Pain Status In Patients Research Articles

Investigating the effect of methylprednisolone pulse on the treatment of back pain

"Background: Pain is a common problem afflicting humanity. Back pain is a musculoskeletal disorder with a high prevalence; this pain may occur to anyone at least once during their lifetime. Aim: the present study was performed to investigate the effect of the use of methylprednisolone pulse on the pain status of patients suffering from back pain in Ilam city. Methods: This study is a clinical trial conducted as double-blind in 2021 in Ilam city with pretest and post-test groups plus a control group. The patients referred with vertebral disc herniation diagnosis suffering from diffuse pain in the right leg were assigned into test and control groups. A methylprednisolone 500 mg IV would be administered to the patient as pulse inside DW 500cc serum. The extent of pain was compared before and after the intervention at one, two, three, and seven days later. Placebo was applied for the control group patients. The data were analyzed by SPSS 16 as well as based on descriptive and analytical tests. Results: According to the findings, no statistically significant difference was observed between the demographic characteristics of patients receiving methylprednisolone and patients in the control group (p 0.05). Also, the result showed the comparison of pain scores of patients in the two groups. According to the findings, the M (SD) pain score in the experimental group was 6.59 (0.88) before the intervention and 1.76 (0.69) in the week after the intervention, which was statistically significant (P=0.000). Also, the changes in the control group's score before intervention were 6.82 (0.71) and after the intervention was 6.77 (1.12) (P>0.05). Conclusions: Considering the effect of methylprednisolone on mitigating the pain of patients suffering from back pain, it is suggested to use injective methylprednisolone for reducing the pain of patients suffering from back pain "

Comparison of hematoma block and sedoanalgesia for analgesia before reduction of distal radius fractures

Purpose: The aim of this study was retrospective assessment of the reduction quality, hospitalization time, and relief of pain in hematoma block assisted closed reduction versus sedoanalgesia assisted closed reduction.
 Materials and Methods: There were 106 patients included who diagnosed as isolated displaced distal fracture of radius and treated with closed reduction. Hematoma block was used in 45 patients and sedoanalgesia was used in 61 patients. Midazolam (0,1 mg/kg) and fentanyl (1 mcg/kg) combination was administered as the sedoanalgesic agent, and lidocaine (10 ml, 1%) as the local anaestetic. Demographic data, fracture type according to Frykman classification, and mechanism of trauma were noted. Pain status of patients were recorded by using the Visual analog scale (VAS). Sarmiento criteria was used for the evaluation of the reduction quality. Cost of the analgesic procedure was assessed based on the prices of the analgesia procedures, used pharmaceuticals and medical consumables.
 Results: Both groups were similar in terms of gender, age, fracture type and affected side., Hospitalization time was shorter in hematoma block group, and VAS was significantly lower. Quality of reduction was similar in both groups. Cost per patient was four times higher in sedoanalgesia group compare to hematoma block group.
 Conclusion: Hematoma block is an effective, easily performed method that can be used prior to the closed reduction of the distal radius fractures to relieve the pain. Older patients can be susceptible to adverse effects of sedoanalgesia and hematoma block can be chosen as a more reliable method to provide the analgesia.

Goshuyuto Reduced the Monthly Intake of Anti-headache Drugs and Improved Pain Status in Patients with 20-Year History of Medication Overuse Headache in an Outpatient Setting.

The management of medication overuse headache (MOH) is sometimes challenging, particularly for patients with a long disease duration. We observed that patients who used goshuyuto, a traditional Japanese medicine, exhibited a favorable clinical course. Two women who had a history of MOH for over 20 years were treated using 5.0-7.5 g/day goshuyuto in an outpatient setting. The treatment reduced their use of habitual drugs, including triptan (33-55%) and non-steroidal anti-inflammatory drugs (75-82%), as well as the headache impact test score-6 (16-23%) over 24 weeks. As goshuyuto has a protective effect on chronic headache and is reported not to lead to MOH, it is a good candidate for the treatment of patients with MOH in an outpatient setting, even for those with an over 20-year history of MOH.

Efficiency of intracavitary levobupivacaine infusion for pain management during cystoscopic procedures: A randomised study.

This study evaluated the effect of intracavitary levobupivacaine infusion diluted with locally applied isotonic solution for pain control in cystoscopy. Included in this study are 100 patients who had previously undergone transurethral tumour resection for bladder tumour and were followed up by cystoscopy. The patients were randomised into five groups (n=20). In the first, second, third, and fourth groups, 4, 6, 8, and 10mL of levobupivacaine HCl (5.0mg/mL) were mixed with 26, 24, 22, and 20mL of isotonic solution, respectively. Hence, the total mixture was 30mL for each group. The fifth group was the control group. In this group, the standard method commonly used in most clinics was utilised. That is, a gel containing Cathejell-2% lidocaine (25mg lidocaine) was applied for local analgesia. Cystoscopic interventions were performed with a 17.5 Fr rigid cystoscope and 0°, 30°, and 70° lens. During cystoscopy and 30min later, the pain status of patients was assessed using the Visual Analogue Scale (VAS) and patient satisfaction was questioned. The mean VAS score during and after the cystoscopy procedure was significantly lower in the levobupivacaine groups compared with the lidocaine group. In addition, patient satisfaction in the levobupivacaine groups was significantly higher than in the lidocaine group. No drug-related side-effects were observed in all groups. Thus, levobupivacaine is a more effective drug than lidocaine alone to control pain during cystoscopy. The use of levobupivacaine is recommended to prevent possible complications of general anaesthesia by eliminating the need for the aforementioned as well as its cost-saving advantage.

The impact of tissue glue in wound healing of head and neck patients undergoing neck dissection.

We investigated the impact of fibrin glue on postoperative drainage amount and duration in head and neck cancer patients who underwent neck dissection. This study was a prospective randomized controlled trial. Patients who were scheduled to undergo neck dissection due to head and neck cancer were eligible for this study. After receiving a detailed explanation, all patients signed an informed consent form before enrollment. Patients were then randomly assigned to the study group (fibrin glue) or control group. In the study group, 2 ml of fibrin glue (Tissucol(®); Duploject, Baxter AG) was applied on the surface of the surgical wound before closure. Basic demographic data along with tumor-related features, operation-related variables, postoperative drainage amount/duration, postoperative pain, and analgesic usage were collected and analyzed. A total of 15 patients were included in the final analyses, with eight patients in the study group and seven patients in the control group. No significant differences were found between the two groups in age, gender, primary site, clinical N stage, neck dissection levels, perioperative bleeding, postoperative drainage amount/duration, hospitalization duration, and postoperative pain status. The application of 2 ml fibrin glue by the method described herein did not reduce the postoperative drainage amount/duration nor the postoperative pain status in patients who underwent neck dissection.

Efficacy of Levobupivacaine Infiltration to Nephrosthomy Tract in Combination with Intravenous Paracetamol on Postoperative Analgesia in Percutaneous Nephrolithotomy Patients

To evaluate the efficacy of intraoperative local anesthetic infiltration in combination with intravenous paracetamol infusion on postoperative pain management in patients who underwent percutaneous nephrolithotomy (PCNL). Sixty adult patients were randomized into three groups with 20 cases in each: Group SP, 20 mL saline was infiltrated through the whole nephrostomy tract intraoperatively and this was followed by intravenous paracetamol (4 × 1 g) infusion postoperatively; group LP, 20 mL of 0.25% levobupivacaine infiltration to the nephrostomy tract followed by intravenous paracetamol infusion; Group LS, 20 mL of 0.25% levobupivacaine infiltration to the nephrostomy tract followed by intravenous saline infusion. In the postoperative period, the pain status of patients was evaluated at postoperative 6 and 24 hours by using the visual analogue scale (VAS). In patients who did not completely respond, meperidine (1 mg/kg intramuscularly) was administered as an additional "rescue" analgesic. Patient satisfaction from the postoperative analgesia management was assessed by a 5 point scale. There was no statistically significant difference between the three groups regarding the demographic characteristics, surgical complications, and postoperative hospital stay. Our findings revealed that in group LP, the amount and frequency of opioid used and related side effects was lesser, VAS score was lower, time to full mobilization was shorter, and the patient satisfaction score was higher when compared with the other two groups. Levobupivacaine infiltration through the nephrostomy tract in combination with intravenous paracetamol infusion was shown to be safe and efficacious as an analgesia method after PCNL.

Postoperative pain status after intraoperative systemic dexmedetomidine and epidural neostigmine in patients undergoing lower abdominal surgery

To determine whether intraoperative systemic dexmedetomidine improves postoperative pain and interacts with epidural neostigmine to produce analgesic effects. Sixty patients undergoing gynaecological surgery were randomly divided into four groups to receive epidural neostigmine and/or systemic dexmedetomidine: control (Group C), epidural neostigmine (Group N), systemic dexmedetomidine (Group D) and co-administered neostigmine and dexmedetomidine (Group ND). Epidural neostigmine (0.3 mg) was administered with 10 mL of 0.75% ropivacaine before the induction of general anaesthesia. Systemic dexmedetomidine (loading dose of 1 mug kg-1 over 10 min followed by 0.4 mug kg-1 h-1) was infused after the induction of general anaesthesia and continued until the end of surgery. The pain status of patients was assessed using the visual analogue scale at 2, 4, 6, 24 and 72 h postoperatively. Intraoperative systemic dexmedetomidine alone did not reduce postoperative pain scores. However, co-administered neostigmine and dexmedetomidine significantly decreased scores at 24 and 72 h (Group C: 3.0 [1.0-5.8] and 2.0 [0.3-3.0]; Group N: 1.5 [0.3-3.4] and 0 [0-1.3]; Group D: 3.5 [0-5.0] and 0 [0-1.4]; and Group ND: 0 [0-1.0]* and 0 [0-0]; median [interquartile range] *P = 0.0031, P = 0.0045 compared with Group C). The intraoperative systemic infusion of dexmedetomidine alone at doses causing sedation does not result in postoperative analgesic effects. However, the co-administration of systemic dexmedetomidine and epidural neostigmine at higher doses may be a useful method to improve postoperative pain although side-effects have to be evaluated.

Validation of a Japanese patient-derived outcome scale for assessingtotal knee arthroplasty: comparison with Western Ontario andMcMaster Universities osteoarthritis index (WOMAC)

We have developed a Japanese self-administeredquestionnaire based on an English version of the WesternOntario and McMaster Universities osteoarthritis index(WOMAC) to measure subjective function and pain status ofpatients who undergo a total knee arthroplasty procedure.Using multiple international cohorts, the performance of thedeveloped Japanese scale was compared to the results of theWOMAC in the United Kingdom, United States, Canada, andAustralia. The developed scale showed a comparable levelof internal consistency and construct/criterion validity. Theresponsiveness of the scale was superior to the concurrentlymeasured MOS Short Form 36 Physical Function scale. Theseresults suggest that the developed scale is reliable, valid, andresponsive for assessing the effectiveness of total knee arthroplastyin the Japanese context despite the cultural life styledifferences from Western countries.

Pain status of patients with severe haemophilic arthropathy.

Patients with severe haemophilia A growing up before the establishment of prophylactic treatment frequently developed significant haemarthropathies. The goal of the following study was to clarify the role of haemarthropathic pain for haemophilic patients. Furthermore, we aimed to determine to what degree daily activities are influenced by the impairment and which therapeutic modalities are used in pain management. Using a questionnaire we consulted 71 haemophiliacs concerning their complaints and how they were treated in 1999 (average age 43 years; range 21-63 years). The pain in the large joints and spine and the effect of specific treatment was estimated by a visual analogue scale. On average, there were four joints with major pain and 0.5 with minor pain. The most frequent sources of pain were the ankle joints (45%), followed by the knee (39%), spine (14%) and elbow (7%). Fifty percent of all patients complained of pain throughout the day if no treatment was applied. In 29% of patients, pain persisted after application of factor VIII (FVIII), while 12% claimed that pain still remained after use of FVIII and pain killers. Restriction in activities of daily life was reported by 89% of the group and 85% reported on an impact of pain on their mood. Patients primarily used FVIII to decrease pain, followed in frequency by use of anti-inflammatory drugs, orthopaedic footwear, liniments and bandages. Haemophilic patients with haemarthropathy are chronic pain patients. By means of the questionnaire, it is possible to reveal the 'silent' sufferers. Sufficient pain treatment is essential so as to increase the patient's quality of life and avoid inadvertent abnormal postures possibly resulting in increased loading of joints and subsequent bleeding episodes.

Maternal Total β-Endorphin Immunoreactivity During Labor and Delivery

Circulating plasma β-endorphin (BIR) levels underestimate the BIR levels in the blood. To determine the effect of epidural anesthesia on BIR, we measured total blood (plasma + erythrocytes) BIR during labor and delivery (19 epidural, 6 control patients). Total BIR levels seem to predict the anesthetic need in patients during labor. Acute changes in the pain status in patients were better predicted by the plasma than the total BIR activity.