), pain level (3.2 vs 7; p<0.001) and C-Test (94.1 vs 85.6; p=0.07). 34 patients (58.6%) were considered good responders, while 24 patients (41.38%) were considered poor responders. There was a trend towards a favourable result for: age>65 years (p=0.01), rotator cuff rupture on preoperative imaging (p=0.01), Cross Arm Test (p=0.02), nocturnal pain (p=0.08), Yergason's test (p=0.16) and Speed's Test (p=0.22). Manual labour appeared to be an unfavourable factor (p=0.07). These factors were incorporated into the 10-point IBTIS score. A score greater than 5 was associated with a favourable result in more than 80% of patients (p<0.001). DiscussionOur score consists of 7 items. We identified 7 pre-operative prognostic factors for a good result after LHB tenotomy. Over 65 years of age was found to be statistically significant in univariate analysis, as was visualization of rotator cuff rupture on pre-operative imaging. The Cross Arm Test was included given its high statistical significance. The Speed's Test and Yergason's Test are ubiquitous in the literature. Nocturnal pain was found in more than 80% of patients. Undertaking manual labour represented an unfavourable prognostic factor after arthroscopic surgery of the LHB. ConclusionThe IBTIS score (Isolated Biceps Tenotomy Index Score) is a pre-operative clinico-radiological score for the surgical treatment of arthroscopic tenotomy of the long head of biceps. Further studies are required to validate its prognostic accuracy. Level of evidenceIII; case-control.

The novel dynamic MPFL-reconstruction technique: cheaper and better?

PurposeReconstruction of the medial patellofemoral ligament (MPFL) is an established procedure to restore patellar stability. Aim of this study is to evaluate the results of a dynamic MPFL reconstruction technique in a large university hospital setting.MethodsTwo hundred and thirteen consecutive patients with 221 knees were surgically treated for recurrent lateral patellar dislocation. All patients obtained dynamic reconstruction of the MPFL with detachment of the gracilis tendon at the pes anserinus while maintaining the proximal origin at the gracilis muscle. Patellar fixation was performed by oblique transpatellar tunnel transfer. Follow-up data including Kujala and BANFF score, pain level as well as recurrent patella instability were collected at a minimum follow-up of 2 years.ResultsFollow-up could be obtained from 158 patients (71%). The mean follow-up time was 5.4 years. Mean pain level was 1.9 ± 2.0 on the VAS. Mean Kujala score was 78.4 ± 15.5. Mean BANFF score was 62.4 ± 22.3. MPFL-reconstructions that were performed by surgeons with a routine of more than ten procedures had a significantly shorter surgical time 52.3 ± 17.6 min. Male patients yielded higher satisfaction rates and better clinical scores compared to females. Complications occurred in 27.2% of procedures, 20.9% requiring revision surgery of which were 9.5% related to recurrent patellar instability. 78% of all patients indicated they would undergo the procedure again.ConclusionDynamic MPFL reconstruction presents a reproducible procedure with increased complication rates, inferior to the results of static reconstruction described in the literature. Despite, it appears to be an efficient procedure to restore patellar stability in a large university hospital setting, without the necessity for intraoperative fluoroscopy.Trial registrationThe study was registered in ClinicalTrials.gov with the registration number NCT04438109 on June 18th 2020.

Efficacy of Preoperative Music Intervention on Pain and Anxiety in Patients Undergoing Cataract Surgery

The aim of the present study was to investigate the impact of preoperative music exposure on intra- and post-operative pain during cataract surgery. This study was conducted alongside a prospective single-masked randomized controlled trial (ClinicalTrials.gov NCT02892825). Patients undergoing first eye cataract surgery were included and randomly assigned to either the intervention or control group. Patients in the intervention group had a 20-min music session through earphones before surgery, while patients in the control group wore earphones without music. Anxiety level evaluated using the visual analog scale and heart rate were collected before and after music intervention. Pain level was assessed using the Numerical Pain Rating Scale, during the surgical procedure, prior to discharge and 7 days postoperatively. A total of 243 patients were included: 119 in the intervention group and 124 in the control group. No significant differences in baseline characteristics, including age, sex and rate of treated hypertension were found between the 2 groups (all p-values > 0.05). In addition, no significantly differences were found in heart rate and anxiety level before music intervention between the 2 groups (all p-values > 0.05). Conversely, anxiety level was significantly lower in the music group after the intervention (respectively, 1.3 ± 1.1 vs 3.2 ± 2.2; p < 0.05). Patients in the music group reported a lower mean pain level during surgical procedure and before discharge compared with control group (respectively, 1.2 ± 0.5 vs 2.1 ± 1.1, p = 0.03 and 0.23 ± 0.4 vs 0.81 ± 0.7, p = 0.04). No difference was found in pain level 7 days postoperatively (0.1 ± 0.3 vs 0.2 ± 0.4, p = 0.1). A significant correlation was found between anxiety level and intraoperative pain level (R = 0.64, p = 0.02). In conclusion, music intervention was effective in reducing anxiety level and self-reported pain both during surgery and in the early postoperative period. Clinical Trial Registration: https://clinicaltrials.gov/ct2/home, identifier NCT02892825.