Prevalence Of Postoperative Pain Research Articles

The prevalence of postoperative pain in the first 48 hours following day surgery at a tertiary hospital in Nairobi.

Day case surgery services are increasing all over the world. The prevalence of postoperative pain after day surgery is found to be high. Little is known about the prevalence of postoperative pain, in Kenya, after day case surgeries. To investigate the prevalence of postoperative pain after day surgery at Aga Khan University Hospital (AKUH), Nairobi, to determine the severity/intensity of postoperative pain following day case surgery. Consecutive sampling was carried out until sample size of one hundred and fifty patients was achieved. The purpose and nature of the study was explained to patients before informed consent was obtained. They were shown how to score their pain using a visual analogue scale prior to the surgical procedure. A questionnaire was used to collect data from the patients. Follow up information was obtained through telephone interviews at 24 and 48 hours, after discharge from the day surgery unit. The prevalence of postoperative pain after day care surgery was found to be 58% within 30 minutes postoperatively, 55.3% after 24 hours, and 34.7% after 48 hours following surgery. The prevalence of moderate to severe postoperative pain was 13% after 24 hours, and 11.7% after 48 hours. The overall prevalence of postoperative pain after day surgery at the Aga Khan University Hospital, Nairobi was noted to be different from what has been reported in the literature. The prevalence of moderate and severe pain however, is less than reported in the literature.

A Comparative evaluation of the Efficacay of two oral medication on post operative pain following single visit root canal therapy – An in vivo study

AIM : To compare the effects of single dose of two oral medication following single visit root canal therapy in teeth with irreversible pulpitis MATERIALS AND METHODS: 30 patients who reported to KVG dental college sullia, seeking treatment on which single visit RCT was performed . In this double blind study anterior or premolar teeth with irreversible pulpitis without any signs and symptoms of irreversible pulpitis were selected divided into 3 groups randomly. A control group without any medication and two groups receiving a single dose of E-90 and Movon-p respectively immediately after the root canal therapy the intensity of pain was recorded on a 10 point VAS for upto 24hr post operatively. RESULTS :E-90 Etoricoxib-90 (group 1) was found to be clinically significant at 10% more compared to the other two groups in the reduction of post operative pain . (Movon-p) wasmore effective compared to the control group where no medication was given CONCLUSION: A single dose of E-90 considerably reduced thepost operative pain compared to the other I. Introduction Pain is an unpleasant sensation that can significantly interfere with the person's quality of life and general functioning . The prevalence of post operative pain has been reported to be significantly higher associated with single visit than with multiple visit root canal treatment .The prevalence of post operative pain following root canal treatment has been reported to be3-58% . Studies regarding post-obturation pain levels that required analgesics have reported significantly higher prevalence associated with single-visit than with multiple-visit treatment. Non Steroidal Anti-inflammatory drugs (NSAIDS) are the most common analgesics in ambulatory patients. Some drugs can prevent the production of inflammatory mediators involved in producing pain , such as prostaglandins owing to pulpal inflammation and necrosis . NASAIDS are widely available , and they have been reported to be effective in managing endodontic pain . Non narcoticanalgesics ,NSAIDS and acetaminophen can all produce analgesia; therefore , they can be effectivefor managing pulp and periradicular pain . (1) Several double blind , placebo - controlled trials in patients with endodontic pain have been carried out with NASAIDS namely ibuprofen and it has shown good efficacy and safety profiles . Studies have shown that a suitable method for controlling moderate to severe pain is to combine two or more drugs ;Movon -P a combination of aceclofenac and paracetamolAceclofenac is a phenylacetic acid derivative that inhibits synthesis of the inflammatory cytokines interleukin-1b and tumour necrosis factor, inhibits prostaglandin E2 production. Paracetamol has analgesic and antipyretic action with weak anti-inflammatory activity. It produces analgesia by increasing pain threshold and antipyresis by acting on the hypothalamic heat-regulating centre. E-(90) Etoricoxib selectively inhibits isoform 2 ofcyclo-oxigenase enzyme (COX-2).(2) This reduces the generation of prostaglandins (PGs) from arachidonic acid. Among the different functions exerted by PGs, their role in the inflammation cascade should be highlighted. Since no studies have been done using this two oral medication hence the purpose of the study is to compare effects of single dose of two oral medication following single visit root canal therapy in teeth with irreversible pulpitis.

A drug utilization study of analgesics for management of postoperative pain in patients admitted at a tertiary care teaching hospital

Background: Postoperative pain is very common and develops naturally as a warning. After surgery, its development can be predicted and should be prevented and treated. Besides the disagreeable aspects and physiological repercussions of postoperative pain, it delays ambulation and hospital discharge. Despite the drugs and anesthetic techniques available, the prevalence of postoperative pain is still high. Methods: Pain assessment was done by BP cuff inflation method and Numerical rating scales both pre and postoperatively. Results: Complain of postoperative pain is more in female patient. Over all complain of postoperative pain was observed more in 31-45 year age group. Complain of postoperative pain was more at 18 hour time interval. Postoperative pain complains was more in patients undergoing general surgery. Postoperatively out of 310 patients 298 patients were received diclofenac only and 18 patients were received diclofenac + tramadol combination of these 112 and 13 patients complained of post-operative pain respectively. Conclusions: 112 patients from diclofenac only received group and 13 patients from diclofenac + tramadol received group complain of post operative pain. Post-operative pain control at 12 hours is sufficient but high post-operative pain scores at 18 hour of post-operative time interval suggesting needs of additional pain control. Majority of study patients received single analgesic (Diclofenac sodium).

Cross-sectional evaluation of post-operative pain and flare-ups in endodontic treatments using a type of rotary instruments

Aim.The purpose of this clinical study was to evaluate the general incidence of post-operative pain and flare-ups in patients who were endodontically treated by two endodontics specialists using rotary instruments (Hero 642, Micro Mega, France) with the same treatment protocol. Methods. Records of 382 teeth belonging to 268 patients treated by two endodontics specialists during a 6-month period were kept and evaluated. Post-operative pain between treatment visits was categorized using a pre-established scoring system. Ninety-five patients were males, whereas 173 were females. Results. Pulpal necrosis without periapicalpathosiswas determined as the most common indication for endodontic treatment (21.7%) followed by irreversible pulpitis and re-treatment without periapical lesions (18.3%, 18.3%, respectively). The general prevalence of post-operative pain and flare-ups was determined as 8.1%, whereas cases that could be classified as real flare-ups which were severe and required an unscheduled visit (scores 2 and 3) comprised 3.4% of the cases. No statistically significant correlation was determined between gender and post-operative pain and flare-up (p = 0.05). There was a significant correlation between number of appointments and the presence of pain and flare-ups. Teeth undergoing multiple visits had a higher risk of developing post-operative pain and flare-ups compared to those with single appointments with a statistical significance (p = 0.03). Conclusions. Teeth with pre-operative pain were more prone to developingpost-operative pain and discomfort with a statistically significant difference (p = 0.02). While no significant correlation was determined between tooth vitality and pain and flare-ups (p = 0.5), a statistically significant relationship existed between the presence of a periapicalpathosisand post-operative pain and flare-ups. Cases with a periapical lesion had a higher risk of developingpain and flare-upscompared to those with no periapical involvement (p = 0.0001). Future studies may focus on the influence of rotary instrumentation systems in more specific groups of cases. Meanwhile; microbiological as well as psychological aspects of flare-ups are topics that warrant further investigation.

Prevalence of postoperative pain in neurosurgery

Prevalence of postoperative pain in neurosurgery

While we are waiting for NFOG 2012 and summer, enjoy this issue of AOGS

While we are waiting for NFOG 2012 and summer, enjoy this issue of AOGS

Ten-Year Follow-up of a Rotating-Platform, Posterior-Stabilized Total Knee Arthroplasty

The rotating-platform, posterior-stabilized knee was designed to decrease polyethylene wear and to address challenges associated with Low Contact Stress mobile-bearing knees. The purpose of the present prospective study was to investigate the long-term clinical and radiographic results and the survival rate for this implant. From January 2000 to October 2001, 117 consecutive patients (138 knees) underwent rotating-platform posterior-stabilized total knee arthroplasty with cement. All patients were followed prospectively. At a mean of 10 ± 0.4 years (range, 9.5 to eleven years) of follow-up, twenty patients had died and eight had been lost to follow-up, leaving eighty-nine patients (106 knees) for analysis. A good to excellent result according to the Knee Society pain score, which improved from an average of 44 to 94 points, was achieved in 96% (eighty-five) of the eighty-nine patients in the final cohort. The mean knee motion improved from 111° to 119°. The prevalence of postoperative pain was 14%. The prevalence of asymptomatic crepitation was 9.4%, and the prevalence of painful crepitation requiring scar excision was 3.8%. Radiographic analysis revealed no malalignment, aseptic loosening, or osteolysis. There were three revisions: one for the treatment of infection and two for the treatment of traumatic supracondylar fractures. Kaplan-Meier analysis revealed that the ten-year survival rate was 100% with revision due to mechanical failure as the end point, 97.7% with revision for any reason as the end point, and 95% with any reoperation as the end point. The ten-year follow-up of the rotating-platform, posterior-stabilized total knee arthroplasty demonstrated excellent clinical results and survival rates with no failures due to osteolysis or loosening.

Postoperative Pain after Manual and Mechanical Glide Path: A Randomized Clinical Trial

Introduction This prospective randomized clinical trial evaluated the incidence of postoperative pain after glide path performed with PathFile (PF) (Dentsply Maillefer, Ballaigues, Switzerland) versus stainless-steel K-file (KF). Methods In 149 subjects, the mechanical glide path was performed with nickel-titanium (NiTi) rotary PF; in 146 subjects, the manual glide path was performed with stainless-steel KFs. Postoperative pain, analgesics consumption, and the number of days to complete pain resolution were evaluated in the following 7 days. An analysis of variance model for repeated measures was used to compare the variation of pain-scale values ( P < .05). The Student's t test for continuous variables normally distributed, the nonparametric Mann-Whitney U test for the nonnormally distributed variables, and the chi-square test for dichotomous variables were used ( P < .05). Despite homogeneous baseline conditions at diagnosis, tooth type, pain prevalence, and scores, the postoperative pain prevalence curves in PF group evidenced a more favorable trend in terms of time to pain resolution compared with the KF group ( P = .004). The difference was also evident in the model adjusted for analgesics consumption in both groups ( P = .012). The mean analgesics intake per subject was significantly higher in the KF group (3.7 ± 2.2) compared with the PF group (2 ± 1.7) ( P < .001). Mean pain stop values were also significantly higher in the KF group (2.7) compared with the PF group (1.7) ( P = .001). Conclusions The glide path with NiTi Rotary PF leads to less postoperative pain and faster symptom resolution.

Atención del dolor agudo postoperatorio: evaluación de resultados en las salas de hospitalización quirúrgicas

ObjectiveTo describe management of acute postoperative pain on the surgical ward. To study the relationship between pain and a variety of surgical procedures and approaches. To determine the level of information patients received, their expectations, and their satisfaction with treatment of postoperative pain. Patients and methodsCross-sectional observational study by survey and review of patient records. We studied 234 patients, including all who were hospitalized for more than 24 hours after scheduled or emergency operations. The main variables recorded were pain intensity at rest and during movement, including on the day after surgery, and the surgical procedure and approach. ResultsThe prevalence of pain (>3 on a numerical scale) on the surgical ward was 33% at rest and 66% during movement. The prevalence of intense pain (>6 on the numerical scale) was 1.7% at rest and 7.3% during movement. Factors related to greater pain intensity were timing, that is, the first day after surgery, when 74.4% of patients experienced their most intense pain; type of surgery and approach (P<.004); and expecting to experience moderate or intense pain (P<.001). ConclusionsRecording the prevalence of postoperative pain on a surgical ward provides information about the real situation of acute postoperative pain control. Pain on movement is a principal indicator for detecting groups of patients for whom analgesic protocols could be improved. Type of surgery and approach is a fundamental factor to consider when comparing the results of analgesic protocols.

Incidence of Postoperative Pain after Single- and Multi-Visit Endodontic Treatment in Teeth with Vital and Non-Vital Pulp

To assess the incidence of postoperative pain after single- and multi-visit endodontic treatment of teeth with vital and non-vital pulp. In total, 306 patients with teeth requiring endodontic treatment were identified and were included in this study. Two experienced clinicians treated the patients, who were randomly assigned to two groups. While the teeth of patients in group 1 were obturated, group 2 were temporarily sealed and obturated after one week. Three days after the root canal instrumentation of each tooth, the patients were asked whether they experienced any postoperative pain and to rate the level of discomfort as no, mild, moderate, or severe pain. Data were analyzed statistically using the chi-square test. No significant difference in postoperative pain was found between vital and non-vital teeth (P>.01). Mild, moderate, and severe pain occurred in 31.4, 13.7, and 4.6% of vital teeth, respectively. Postoperative pain occurred in 107 (69.9%) and 106 (69.3%) teeth in the single- and multi-visit treatment groups, respectively. There was no significant difference in postoperative pain between the two groups (P>.01). The prevalence of postoperative pain did not differ between vital and non-vital teeth. The majority of patients in either groups reported no or only mild pain.

Single- or multiple-visit endodontics: which technique results in fewest postoperative problems?

The Cochrane Central Register of Controlled Trials, Medline, Embase, six thesis databases (Networked Digital Library of Theses and Dissertations, Proquest Digital Dissertations, OAIster, Index to Theses, Australian Digital Thesis Program and Dissertation.com) and one conference report database (BIOSIS Previews) were searched. There were no language restrictions. Studies were included if subjects had a noncontributory medical history; underwent nonsurgical root canal treatment during the study; there was comparison between single- and multiple-visit root canal treatment; and if outcome was measured in terms of pain degree or prevalence of flare-up. Data were extracted using a standard data extraction sheet. Because of variations in recorded outcomes and methodological and clinical heterogeneity, a meta-analysis was not carried out, although a qualitative synthesis was presented. Sixteen studies fitted the inclusion criteria in the review, with sample size varying from 60-1012 cases. The prevalence of postoperative pain ranged from 3-58%. The heterogeneity of the included studies was far too great to yield meaningful results from a meta-analysis. Compelling evidence is lacking to indicate any significantly different prevalence of postoperative pain or flare-up following either single- or multiple-visit root canal treatment.

The prevalence of postoperative pain in a sample of 1490 surgical inpatients

To measure the prevalence of postoperative pain, an assessment was made of 1490 surgical inpatients who were receiving postoperative pain treatment according to an acute pain protocol. Measurements of pain (scores from 0 to 100 on a visual analogue scale) were obtained three times a day on the day before surgery and on days 0-4 postoperatively; mean pain intensity scores were calculated. Patients were classified as having no pain (score 0-5), mild pain (score 6-40), moderate pain (score 41-74) or severe pain (score 75-100). Moderate or severe pain was reported by 41% of the patients on day 0, 30% on days 1 and 19%, 16% and 14% on days 2, 3 and 4. The prevalence of moderate or severe pain in the abdominal surgery group was high on postoperative days 0-1 (30-55%). A high prevalence of moderate or severe pain was found during the whole of days 1-4 in the extremity surgery group (20-71%) and in the back/spinal surgery group (30-64%). We conclude that despite an acute pain protocol, postoperative pain treatment was unsatisfactory, especially after intermediate and major surgical procedures on an extremity or on the spine.

The prevalence of postoperative pain and flare‐up in single‐ and multiple‐visit endodontic treatment: a systematic review

The aim of this systematic review was to assess the evidence regarding postoperative pain and flare-up of single- or multiple-visit root canal treatment. CENTRAL, MEDLINE and EMBASE databases were searched. Reference lists from identified articles were scanned. A forward search was undertaken on the authors of the identified articles. Papers that had cited these articles were also identified through Science Citation Index to identify potentially relevant subsequent primary research. The included clinical studies compared the prevalence/severity of postoperative pain or flare-up in single- and multiple-visit root canal treatment. Data in those studies were extracted independently. Sixteen studies fitted the inclusion criteria in the review, with sample size varying from 60 to 1012 cases. The prevalence of postoperative pain ranged from 3% to 58%. The heterogeneity amongst included studies was far too great to conduct meta-analysis and yield meaningful results. Compelling evidence indicating a significantly different prevalence of postoperative pain/flare-up of either single- or multiple-visit root canal treatment is lacking.

The Prevalence of Postoperative Pain in a Cross-sectional Group of Patients After Day-case Surgery in a University Hospital

Although a great variety of surgical procedures are performed on an ambulatory basis, little is known about postoperative pain experience at home after ambulatory surgery. This study was performed to assess the prevalence and course of postoperative pain in the early postoperative period after ambulatory surgery. Over a period of 4 months, 648 patients who underwent day-case surgery were included in our study. Data were collected with interviews and questionnaires. Pain intensity was measured using a visual analog scale (VAS) during 4 days after surgery. Side effects of anesthesia and analgesia techniques were also recorded. On the day of the operation, 26% of the patients had moderate to severe pain (defined as mean VAS >40 mm). Mean VAS-scores were greater than 40 mm in 21% on postoperative day (POD) 1, in 13% on POD 2, in 10% on POD 3, and in 9% on POD 4. Operations of nose and pharynx, abdominal operations, plastic surgery of the breasts, and orthopedic operations were the most painful procedures during the first 48 hours. This study showed that an important number of patients still experience moderate to severe pain in the postoperative period after day-case surgery even after a 4-day period. Furthermore, the type of operation should be considered when planning postoperative analgesia for ambulatory surgery.

Outcome of Root Canal Obturation by Warm Gutta-Percha versus Cold Lateral Condensation: A Meta-analysis

The purpose of this study was to evaluate clinical outcome differences of root canal obturation by warm gutta-percha (GP) or cold lateral condensation (CLC) through a systematic review and meta-analysis. There were 10 clinical studies evaluated. Postoperative pain, long-term outcomes, obturation quality, and overextension were the characteristics investigated. The results suggest that the two obturation techniques are not significantly different except in overextention. The relative risk (RR) value of warm GP versus CLC and 95% confidence interval (CI) of the first three criteria were 1.10 (0.71, 1.71), 0.78 (0.58, 1.05), and 1.31 (0.98, 1.76), respectively. Overextension was more likely to occur in the warm GP obturation group in comparison with the CLC group. The RR value and 95% CI were 1.98 (1.33, 2.93). In conclusion, warm GP obturation demonstrated a higher rate of overextension than CLC. Postoperative pain prevalence, long-term outcomes, and obturation quality were similar between the two groups.

Experiencia en el tratamiento multidisciplinar del dolor agudo postoperatorio

ObjectiveTo evaluate the prevalence of postoperative pain in a general hospital. Material and methodA manual model of the visual analog scale (VAS) was constructed, which implemented an intervention algorithm. A prospective, randomized study was carried out that included patients from orthopedic, digestive, gynecological and obstetric surgery. Patients aged less than 16 years old and those with an altered level of consciousness were excluded. Several variables were entered into the File Maker computer program. Two questionnaires, one on patient satisfaction and another evaluating the use of VAS, were administered to nurses and patients. ResultsVAS was included as one more nursing instrument for periodic measurement. Three hundred seventy-six patients (mean age, 52.1 ± 17.6 years) were included. The mean maximum VAS registered was 46 points. Moderate or severe pain (VAS, 41-100) was found in 51.8% of the patients. Maximum VAS values were registered on the third postoperative day in 7.4% of the patients. Incorrect pharmacological prescription increased the percentage of severe pain. Overall patient satisfaction with the treatment received was good but satisfaction was lower in patients with severe pain. Satisfaction with the use of VAS was fair among nurses and very good among patients. ConclusionsIn the present study, more than 50% of the patients presented moderate or severe postoperative pain.

A.417 Survey on postoperative pain prevalence and severity in the French largest public hospital group

A.417 Survey on postoperative pain prevalence and severity in the French largest public hospital group