Median Pain Level Research Articles

Ocular pain: a casualty study. The spectrum and prevalence of pain in acute eye disease.

This study examined the prevalence and severity of ocular pain in eye casualty patients. All new patients presenting over a 1 month period were invited to indicate their pain level using a visual analogue scale. The results for 352 patients were analysed, and median pain levels calculated for 29 common diagnoses. Of those responding, 94% (= 47% of all new patients) had ocular pain at presentation. While many results were predictable, some diagnoses were associated with higher pain scores than expected. Junior ophthalmologists also were asked to indicate their perceptions of pain severity for the 29 diagnoses using the same visual analogue scale.

Flexible sigmoidoscopy screening for colorectal cancer in average-risk subjects: a community-based pilot project.

To test a pilot screening program for colorectal cancer. Subjects, chosen at random and recruited by mail, were examined by flexible sigmoidoscopy. Normal-risk, asymptomatic men and women aged 55-59 years recruited from the community, July to December, 1995. Number of polyps detected and cancers diagnosed, and compliance with screening. Letters of invitation were sent to 3500 subjects; of these, 2881 were eligible for inclusion in the study and 342 (12%) consented to participate. A further 3.5% of non-compliant subjects attended the screening program after a telephone survey assessing reasons for non-attendance. Common reasons for non-attendance were a lack of interest (30%) or a lack of time, mainly due to work commitments (28%). A third of subjects had polyps and 46% of these were adenomas. Three subjects were found to have adenocarcinoma: in two the cancer was confined to a polyp and treated with polypectomy, and one subject underwent anterior resection (overall prevalence of cancer, 0.9%). The median depth of insertion achieved with flexible sigmoidoscopy was 55 cm (range, 25-100 cm). Median pain level (on a scale of 0 = no pain to 10 = worst pain imaginable) was 2 (range, 0-8.5), and 99% of the subjects would have the test again if required. Flexible sigmoidoscopy was well tolerated and had an acceptable detection rate of adenomatous polyps and early cancer. Subject compliance emerged as a major issue which requires further evaluation to maximise participation in future programs.

Buffered Lidocaine: Analgesia for Intravenous Line Placement in Children

To evaluate the effectiveness of intradermal buffered lidocaine as analgesia before intravenous line (i.v.) placement in children. This was a randomized clinical trial undertaken in the emergency department (ED) of a regional children's hospital. Participants were children 8 to 15 years old, seen in the ED and in need of i.v. lines. They were enrolled by three ED nurses. Participants were randomized to receive either intradermal buffered lidocaine or no analgesia. Before placement of the i.v. line, patients recorded the amount of pain they were in (baseline pain) on a visual analog pain scale. The primary outcome measure was amount of pain caused by the initial i.v. attempt, even if that attempt was unsuccessful. This was recorded by the participant on a visual analog scale. Demographic characteristics, the number of attempts to successful placement, and the time required to place the i.v. line were also recorded. Differences in pain of initial i.v. attempt and time to place the i.v. line were evaluated with the Mann-Whitney U test. Differences in success of i.v. line placement were evaluated with the chi 2 test. Fifty-nine patients completed the study. Thirty received buffered lidocaine, and 29 received no analgesia before i.v. line placement. There was no significant difference between the two groups with regard to baseline pain or demographic characteristics. The median level of pain of the initial i.v. attempt as measured by the visual analog scale was 2.3 in the buffered-lidocaine group and 4.4 in the no-lidocaine group. Thirty-three percent of patients in the lidocaine group and 28% percent in the no-lidocaine group required more than one i.v. attempt. The median time to i.v. line placement was 10 minutes in the lidocaine group and 6 minutes in the no-lidocaine group. Use of intradermal buffered lidocaine is an effective way to diminish the pain of i.v. line placement in children 8 to 15 years of age. There was no difference in i.v. success rate in this study; however, larger numbers of patients would be required to detect statistically significant differences. We recommend the routine use of intradermal buffered lidocaine for analgesia before i.v. line placement in older children in all but emergent situations.