Painful Procedures Research Articles

Effects of acoustic stimulation on painful procedures in preterm and full-term infants: A systematic review and network meta-analysis.

Effects of acoustic stimulation on painful procedures in preterm and full-term infants: A systematic review and network meta-analysis.

How frequently do hospitalized children undergo painful procedures? A longitudinal study on the number of procedures and associated factors.

How frequently do hospitalized children undergo painful procedures? A longitudinal study on the number of procedures and associated factors.

Factors Causing Incomplete Colonoscopy Reported by the Endoscopist: A Population-based Study.

Colonoscopy is a primary diagnostic method for colorectal cancer screening. Ensuring completeness is critical for its effectiveness. The aim of this study is to explores patient and procedure-related contributors to incomplete colonoscopy in a Danish high volume endoscopy unit. A population-based register study was conducted, using data from electronic health records from a Danish hospital was analyzed, covering all colonoscopies performed between July 2015 and August 2019. The primary outcome assessed was the completeness of the index colonoscopy, with incomplete cases further classified based on the causes for incompleteness that were assessed and documented in real-time by the endoscopist. Data also included patient demographics and comorbidities, and profession of the endoscopist. Among 33,128 colonoscopies, prevalence of incomplete colonoscopies was 6.55%, with inadequate bowel preparation as the leading cause (60.3%). Men were more prone to inadequate bowel preparation, while procedural pain, non-passability, and stenosis were associated with women. Physician endoscopists exhibited higher incomplete colonoscopy rates compared to nurse endoscopists, and patients with higher comorbidity scores were more likely to have incomplete colonoscopy. This study highlights the prevalence of incomplete colonoscopy and recognizes modifiable risk factors like inadequate bowel preparation and procedural pain. Findings underscore the need for personalized interventions, stressing ongoing endoscopist education and targeted strategies to improve colonoscopy effectiveness.

Effectiveness of social robots in improving psychological well-being of hospitalised children: A systematic review and meta-analysis.

Effectiveness of social robots in improving psychological well-being of hospitalised children: A systematic review and meta-analysis.

Anxiety during transcatheter aortic valve replacement under local anesthesia - the ART-VR trial.

Anxiety during transcatheter aortic valve replacement under local anesthesia - the ART-VR trial.

Comparative Evaluation of Dexmedetomidine vs Nalbuphine for Control of Postspinal Shivering

ABSTRACT Background and Aims: Perioperative shivering is remarkably perturbing for the patient, impeding monitoring, aggravating postoperative pain in procedures requiring spinal anaesthesia. Our research had a primary objective of comparing the efficacy of dexmedetomidine and nalbuphine for managing shivering, which occurs postspinal anaesthesia. While the secondary aim encompassed the examination of hemodynamic alterations and their related potential negative outcomes. Material and Methods: This prospective randomized study was carried out on a cohort of 60 patients classified as American Society of Anaesthesiologists (ASA) physical status I and II, who were slated for surgical interventions under spinal anaesthesia. They were allocated into two groups of 30 patients each. Group D received dexmedetomidine 1 mcg/kg, and group N received 0.05 mg/kg nalbuphine following the onset of shivering. The principal focus of this research endeavour was to investigate and analyse the efficacy of the drugs in controlling shivering, assessed through the wrench shivering grade. Additionally, the secondary objective involved monitoring the hemodynamic changes and the potential negative outcomes associated with the administration of these medications. Results: The extent of shivering control exhibited a significant reduction in group D compared to group N (2.55 ± 1.06 min and 4.69 ± 1.643 min, respectively, with a P < .001). However, the success rate in group D was 86%, and in group N, it was 76%. Group D showed reduced diastolic blood pressure, mean arterial blood pressure, and heart rate compared to group N. Although bradycardia, hypotension, and sedation were observed in both groups, sweating was noted in group N. Conclusion: Dexmedetomidine is a better alternative in controlling shivering with a quicker response time and less recurrence. Nalbuphine also appears to be effective in controlling shivering and is more economical. However, further insight into its application for shivering should be gained through thorough research and randomised trials before safe implementation.

Predictors of vasovagal symptoms or syncope during outpatient diagnostic hysteroscopy: A prospective observational study.

Predictors of vasovagal symptoms or syncope during outpatient diagnostic hysteroscopy: A prospective observational study.

The Effect of Using Thermomechanical Stimulation and Virtual Reality Glasses During Peripheral Intravenous Catheterization on Pain and Patient Satisfaction: A Randomized Controlled Trial.

The Effect of Using Thermomechanical Stimulation and Virtual Reality Glasses During Peripheral Intravenous Catheterization on Pain and Patient Satisfaction: A Randomized Controlled Trial.

Examining the effect of virtual reality application on pain and anxiety in the care of chronic wounds on the leg.

Examining the effect of virtual reality application on pain and anxiety in the care of chronic wounds on the leg.

The impact of foot reflexology on postoperative pain and fear in children following circumcision: A randomized controlled trial.

The impact of foot reflexology on postoperative pain and fear in children following circumcision: A randomized controlled trial.

Evaluation of Care related Pain in Critically Ill Mechanically Ventilated Patients in the ICU of a Tertiary Care Centre

ObjectivesThe purposes of this study are to (1)assess the levels of care-related pain prior to and during routine nursing procedures among mechanically ventilated patients, (2) identify care-related procedures that are likely to induce or increase pain in mechanically ventilated patients, and (3) investigate the relationship between care related pain levels and patient gender, age, and analgesia and/or sedatives prior to or during procedures.Materials and methodsA prospective observational study conducted between January 2023-August 2024, patients were assessed twice during either nociceptive and non-nociceptive care-related procedures, immediately prior to one of the selected routine procedures being conducted and then during the procedure using the Behavioural Pain Scale (BPS), Ramsay scale (RS), and two haemodynamic parameters (blood pressure [BP] and heart rate [HR]. Nociceptive care-related procedures include repositioning (i.e. patients rolled to one side from their initial position), endotracheal suctioning, and vascular punctures (i.e. cannulation). Non-nociceptive care-related procedures include eye care (simple eye washes with normal saline and cotton wool ball), mouth care (brush teeth and tongue with a mouth swab soaked in normal saline as a cleansing agent), and central venous catheter dressing changes.ResultsThis study found that 33.3% of patients experience pain at rest (BPS score >3).1–7 The current study findings verify that repositioning is the most painful routine nursing procedure. The second most painful procedure is endotracheal suctioning. The study also suggests that other hygiene interventions used on critically ill mechanically ventilated patients (such as mouth care), exacerbate pain in patients to a similar degree to other routine nursing procedures such as dressing change and invasive procedures.ConclusionCare-related pain is a real problem in critically ill patients, particularly in those patients who are unable to self-report pain. The intensity of care-related pain varies noticeably, depending on the type of procedure. In the absence of self-report of pain, clinicians must rely on other alternatives to assess pain. Performing systematic initial and ongoing assessment of pain, administering supplementary pre-emptive analgesia, and considering factors that exacerbate pain are crucial steps in improving pain management in critically ill mechanically ventilated patients.

Procedural pain in pediatric care: Nitrous oxide and the greenhouse effect.

Procedural pain in pediatric care: Nitrous oxide and the greenhouse effect.

Procedural Pain and Choice of Anesthetic at Time of Polyacrylamide Hydrogel Injections for Stress Urinary Incontinence: A Randomized Controlled Trial

Procedural Pain and Choice of Anesthetic at Time of Polyacrylamide Hydrogel Injections for Stress Urinary Incontinence: A Randomized Controlled Trial

Analgesic Efficacy of a Long-Acting Transdermal Buprenorphine in Rats (Rattus norvegicus)

Zorbium is the first long-acting transdermal buprenorphine (LAT-bup) approved by the FDA for relieving postoperative pain in cats for 72 h. This study aimed to investigate LAT-bup’s efficacy for attenuating postoperative mechanical and thermal hypersensitivity in a rat incisional pain model. We hypothesized that a high dose of LAT-bup would attenuate mechanical and thermal hypersensitivities more effectively than a low dose in rats for 96 h postoperatively. Two experiments were conducted. In experiment 1, a total of 34 Sprague–Dawley rats were randomly assigned into one of 4 treatment groups: (1) saline (0.9% NaCl, 5 mL/kg, transdermal); (2) buprenorphine extended-release (Bup-ER; 1.2 mg/kg, SC); (3) low-dose long-acting transdermal buprenorphine (LAT-bup low; 5 mg/kg, transdermal); or (4) high-dose long-acting transdermal buprenorphine (LAT-bup high; 10 mg/kg, transdermal). One hour after drug application, a 1-cm incision was made on the left plantar paw of the rat under isoflurane anesthesia. Mechanical and thermal hypersensitivity were measured at −24 h (24 h before surgery) and at 4, 24, 48, 72, and 96 h postsurgery. In experiment 2, 49 rats were used to measure plasma buprenorphine levels at various time points: 20 and 40 min and 1, 4, 24, 48, 72, and 96 h. Clinical observations were recorded daily, and a gross necropsy was performed at 96 h. Bup-ER and high-dose LAT-bup effectively reduced mechanical hypersensitivity from 4 to 48 h. However, neither the low nor high doses of LAT-bup attenuated thermal hypersensitivity. Plasma buprenorphine concentrations remained above 1 ng/mL from 4 to 96 h across all groups. This study demonstrates that high-dose LAT-bup attenuated postoperative mechanical hypersensitivity as effectively as Bup-ER for up to 48 h in this rat incisional pain model. Based on these findings, we recommend LAT-bup at 10 mg/kg for minor incisional pain procedures in rats.

Rubber Band Ligation versus Injection Sclerotherapy for the Management of Grade I and Grade II Haemorrhoids: A Prospective Interventional Study

Introduction: Several approaches are available for treating haemorrhoids, ranging from conservative in-office procedures to more invasive surgeries. Rubber Band Ligation (RBL) and Injection Sclerotherapy (SCL) are two widely used, minimally invasive techniques that can be performed in an office setting. While both methods relieve symptoms and enhance patients’ quality of life, they vary in mechanisms, techniques, and outcomes. Despite their popularity, there is limited comparative research on their efficacy, safety, and patient satisfaction. Aim: To compare RBL and SCL regarding post-procedural pain, bleeding, relief of symptoms, and recurrence. Materials and Methods: A prospective interventional study was conducted at Sri Ramachandra Institute of Higher Education and Research, Chennai, from July 2019 to July 2021. A total of 60 patients over the age of 18 years, with grade I or II haemorrhoids, undergoing RBL or injection SCL were included. Patients were recruited by convenience sampling and allocated alternately, i.e., RBL (n=30) or SCL (n=30), and systematically compared in terms of post procedural pain, bleeding, relief of symptoms, and recurrence. Data was analysed using IBM SPSS version 23.0 statistics software. The t-tests and Chi-square tests were applied and p-value of <0.05 was considered significant. Results: The mean pain score immediately post-procedure (30 minutes) was 2.6 and 1.7 in the RBL and SCL groups, respectively, p=0.024. The same trend was reported on day zero and mean pain score was significantly lower in the SCL group (0.37) as compared to the RBL group (0.93), p=0.008. In the first week, 53.3% of the RBL group presented with bleeding as compared to 20% of the SCL group, p=0.007. Patients in the RBL group reported better relief of symptoms (i.e., pain, bleeding, pruritus, sensation of mass per rectum) than patients in the SCL group, 93.3%, and 83.3%, respectively, though this data was not statistically significant. The RBL group had one recurrence (3.3%) and the SCL group had three recurrences (10%). Conclusion: The SCL group outperformed the RBL group regarding pain and bleeding in the first week post-procedure. However, clinically the pain experience was similar for both groups. While data beyond the first week was not statistically significant, SCL remains a safe and effective treatment for early haemorrhoids.

Factors Explaining Procedural Pain Management in Newborn Intensive Care Unit: A Cross- Sectional Study

Introduction: Recent research has highlighted the significant impact of procedural pain on critically ill neonates. However, effective pain management strategies to mitigate long-term negative consequences are still underutilized. Objective: To determine the effect of nurse factors on procedural pain management in neonates performed by neonatal nurses, when controlling organizational context factors and infant factors. Method: This study was cross-sectional correlation design. The participants consisted of 118 Thai NICU nurses. The Data collecting used by a self-report questionnaire. The descriptive statistics and hierarchical multiple regression analysis are used to analyze the data. Result: The findings showed that organizational supportive resources and nurse-physician collaboration had significantly positive effects on pain management in neonates (β = .349, p < .001, and β = .362, p < .001). Gestational age had a significant negative effect on pain management in neonates (β = -.414, p < .001). Knowledge, attitude, and nurses’ experience of infant care had significant positive effects on pain management in neonates (β = .435, p < .001, β = .257, p < .01, and β = .236, p < .01, respectively). When controlling for the organizational context factors and the infant factor, nurse factors still predicted procedural pain management in neonates. Together, the predictor variables explained 54.8% of the total variance of nurses’ pain management in neonates. It can conclude that nurse factors are important predictors of procedural pain management in neonates. Conclusion: Thus, there is a need for nurse empowerment and enhanced knowledge about neonatal pain assessment and management among NICU nurses.

Pain And Anxiety During AV Fistula Cannulation Among Hemodialysis Patients

AV fistula cannulation is a routine yet often painful and anxiety-inducing procedure for patients undergoing maintenance hemodialysis. Despite its frequency, procedural pain and psychological distress remain under-addressed, especially in low-resource settings like Pakistan. Objective: To assess the severity and prevalence of pain and anxiety during AV fistula cannulation among hemodialysis patients in a tertiary care hospital in Pakistan. Methods: This cross-sectional descriptive study was conducted at the Dialysis Unit, Department of Nephrology, Nishtar Hospital Multan, from 15 December to 15 March. A total of 135 patients undergoing maintenance hemodialysis through AV fistula were included. Pain was evaluated using the Visual Analog Scale (VAS), and anxiety was measured using the Hospital Anxiety and Depression Scale – Anxiety subscale (HADS-A). Data were analyzed using SPSS v25, with chi-square tests for statistical significance (p<0.05). Results: Pain during cannulation was reported by 92.6% of patients, with 28.1% experiencing mild, 38.5% moderate, and 25.9% severe pain. Anxiety was present in 62.9% of patients (31.1% mild, 20.7% moderate, 11.1% severe). Significant associations were found between anxiety and female gender (p<0.05), as well as between severe pain and longer dialysis duration (p=0.032). Conclusion: Pain and anxiety are highly prevalent during AV fistula cannulation among Pakistani hemodialysis patients. Integrating pain management and psychological screening into routine dialysis care may significantly improve the well-being of this vulnerable population.

Pediatric Delirium in Pediatric Intensive Care Setting: A Review of Recognition and Prevalence

Delirium is defined as an etiologically nonspecific organic cerebral syndrome characterized by concurrent disturbances of consciousness and attention, perception, thinking, memory, psychomotor behavior, emotion, and the sleep-wake schedule. It is typically marked by rapid changes in mental status that fluctuate throughout the day, with the duration being variable and the degree of severity ranging from mild to severe. Unlike adults, pediatric delirium (PD) is often an under-recognized neuropsychiatric disorder in pediatric critical care despite being commonly reported in this population. The prevalence of delirium is estimated at 10-30% in pediatric intensive care units (PICU) and 49-66% in surgical or cardiac PICUs. It is a serious condition in PICU, where critically ill children are exposed to a variety of stressors such as pain, medications, and invasive procedures. PD has been linked to high rates of morbidity and mortality as well as prolonged ICU stays with the consequence of increased hospitalization costs. Patients who are at increased risk of delirium include those with infections, metabolic disorders, hypertension, pain, and medication withdrawal. Younger age groups and underlying developmental delay are also risk factors among children admitted to PICU. The under-diagnosis of this condition in PICU is likely due to a lack of awareness of PD and its overlapping symptoms with other clinical manifestations related to pain, sedation, or withdrawal syndrome, which pose challenges in diagnosing PD accurately. In recent years, several delirium rating scales have been developed and validated as screening tools. Increased use of routine screening improves diagnostic accuracy and implementation of treatment. This review introduces PD and focuses on its prevalence, recognition and brief management in pediatric intensive care setting.

Identifying candidate biomarkers for detecting bronchogenic carcinoma stages using metaheuristic algorithms based on information fusion theory

ObjectiveInvasive lung cancer staging poses significant challenges, often requiring painful and costly biopsy procedures. This study aims to identify non-invasive biomarkers for detecting bronchogenic carcinoma and its various stages by analyzing gene expression data using bioinformatics and machine learning techniques. By leveraging these advanced computational methods, we seek to eliminate the need for surgical intervention in the diagnostic process.MethodsWe utilized the TCGA-LUAD dataset, including gene expression data from healthy and cancerous samples. To identify robust biomarkers, we applied eight metaheuristic algorithms for feature selection, combined with four classification methods and two data fusion techniques to optimize performance.ResultsOur approach achieved 100% accuracy in distinguishing healthy samples from cancerous ones, outperforming existing methods that reported 97% accuracy. Notably, while prior methods have struggled to separate bronchogenic carcinoma stages effectively, our research achieved an approximate accuracy of 77% in stage classification. Furthermore, using gene enrichment methods, we identified 5, 7, and 16 diagnostic biomarker candidates for stages I, II, III, and IV, respectively.ConclusionThis study demonstrates that integrating bioinformatics, gene set enrichment, and biological pathway analysis can enable non-invasive diagnostics for bronchogenic carcinoma stages. These findings hold promise for developing alternatives to traditional, invasive staging systems, potentially improving patient outcomes and reducing healthcare costs.Supplementary InformationThe online version contains supplementary material available at 10.1007/s12672-025-02395-5.

Efficacy of Aromatherapy on Children: A Systematic Review with Meta-Analysis

BACKGROUND. Aromatherapy is one of the most commonly practiced complementary therapies by nurses, identified as central to holistic nursing care and in line with nursing theoretical foundations. Although it is also a widely used intervention in children, studies that have made a quantitative synthesis of its effect on this population are lacking in the literature. OBJECTIVE. To assess the effectiveness of aromatherapy in reducing procedural pain, anxiety, stress-related physiological responses, and in improving sleep duration among pediatric patients undergoing diagnostic or therapeutic procedures. METHODS. Studies were searched from biomedical databases, trial registries, web resources, and refereed journals. The risk of bias of included studies was assessed with RoB 2 and ROBINS-I, and the overall effect size of the intervention was calculated by creating random-effects meta-analyses graphically represented by forest plots. The summary of results was illustrated with a table in accordance with the GRADE method. RESULTS. Thirty-three studies with generally high risk of bias were included (N = 2650, mean age: 1.8 days-12.3 years, males: 33%-75%). Aromatherapy appears to have a positive and large effect on pain [SMD = -1.12 (95% CI: -1.60, -0.65), N = 1794, 27 comparisons, 22 studies], anxiety [SMD = -1.08 (95% CI: -1.52, -0.64), N = 856, 15 comparisons, 9 studies] and sleep duration [SMD = -0.95 (95% CI: -1.94, 0.03), N = 330, 4 studies]; in addition, it also appears effective on physiological signs of stress. The certainty/quality of evidence is very low. CONCLUSIONS. Due to the very low certainty/quality of evidence, at the current state of research it is not possible to make a conclusive assessment of the effect of aromatherapy on pain, anxiety, sleep duration, and stress in children undergoing diagnostic and therapeutic procedures.