Reduction In Pain Intensity Research Articles

Effects of an afforestation activity on thermal and mechanical pain mechanisms: A clinical trial

Sensory stimulation has shown the capacity to modulate pain mechanisms. Yet, the optimal methods of sensory stimulation remain uncertain. Afforestation activities stand out as a potential stimulation method, as they allow individuals to interact with multisensory stimuli produced in green environments. Exposure to natural multisensory stimuli has been shown to induce neurobiological activations in pain-related brain areas in healthy populations. However, the possible impact of the natural multisensory stimuli on the pain mechanisms themselves is yet to be explored. This study aimed to investigate the potential effects of sensory stimulation experienced during participation in an afforestation program on thermal and mechanical pain mechanisms. A single-group, pretest-posttest clinical trial was used. Forty-seven healthy adults performed an afforestation activity for 90 minutes. Measurements included cold pain detection and tolerance thresholds via the Cold Pressor Test, wind-up and mechanical pain sensitivity through a pinprick stimulator, and pressure pain detection and tolerance thresholds utilizing pressure algometry. For both thermal and mechanical pain thresholds, pain intensity was assessed using the 101-point Numeric Rating Scale. The results showed significant reductions in the cold pain intensity at the moment of detection (p = .046), mechanical pain sensitivity (p ≤ .014), and increases in the thresholds of pressure pain detection (p = .005) and tolerance (p ≤ .046). Therefore, the interaction with natural multisensory stimuli could be a possible therapeutic strategy to positively modulate mechanical pain sensitivity and pressure pain thresholds.

Meditation: A Promising Approach for Alleviating Chronic Pain.

Chronic pain is a complex and pervasive health issue that significantly impacts the lives of millions. Various cultureshave been practicing meditation for thousands of years, and it has been shown that it has many positive effects onmental and physical health. The impact of meditation on chronic pain is encouraging as it will form the base for future advancements. Meditation can improve the body's natural pain-relieving processes, lower stress levels, and boost body awareness. Patients can select from a variety of meditation techniques and include them in their treatment plans in a way that suits them best. Although it may not be a permanent solution, meditation can give patients a useful tool for managing their pain. In both clinical and experimental contexts, mindfulness meditation has been shown to lessen pain dramatically.Meditation may be used to manage chronic pain, which has several benefits, including pain alleviation, stress reduction, improved sleep, and general health. The research study provides insights into various kinds of meditation practices as well as the scientific basis of the mechanisms that are mentioned in the literature for the management of pain. Meditation practices have been scientifically shown in numerous randomized controlled studies to reduce pain intensity, enhance pain tolerance, and improve quality of life in those with chronic pain.Although more research is necessary to fully understand the mechanisms underlying the practice, the encouraging evidence is currently available.

Laser auriculotherapy associated with cupping therapy in chronic spinal pain: Randomized controlled clinical trial

BackgroundMusculoskeletal spine disorders are common causes of chronic pain and impair functionality. Laser auriculotherapy and cupping has played a significant role in the treatment of chronic pain. Objective: to evaluate the effect of laser auriculotherapy associated with cupping at systemic acupuncture points on chronic spinal pain. Methods: Randomized controlled clinical trial. Volunteers underwent three evaluations: an initial evaluation, a final evaluation immediately after the last intervention session, and a 15-day follow-up. The pain was identified using the numeric pain scale. The pain threshold was also evaluated against mechanical stimulation using a Digital Dynamometer at specific points in the cervical, thoracic and lumbar regions. Fifty individuals with chronic spinal pain, randomized into groups: experimental (n = 25), submitted to 10 sessions of auriculotherapy with laser and cupping therapy and control (n = 25). Results: The experimental group achieved pain intensity reduction between pre and post and follow-up moments (p < 0.0001), of greatest pain in the last seven days among all moments (p < 0.0001), of least pain in the pre with post moment (p = 0.006) and follow-up (p = 0.002), and an increased pain threshold between pre and post (p = 0.023). The control group achieved a reduction in the nociceptive threshold between pre and post (p = 0.001) and follow-up (p < 0.0001). The experimental group showed reduced pain intensity (p = 0.027) and greater pain (p = 0.005) after intervention and in pain intensity (p = 0.018), greater (p < 0.0001) and less pain (p = 0.025) at follow-up, compared to the control group. Conclusion: Auriculotherapy with laser associated with cupping therapy may effectively reduce pain intensity and increase the nociceptive threshold.

Dexmedetomidine and Bupivacaine Versus Bupivacaine Alone in Ultrasound Guided Fascia Iliaca Compartment Blockade for Femoral Fractures

Background: Pain control is one of the most important issues in femoral fractures. One of the most effective methods is the fascia iliaca compartment block. Objectives: The aim of this study was to compare the efficacy of the addition of dexmedetomidine to bupivacaine on the quality of ultrasound guided blockade of the fascia iliaca compartment in adults undergoing femoral shaft fracture surgery. Methods: This study was a double-blind clinical trial. We studied 60 adults who were hospitalized for a femoral shaft fracture. The patients were divided into two equal groups receiving either bupivacaine alone or bupivacaine and dexmedetomidine for compartment blockade of the iliac fascia. Group allocation was based on the method of randomization from concealed envelopes. Primary outcomes were pain intensity, sedation and analgesic consumption assessed at 1, 2, 6 and 24 hours after surgery in two groups. Data were analyzed using SPSS software. Results: Pain intensity was lower in the dexmedetomidine group 1, 2, 6 and 24 hours after surgery (p&lt;0.05). The sedation score was also higher in the dexmedetomidine group 6 and 24 hours after surgery (p&lt;0.05). The dose of analgesics used by the dexmedetomidine group was significantly lower 6 and 24 h after treatment. No hypotension, respiratory depressionand bradycardia occurred in the patients participating in this study. Conclusion: The addition of dexmedetomidine to bupivacaine during ultrasound-guided blockade of the fascia-iliac compartment is associated with reduced pain intensity and improved sedation in patients undergoing femoral fracture surgery.

Efektifitas Terapi Murottal Al-Qur’an terhadap Intensitas Nyeri pada Pasien Pascaoperasi Ortopedi

This study aims to determine the effectiveness of mutual Al-Qur'an therapy on pain intensity in post-orthopedic surgery patients. This research method is Quasi experiment pre-post non-equivalent with a control group. The sample of this study were long bone ORIF postoperative patients totaling 37 in the control group and 37 in the experimental group. Data collection was carried out twice pre and post murottal intervention with the Brief Pain Inventory (BPI) instrument. Data analysis used Mann-Whitney statistical test analysis. The results showed that the p-value was 0.000 (α &lt;0.05) which indicated that Ha was accepted or murottal Al-Qur'an therapy was effective in reducing pain intensity in post-orthopedic surgery patients at dr. Fauziah Bireuen. In conclusion, Al-Qur'an murotal therapy can be applied as an intervention in providing nursing care to post-ORIF patients to reduce pain levels.&#x0D; &#x0D; Keywords: Al-Qur'an Murottal Therapy, Pain Intensity, Postoperative Orthopedic.

The Therapeutic Effect of Botulinum Toxin Type A on Trigeminal Neuralgia: Are There Any Differences between Type 1 versus Type 2 Trigeminal Neuralgia?

Botulinum toxin type A is an effective treatment for trigeminal neuralgia. Moreover, its efficacy in type 2 trigeminal neuralgia and comparative studies between type 1 and type 2 trigeminal neuralgia (TN) still need to be improved. We treated 40 TN patients with onabotulinumtoxinA; 18 had type 1 TN, and 22 had type 2 TN. We compared the baseline pain score with the Visual Analogue Scale (VAS) and paroxysm frequency (number per week) at the baseline with those obtained at 1-month and 3-month follow-ups. Nonetheless, we compared the baseline Penn Facial Pain Scale with the scores obtained at the 1-month follow-up. BoNT/A effectively reduced pain intensity and frequency at the 1-month and 3-month follow-ups. Moreover, the type 1 TN and type 2 TN groups had baseline pain scores of 7.8 ± 1.65 and 8.4 ± 1.1, respectively. Pain significantly improved (p < 0.001) in both groups to 3.1 ± 2.3 (type 1 TN) and 3.5 ± 2.3 (type 2 TN) at the 1-month follow-up and to 3.2 ± 2.5 (type 1 TN) and 3.6 ± 2.5 (type 2 TN) at the 3-month follow-up. There was no difference between the two groups (p 0.345). The baseline paroxysm frequencies (number per week) were 86.7 ± 69.3 and 88.9 ± 62.2 for the type 1 and type 2 TN groups, respectively; they were significantly reduced in both groups at the 1-month and 3-month follow-ups without significant differences between the two groups (p 0.902). The Pain Facial Pain Scale improved at the 1-month follow-up, and no significant differences were found between the two groups. There was a strong correlation between background pain and paroxysm pain intensity (r 0.8, p < 0.001). Botulinum toxin type A effectively reduced the pain, paroxysm frequency, and PFPS scores of type 1 and type 2 trigeminal neuralgia patients without statistically significant differences. Facial asymmetry was the only adverse event.

The holistic effects of medical cannabis compared to opioids on pain experience in Finnish patients with chronic pain

BackgroundMedical cannabis (MC) is increasingly used for chronic pain, but it is unclear how it aids in pain management. Previous literature suggests that MC could holistically alter the pain experience instead of only targeting pain intensity. However, this hypothesis has not been previously systematically tested.MethodA retrospective internet survey was used in a sample of Finnish chronic pain patients (40 MC users and 161 opioid users). The patients evaluated statements describing positive and negative phenomenological effects of the medicine. The two groups were propensity score matched to control for possible confounding factors.ResultsExploratory factor analysis revealed three experience factors: Negative Side Effects, Positive Holistic Effects, and Positive Emotional Effects. The MC group (matched n = 39) received higher scores than the opioid group (matched n = 39) in Positive Emotional Effects with large effect size (Rank-Biserial Correlation RBC = .71, p < .001), and in Holistic Positive Effects with medium effect size (RBC = .47, p < .001), with no difference in Negative Side Effects (p = .13). MC and opioids were perceived as equally efficacious in reducing pain intensity. Ratings of individual statements were exploratively examined in a post hoc analysis.ConclusionMC and opioids were perceived to be equally efficacious in reducing pain intensity, but MC additionally positively affected broader pain-related factors such as emotion, functionality, and overall sense of wellbeing. This supports the hypothesis that MC alleviates pain through holistically altering the pain experience.

Comparative effectiveness of noninvasive therapeutic interventions for myofascial pain syndrome: a network meta-analysis of randomized controlled trials.

Myofascial pain syndrome (MPS) has an impact on physical health and quality of life for patients, with various noninvasive methods used for relieving myofascial pain. The authors aimed to compare the effectiveness of different noninvasive therapeutic interventions for MPS. The authors searched PubMed, Embase, CINAHL Complete, Web of Science, Cochrane, and Scopus to identify randomized controlled trials describing the effects of any noninvasive treatments in patients with MPS. The primary outcome was pain intensity, while pressure pain threshold and pain-related disability were secondary outcomes. The analysis included 40 studies. Manual therapy [mean difference (MD) of pain: -1.60, 95% CI: -2.17 to -1.03; MD of pressure pain threshold: 0.52, 95% CI: 0.19 to 0.86; MD of pain-related disability: -5.34, 95% CI: -8.09 to -2.58], laser therapy (MD of pain: -1.15, 95% CI: -1.83 to -0.46; MD of pressure pain threshold: 1.00, 95% CI: 0.46 to 1.54; MD of pain-related disability: -4.58, 95% CI: -7.80 to -1.36), extracorporeal shock wave therapy (MD of pain: -1.61, 95% CI: -2.43 to -0.78; MD of pressure pain threshold: 0.84, 95% CI: 0.33 to 1.35; MD of pain-related disability: -5.78, 95% CI: -9.45 to -2.12), and ultrasound therapy (MD of pain: -1.54, 95% CI: -2.24 to -0.84; MD of pressure pain threshold: 0.77, 95% CI: 0.31 to 1.22) were more effective than no treatment. Our findings support that manual therapy, laser therapy, and extracorporeal shock wave therapy could effectively reduce pain intensity, pressure pain threshold, and pain-related disability with statistical significance when compared with placebo. This finding may provide clinicians with appropriate therapeutic modalities for patients with MPS among different scenarios.

COMPARATIVE STUDY OF BUPIVACAINE WITH DEXMEDETOMIDINE AND BUPIVACAINE ALONE IN SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK

Objective: The objective is to compare the efficacy of bupivacaine with dexmedetomidine and bupivacaine alone when used for supraclavicular brachial plexus block in patients undergoing upper limb surgeries. Methods: This was a comparative study conducted in the department of anesthesiology of a tertiary care medical college. 80 patients scheduled for upper limb surgeries under supraclavicular brachial plexus block were included on the basis of a predefined inclusion and exclusion criteria. Patients were divided into 2 groups depending on whether they received only Bupivacaine (Group B) or Bupivacaine and Dexmedetomidine (Group BD) for supraclavicular block. The onset and duration of sensory as well as motor blockade, intensity of Pain as assessed by Visual Analog Score, requirement of rescue analgesia, hemodynamic profile, and side effects were compared in both the groups. For statistical purpose p&lt;0.05 was taken as statistically significant. Results: Group BD exhibited significantly faster onset and longer duration of sensory blockade compared to Group B. Group BD also showed significantly faster onset and longer duration of motor blockade compared to Group B. Moreover, Group BD had significantly longer analgesia duration (614.84±52.02 min) compared to Group B (352.62±32.46 min). The hemodynamic parameters, including mean heart rate and mean arterial pressure, were not significantly different between the groups. In addition, side effects such as bradycardia and hypotension were observed in Group BD, but these differences were not statistically significant. Conclusion: Dexmedetomidine, when used as an adjuvant to bupivacaine during supraclavicular brachial plexus block in upper limb surgeries provided longer-lasting analgesia, and reduced pain intensity as compared to Bupivacaine alone with a comparable side effect profile.

The effects of transcranial direct-current stimulation (tDCS) on pain intensity of patients with fibromyalgia: a systematic review and meta-analysis

IntroductionFibromyalgia (FM) is a chronic pain condition that affects millions of people worldwide. Transcranial Direct Current Stimulation (tDCS) is a non-invasive brain stimulation technique that has shown promise as a potential treatment for FM by modulating pain perception and reducing symptoms, such as fatigue and depression. We aimed to systematically review studies that assess the effect of tDCS on pain reduction in FM patients.MethodsSeven electronic databases (PubMed, Scopus, Embase, PsycINFO, Web of Science, Cochrane, and CINAHL Complete) were searched for records in English. Studies that measured the effect of tDCS on pain intensity in FM patients were included. The Cochrane Collaboration’s tool was used to assess the quality of the included studies. A random-effect model was preferred, and statistical analysis was performed by Stata software version 17.ResultsTwenty studies were included for qualitative, and eleven for quantitative analysis. Out of 664 patients included in the study, 443 were in the stimulation group. The left M1 area was the most common stimulation target (n = 12), and 2 mA was the most common stimulation amplitude (n = 19). The analysis showed that active tDCS significantly reduced pain intensity in FM patients in comparison to the sham group (SMD= -1.55; 95% CI -2.10, -0.99); also, no publication bias was noted.ConclusionOur systematic review highlights the potential effect of tDCS on the reduction of pain intensity in FM patients. Additionally, this current evidence could suggest that tDCS applied at an intensity of 2mA to the left M1 is the most effective strategy.

Pain outcome of non-instrumented lumbar decompressive surgery for degenerative lumbar spine disease using patient-reported pain outcome instruments.

A clinical disorder known as degenerative lumbar spine disease (DLSD) is characterized by persistent low back pain (LBP) coupled with radiculopathy and other signs of neurologic impairment. Using patient-reported pain outcome assessment tools, this study evaluated the pain outcome of non-instrumented lumbar decompressive surgery for DLSD. A prospective longitudinal research was conducted. Using the metric visual analog scale (VAS) score and the Oswestry disability index (ODI), consenting patients who underwent non-instrumented lumbar decompressive surgery for symptomatic DLSD were evaluated for radicular pain and LBP. The evaluation was conducted both immediately before surgery and 6 months after surgery. Data generated by comparing the pre-operative and post-operative VAS and ODI scores were then analyzed using descriptive and inferential statistics. Sixty-seven patients in total completed the study. Thirty-six (54%) males and 31 (46%) females, with a mean age and body mass index of 55.28 years and 29.5 k/m2, respectively. At 6 months postoperatively, there was significant pain reduction from the pre-operative baseline VAS for LBP (67.12-32.74) with P < 0.001, VAS for radicular pain (75.39-32.75) with P < 0.001, and ODI (65.30-27.66) with P < 0.001. There was a greater decrease in radicular pain than in LBP following lumbar decompressive only surgery (P = 0.03). Patients with symptomatic DLSD and high pre-operative back pain scores without considerable listhesis should anticipate a significant reduction in radicular and back pain intensity, as well as pain-related functional disability, 6 months after non-instrumented lumbar decompressive surgery.

Virtual reality hypnosis diminishes experimental cold pain and alters autonomic responses.

Immersive virtual reality (VR) is a promising tool to reduce pain in clinical setting. Digital scripts displayed by VR disposals can be enriched by several analgesic interventions, which are widely used to reduce pain. One of these techniques is hypnosis induced through the VR script (VRH) which is facilitated by immersive environment and particularly efficient even for low hypnotizable patients. The aim of this study is to assess the efficacy of a VRH script on experimentally induced cold pain perception (intensity and unpleasantness) and physiological expression. 41 healthy volunteers had been recruited in this within-subjects study. They received 9 stimulations of 20 s (3 non-nociceptive cold; 3 low nociceptive cold and 3 highly nociceptive cold) during a VRH session of 20 min (VRH condition) or without VRH (noVRH condition). Physiological monitoring during the cold pain stimulation protocol consisted of recording heart rate, heart rate variability and respiratory frequency. Maximum cold pain intensity perception, measured through the visual analog scale (VAS) on 10, was of 3.66 ± 1.84 (VAS score/10) in noVRH condition and 2.46 ± 1.54 in VRH (Wilcoxon, p < 0.0001). Considering pain unpleasantness perception, 3.68 ± 2.06 in noVRH and 2.21 ± 1.63 in VRH (Wilcoxon, p < 0.0001). Hypnotizability negatively correlated with the decrease in VAS intensity from noVRH to VRH (Spearman r = -0.45; p = 0.0038). In our sample, we found that 31/41 volunteers (75.6%) displayed a reduction of more than 10% of their VAS pain intensity and unpleasantness scores. Trait anxiety was the best predictor of the VRH responders, as well as heart rate variability. In addition, respiratory rate was diminished under VRH in every subgroup. VRH is an effective tool to reduced pain intensity and unpleasantness in a vast majority of healthy subjects. We further indicate in this study that heart rate variability parameter RMSSD (root mean square of successive differences) is a good predictor of this effect, as well as anxiety as a personality trait (but not state anxiety). Further studies are expected to determine more precisely to whom it will be the most useful to offer tailored, non-pharmacological pain management solutions to patients.

The Impact of Indoor Plants on Patient Recovery: Physiological and Psychological Effects in Dental Clinics

Patient recovery and well-being in healthcare settings can be influenced by various factors, including the stress induced by hospitalization and medical care. This study investigated the impact of indoor plants on patient recovery in dental clinics using state-of-the-art techniques to address the limited evidence supporting the claim that nature can alleviate stress and pain in hospitals. Thirty patients were randomly assigned to either a room with indoor plants or a control room without plants for a duration of 5 minutes after their treatment. Physiological responses were assessed using electroencephalography (EEG), heart rate variability, and skin conductance, whereas psychological responses were evaluated using the State-Trait Anxiety Inventory (STAI) and a visual analogue scale (VAS). The results revealed a significant increase in alpha wave power in the frontal region, indicating enhanced relaxation, as well as a significant increase in parasympathetic activity, suggesting improved autonomic balance. Furthermore, a significant decrease in skin conductance was observed when indoor plants were present compared with their absence, indicating reduced physiological arousal. Psychological assessments using the STAI demonstrated lower levels of stress and anxiety, whereas the VAS indicated reduced pain intensity among participants. Overall, these findings suggest that the presence of indoor plants contributes to patients’ relaxation and improved coping mechanisms during the recovery process. This study highlights the significance of incorporating indoor plants into healthcare settings to enhance patients’ overall well-being and promote positive recovery outcomes.

The Impact of Hot Spring Hydrotherapy on Pain Perception and Dysfunction Severity in Patients with Chronic Low Back Pain: A Systematic Review and Meta-Analysis.

Chronic Low Back Pain (CLBP) is a prevalent global health issue, leading to prolonged discomfort and functional limitations. Hot spring hydrotherapy, which utilizes mineral-rich, warm spring water, offers a unique physical therapy that holds promise in alleviating CLBP symptoms. This meta-analysis aims to assess the effectiveness of hot spring hydrotherapy in improving CLBP symptoms, encompassing pain intensity, functional disability, quality of life, and medication usage. A systematic review and meta-analysis were conducted by searching relevant literature in multiple databases. Included studies compared hot spring hydrotherapy with control interventions or other treatments. Standardized mean differences (SMD) with 95% confidence intervals (CI) were calculated for pain intensity, functional disability, medication usage, and quality of life. A total of 16 studies met the inclusion criteria, involving 1656 participants with chronic low back pain across various countries. The meta-analysis demonstrated that hot spring hydrotherapy was effective in reducing pain intensity (SMD = -0.901, 95% CI [-1.777, -0.025], P < 0.05) and improving functional disability (SMD = -3.236, 95% CI [-4.898, -1.575], P < 0.0001) in CLBP patients. Hot spring hydrotherapy also resulted in a significant reduction in medication usage (P < 0.05). Subgroup analysis showed that the effects of hot spring hydrotherapy were more pronounced in patients aged 60 and above, while no significant differences were observed in patients below 60 years of age, single hot Spring Hydrotherapy help improve patients' quality of life. Hot spring hydrotherapy is an effective intervention for improving CLBP symptoms, including pain intensity, functional disability, and medication usage. It is particularly beneficial for CLBP patients aged 60 and above. These findings support the integration of hot spring hydrotherapy into the treatment approach for CLBP, although further research is needed to determine its efficacy in younger patients and to explore the underlying mechanisms of its therapeutic effects. CRD42023430860.

Muscle energy technique to reduce pain and disability in cases of non-specific neck pain: A systematic review and meta-analysis of randomized controlled trials

BackgroundTo investigate the effectiveness of muscle energy technique (MET) for treatment of non-specific neck pain (NSNP). MethodsA literature search was performed using electronic databases from their inception until October 2023 for randomized controlled trials (RCTs) that investigated the effects of MET on NSNP. A change in pain intensity and reduced disability were the primary and secondary outcomes, respectively, standardized using Hedges’ g. A random effects model was used for data pooling. ResultsThis study included 26 RCTs comprising 1170 participants. The results showed that MET significantly reduced pain intensity (Hedges' g = −0.967 95 % CI = −1.417 to −0.517, p < 0.001). However, subgroup analysis revealed that this significant benefit was observed only when MET was combined with other treatments and not with MET monotherapy. MET also reduced disability (Hedges’ g = −0.545, 95 % CI = −1.015 to − 0.076, p = 0.023). Meta-regression analysis showed that an increase in treatment duration/session per week contributed to greater pain reduction. No adverse events were reported following the MET. ConclusionsIn conclusion, our meta-analysis suggests MET's potential effectiveness within a combined treatment for NSNP. However, the evidence's low certainty is likely influenced by bias and study variations. To strengthen these findings, future research should focus on higher-quality clinical trials, longer follow-up periods, and prediction interval presentations.

Clinical efficacy and patients' perception of virtual reality during wound care in adults: A systematic review with meta-analysis of randomised clinical trials.

This study was aimed to review Virtual Reality's (VR) impact on pain, anxiety, opioid usage, physiological and behavioural responses, and patients' experience during wound care (WC) in adults. We searched multiple databases (Embase, Medline ALL, Web of Science Core Collection, Cochrane Central Register of Controlled Trials, CINAHL, Scopus and Google Scholar) from inception until January 27th, 2023. Included studies compared VR alone or as an adjunct to standard WC with standard WC or other distraction methods, in adults with burn or non-burn-related wounds. The risk of bias was assessed using the revised Cochrane risk-of-bias tool for randomised parallel-group and crossover trials. The review followed PRISMA guidelines for reporting. Fourteen studies were eligible for inclusion. The meta-analysis was limited to studies comprising solely of adult participants. VR reduced pain intensity compared to standard WC in all study designs. Despite not being included in the meta-analysis due to reasons such as mixed population or lack of sufficient statistical data, other studies showed significant pain reduction using VR. Additionally, VR improved patients' experience of WC. No clear effect was found on other outcomes including anxiety, opioid usage and physiological and behavioural responses. VR shows promise in reducing acute pain and enhancing patients' experience of WC. The observed variations in the effects of VR at group and individual levels indicate the need for a personalised treatment plan by selecting the right VR for the right patient given at the right time.

Efektivitas Latihan Relaksasi Autogenik terhadap Intensitas Nyeri pada Pasien Pascaoperasi Fraktur

This study aims to identify the effectiveness of autogenic relaxation exercises on pain intensity in post-operative fracture patients at Advent, Royal Prima, and Murni Teguh Medan Hospitals. This research method is a quasi-experiment with a non-equivalent control group design. Sampling used non-probability sampling with the convenience sampling method. The respondents in this study were 24-hour post-surgical fracture patients who were hospitalized, totaling 78 respondents consisting of 39 respondents in the intervention group and 39 respondents in the control group. Data analysis used Mann-Whitney statistical test analysis. The results showed that p-value = 0.000 (p&lt;0.05). In conclusion, autogenic relaxation exercises are effective in reducing pain intensity in patients after fracture surgery and are recommended as a nursing intervention and alternative therapy to reduce pain intensity in patients after fracture surgery.&#x0D; &#x0D; Keywords: Autogenic Relaxation Exercise, Fracture, Pain.

Slow Deep Breathing Intervention to Reduce Pain Intensity in Mild Head Injury Patients

Background: One of the most common factors that cause head injuries is traffic accidents. Minor head injury is a nervous system disorder caused by a violent blow or jolt to the head or body. As a result of this accident an individual can lose consciousness which is characterized by headaches and pain. Pain is a physiological problem. Interventions that can be used in overcoming pain are by providing slow deep breathing non pharmacological therapy.&#x0D; Purpose: This study was to obtain an overview of slow deep breathing therapy in patients with mild head injuries and reduce pain intensity.&#x0D; Methods: The writing used is descriptive method in the form of case studies through the nursing process approach which includes assessment, nursing diagnoses, planning, implementation and evaluation. The study was conducted at the BLUD RSU Banjar City on 27-31 May 2022. The participants in this study were the patient Mrs. S is 36 years old. Complains of pain in the back of the head. The process of assessing and establishing a diagnosis is focused on the main problem. Subjective and objective data become a reference for evaluation of nursing implementation on a regular basis.&#x0D; Result: Based on the assessment of the pain scale, it was found that the original scale decreased from 4 (1-10) to 1 (1-10). Using the Numeric Rating Scale (NRS) measurning instrument.&#x0D; Conclusion: The author found the effect after giving slow deep breathing intervention on reducing pain intensity in patients with mild head injury and getting effective results, as evidenced by a decrease in the intensity of the pain scale. From the case study, slow deep breathing intervention can be an alternative intervention for mild head injury patients so that complications from the disease do not occur.

Factors affecting the intensity of chronic musculoskeletal pain in patients with cardiovascular disease and evaluation of the efficacy of magnesium emulsion cream for muscle cramps.

Chronic musculoskeletal pain (CMP) is associated with an increased risk of cardiovascular disease (CVD). This study aimed to determine the factors associated with the intensity of CMP in patients with underlying CVD and to evaluate the efficacy of Ice Power Magnesium In Strong Cream in patients with muscle cramps. We investigated 396 patients with or without CMP who visited an outpatient cardiology clinic and analyzed the features of CMP and factors associated with pain intensity and specific types of CVD in study 1. We also analyzed 73 patients who had muscle cramps in the lower extremities in study 2 to evaluate the efficacy of Ice Power Magnesium In Strong Cream in reducing pain intensity. In study 1, multivariable linear regression analysis showed that older age (regression coefficient [B] = 0.66, 95% confidence interval [CI], 0.07-1.24), female sex (B = 1.18, 95% CI, 0.59-1.76), presence of hypertension (B = 0.69, 95% CI, 0.05-1.33), and use of calcium supplements (B = 1.27, 95% CI, 0.31-2.24) were significantly associated with a higher intensity of CMP. In study 2, the mean pain scores at baseline, week 2 and week 4 after treatment were 5.99 ± 2.12, 2.92 ± 2.63, and 1.90 ± 2.41, respectively, and the reductions were significant at both week 2 and week 4 after treatment (P < .05). Older age, female sex, hypertension, and use of calcium supplements were associated with an increased intensity of CMP. Ice Power Magnesium In Strong Cream was effective in reducing the pain intensity of muscle cramps in the lower extremities.

EVALUATING THE EFFICIENCY OF NON-PHARMACOLOGICAL PAIN MANAGEMENT TECHNIQUES DURING LABOR AND DELIVERY

Labor and delivery is a natural procedure that causes women significant pain and discomfort. Many women choose pharmacological pain management techniques, yet there is growing interest in non-pharmacological pain management techniques, viewed as safer and more natural than pharmacological methods. This study aimed to assess the efficacy of non-pharmacological pain management techniques during labor and delivery. In a randomized controlled trial, we randomly assigned 246 expectant women to either a non-pharmacological intervention or a control group. During labor and delivery, the non-pharmacological intervention group received a combination of relaxation techniques, including massaging and physical therapy, aromatherapy, TENS, and mixed interventions. The control group received standard care devoid of non-pharmaceutical interventions. Pain levels were measured using a visual analog scale at 30-minute intervals. Additionally, the length of labor, delivery mode, and birth outcomes were recorded using the APGAR score system. The demographic characteristics of patients in both groups were comparable and non-significant in variations (p&gt;0.05). Forty participants utilized each non-pharmacologic technique. Comparing VAS pain scale scores at 30-minute intervals, the distribution of pain intensity levels was comparable between the groups. The larger fraction of neonates in the non-pharmacological group had higher APGAR scores, indicating no need for immediate medical attention. Based on a reasonable comparison of the effectiveness of various interventions for managing labor pain and distress, it was found that 9 (22.5%) of 40 patients who received massaging therapy reported low efficacy in managing labor pain, 13 (32.5%) reported moderate efficacy, and 28 (70%) reported high efficacy. In the aromatherapy of 40 patients, 16 reported low efficacy, 21 reported moderate efficacy, and 13 reported high efficacy in managing labor pain. Ten patients (25%) reported low efficacy, 12 patients (30%) reported moderate efficacy, and 28 patients (70%) reported high efficacy in managing labor pain through TENS. It provided cost-effective and safe alternatives to pharmaceutical interventions during labor and delivery. When properly implemented, these techniques reduced pain intensity comparable to commercial medicines while significantly improving the birthing experience and potentially contributing to better maternal and neonatal outcomes.