Degree Of Patient Satisfaction Research Articles

Safety and Effectiveness of a New Electrical Detachable Microcoil for Embolization of Hemorrhoidal Disease, November 2020–December 2021: Results of a Prospective Study

Purpose: The purpose of this study was to prospectively evaluate the efficacy and safety of a new, bare platinum, detachable microcoil as a metallic embolization agent in the treatment of hemorrhoidal disease. Material and Methods: This prospective single-center study evaluated a new, bare platinum, electrical, detachable microcoil (Prestige plus coil (Balt Montmorency France)) for use in vascular embolization in patients with hemorrhoidal disease. Between January 2020 and January 2021, 24 embolization procedures were performed in 21 patients (12 males, 9 females; mean age 44.3 ± 7.3). The inclusion criteria were: (a) participants with grade I, II and III hemorrhoidal disease on the Goligher classification; (b) patients older than 18 years of age with a score of greater than 4 on the French bleeding score (FBS) scale; (c) patients with scores greater than 2 on the scale of discomfort proposed by Tradi and Farfallah. (d) patients who underwent treatment that included the use of the new novel coil (Prestige plus coil (Balt)) as an embolic material. The exclusion criteria were participants who failed to provide informed consent and participants diagnosed with rectal bleeding due to other causes (cancer, fissures or others). Participants with severe renal insufficiency, non-correctable coagulation abnormalities and adverse reactions to the contrast medium not correctable with medication were also excluded. The symptoms, technical aspects, the transarterial approach, clinical and technical success complications and short-term outcomes were assessed. Results: Technical success was obtained in 100% of the cases. Seventeen (80.9%) patients experienced improvements in their hemorrhoidal disease. The VAS and QL scores improved by 4 and 1.5 points (81.2% and 87.5%), respectively, after embolization (pV: 0001). Three (14.2%) patients underwent a second embolization due to rebleeding. One patient (4.7%) underwent surgery. No major complications were observed. Three patients had minor complications. The assessment of subjective post-treatment symptoms and QL surveys showed significant differences from the baseline survey. Likewise, the measurement of the degree of satisfaction using a telephone survey at 12 months revealed a high degree of patient satisfaction over 10 points (mean 8.3 ± 1.1). Conclusions: The present study demonstrates that the use of the new, platinum, detachable, electrical microcoil is safe and well-tolerated in the treatment of hemorrhoidal disease. Key points: Catheter-directed hemorrhoidal dearterialization (CDHD) is the procedure of embolization with embolic agents for the treatment of internal hemorrhoids. CDHD is a simple and safe procedure that is accepted by patients and preserves the anal sphincter; it presents few complications when metal devices or microspheres are used as embolic agents. As the recommended embolization agent in treatments, the Prestige electrical, detachable coil is a safe, easy-to-use and effective arterial embolic device.

Satisfaction With Health Care Services at the Pediatric Specialist Clinic of the National Referral Center in Malaysia: Cross-sectional Study of Caregivers' Perspectives.

The concept of customer satisfaction is gaining hold in all corporate sectors worldwide, and a satisfaction survey is used as a tool to discover service problems and as a chance for customers to rate their experience with health care services. A high degree of patient satisfaction with the services given has been found in numerous studies conducted in Malaysian public health care facilities. However, there is limited information available on caregiver satisfaction with pediatric clinics run by the Ministry of Health (MoH) of Malaysia. This was the first research performed at a public hospital's pediatric clinic, which was the first hospital to adopt the public-private-partnership model under the MoH, with the aim of discovering the prevalence and factors affecting the satisfaction of caregivers at the national referral center. Cross-sectional research using the standard self-administered SERVQUAL questionnaire was conducted among caregivers accompanying their children to the clinic. The questionnaire consists of 16 paired statements to evaluate their expectations and experiences with the clinic services. A total of 459 caregivers were involved in this study with a majority aged between 30 and 39 years (n=254, 55.4%). Caregivers from the Indian community (adjusted odds ratio [AOR] 2.91, 95% CI 1.37-6.18) and lower income groups (AOR 2.94, 95% CI 1.87-4.64), and those with lower educational backgrounds (AOR 3.58, 95% CI 1.19-10.72) were more likely to be satisfied with the quality of pediatric clinic services. Housewives/househusbands (AOR 0.48, 95% CI 0.25-0.90), on the other hand, appeared less likely to be satisfied with the services provided during their visit to the clinic. Looking at overall patient satisfaction, 50.5% (n=232) of caregivers demonstrated satisfaction with the quality of services, compared to 49.5% (n=227) of dissatisfied respondents. This paper suggests that, although most caregivers are satisfied with the services, greater emphasis must be placed on delivering reliable service in response to the MoH's mission to provide quality and integrated people-centered health services in Malaysia.

Influence of treatment methods on quality of life of patients with hemorrhoidal disease

Introduction. The effectiveness of the treatment of hemorrhoidal disease is based on the frequency of recurrence of hemorrhoid symptoms, the development of early and late postoperative complications, as well as the degree of patient satisfaction with the results of treatment. However, such an indicator as quality of life, which reflects the health of the patient, is not taken into account.Aim. Obtaining data on the influence of the method and type of treatment on the quality of life of patients suffering from acute or chronic hemorrhoids.Materials and methods. The analysis of the influence of the treatment method on the quality of life of patients suffering from acute or chronic hemorrhoids was carried out. The analysis included 1032 patients with stage I–IV hemorrhoids. The age of the patients was 44.8 ± 13.0 (18–94) years. The study included 509 (49.3%) men and 523 (50.7%) women.Results. Quality of life indicators before treatment in all groups are within the reference values, which is associated with adaptation of patients to the disease. After treatment, quality of life indicators naturally increase. However, in patients after hemorrhoidectomy, regardless of the nature of the technique, quality of life indicators are significantly lower than in patients of groups 1 and 2.Conclusions. Quality of life indicators in all groups before treatment are within the reference values and do not have statistically significant differences in the considered indicators. After the treatment, there is a statistically significant increase in the quality of life indicators in all scales. After hemorrhoidectomy, regardless of the nature of the technique, quality of life indicators are significantly lower than in patients of groups 1 and 2, which is associated with surgical trauma. Since the groups of patients are heterogeneous in terms of the stages of the disease, it can be assumed that for each stage of hemorrhoids, there is a subjective perception of the disease, which can be reflected in the quality of life indicators, which requires additional analysis of the results obtained.

Clinical Use of Aligners Associated with Nuvola® OP System for Transverse Maxillary Deficiency: A Retrospective Study on 100 Patients.

Introduction: Aligners represent a common treatment for orthodontic patients thanks to their countless advantages including aesthetics, comfort, and oral hygiene maintenance; at the same time, they are associated with a reduced number of visits and a low incidence of complications. Although aligners have undergone considerable improvements over time, to date they have limitations in resolving the most serious malocclusions related to transverse maxillary deficiency. The aim of the present study was to retrospectively evaluate an orthodontic protocol (the Nuvola® OP System) which associates a morpho-functional corrector (to be used for 30 min/day) with the aligner, allowing for the treatment of cases that would be difficult or unpredictable with aligners alone. Methods: Linear measurements were taken on STL files of 100 patients. In 77 patients between 18 and 55 years (mean 28.6 ± 16.2 (standard deviation) years), 3D superimpositions of the maxilla obtained from intraoral scans before and after treatment were performed in order to evaluate the degree of maxillary expansion. The normality of the data distribution was tested. The pre- and post-treatment data were compared using a paired t-test with a 5% significance level. After treatment, a questionnaire was proposed to assess patients’ degree of satisfaction and compliance. Results: A statistically significant difference (p < 0.05) for each distance evaluated was found. The maximum expansion was obtained at the first molar level (2.35 ± 1.64 mm). Of the subjects who completed the questionnaire, 96% were satisfied and 90% were able to perform the protocol without difficulty for the required duration. Conclusions: A significant expansion of the maxillary arch as well as a high degree of patient satisfaction and compliance were observed with the Nuvola® OP System. Further studies are needed in order to clinically evaluate the relative contribution of the aligners and morpho-functional device to the obtained expansion.

Satisfactory Functional Outcome and Significant Correlation with the Length of Haglund's Deformity after Endoscopic Calcaneoplasty: A Minimum 4-Year Follow-Up Study.

Background Haglund's syndrome is a posterosuperior calcaneal prominence with posterior heel pain causing functional disability to the patient. Operative treatment is indicated after failure of conservative measures and includes resection of the bony hump along with retrocalcaneal bursectomy. This study aimed to evaluate the functional outcome and degree of patient satisfaction after endoscopic resection of Haglund's deformity with assessment of correlation with the length of bony exostosis. Methods Seventeen patients (21 feet) with a mean age of 44.7 ± 5.1 years were included in this study. Six females and 11 males underwent endoscopic calcaneoplasty. Clinical outcome evaluation included the assessment of the visual analog scale (VAS) and the American Orthopedic Foot and Ankle Society score (AOFAS). The preoperative and postoperative lengths of bony exostosis were measured radiologically. The paired t test and the Wilcoxon signed-rank test compared the preoperative and final postoperative means. P < 0.05 was considered statistically significant. Results The mean follow-up period was 56.4 ± 5.1 months. Statistically significant improvements in the preoperative mean of AOFAS (from 55.7 ± 9.3 to 94.3 ± 7.1) and VAS (from 8.1 ± 1.4 to 0.7 ± 1.04) at the final follow-up were noted (P < 0.0001). There was a statistically significant correlation between clinical scores (AOFAS and VAS) and the final postoperative length of the bone above parallel pitch lines (PPLs). The patients were satisfied and returned to their previous activities without reporting major morbidities except one patient who had mild pain with exertion. Conclusion Endoscopic calcaneoplasty is a safe, less invasive surgical procedure for the management of Haglund's syndrome after failure of conservative treatment. It provided a satisfactory clinical result without serious complications at a minimum 4-year follow-up.

Implementation of electronic messaging protocol for pediatric urology preoperative scheduling: A pilot study

Preparing patients for surgery is a task healthcare organizations strive to optimize. Electronic messaging (EM) provides an opportunity for streamlining components of this arduous process. Our study aims to evaluate our early experience in utilizing EM to provide preoperative information to pediatric urology patients. To assess the effectiveness of EM in preparing patients for pediatric urologic surgery. This study compared a 6-week pilot program of EM (Figure1) with traditional nurse phone calls (NPC) in preoperative instruction of pediatric urology patients. The same preoperative instructional information was provided via either source. Data collected included time and resources used by the healthcare system and patient/parent satisfaction. The EM group included 98 patients, while the NPC group included 212 patients. Case cancellation rate between the two cohorts was similar, with a 6.67% cancellation rate in the EM cohort and a 10.55% cancellation rate in the NPC cohort (z=-1.137, p=0.25). There were 4EM-related operating room delays with an average case delay of 31.5min (5-60min). Twenty-four (24%) EM patients/families required secondary phone calls, while 106 (50%) NPC required a follow up phone call (p<0.01). 94% of EM participants recommended EM for future perioperative instructions. Accounting for the average case volume within our entire children's hospital, the average total daily cost for EM is $5.96/day, as compared to an average total cost of $87.78/day to perform NPC. This represents an estimated cost savings of $81.82 per day or $21,273.20 per year, based upon average total case volume at our institution. In our initial experience, EM effectively communicates the necessary preoperative information to patients and/or families undergoing pediatric urology surgery. Our results demonstrate low case cancellation and delay rates and high patient/family satisfaction. Also demonstrated was the cost savings by replacing the NPC with EM. A great benefit of EM was the increased time it provided for nurses to perform other patient care duties, which is important given our current nationwide nursing shortage. Limitations of the study included a narrow scope assessing only pediatric urology patients as well as a short study period. Further studies will further define and refine the role of perioperative EM. Changing to an EM system for preoperative instructions in the pediatric urology population met with a high degree of patient satisfaction and decreased costs for healthcare systems without increasing case delay or cancellation rates.

Can we do without the doctor?

Healthcare is important for maintaining social order as medical doctors set the standard for normality. The degree of patient satisfaction is central to the very economy of the functioning of the entire health system, as the outcome of the treatment also depends on the degree of involvement of the person and the enhancement of his individuality. Ensuring citizens, a level of health protection that meets certain requirements and quality standards is increasingly difficult to achieve due to an ever-decreasing number of resources in health systems with a universalistic and supportive vocation. Attention must be shifted from individual behaviors to the structural factors that determine them. Through this reformulation, speaking in terms of global health means speaking of ethics, of social responsibility extended to the various sectors of the health field at the center of which is the figure of the medical doctor.

QUALITY OF CARE PROVIDED TO MOTHERS DURING LABOR AND DELIVERY ASSESSED BY LABOR AND DELIVERY SATISFACTION INDEX (LADSI)

Introduction: Understanding maternal expectations is an important ingredient in making childbirth a safe and satisfying experience. Knowledge gained from the study will assist to identify aspects of care that produce a high degree of patient satisfaction. Knowledge gained from the study can also lead to improved communications and relationships between mothers and providers of maternity care. Objective: To study level of satisfaction regarding quality of care provided to mothers during labor and delivery. Method: A cross-sectional study was conducted among 1035 mothers admitted in in post-partum wards of Obstetrics &amp; Gynecology department of Government Medical College, Kottayam. Socio demographic details were recorded and maternal satisfaction was assessed using LADSI six point likert scale-(strongly agree-agree-mildly agree-strongly disagree-disagree-mildly disagree). Results: The overall satisfaction of quality of care provided to mothers during labor and delivery in Kottayam medical college came to be as 64.8%. A signicant association between variables like age, income, occupation, parity, hours spent in labor room, place to overall satisfaction Conclusion: Care givers need to fully understand the expectations the mothers have and provide care that is consistent with those expectations. The Prenatal, antenatal, delivery and postnatal care should be enhanced to increase maternal satisfaction in the health services and provide maternal-friendly outcome.

Lipoabdominoplasty in post-bariatric Surgery: a relevant Alternative to Fleur-de-Lis abdominoplasty?

The number of bariatric procedures, and thus also the number of post-bariatric operations, has increased dramatically in recent years. Although long scars are common in post-bariatric surgery and accepted in favour of body shape reconstruction, we increasingly notice the wish for aesthetically pleasing results in addition to the desire for body contouring. In particular, Fleur-de-Lis abdominoplasty (FdL) is viewed critically by younger patients after massive weight loss due to the visible vertical scar. Surgeons are also often bothered by the unsatisfying aesthetic outcome as well as the higher rate of complications. Retrospective analysis of 20 female patients with massive weight loss following bariatric surgery, who received lipoabdominoplasty instead of Fleur-de-Lis abdominoplasty in the period from January 2019 to June 2020. Data analysis was based on measurements of preoperative vertical and horizontal excess skin and fat (Pittsburgh Rating Scale), Body Mass Index, surgical technique and final result. Twenty female patients with an indication for FdL abdominoplasty underwent radical liposuction of the abdomen combined with abdominoplasty. The original weight before massive weight reduction ranged between 100 and 168 kg. Average weight reduction was 56.5 kg. The mean BMI was 27.3 kg/m². The average age of our cohort was 40 years. One patient (5 %) had a major complication. This was an infected seroma which could be treated conservatively. Two other patients (10 %) developed an uninfected seroma as a minor complication. Our work shows that lipoabdominoplasty can be performed safely and well even in patients after massive weight loss. It is possible to achieve good body contours without vertical incisions and with a high degree of patient satisfaction. The number of patients who have to undergo FdL abdominoplasty can be successfully reduced by this technique.

Treatment of cutaneous photoaging lesions with autologous platelet concentrate

Background: Facial aging causes a devastating physical and mental impact on quality of life. Objective: To evaluate the efficacy and safety of autologous platelet concentrate (APC) in the treatment of cutaneous photoaging (SCF). Method: Between March 1, 2017 and March 31, 2021, at the “Hermanos Ameijeiras” hospital, a randomized, single-center, double-blind and controlled clinical trial was carried out in 164 patients with ECF. A group treated with CPA was compared to another treated with fresh autologous plasma (AFP). The treatment was applied monthly for 1 year. Results: Three months after the end of the treatment, there were significant differences between the patients treated with CPA compared to those treated with PFA in terms of the improvement in the degree of photodamage and the degree of satisfaction (p &lt;0.001). All adverse events were of mild intensity, did not imply changes before the intervention and were completely resolved. Conclusions: The autologous platelet concentrate proved to be effective and safe to reduce the signs of skin aging, associated with a high degree of patient satisfaction.

Telerrehabilitación en tiempos de COVID: una encuesta de satisfacción a cuidadores y pacientes con daño cerebral

AimTo determine the satisfaction degree of caregivers and stroke patients who received physiotherapy in telerehabilitation (TR) format during the first wave of the SARS-CoV-2 pandemic. Material and methodsA descriptive study was developed using a questionnaire. The questionnaire included questions on general experience, problems encountered, subjective results obtained and suggestions for future editions. ResultsTwenty-six subjects were selected: 16 patients (9 men and 7 women) with a diagnosis of stroke and 10 caregivers (3 men and 7 women). 87.6% of the patients and 90% of the caregivers found the connection system easy to use, although 30% said they would choose another connection system in the future. In addition, 87.6% of patients agreed or strongly agreed to repeat the TR treatment. ConclusionStroke patients and caregivers participating in the TR program showed an acceptable satisfaction degree with their participation.

Voice rest after vocal fold polyp surgery: A Swedish register study of 588 patients.

ObjectiveTo evaluate the impact of voice rest on patient‐reported voice outcome 4 months after vocal fold polyp surgery.MethodsPreoperative information was collected about age, sex, and smoking habits and the voice handicap index‐10 (VHI‐10). Four months postoperatively, voice rest (total voice rest, spoke single words, and spoke normally), and pre and postoperative voice therapy were reported. This was correlated to voice satisfaction from a two‐category subjective evaluation “satisfied/ not satisfied” and to VHI‐10. Logistic regression models with relative risk for NOT being satisfied with voice after surgery were performed.ResultsData from 588 patients were available. The group “spoke normally” showed the highest degree of patient satisfaction (92%). Younger patients (<59 years) were more satisfied than older (90% vs. 81.5%). High age and low VHI‐10 scores before surgery were statistically significant for negative voice outcome. Gender or voice rest type did not significantly affect outcome. The largest improvement in VHI‐scores was in the group who spoke normally and least in the group who spoke single words.ConclusionWe found no significant difference in the two‐category subjective voice outcome depending on voice rest. VHI‐10 showed a statistically significant positive effect on self‐evaluated voice outcome, with the largest improvement in the group with no voice rest. However, the clinical relevance of the VHI changes is unclear. The present study does not show any advantage of total voice rest as compared to relative voice rest or speaking freely. High age and low preoperative VHI scores were significant risk factors for worse voice outcome. Level of evidence: 4

Impact of subnasal lip lift on lip aesthetic: a systematic review.

This study is to perform a systematic review of the literature on surgical correction of the upper lip in order to assess whether the subnasal lip lift technique improves lip aesthetics and maintains its stability. A systematic search was carried out using the PubMed, Science Direct, Scopus, Cochrane Library and EMBASE databases, based on records published until July 2020. The quality of the included studies was assessed using the Cochrane Handbook for Systematic Reviews of Interventions. In the absence of randomized clinical trials, prospective or retrospective cohort studies, case control and case series were considered eligible. Of the 464 articles initially found by the two reviewers, 4 were selected, with 2 retrospective cohorts and 2 case series. The results of the studies showed that 92.4% of subnasal lip lift cases were performed in women with an age range between 21 and 65years (mean of 36.6years). Only one of the 4 studies did not contain information regarding the sex and age of the patients. The bull's horn excision pattern for subnasal lip lift was used to perform the subnasal lip lift in 75% of the included studies. All studies pointed to an improvement in lip aesthetics after the subnasal lip lift, based on anthropometric measures and the degree of patient satisfaction while maintaining results for varying periods of time (from 12 to 59.1months). The studies included in this review suggest that the subnasal lip lift improves lip aesthetics in adult patients and maintains its stability for a certain period of time.

Comparison of peripherally inserted central catheters (PICCs) versus totally implantable venous-access ports in pediatric oncology patients, a single center study

To compare the efficacy of peripherally inserted central catheters (PICCs) and totally implantable venous-access ports (TIVAPs) for chemotherapy of pediatric patients with malignant tumors. A total of 96 children with malignant tumors who received catheterization of PICCs or TIVAPs for chemotherapy from May 2020 to May 2021 in Department of Pediatric Oncology of Qilu Hospital of Shandong University were selected. Then, the pathological features of disease, the age of children, the indwelling time, the incidence of postoperative complications, and the satisfaction degree were compared between the two groups. The age of children in the TIVAP group was younger than that in the PICC group (P < 0.05). The indwelling time in the TIVAP group was 7.2 ± 2.757 months,which was significantly longer than 5.65 ± 2.058 months in the PICC group (P < 0.05). The incidence of postoperative complications in the TIVAP group without systemic or local infection was markedly lower than that in the PICC group (P < 0.05). The satisfaction degree of patients in the TIVAP group without unsatisfied was markedly higher than that in the PICC group (P < 0.05). TIVAPs may be the first choice for chemotherapy of children with malignant tumors.

Recommendations by the Spanish Society of Rheumatology on Fibromyalgia. Part 1: Diagnosis and Treatment.

To prevent the impairment of fibromyalgia patients due to harmful actions in daily clinical practice that are potentially avoidable. A multidisciplinary team identified the main areas of interest and carried out an analysis of scientific evidence and established recommendations based on the evidence and "formal evaluation" or "reasoned judgment" qualitative analysis techniques. A total of 39 recommendations address diagnosis, unsafe or ineffective treatment interventions and patient and healthcare workers' education. This part I shows the first 27 recommendations on the first 2 areas. Establishing a diagnosis improves the patient's coping with the disease and reduces healthcare costs. NSAIDs, strong opioids and benzodiazepines should be avoided due to side effects. There is no good evidence to justify the association of several drugs. There is also no good evidence to recommend any complementary medicine. Surgeries show a greater number of complications and a lower degree of patient satisfaction and therefore should be avoided if the surgical indication is not clearly established.

Nonsurgical Rhinoplasty: Long-Term Follow-Up of High G' HA Nasal Injections.

Rhinoplasty is one of the most requested aesthetic procedures performed by plastic surgeons world-wide and nonsurgical rhinoplasty is becoming the gold standard in aesthetic nasal treatment. Follow-up clinical examinations were performed on all 107 patients, being a safe and predictable technique with a high degree of satisfaction for the patients. Nonsurgical rhinoplasty using hyaluronic acid is an effective, fast, and safe nasal reshaping procedure with a high degree of patient satisfaction. Generally, due to the gradual reabsorption of the filler, the results last up to 8 to 12 months after treatment, making it a valid minimally invasive alternative to surgical rhinoplasty. Consequently, to maintain the effects it is necessary to repeat the treatment once a year.

Prospective cohort study of topical versus general anaesthesia for flexible bronchoscopy

BackgroundTopical anaesthesia (TA) and general anaesthesia (GA) are performed for flexible bronchoscopy (FB) worldwide. However, few studies have compared the two anaesthesia methods in terms of perioperative discomforts.Methods648 patients undergoing...

Prospective cohort study of topical versus general anaesthesia for flexible bronchoscopy.

Topical anaesthesia (TA) and general anaesthesia (GA) are performed for flexible bronchoscopy (FB) worldwide. However, few studies have compared the two anaesthesia methods in terms of perioperative discomforts. 648 patients undergoing FB were recruited in Shanghai Pulmonary Hospital, a specialised medical centre in China, from January 2019 to December 2019. The patients underwent FB under TA or GA. The TA group received 1% lidocaine by nasal route, and the GA group received total intravenous anaesthesia. The level of perioperative discomfort and patient satisfaction were assessed. The investigators were blind to the group allocation. Finally, 239 patients received TA and 182 patients received GA. The basic demographic properties were comparable between two groups. There were no significant differences in terms of sore throat, 61.5% in TA group vs 57.1% in GA group. However, there was a significant difference in terms of postoperative nausea and vomiting (34.3% in TA group vs 56.6% in GA group), and dizziness (37.7% in TA group vs 78% in GA group). There was a significant difference in terms of total complication scores (17.2 ± 5.1 in TA group vs 7.7 ± 4.3 in GA group) and satisfaction degree of patients (2.6 ± 1.1 in TA group vs 4.3 ± 0.8 in GA group). Compared with TA, GA significantly reduced the total complication scores of perioperative discomforts and improved the satisfaction score of patients for FB. This clinical trial was registered with www.chictr.org.cn (ChiCTR1800019971).

The Quality of Life and Satisfaction After Orthognathic Surgery in Saudi Arabia

Orthognathic surgery is used to treat dental issues such as misaligned jaws and teeth and skeletal abnormalities related to them. It is often recommended when there are significant dentofacial abnormalities that cannot be corrected by orthodontic therapy alone, particularly in adults when the natural growth pressures have stopped. This research aimed to assess the health-related QoL and degree of patient satisfaction among Saudi Arabian patients having orthognathic surgery. The null hypothesis w

Value of Music and Nitrous Oxide for Pain Control during Extracorporeal Shock Wave Lithotripsy (ESWL).

To compare the efficacy of 4 different analgesic regimens that include music and nitrous oxide during the treatment of renal lithiasis with ambulatory extracorporeal shock wave lithotripsy (ESWL). A single-centre, longitudinal, prospective, randomized, open and parallel group study was conducted. Patients with renal lithiasis were included and were randomized to Group A (basal analgesia: midazolam (1 mg), fentanyl (0.05 mg) and dexketoprofen (50 mg)), Group B (basal analgesia and nitrous oxide), Group C (basal analgesia and music) and Group D (basal analgesia, nitrous oxide and music). For the measurement of pain, a visual analogue scale ranging from 0 (no pain) to 100 (maximum pain imaginable) was used. Patient satisfaction was assessed using a Likert questionnaire. The epidemiological data of the patients in terms of lithiasis, previous clinical and ESWL sessions, and pain measured with the VAS before, during (maximum) at the end of the session and at discharge were recorded. Data on complications were also collected, as was the patients' subjective evaluation of the treatment and their satisfaction. The ESWL procedure was performed with a Storz Modulith SLX-F2® lithotripter. A maximum of 4000 waves were applied at a frequency of 1.5 Hz. Eighty patients were included (20 per group). None of the analgesia guidelines proved to be superior to the others for pain control during the ESWL session. Patients younger than 50 years had significantly higher values for the maximum VAS. Only 13.75% of patients required rescue analgesia. A total of 77.5% described their experience as good, very good or excellent, regardless of the assigned group. The addition of nitrous oxide and/or music did not result in a statistically significant improvement over the basal analgesia regimen of midazolam, fentanyl and dexketoprofen; however, the degree of patient satisfaction was very high.