Pain Intensity Numerical Scale Research Articles

Efficacy of S-Flurbiprofen Plaster for Analgesia Following Total Hip Arthroplasty.

S-flurbiprofen (SFP) plaster, a non-steroidal anti-inflammatory drug preparation that penetrates effectively into deep tissue, is currently used as a conservative treatment for osteoarthritis. We investigated the analgesic and adverse effects of SFP plaster after total hip arthroplasty (THA). A retrospective comparative study identified 100 patients who underwent primary THA in our department. Group A consisted of 50 patients who received the selective cyclooxygenase-2 inhibitor celecoxib for 14 days after surgery, while Group B consisted of 50 patients who received SFP plaster for 14 days after surgery. We noted the numerical rating pain intensity scale (NRS) score, body temperature, and adverse effects of the analgesics. Groups A and B showed no significant difference in NRS scores (p > 0.05). The body temperature was significantly higher in Group B than in Group A on days one, two, three, and five (p < 0.01). In Group A, two patients (4%) showed drug-induced renal dysfunction, and one patient (2%) showed gastrointestinal disturbance. Patients in Group B showed no systemic or local adverse effects. The application of SFP plaster after THA provided an analgesic effect similar to that obtained with oral celecoxib without causing obvious side effects. Applying an SFP plaster may be an effective solution for postoperative analgesia.

A Novel Therapeutic Approach of 980 nm Photobiomodulation Delivered with Flattop Beam Profile in Management of Recurrent Aphthous Stomatitis in Paediatrics and Adolescents-A Case Series with 3-Month Follow-Up.

Background/Objectives: Recurrent aphthous stomatitis (RAS) is one of the most common oral mucosal lesions and a very debilitating lesion, especially in paediatric and adolescent patients. The current pharmacotherapy offers a pain relief but not without side effects, and therefore photobiomodulation (PBM) can be an alternative therapy. To the authors' best knowledge, no published study has explored the efficacy of λ 980 nm laser PBM in the management of all RAS subtypes in paediatric and adolescent patients, and therefore, this prospective observational clinical study was conducted to bridge this gap by evaluating λ 980 nm laser PBM efficacy in symptomatic RAS management in paediatric and adolescent patients. The objectives were to evaluate (1) pain intensity alleviation; (2) wound healing rate; (3) wound size closure; (4) a complete resolution; (5) evidence of recurrence; and (6) patients' treatment satisfaction. Methods: The study's variables were assessed at the following timepoints: T0: pre-treatment; T1: immediately after first PBM session; T2: 5 hours (h) post first PBM session (via telephone call); T3: immediately after second PBM session (three days post first PBM session); T4: three-day follow-up (after complete PBM treatments); T5: two-week follow-up; and T6: three-month follow-up. The following PBM dosimetry and treatment protocols were employed: λ 980 nm; 300 mW; 60 s; 18 J; CW; flattop beam profile of 1 cm2 spot size; 18 J/cm2; and twice-a-week irradiation (72 h interval). Results: At T1, significant immediate pain intensity relief was reported. 33.33% recorded "4" and 66.67% reported "5" on the quantitative numeric pain intensity scale (NPIS), and this continued to improve significantly (83.33%) at T2. All the subjects reported "0" on the NPIS at T3, T4, T5 and T6. There was a significant reduction in the lesion surface area (>50% complete healing) at T3 compared to T0. Complete healing (100%) with no evidence of scarring and lesion recurrence observed at T4, T5 and T6. Very good patients' satisfaction was reported at all timepoints. Conclusions: This is the first report demonstrating λ980 nm efficacy in all RAS subtype management in paediatric and adolescent patients with a 3-month follow-up, whereby its PBM dosimetry and treatment protocols were effective from scientific and practical standpoints, and hence multicentre RCTs with large data are warranted to validate its reproducibility and to enrich the knowledge of PBM application in all RAS subtypes.

A Study to Evaluate the Effectiveness of Acupressure on Dysmenorrhea among Nursing Students at Shri Vinoba Bhave College of Nursing, Silvassa, Dadra and Nagar Haveli

ABSTRACT INTRODUCTION Menstruation is the normal process that occurs in all healthy adult. Menstrual pain or dysmenorrhea is the pain in the lower abdomen before or during menstruation. India has one of the fastest growing youth populations in the world, with an estimated 190 million adolescents. Girls below 19 years of age comprising 21% of India’s total population. In India 67.2% adolescent girls suffer from dysmenorrhea and 60% of them have disrupted daily routines.The incidence of menstrual pain to women in the world is relatively high on the average of more than 50% in every country.Acupressure is an ancient healing art that uses fingers to press key points on the surface of the skin to stimulate body’s natural self-curative abilities. Acupressure release tension, increases circulation, reduces pain, and develops vibrant health, with a view to this; the study was conducted to assess the effectiveness of acupressure on dysmenorrhea among nursing student at Shri Vinoba Bhave College of Nursing, Silvassa. AIM Aim of the study is to evaluate the effectiveness of acupressure on reduction of pain during menstruation among nursing students at Shri Vinoba Bhave College of Nursing, Silvassa, Dadra and Nagar Haveli. METHODOLOGY Quasi experimental, time series non-equivalent control group design with Non probability purposive sampling technique was used to select 60 nursing students, 30 experimental and 30 control group. Dysmenorrhea is assessed by WaLIDD scale. Tool was used for data collection were Numerical pain intensity scale, socio-demographic variable, baseline clinical data. Pretest was done before intervention in experimental group and control group. Acupressure therapy was given to experimental group and pain was assessed after 30 min, 60 min, and 120 min in both groups. RESULT Result shown that the mean score (8.10±0.84, 6.88±0.68, 6.49±0.69, 5.82±0.65) of experimental group is apparently lower than the mean score (8±0.83, 4.78±0.52, 3.83±0.47, 3.06±0.49) of control group except for the mean pretest score. The level of pain score status between the different time intervals pre and post observations in experimental group shows that the obtained F Value 207.2968(df=9) and the p value was 0.0001. the p value is &lt;0.05 level of significance so it shows that statistical significance was very high in the experimental group respectively, compare than control group, hence research hypothesis (H1) is accepted and inferred that acupressure therapy is very effective in reducing the pain during menstruation and providing comfort. CONCLUSION Study proved that SP6 acupressure can be used as an effective intervention to decrease menstrual pain. Acupressure is a very effective means of decreasing dysmenorrhea. It can be assumed that applying acupressure with the same intensity for a shorter time is effective in reducing menstrual pain. KEY WORDS Acupressure, dysmenorrhea, complimentary and alternative therapy.

A Comparative Study to Evaluate the Effectiveness of Crushed Ice Pack Application and Sitz Bath on Episiotomy Pain and Wound Healing Among Postnatal Mothers

An episiotomy is an incision made in the perineum- the tissue between the vaginal opening and the anus during child birth. Pain at the episiotomy site is more distressing for the mother during postnatal period. An ice pack application or warm shallow bath (sitz bath) may increase comfort and promotes healing. The main aim of this present study was to compare the effect of Crushed ice pack application and Sitz bath on episiotomy pain and wound healing among postnatal mothers. A Matched group design was adopted in this study. By using Non probability purposive sampling technique 22 postnatal mothers with episiotomy were selected as samples at Ramakrishna Hospital, Coimbatore and 11mothers were assigned randomly to each group I and group II. Episiotomy pain was assessed by using Numerical Pain Intensity scale and Wound healing was assessed by using Davidson REEDA scale. Group I received crushed ice pack application and Group II received sitz bath. Intervention was given for 10 minutes twice a day for three consecutive days from first postnatal day. Data were analysed by using descriptive and inferential statistical methods. The statistical analysis revealed that the calculated mean scores of episiotomy pain in the group I and group II was1.72 and 2.9 respectively and the mean difference is 1.2 with the standard deviation of group I and group II was 0.64 and 0.53 respectively. The calculated ‘t’ value 11.3 was greater than the table value of 2.086 at 0.05 level of significance. The calculated mean scores of episiotomy wound healing in the group I and group II was 1.54 and 1.81 respectively and the mean difference is 0.27 with the standard deviation of group I and group II was 0.5 and 0.6 respectively. The calculated‘t’ value 2.6 was greater than the table value of 2.086 at 0.05 level of significance. Finally, the study concluded that the crushed ice pack application was more effective than sitz bath in reducing the level of episiotomy pain and promotes wound healing among postnatal mothers.

The Relationship Between the Functional and Physical Condition with Pain and Trauma of Basketball Players in Terms of Gender

Background. Lower extremity injuries account for more than half of the trauma experienced by basketball players. With a high number of trauma, it is important to include trauma prevention programs and monitor the physical and functional condition of the players. It is not clear what is the relationship between the functional and physical condition with pain and trauma of basketball players in terms of gender.&#x0D; The aim. To determine the relationship between the functional and physical condition with pain and trauma of basketball players in terms of gender.&#x0D; Methods. 20 basketball players (10 boys and 10 girls) participated in the study. Information about trauma and training status of basketball players was collected through a questionnaire. The functional status of the subjects was assessed with the Functional Movement Screen and the Y Balance Test. The physical condition was assessed by: Ely’s (for the length of the rectus femoris muscle), Thomas (for the length of the iliopsoas muscle), and Pendulum (for the mobility of the spine) tests. Pain intensity was assessed on a numeric pain intensity scale.&#x0D; Results. In female players, a moderate inverse relationship was found between functional condition and pain (r = -0.679, p&lt;0.05), and a strong relationship with trauma (r = -0.898, p&lt;0.05) was found. For male players, the relationship between functional condition and pain and trauma was not established (r=-0.460, p&gt;0.05 and r=-0.571, p&gt;0.05, respectively). An inverse relationship was established between the length of the iliopsoas muscle in females and pain (r=-0.661, p&lt;0.05) and trauma (r= -0.500, p&gt;0.05). The relationship between the length of the rectus femoris muscle and pain was found in both males (r=-0.687, p&lt;0.05) and females (r=-0.887, p&lt;0.05), and the relationship with trauma was found only in females (r=- 0.816, p&lt;0.05).&#x0D; Conclusions. The functional and physical condition of female basketball players is more related to the intensity of pain and trauma than that of male basketball players.&#x0D; Keywords: Functional movement, muscle length, basketball, trauma, gender.

Global perceived improvement and health-related quality of life after physical therapy in Lebanese patients with chronic non-specific low back pain.

The effectiveness of physical therapy (PT) in patients with chronic non-specific low back pain (CNSLBP) is mainly evaluated through pain, disability, and health-related quality of life (HRQOL). However, recent studies have recommended the consideration of improvement from patients' perspectives. This study aimed to investigate the relationship between the global perception of improvement in Lebanese patients with CNSLBP who have undergone PT, the HRQOL levels, as well as pain intensity. 132 patients with CNSLBP who have undergone PT completed a questionnaire consisting of sociodemographic and CNSLBP characteristics questions, pain intensity numeric scale (NRS), 12-Item Short-Form Health Survey (SF-12), and the Global Perceived Effect scale (GPE). Binary logistic regressions and Pearson correlation coefficient were used for analyses. Global perceived improvement of PT varies according to HRQOL levels. A significant correlation was found between pain intensity after PT, perceived improvement from PT, and HRQOL. Educational level and pain irradiation have been shown to be predictive factors of perceived improvement after PT. Pain and HRQOL are interrelated and contributed to elucidating the global perception of improvement after PT in patients with CNSLBP. The findings suggest that patients' global perception of improvement should be considered in evaluating the benefits of physical therapy in addition to pain and HRQOL.

The impact of depression and anxiety on pain reported by patients with rheumatoid arthritis undergoing treatment

This study analyzed the joint pain of 46 patients with rheumatoid arthritis (RA) undergoing treatment with disease-modifying antirheumatic drugs (DMARD), for at least one year, and evaluated by pain intensity numeric scale and by the McGill Pain Questionnaire (MPQ), anxiety and depression by the Hospital Anxiety and Depression Scale (HADS). We compared them with 46 patients without RA matched by age and sex. We also examined the relationships between anxiety and depression and pain intensity, disease activity and physical dysfunction accessed by the Rheumatoid Arthritis Disease Activity Index (RADAI) and the Health Assessment Questionnaire (HAQ), respectively. Most patients with RA, 93.5%, continued to report joint pain and had higher pain intensity and higher scores in all domains of the McGill Pain Questionnaire (MPQ) than 58.7% of the 46patients without RA with joint pain. Patients with RA were more likely to have depression defined by HADS≥11 than the controls but the association was non-significant when adjusted for the presence of pain. The median score of anxiety symptoms was significantly higher in patients with RA than in those without RA. There was an association of depression and a positive significant correlation of anxiety symptoms with higher intensity of pain, disease activity and physical dysfunction. There was no difference between patients with RA and depression and without depression on the sensory domain and in the total MPQ score. Otherwise, there was a moderate significant correlation of the levels of anxiety with all pain domains of the MPQ, except the sensory one. In conclusion, pain remains a prevalent symptom in RA patients despite treatment. More studies are necessary to verify if the qualitative assessment of pain could be used to evaluate the influence of anxiety and depression on pain reported by these patients.

The Changes in Psychological and Functional Limitation after Pain Neuroscience Education in Chronic Non-Specific Neck Pain: (A Quasi Experimental Study)

Background: Chronic Non-specific neck pain is a common disorder that causes ramifications from psycho-social factors. Can be related to limited cervical mobility, impaired functions, and stress at work Pain is a common human experience, and the inability to feel pain poses a risk to a person’s survival. PNE explains how pain operates fundamentally, including three core bio-psychosocial therapeutic options that are biological, psychological, and social. Objective: To study the impact of PNE on psychosocial and functional limitations in patients with chronic non-specific neck pain. Methods: The study is a quasi-experimental study comprising 85 participants, with pre-test (Group A) and post-test (Group B) receiving PNE. Results: The mean NPRS scores obtained in the PNE group were 5.63±1.3 in the pre-test and 2.3±1.2 in the post-intervention, and the mean difference was 3.33(Mean of paired differences). The mean PCS scores obtained in the PNE group were 25.09±4.31in the pre-test and 12.04±4.25 in the post-intervention, and the mean difference was 13.05. The mean NDI scores obtained in the PNE group were 30.67±17.34 in the pre-test and 7.50±3.74 in the post-intervention, and the mean difference was 23.17. It shows significant improvement in pain intensity and functional limitations. Conclusion: The present study concluded that pain neuroscience education has an impact on changing psychosocial and functional limitations in patients with chronic non-specific neck pain using the Neck Disability Index, Pain Catastrophizing Scale, Numerical Pain Intensity Scale, and Neurophysiology of Pain Questionnaire.

Pengaruh Kombinasi Genggam Jari dan Aromaterapi Jasmine Terhadap Nyeri Pasien Post Operasi Sectio Caesarea

Mothers with sectio caesarea will experience several problems such as pain, impaired mobility and anxiety. The pain felt by the mother of Sectio Caesarea can come from the incision scar under the abdomen. However, the severity of pain experienced by the mother will differ depending on the psychological and physiological as well as the pain tolerance experienced by the mother. Non-pharmacological therapies that can be given to reduce pain are a combination of finger grips and Jasmine aromatherapy. The method used in this study is a descriptive case study design with a case study approach based on the application of evidence-based practice of giving a combination of finger grip with jasmine aromatherapy. The sample of 2 people in this study was mothers after sectio caesarea surgery. This case study was conducted in June 2022. The measuring instrument uses a numerical pain intensity scale. The results obtained from both pain subjects can decrease from moderate pain decreased to mild pain. There was a reduction in pain after a combination of finger grips and Jasmine aromatherapy in post-sectio caesarea mothers. Suggestions for the public are expected to be able to independently apply finger gripping techniques with a combination of jasmine aromatherapy in reducing pain.

Determining the Frequency, Severity and Complications After Surgery of Uncomplicated Implants in Patients Referred to the Implant Department of the Faculty of Dentistry of Tehran University of Medical Sciences in the Academic Year of 2020-2021

Introduction: This prospective analytical study was conducted with the aim of determining the prevalence, severity and factors affecting the short-term complications of implant surgery.&#x0D; Methods: In a descriptive cross sectional study, patients referring to the implant department of Tehran University of Medical Science from 2020 to 2021 were included (292 implants in 152 patients). Patients underwent Simple implant placement without hard and/or soft tissue grafts were included. After 7 and 14 days, ecchymosis, bleeding, swelling, delayed wound healing, infection, and trismus were recorded. Pain, the most common outcome after surgeries was assessed based on the number of days the patient had pain, the number of analgesics used and the severity of pain (Numeric pain intensity scale) using SPSS software version 16. The relationship between complications and measured variables was examined by logestic regression analyses.&#x0D; Results: The most common complications on the 7th day follow up were ecchymosis (3.9%) and delayed wound healing (3.9%). The mean pain score was 1.61 ± 1.32. No patient had pain more than 3 days after surgery. The mean number of analgesic used was 2.23 ± 1.82. Based on logistic regression analyses, only patient age and the number of days of analgesics use showed a significant relationship with the number of analgesics used (P˂0.001). Neither the level of expertise of the surgeon nor the patients' gender had nosignificant effect on the degree of complications pain and amount of patient pain and the consumption of analgesics (P˃0.05). Patients with poor oral hygiene used more analgesics in comparison to patients with favorable oral hygiene.&#x0D; Conclusion: The overall prevalence of post-operative complications after simple implant surgeries was less than 4%. The older the patient, the higher the consumption of analgesics.

Predictors of quality of life of individuals living in Brazil with spinal cord injury/disease.

A cross-sectional, descriptive study. To investigate the demographic, clinical behavioral, and rehabilitation predictors of the quality of life (QoL) of people with spinal cord injury/disease (SCI/D) in a middle-income country. Ninety-five participants living in the community were evaluated with the following instruments: World Health Organization Quality of Life - Bref; International SCI Core DataSet; Clinical Interview; Spinal Cord Secondary Conditions Scale and Patient Health Questionnaire; Numerical Pain Intensity Scale; Short-Form 12 Health Survey - Item 8 (how much pain hinders activities); Patient Health Questionnaire 2, Numerical Fatigue Scale. Data were analyzed via Spearman correlation, univariate analysis, and multiple regression to explain the effects associated with quality-of-life predictors. The main factors that decreased quality of life were fatigue (by 11.5%), depression (by 5.5-12.8%), pain (by 1.3 in total life quality, in the physical domain by 8.6-9.6%), sores (15.6% in the physical domain only). The practice of sports increased the total quality of life by 14.4%, in the physical domain by 11.9%, in the psychological domain by 17.2%, and in the social domain by 23.7%. Fatigue, risk of depression, pain, and the presence of sores are predictors of poor quality of life, and sports are a predictor of a better quality of life, for people with spinal cord injury. Multidisciplinary rehabilitation, in addition to policies, to increase accessibility and social inclusion, and incentives or subsidies for the practice of sports could improve QoL following SCI/D.

A Study to assess the Effectiveness of Billig’s Exercise in reducing Dysmenorrhoea among Adolescent Girls

Statement of the Problem: A study to assess the effectiveness of Billig’s exercise in reducing dysmenorrhoea among adolescent girls at Alchemy school, saravanampatti, Coimbatore. Study objective: (a) To assess the pre test level of dysmenorrhoea among adolescent girls in the experimental and control group(b)To assess the post test level of dysmenorrhoea among adolescent girls in the experimental and control group (c)To assess the effectiveness of Billigs exercise on dysmenorrhoea among adolescent girls in the experimental group (d) To find out the association between post test level of dysmenorrhoea among adolescent girls with their selected demographic variables. Methodology: Experimental approach, a subtype of quantitative approach, the research design was quasi experimental design, non equivalent control group pre test and post test was used for the present study. The sample for the study consists of 60 adolescent girls with dysmenorrhoea, 30 in experimental group and 30 in control group, selected by purposive sampling techniques, a type of non probability sampling method. Numerical Pain Intensity Scale was used to assess the level of menstrual pain of adolescent girls is both group. Results: Inferential and descriptive statistical were used to analyze the data. The pre test value of menstrual pain in adolescent girls for experimental and control group was 5.2 and 4.63 respectively. The mean post test score was 1.8 and 4.33 for experimental and control group. The comparison was done between two group by performing the independent‘t’ test and the value was 5.57.Conclusion: The study shows that Billig’s exercise is effective to reduce menstrual pain among adolescent girls.

The Efficacy of Ultrasound-guided Transversus Abdominis Plane Block Versus Quadratus Lumborum Block for Postoperative Analgesia in Lower-Segment Cesarean Section with Low-Dose Bupivacaine: A Randomized Controlled Trial.

The study sought to compare the postoperative analgesia after ultrasonography (USG)-guided bilateral transversus abdominis plane (TAP) block versus quadratus lumborum (QL) 1 block with lower concentration of bupivacaine in patients undergoing lower-segment cesarean section (LSCS). A randomized controlled trial was conducted at a tertiary hospital, Bengaluru, from 2019 to 2021. Fifty-six patients belonging to the American Society of Anesthesiologists physical status Class I and II aged 20-40 years posted for LSCS under subarachnoid block were divided into two groups. Patients in Group I were given bilateral TAP block and patients in Group II were given bilateral QL1 block under USG guidance at the end of surgery using 0.125% bupivacaine (20 ml) and 4 mg dexamethasone. Patients were monitored for postoperative pain with Numerical Pain Intensity Scale (NPIS) at 0, 1, 4, 8, 12, and 24 h. Rescue analgesic was given if NPIS score was 6 or more. Time to first dose of rescue analgesic was noted. NPIS scores and time to rescue analgesic were compared using independent t test. P < 5% was considered statistically significant. Average NPIS scores were less at 0, 1, and 4 h (<6) and higher at 8, 12, and 24 h in both the groups postoperatively. NPIS scores at 8 h were significantly higher in Group I compared to Group II (P = 0.02). Time to first dose of rescue analgesic was 7.32 h in Group I and 9.07 h in Group II (P < 0.001). Postoperative analgesia was better with USG-guided QL1 block versus USG-guided TAP block with 0.125% bupivacaine and 4 mg dexamethasone in patients undergoing LSCS.

Effects of Online Facial Exercise and Self-Massage Program on Neck and Head Pain and Quality of Life

Background. Due to the COVID-19 pandemic and the lockdown, most people with headache and neck pain were unable to access health care services, so it is unclear which remote physiotherapy methods would be effective in treating neck and head pain.&#x0D; Aim. To investigate the effects of virtual facial exercise and self-massage on women’s neck and head pain and functional condition.&#x0D; Methods. The study included 33 women 45–59 years old, who had experienced neck and head pain in the past month and were not taking pain medications. All subjects were in the experimental group. Facial exercise and self-massage for 20 minutes daily for 20 days were performed by the subjects following virtual instructions. Before and after the intervention, the intensity of neck and head pain was assessed using numeric pain intensity scale, the quality of life was assessed using neck disability index and headache disability index.&#x0D; Results. Neck pain decreased by 3.82 ± 2.63 points (p &lt; 0.05), headache decreased by 2.82 ± 1.93 points (p &lt; 0.05), neck functional disability decreased by 7.33 ± 4.57 points (p &lt; 0.05), headache disability index values decreased by 15.57 ± 8.47 points (p &lt; 0.05).&#x0D; Conclusion. After the application of virtual facial exercise and self-massage, women’s neck and head pain was reduced and the quality of life improved.&#x0D; Keywords: neck pain, headache, physiotherapy, massage, quality of life.

The Effect of Alpinia Galanga Warm Compress in Reducing Rheumatoid Arthritis Pain Intensity in the Elderly: A Quasi-Experimental Study

Backgrounds: Rheumatoid arthritis is a chronic inflammatory disease that causes inflammation and swelling of the synovial membrane. In patients with advanced stages, it will make the patient unable to carry out daily activities and his quality of life decreases.The study at to know the effect of Alpinia Galanga Warm Compress in Reducing Rheumatoid Arthritis Pain Intensity in the Elderly.Methods: The method of the research was used quasi experiment by using one group pre-test and post-test design without control group. This study was conducted on 45 patients with Rheumatoid Arthritis in Guna Bakti Foundation in Medan, Indonesia. The research process began with measuring the intensity of pain in all of patient using an observation sheet and numerical pain intensity scale before being given a warm galangal compress (pretest), then a warm galangal compress was carried out for 20 minutes, after which it was measured again (posttest) the intensity of the pain scale. Results: Based on the results of the study, 80% of respondents experienced a decrease in the Rheumatoid arthritis pain scale as a result of giving warm galangal compresses. From the significance value of the Wilcoxon test results obtained p-value &lt;0.001 which value is smaller than the error level (α) 0.05 or with a significance of 95%, then the hypothesis Ho is rejected while Ha is accepted. The conclusion of this study is the effect of Alpinia galanga warm compress in reducing rheumatoid arthritis pain (p&lt;0.001).Conclusion: Galangal warm compresses are effective in reducing Rheumatoid Arthritis pain. Therefore, such interventions are recommended for these patients.

Impact of Enhanced Recovery Pathway Application Outcomes on Nurses and Women Undergoing Cesarean Section

Enhanced recovery after surgery is a standardized, multidisciplinary approach for caring patients with a goal of decreasing length of hospital stay and care without negatively affecting patient outcomes. Aim: to investigate the impact of enhanced recovery pathway application outcomes on nurses and women undergoing cesarean section. Design: A quasi experimental (pre-posttest for maternity nurses and study/control groups for women undergoing cesarean section) design was utilized in this study. Settings: This study was conducted at the obstetrics departments affiliated to University Hospital and Shebin El-Kom teaching hospital, Menoufia Governorate, Egypt. Sample: A convenient sample of 50 maternity nurses worked in the previous settings and a purposive sample of 250 cesarean delivery women were recruited in this study. Instruments: for collecting data; a structured interviewing questionnaire, knowledge assessment & an observational checklist for the nurses, knowledge assessment instrument, an observational checklist and numeric pain intensity scale for the mothers were used. Results: There was an increase in total knowledge and practice scores of the maternity nurses regarding the enhanced recovery pathway application. Also, its application following CS had an effect on relieving the women’s postoperative problems especially pain than those who received the routine hospitals nursing care only.Conclusion: application of enhanced recovery pathway significantly reduces the postoperative complications especially pain, length of hospital stay, and improves the maternity nurses' knowledge and practice scores post caesarean . Recommendation: Enhanced recovery pathway should be applied during cesarean section operations to improve the patients' outcomes and reduce the postoperative complications

Intra-Articular Injection of PRP in the Treatment of Knee Osteoarthritis Using Big Data.

Observing data on the characteristics of intra-articular injection of sodium citrate for knee osteoarthritis is an important reference value for human safety and evacuation design. To address the problems of slow data collection and poor accuracy of results of knee osteoarthritis behavior, under intensive conditions of intra-articular injection for knee osteoarthritis, this paper designs a data mining-based feature extraction system for intra-articular injection of sodium citrate for knee osteoarthritis. Using the Hadoop architecture, we extract the basic data of human behavior in the two-dimensional plane by storing and stitching the collected continuous data and discriminate the behavioral categories of knee osteoarthritis. We collected a real dataset from 84 patients with knee osteoarthritis treated in our hospital from October 2019 to October 2020. The dataset was divided into 42 patients in the tretinoin group and 42 patients in the sodium glutamate group according to the randomized number table method. The trimethoprim group was treated with intra-articular injection of trimethoprim, and the sodium citrate group was treated with intra-articular injection of sodium citrate. The clinical efficacy, joint mobility, intra-articular fluid volume, Lysholm score of knee joint, numerical pain intensity scale (NRS) score, and adverse effects of the two groups were compared before and after treatment. In our experiments, we observed that, compared with triamcinolone acetonide intra-articular injection, sodium hyaluronate intra-articular injection is more effective in the treatment of knee osteoarthritis. It can effectively improve knee function and reduce pain and adverse reactions.

The effect of active gas aspiration to reduce pain after laparoscopic sleeve gastrectomy for morbid obesity: a randomized controlled study

IntroductionResidual, intra-abdominal CO&lt;sub&gt;2&lt;/sub&gt; contributes to abdominal distension and pain after laparoscopic surgery. Our aim was to investigate the effects of active gas aspiration on postoperative outcomes and pain following laparoscopic sleeve gastrectomy.Material and methodsPatients were randomly assigned to either the active gas reduction group (Group 1, n = 69) or the control group (Group 2, n = 74). After completion of the operative procedures, residual gas was aspirated with a flexible cannula in Group 1. In Group 2, gas release from the abdomen was performed using the port site by opening the gas tap only. The demographic data, body mass index, educational status, operation time, insufflated CO&lt;sub&gt;2&lt;/sub&gt; volume during the operation, and intraabdominal pressure were recorded. Postoperative pain assessment was performed using a numerical pain intensity scale (NPIS) at the 1st h, the 24th h, and the 3rd day.ResultsNPIS scores at the 24th h were significantly lower in Group 1 (p &lt; 0.001). However, there were no significant differences in the NPIS scores following the 1st h and the 3rd day. No differences were found in the operation time (p &gt; 0.05). According to the correlation analysis between the operation time and NPIS scores between the groups, in Group 1 the duration of surgery was significantly proportional to NPIS24. All patients were discharged from the hospital on the 4th postoperative day.ConclusionsActive aspiration of the remaining gas just before the removal of the trocars is a simple procedure that reduces pain, leading to a more comfortable hospital stay.

Thoracic paravertebral nerve catheter reduces postoperative opioid use for vertebral body tethering patients.

Vertebral body tethering is increasingly being performed, yet postoperative pain management has not yet been optimized. We sought to determine whether the addition of a thoracic paravertebral block in addition to a standard multimodal postoperative pain management program could provide greater pain relief, reduced analgesic requirement, and reduced length of stay. Patients who underwent VBT at a single tertiary referral center were retrospectively reviewed. All patients received a single-shot intrathecal (IT) injection at the completion of the procedure in addition to a standardized multimodal pain management program. 45 patients received a thoracic paravertebral catheter with lidocaine infusion (TPVB) which was left in place for 4-6days, whereas 24 control patients did not have a TPVB. Length of stay, maximum postoperative Numeric Pain Intensity Scale (NPIS), and total dose of opioids, ibuprofen, ketorolac and acetaminophen administered during hospitalization were evaluated. 69 patients met inclusion criteria. The mean cumulative dose of opioids administered during hospitalization was 148 oral morphine milligram equivalent (MME) in the control group vs. 47 MME in the TPVB group (p < 0.0001). Severe postoperative NPIS of ≥ 7 was reported in 9 out of the 24 control patients (38%) and in 13 out of the 45 patients (29%) who received a TPVB in addition to the standardized care (p = 0.46). There was no significant difference in the mean cumulative dose of NSAIDs (ibuprofen, ketorolac) consumed by the control group compared to the TPVB group (2632mg vs. 1630mg, p = 0.77). Mean length of stay in the control group was 3.8 vs. 3.0days in the TPVB group (p < 0.001). There were no major complications associated with use of the TPVB. In this series compared to controls, patients treated with a TPVB had reduced postoperative requirement of opioids and decreased length of hospital stay.

A comparison of preincisional and postincisional ultrasound guided transversus abdominis plane block.

Background and Aims:Transversus abdominis plane blocks are part of the multimodal analgesia used for lower abdominal surgeries.Our aim of this study was to compare the analgesic efficacy of preincisional and postincisional TAP blocks in patients undergoing total abdominal hysterectomies.Material and Methods:54 American Society of Anesthesiologists physical status I and II patients aged between 30 and 60 years who underwent a total abdominal hysterectomy under spinal anesthesia in our hospital were chosen for the study. Alternate patients satisfying the inclusion criteria were either given a preincisional or postincisional transversus abdominis plane block bilaterally. Postoperatively, the numeric pain intensity scale was observed, along with nausea, vomiting, and sedation scores.Results:Pain scores were significantly lower (P < 0.05) in the preincisional TAP block group from the 2nd postoperative hour onwards till 12 h, and thereafter it was comparable between both the groups. The total morphine requirement was significantly less in the preincisional TAP group (P-value 0.001). Also, the mean time to the first request for morphine was significantly longer in patients belonging to the preincisional TAP block group (P-value of 0.002). There were no significant differences in the sedation scores postoperatively, except at the 4th hour, where it was significantly higher (P-value of 0.024) in the postincisional TAP group. Post operative nausea and vomiting was significantly higher and so the dose of the antiemetic used was also observed to be more in the postincisional TAP block group.Conclusion:Preincisional TAP blocks are more effective than postincisional ones with better analgesia and lesser side effects, for total abdominal hysterectomies.