Relieving Pain Research Articles

Effects of Virtual Reality on Relieving Pain During Endoscopy in Adults: A Systematic Review and Meta-Analysis of Randomised Clinical Trials.

Virtual reality is an emerging non-drug treatment for pain caused by endoscopy procedure. We conducted a meta-analysis to evaluate the effectiveness and safety of virtual reality based interventions for pain during endoscopy. PubMed, EMBASE, Cochrane Library, Web of Science and Clinical Trials database were searched until 26 May 2024. Randomised controlled trials on the application of virtual reality in endoscopic examinations were included. The standardised mean difference (SMD) was calculated using random-effects models, and included studies were appraised using Cochrane Risk of Bias tool version 1. Meta- analysis was conducted using Stata Statistical Software version 17.0. Overall, 21 studies enrolling 1721 participants were included. Our results demonstrated that the patients receiving the virtual reality intervention had lower pain scores than those receiving the usual care (SMD = -0.42; 95% CI = -0.65, -0.20). Subgroup analysis showed that real-time assessment of pain scores during the medical process had less heterogeneity (I2 = 20.2%, p = 0.257) and a smaller range of confidence intervals (95% CI = -0.43, -0.14) than retrospective assessment (95% CI = -0.75, -0.09). For different types of endoscopes, virtual reality was statistically significant for reducing pain during colonoscopy (SMD = -0.70; 95% CI = -1.12, -0.28), cystoscopy (SMD = -0.28; 95% CI = -0.53, -0.04) and laparoscopy (SMD = -0.54; 95% CI = -0.98, -0.10). Additionally, statistically significant improvements in relieving anxiety were reported when using virtual reality (SMD = -0.56; 95% CI = -0.78, -0.35). The application of virtual reality can effectively relieve the pain and anxiety of endoscopy. The types of endoscopy and the way of retrospective evaluation of pain scores were the main sources of heterogeneity. More rigorous studies about the relationship between virtual reality and endoscopic pain relief will be needed. The application effect of virtual reality technology on endoscopy was verified by summarising several randomised controlled trials. Patients and healthcare providers can be better informed about the use of such intervention to relieve pain. Virtual reality is recommended as being potentially useful and practical for reducing the pain of endoscopy.

Management of painful pemphigus vulgaris – Relieving pain and restoring dignity

Management of painful pemphigus vulgaris – Relieving pain and restoring dignity

Free Your Fascia: Relieve Pain, Boost Energy, Ease Anxiety and Depression, Lower Blood Pressure, and Melt Years off Your Body with Fascia Therapy (1st Edition)

Free Your Fascia: Relieve Pain, Boost Energy, Ease Anxiety and Depression, Lower Blood Pressure, and Melt Years off Your Body with Fascia Therapy (1st Edition)

Use of Flurbiprofen Ester in 4-Dimensional Hysterosalpingography: Does Flurbiprofen Ester Relieve Pain During an Infertility Evaluation?

Use of Flurbiprofen Ester in 4-Dimensional Hysterosalpingography: Does Flurbiprofen Ester Relieve Pain During an Infertility Evaluation?

The Effects of Different Doses of Gabapentin on Relieving Pain Due to Cesarean Section: A Randomized Clinical Trial

The Effects of Different Doses of Gabapentin on Relieving Pain Due to Cesarean Section: A Randomized Clinical Trial

Clinical Study on the Treatment of Primary Dysmenorrhea of Cold-congealed Qi Stagnation and Blood Stasis Type with the Addition and Subtraction of Regulating Menstruation and Relieving Pain Soup

Clinical Study on the Treatment of Primary Dysmenorrhea of Cold-congealed Qi Stagnation and Blood Stasis Type with the Addition and Subtraction of Regulating Menstruation and Relieving Pain Soup

Treating Persistent Pain: A Nurse Co-Led, Interdisciplinary Model for Primary Care

The public health crisis of chronic pain has only increased in recognition since the Institute of Medicine's (IOM) Relieving Pain in America (2011) called for a cultural transformation in the way pain is viewed, treated, and put forward specific recommendations for action. The National Pain Strategy (NPS) provides a roadmap for putting these recommendations into practice. We implemented a program that placed nurses and behavioral specialists at the head of an interdisciplinary team utilizing best practices. In this program, nurses enacted the NPS recommendations to advance care for patients with persistent pain on long-term opioid treatment. This program promoted professional growth in nurses along with fostering success for patients. Compared with patients receiving usual care, patients in the program achieved greater reductions in pain severity, pain-related disability, and pain-related functional interference and reported greater satisfaction with pain-related care and primary care services. This article will detail the NPS-aligned practice approaches these nurses and their teams used, describe the training for the nurses, and speak to opportunities to enhance the nurse's capacity for this role in hopes of providing a model for the future implementation of an NPS-based approach by nurses.

Effect Analysis of Ice Pack Cold Compress Time on Relieving Pain of Patients with Nasal Cavity Tamponade after Nasal Endoscopy

Effect Analysis of Ice Pack Cold Compress Time on Relieving Pain of Patients with Nasal Cavity Tamponade after Nasal Endoscopy

Clinical Effect of High-Quality Nursing on Relieving Pain after Cesarean Section

Clinical Effect of High-Quality Nursing on Relieving Pain after Cesarean Section

Effect of Virtual Reality on Relieving Pain and Anxiety of Circumcision in Children

Background: Circumcision is a common surgery and causes severe pain and anxiety in children. Today, virtual reality is used as an easy and cost-effective non-pharmacological method to manage pain and anxiety with no side effects. Aim: This study aimed to investigate the effect of virtual reality on the reduction of pain and anxiety in children who underwent circumcision. Method: This single-blind randomized clinical trial was performed on 40 children in 2019. The research instruments included the demographic survey, the Observational Scale of Behavioral Distress, and the Oucher pain scale which were completed in both groups 30 min before and after the circumcision (immediately after dressing the surgical wound). Anxiety immediately before circumcision. The children�s pain was assessed during anesthesia in both groups. A two-step intervention was performed on the experimental group. A preoperative virtual reality training video and a virtual reality animation were presented to distract the patients during the circumcision. All these steps except virtual reality were performed in the control group. Data were analyzed using SPSS software (version 16). Results: Virtual reality as a distraction technique significantly reduced anxiety and pain at the onset of circumcision (p <0.001) and during anesthesia (p <0.001) as well as pain (P=0.005) and anxiety (p <0.001) at the end of the circumcision in the intervention group compared to the control group. Implications for Practice: Clinical use of virtual reality can be used for the reduction of pain and anxiety in children during the circumcision process.

Effect of Breastfeeding on Relieving Pain during Immunization in Infant

Background Advantages due to immunization are numerous and cannot be avoided but at the same time pain inflicted on babies needs to be addressed when possible. Pain associated with immunization injections has often been overlooked when remedies are available. Objective To find out the effect of breastfeeding on relieving pain during immunization injection in infants. Method An experimental study was conducted at Immunization clinic of B.P. Koirala Institute of Health Sciences (BPKIHS). Total 124 subjects were divided randomly into two groups. Experimental subjects were allowed to breastfeed for 5-10 minutes before immunization while control group was immunized without breastfeeding. Interview Questionnaire was used to obtain demographic variables and measurements were obtained. Measures of pain was recorded using duration of cry and Modified Behavior Pain Scale, by Taddio et al. Data was analyzed by using SPSS 20.0 where variables were assessed with frequency tables, Pearson's Chi-Square test, independent t test and Mann Whitney U test. Result The mean pain score in experimental group was 7.10 and in control group 7.56 which was statistically significant (p=0.001). The median duration of cry was significantly shorter in experimental group i.e. 25 seconds (IQR: 20-30) than control group 42.5 seconds (IQR: 30-61.5) (p < 0.001). Conclusion Breastfeeding before immunization is effective in reducing pain in infants.

Investigation of a New Catheter on Relieving Pain During Male Cystoscopy - A Randomized Clinical Trial.

To investigate the pain intensity and tolerability of a new catheter applied to urethral surface anesthesia during rigid cystoscopy in male patients, and explore the prospects of its application and the anesthetic method in hospitals at primary levels. 252 adult male patients were randomly divided into the experimental group and the control group.1% lidocaine solution was irrigated into the posterior urethra of the experimental group using the new catheter before cystoscopy, while the control group was administered with lidocaine gel. Both groups were assessed by visual analogue scale(VAS) with their pain perceived during administration of lidocaine (control group) /during insertion of catheter and administration of lidocaine (experimental group) (T1),during the insertion of cystoscope (T2),at the beginning of cystoscopy (T3),The third minute of cystoscopy (T4), during the first urination after the procedure (T5), as well with the maximum pain(Pmax) perceived during the whole procedure. The fluctuations of blood pressure and heart rate in each group before, after and during the procedure were recorded, and the anesthesia costs in both groups were calculated. Except a slightly higher score in T1, the scores of VAS in experimental group were lower than those of control group in T2,T3 and T4. The Pmax of the control group was 4.92(SD=1.20), which was higher than in the experimental group of 3.89(SD=0.95,P<0.01).There was no significant difference onblood pressure variation in both groups. While heart rate variation in experimental group was lower than that in control group (16.3%,SD=3.4 vs. 22.6%,SD=5.0, P<0.01).No obvious complications were found in both groups. The anesthesia cost of the experimental group is about 1.53 dollars, with 1.75 dollars lower than that of the control group. It is tolerable and beneficial to apply the new catheter for male urethral anesthesia. It can significantly relieve the pain during rigid cystoscopy in male patients, and is low in cost and easy in operation. Thus this method is worth being recommended to hospitals, especially at communityhospitals or primary hospitals.

6D1 Effects of Auricular Point Acupressure with Seeds on Relieving Pain: A Systematic Review

The purpose of this systematic review is to review the effectiveness of auricular point acupressure with seeds(APA-S) on pain management, and its method related to acupressure intervention. Nine electronic databases were searched from the establishment of the database until December 31, 2017. All randomized controlled trials (RCTs) were included if they clearly defined APA-S intervention and evaluated pain outcomes. 1511 records were identified, but only 45 studies were identified for analysis. Among the 45 studies, 43 (95.6%) were positive studies which showed that APA-S could effectively relief pain, and/or reduced the analgesics consumption or the use of Patient Controlled Analgesia (PCA) of the experimental groups (based on the final data) while compared with the control groups (P<0.05).37 (86.0%) had a Jadad score of 3, while 4 (9.3%) and 2 (4.7%) had 5 and 4 points respectively. 25 studies (58.1%) focused on acute pain, 18 (41.9%) focused on chronic pain and 16 of them were chronic non-malignant pain studies, 2 of them focused on chronic malignant pain.Besides pain intensity, 7 positive studies considered the consumption of analgesics(n=3) or PCA (n=4) as the measurements of outcome, and all of them found a positive outcome. The remaining 2 studies were negative studies, accounting for 4.4%.Their Jadad score were 3 and 5 respectively.Both of the negative studies focused on acute pain. As far as the method related to APA-S intervention was concerned, among the 43 positive studies, Shenmen(n=43), subcortical(n=33) and sympathy(n=27) were the most commonly adopted acupoints. Vaccaria seeds(n=37) were the most commonly chosen stimulators. Period of AAT-S intervention was different in different category of pain: less than or equal to 3 days(n=14) and 28 days(n=6) was the most commonly period for treating acute and chronic pain respectively.The review begins to establish a credible evidence base for the use of APA-S in pain relief.

Editorial introductions

Editorial introductions

Effectiveness of Warm Saline Distension Media on Relieving Pain in Outpatient Office Hysteroscopy: A Randomized Controlled Clinical Trial

Background: Outpatient hysteroscopy is the preferred examination procedure for diagnosis of intrauterine pathology and abnormal uterine bleeding causes, in addition for therapeutic operative management. It is desirable to apply as many procedures as possible with an office hysteroscopy, if they are implemented in a safe and effective fashion. Aim: Evaluation and investigation of the effectiveness of warm saline distensibility media in reducing the pain perceived in women undergoing diagnostic hysteroscopy procedure. Methodology: A randomized controlled clinical research trial that recruited 82 women scheduled for outpatient office hysteroscopy in Early cancer detection unit in Ain Shams Maternity Hospital from April 2017 till May 2018. Two research groups were categorized into warm saline and normal room temperature saline research groups each contained 41 cases. Comparative analysis of pain perceived in both groups was conducted to assess efficiency of warm saline to reduce pain perception. Results: Hysteroscopic findings didn’t differ significantly between the two groups, namely ease of introduction of hysteroscope, position of uterus and morphological appearance of the ectocervix, endocervical canal, endometrium, endometrial cavity, and tubal ostia. Also, no statistically significant differences were observed between the two groups in the duration of procedure. Parameters of pain assessment differed statistically significantly between the two research groups. p value &lt;0.001 .Simple analysis of VAS scores revealed a statistically significantly lower VAS score at the end of the procedure in the warm distention medium group in comparison to the room-temperature distention medium group. The same finding remained constant after 15 minutes from the end of the procedure. Assessment of variation of VAS score with combined variation of temperature of distention medium over time was assessed using repeated measure ANOVA analysis. Patient satisfaction, indicated by the proportion of the patients who would undergo the hysteroscopic examination again by usage of same method, was statistically significantly higher in the warm distention medium research group in comparison to the room-temperature medium research group (89.74% vs 71.05% consecutively).(p value &lt;0.04) Conclusions: Pain is measured by VAS score is statistical significantly lower at the end of the procedure in warm saline distension medium research group in comparison to room temperature distension medium research group (1.64+0.82vs 3.05+1.17) consecutively. Denoting possible effectiveness of warm saline in reducing pain perceived in office hysteroscopy

Virtual Reality as a Distraction Intervention to Relieve Pain and Distress During Medical Procedures: A Comprehensive Literature Review.

This review aims to provide a framework for evaluating the utility of virtual reality (VR) as a distraction intervention to alleviate pain and distress during medical procedures. We first describe the theoretical bases underlying the VR analgesic and anxiolytic effects and define the main factors contributing to its efficacy, which largely emerged from studies on healthy volunteers. Then, we provide a comprehensive overview of the clinical trials using VR distraction during different medical procedures, such as burn injury treatments, chemotherapy, surgery, dental treatment, and other diagnostic and therapeutic procedures. A broad literature search was performed using as main terms "virtual reality," "distraction," and "pain." No date limit was applied and all the retrieved studies on immersive VR distraction during medical procedures were selected. VR has proven to be effective in reducing procedural pain, as almost invariably observed even in patients subjected to extremely painful procedures, such as patients with burn injuries undergoing wound care, and physical therapy. Moreover, VR seemed to decrease cancer-related symptoms in different settings, including during chemotherapy. Only mild and infrequent side effects were observed. Despite these promising results, future long-term randomized controlled trials with larger sample sizes and evaluating not only self-report measures but also physiological variables are needed. Further studies are also required both to establish predictive factors to select patients who can benefit from VR distraction and to design hardware/software systems tailored to the specific needs of different patients and able to provide the greatest distraction at the lowest cost.

Editorial introductions

Editorial introductions

Pain Psychology and the Biopsychosocial Model of Pain Treatment: Ethical Imperatives and Social Responsibility.

Worldwide, the need for more effective treatment for pain has steadily gained recognition as the cornerstone of patient-centered care. Nationally, the Institute of Medicine’s (now Academy) report on Relieving Pain in America [1] and the National Pain Strategy [2] both specify a need to treat pain comprehensively, and to better educate clinicians across disciplines as to the importance of multidisciplinary pain care. Despite the psyche’s integral role in the experience of pain, few individuals or professionals are aware that pain is defined as an aversive “sensory and emotional experience,” [3] and even fewer understand how to address the emotional aspects of the pain experience. We underscore the ethical imperative to orient students, the public, medical care providers, and mental health professionals to the integral role of psychological factors in the experience of pain. In doing so, we hope to have the opportunity to steer the health of the population toward more effective treatment for pain. Anecdotally, pain specialists and many primary care providers have long experienced difficulty referring individuals with chronic pain to psychologists skilled in pain treatment, or to therapists who address pain in the psychotherapeutic context. In part, the difficulty was attributed to a lack of health care insurance coverage for psychological services, or to strict limitations in coverage that rendered treatment insufficient and ineffective. Enactment of the Mental Health Parity Act, an aspect of the Patient Protection and Affordable Care Act [4], has led to improvements but barriers persist …

Relieving Pain in St. Joseph, Missouri: A Health Services Partnership for Changing the Way Pain is Perceived, Judged and Treated.

This year the Department of Health and Human Services will publish a National Pain Strategy (NPS) Report, one of the most important recommendations of the Institute of Medicine (IOM) report, Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education and Research . The Pain Action Alliance to Implement a National Strategy (PAINS), a national alliance committed to fostering, supporting, and networking community- and state-based initiatives to improve chronic pain care and to supporting the NPS Report was created to promote implementation of the key IOM recommendations. PAINS believes that building and sustaining sufficient administrative and clinical infrastructure to support interdisciplinary, integrated pain care must be built at the community and state levels for the report to take root. The project Relieving Pain in St. Joseph, Missouri , begun in 2014 with the support of PAINS, is an example of a community-based initiative to promote integrated pain care, and it is our hope that sharing information about this project will benefit others considering similar work. The St. Joseph Community Access Network (CAN) was established in Buchanan County, Missouri, to help the estimated 30,000 uninsured and under-insured residents who seek primary care treatment in the emergency room (ER). In 2009, Heartland Regional Medical Center (now Mosaic), Northwest Health Services (Federally Qualified Health Center—FQHC), the Social Welfare Board (free clinic), and other healthcare providers in St. Joseph agreed to establish a network of patient-centered health homes to improve the overall health of this population and address the issue of inappropriate ER utilization. In January 2014, after successfully establishing a network of health homes and care coordination and achieving national committee for quality assurance (NCQA) level III recognition, CAN initiated a new project to promote integrative pain management (IPM) into these health homes. A work group including primary care providers, behavioral health …

A Review of Chronic Noncancer Pain: Epidemiology, Assessment, Treatment, and Future Needs

The 2011 Institute of Medicine report Relieving Pain in America estimates that 100 million adult Americans are affected by chronic pain, costing a staggering $560 billion to $635 billion annually. In the context of this immense personal and socioeconomic burden, it is essential that all stakeholders, including providers, patients, third-party payers, and policy makers, understand the necessities of appropriate, accurate assessment and treatment of patients with chronic pain. This review examines the psychosocial consequences of pain and existing disparities in treatment. Particular emphasis is given to the challenge of using prescription opioids in the treatment of chronic noncancer pain, given the ongoing epidemic of deaths from prescription opioid overdose. Strategies for initial risk assessment and ongoing monitoring are discussed for detecting opioid misuse, abuse, and addiction. In addition, the challenges of treating patients with comorbid pain and substance use disorder are reviewed, and the role of the addiction specialist is highlighted. The biopsychosocial model of pain is reviewed as a framework for the interdisciplinary, multimodal approach to pain management, which is often necessary to treat patients with complex chronic pain conditions and comorbid psychiatric diagnoses. An interdisciplinary team consisting of pain specialists, mental health providers, physical/occupational therapists, nurses, and primary care providers is necessary not only for ongoing assessment of multiple relevant outcomes but also for overseeing the delivery of multimodal treatments (e.g., medications, interventions, physical/occupational therapy, and psychosocial education). To move toward personalized treatment of patients with pain, future needs in research, clinical care, and education are discussed.