Significant Difference In Pain Perception Research Articles

Effect of verbal and written information on the perception of pain and analgesic consumption, in adolescent orthodontic patients: A randomised controlled trial.

To investigate the impact of written instructions, about post-bonding pain, on patients' pain perception and analgesic consumption and to evaluate the correlation of pain with personality types. Two-arm parallel randomised controlled trial. University Hospital Centre Zagreb, Zagreb, Croatia. Participants included adolescents in the permanent dentition with mild or moderate crowding. The participants were randomly allocated, using computer-generated random list, into two groups. After bonding and archwire insertion, all participants received oral instructions on potential pain occurrence and pain control. Participants in the study group also received written information on post-bonding pain. Pain intensity was evaluated using the Numerical Rating Scale immediately after (T0), 2 days (T1) and 7 days (T2) after the placement of the fixed orthodontic appliance. Analgesic consumption was assessed as yes or no, and personality traits were assessed using the Big Five Inventory. Operators who scored pain intensity and recorded analgesic consumption and personality traits were blinded to the group allocation. Statistical analyses included the t-test, Mann-Whitney U-test, Spearman correlations and stepwise regression analysis. The highest rate of pain was recorded at T1 (P < 0.001). No statistically significant difference in pain perception between groups was observed. There was no statistically significant difference in analgesic consumption between the two groups (P = 0.81). The correlations between personality traits and pain perception were not significant. The additional written information had little impact on pain perception, and it had no relationship to personality types. The perception of pain and analgesic consumption were not affected by the provision of additional written information (P = 0.81). Participants' personality types did not affect the impact of the information given.

Pain and root resorption due to surgical interventions to accelerate tooth movement in orthodontics: A systematic review and meta-analysis.

There are several publications that show the efficacy of surgical interventions in accelerating the rate of tooth movement in orthodontics. Consequently, possible adverse effects must also be evaluated. The aim of the present study was to compare the perception of pain and root resorption between orthodontic treatment with a surgical acceleration intervention vs. conventional orthodontic treatment. An electronic search was conducted in the MEDLINE, Scopus, Web of Science (WoS), ScienceDirect, Cochrane Library, and Virtual Health Library (VHL) databases up to September 12, 2022. Randomized or non-randomized, controlled, parallel-arm or split-mouth clinical trials were included. Fixed-and random-effects meta-analyses were performed with regard to heterogeneity. The risk of bias (RoB) was assessed using the RoB 2.0 and ROBINS-I tools. A total of 1,395 articles were initially retrieved, 40 studies were finally included in the review and 15 studies were eligible for quantitative analysis. The meta-analysis showed a significant difference in pain perception between acceleration surgery vs. conventional orthodontics at 24 h (p = 0.040); however, this difference was not significant at 7 days (p = 0.080). Overall, the patients who underwent any acceleration procedure presented significantly less resorption as compared to those who were applied conventional treatment (p < 0.001). A similar significant difference was found in retraction movements (p < 0.001) and alignment movements (p = 0.030). In the first 24 h, surgical interventions for the acceleration of tooth movement produce a greater perception of pain as compared to conventional orthodontic treatment, but the perception is similar after 7 days. Acceleration surgery results in less root resorption - in alignment movements, and especially in retraction movements.

Effects of Hydrotherapy on the Management of Childbirth and Its Outcomes-A Retrospective Cohort Study.

The main objective of this study was to generate further evidence on maternal and birth outcomes associated with the use of hydrotherapy during labor, specifically aiming to describe the effects of water immersion during all stages of labor (first, second, and third) on women. A retrospective cohort study was carried out on a random sample of women who gave birth at the Costa del Sol Hospital between January 2010 and December 2020. The calculated sample size was 377 women and the data were extracted from their partograms. After data extraction, two groups were formed: one group used hydrotherapy during childbirth (n = 124), while the other group included women who did not use hydrotherapy during the childbirth process (n = 253). The results highlight significant differences in pain perception, analgesia use, types of labor, and delivery times between the two groups. Women who did not use hydrotherapy reported higher pain perception, with a median (IQR) of 8 (7-9) on a numerical scale, compared to a median (IQR) of 6 (5-7) for the hydrotherapy group. Furthermore, the group without hydrotherapy required epidural analgesia in 40% of cases, while in the hydrotherapy group, it was only necessary in 20%. In terms of the type of delivery, the hydrotherapy group had more spontaneous vaginal deliveries compared to the non-hydrotherapy group, which had more operative vaginal deliveries. The overall duration of labor was longer in the hydrotherapy group, especially in women who arrived at the hospital late in labor. Hydrotherapy is associated with a longer time to delivery. Women with a higher pain tolerance tend to opt for hydrotherapy instead of epidural analgesia.

Comparative assessment between chewing gum, bite wafers, and ibuprofen in pain control following separators placement among orthodontic patients

ObjectiveThis study aimed to evaluate the efficiency of chewing gum and using bite wafers in reducing pain after the placement of separators in orthodontic patients and to compare that efficiency with ibuprofen use. Additionally, this study evaluated the effect of non-pharmacological pain control methods on the frequency of separators falling out. MethodsThe study sample comprised 105 female patients between 15 and 35 years of age. The patients were randomly selected and classified into three groups (35 each). Each group was given either ibuprofen, viscoelastic bite wafers, or chewing gum immediately after the placement of separators and every 8 h for 1 week, as needed. The patients were asked to record their pain perception using a visual analog scale following separator placement at 2 h, 6 h, bedtime, 24 h, and at 2, 3, and 7 days. Analysis of variance testing was used for the data analysis. ResultsAmong the three studied groups, there were no significant differences in pain perception at any time point. The patients experienced significantly higher pain scores at bedtime and 24 h after separator placement. In addition, there were statistically significant findings in pain perception at different time points within each pain relief method (p = 0.000, p < 0.05). ConclusionThe use of chewing gum and bite wafers in alleviating orthodontic pain was beneficial and comparable to ibuprofen use following the placement of separators before orthodontic treatment among orthodontic patients.

The effectiveness of low-level laser therapy and low-intensity pulsed ultrasound in reducing pain induced by orthodontic separation: a randomized controlled trial

BackgroundThe low-level laser therapy (LLLT) and low-intensity pulsed ultrasound (LIPUS) have been recently applied to control pain during orthodontic treatment.ObjectiveTo evaluate and compare the effectiveness of LLLT and LIPUS in reducing pain induced by orthodontic separation.Study designA single-blinded randomized controlled trial.MethodsOne hundred and fifty patients were randomly assigned into three groups; LLLT group, LIPUS group, and control group. After 5 min from the separators’ placement, the first dose of the laser or the ultrasound was applied, the second dose was applied after 24 h, and the third dose was applied after 48 h on both maxillary and mandibular first molars. The exposure of laser was for 20 s at each point (maxillary and mandibular first molars), with an 810-nm aluminum-gallium-arsenide (AlGaAs) diode laser on continuous mode. The output power set at 150 mW, the energy density of 4 J/cm2, and a laser spot diameter of 7 mm were applied. Whereas the frequency of ultrasonic toothbrush was 1.6 MHz; and average output intensity was 0.2 W/cm2. The application was for 20 min (5 min on each first molar). The control group received the separators without another intervention. A Visual Analog Scale (VAS 100 mm) was used to assess pain intensity at several time intervals during the first four days after the separators’ placement.ResultsA total of 145 patients were assessed. There was a significant difference in pain perception among the three groups after 5 min (P = .002). The maximum pain level was reached after 24 h. However, the laser group and the ultrasound group showed a statistically significant decrease in pain scores compared to the control group at all the assessment time points (P < .001). Whereas there was no difference between the laser group and the ultrasound group in reducing the pain scores (P > .05).ConclusionsThe LLLT and the LIPUS effectively reduce the separation pain when applied in multiple doses without differences between them.Trial registrationThis trial was registered with the German Clinical Trials Register (DRKS). (https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID= DRKS00029991). Date of registration: 26/08/2022.

Acupressure versus NSAID for relief of orthodontic pain : A randomized controlled clinical trial.

To compare ibuprofen and acupressure for pain relief after insertion of elastomeric orthodontic separators. Arandomized control clinical trial was conducted in an orthodontic clinic. Atotal of 75orthodontic patients aged 12-16years participating in the study were randomly allocated to receive either 400 mg of oral ibuprofen, applying acupressure therapy, or no pain-relief approach. Pain scores were recorded on visual analog scales (10 cm) over aweek at different times (4,10, 18, 24 h, and 1week). The margin of equivalence was defined as 10 mm. For all timepoints, the control group recorded the highest pain. For the ibuprofen and acupressure group, after 4 h, 18 h, and 1week, no significant difference was noted. However, after 10 h, no significant difference in pain between the control and acupressure groups was noted and the ibuprofen group showed significantly lower pain. In the acupressure group, the highest pain was noted at 10 h. After this timepoint, pain progressively decreased with time and the lowest pain was noted after 1week. In the control and ibuprofen groups, the highest pain was after 4 h, and then progressively decreased with time and the lowest pain was noted after 1week. There was no significant difference in pain perception between participants using ibuprofen or acupressure and both groups recorded significantly lower pain than the control group at most of the observed timepoints. Results support the analgesic effect of the acupressure approach.

Humanization of the Reaction Specificity of Mouse Alox15b Inversely Modified the Susceptibility of Corresponding Knock-In Mice in Two Different Animal Inflammation Models.

Mammalian arachidonic acid lipoxygenases (ALOXs) have been implicated in the pathogenesis of inflammatory diseases, and its pro- and anti-inflammatory effects have been reported for different ALOX-isoforms. Human ALOX15B oxygenates arachidonic acid to its 15-hydroperoxy derivative, whereas the corresponding 8-hydroperoxide is formed by mouse Alox15b (Alox8). This functional difference impacts the biosynthetic capacity of the two enzymes for creating pro- and anti-inflammatory eicosanoids. To explore the functional consequences of the humanization of the reaction specificity of mouse Alox15b in vivo, we tested Alox15b knock-in mice that express the arachidonic acid 15-lipoxygenating Tyr603Asp and His604Val double mutant of Alox15b, instead of the arachidonic acid 8-lipoxygenating wildtype enzyme, in two different animal inflammation models. In the dextran sodium sulfate-induced colitis model, female Alox15b-KI mice lost significantly more bodyweight during the acute phase of inflammation and recovered less rapidly during the resolution phase. Although we observed significant differences in the colonic levels of selected pro- and anti-inflammatory eicosanoids during the time-course of inflammation, there were no differences between the two genotypes at any time-point of the disease. In Freund's complete adjuvant-induced paw edema model, Alox15b-KI mice were less susceptible than outbred wildtype controls, though we did not observe significant differences in pain perception (Hargreaves-test, von Frey-test) when the two genotypes were compared. our data indicate that humanization of the reaction specificity of mouse Alox15b (Alox8) sensitizes mice for dextran sodium sulfate-induced experimental colitis, but partly protects the animals in the complete Freund's adjuvant-induced paw edema model.

The Effect of Positive Therapeutic Communication on Pain (POPAIN) and Anxiety During Arterial Blood Gas Standardized Procedures in the Emergency Department Compared to Traditional Communication: Protocol for a Monocentric Randomized Controlled Trial.

In the emergency department (ED), medical procedures, such as arterial blood gas (ABG) testing, can cause pain and high stress levels. However, ABG testing is a routine procedure assessing the severity of the patient's condition. To reduce the pain of ABG, several methods have been investigated without significant difference in pain perception. Communication, a key element of care, has shown a significant effect on pain perception. A positive communication strategy, including positive, kind, or reassuring words, can reduce pain perception, while negative words can raise this perception, causing discomfort, known as the "nocebo effect." Although some studies have compared the impact of verbal attitudes, particularly in anesthesia and mainly with staff already trained in hypnosis, to the best of our knowledge, none have investigated the effect of communication in the emergency setting, where patients may be more suggestible to the words used. In this study, we will investigate the effect of positive therapeutic communication on pain, anxiety, discomfort, and global satisfaction in patients requiring ABG compared to nocebo and neutral communication. A single-center, double-blind randomized controlled trial (RCT) with 3 parallel arms will be conducted with 249 patients requiring ABG during their ED visit. Patients will be randomly assigned to 1 of 3 groups before receiving ABG: positive communication group, negative communication (nocebo) group, or neutral communication (neutral) group. The communication and the words used by the physicians during hygiene preparation, artery location, and puncture will be imposed in each group. The study will be proposed to each patient corresponding to the inclusion criteria. The physicians will not be trained in hypnosis or in positive therapeutic communication. The procedure will be recorded with audio recorders to test its quality. Intention-to-treat analysis will be performed. The primary endpoint is the onset of pain. The secondary outcomes are patient comfort, patient anxiety, and global satisfaction of the patient with the communication strategy used. On average, 2000 ABG procedures are performed each year in the EDs of hospitals. In this study, 249 patients are expected to be included. With a projected positive response rate of 80%, we intend to include 25 (10%) patients per month. The inclusion period began in April 2023 and will run until July 2024. We hope to publish the results of the study during the fall of 2024. To the best of our knowledge, this study is the first RCT assessing the use of positive communication on pain and anxiety in patients undergoing the ABG procedure in the ED. A reduction in pain, discomfort, and anxiety is expected when using positive communication. If the results are positive, this could be useful to the medical community and encourage clinicians to monitor their communication during care. ClinicalTrials.gov NCT05434169; https://clinicaltrials.gov/ct2/show/NCT05434169. PRR1-10.2196/42043.

Local Anesthesia Onset and Pain Perception in Hemophilic and Thalassemic Conditions.

The study aims to evaluate and compare the onset of local anesthesia (LA) and pain perception during endodontic treatment in hemophilic and thalassemic patients. Methods: The study included 90 patients with symptomatic irreversible pulpitis of the mandibular molars. Three groups (n = 30 in each group) were included. Group 1: hemophilic patients; group 2: thalassemic patients; and group 3: individuals without any systemic diseases. Onset of LA and visual analogue scale (VAS) scores was recorded immediately after the administration of local anesthesia, during the pulp exposure procedure, and during canal instrumentation, and were compared between the three groups. Frequency distribution, ANOVA, and linear regression analysis (p < 0.05) were applied. Results: The mean onset time was 46 ± 34 s in the hemophilic group, 42 ± 23 s in the thalassemic group, and 38 ± 12 s in controls, but the differences were statistically insignificant. After LA administration (LA-VAS), all three groups experienced a statistically significant reduction in pain (p = 0.048). On pulp exposure (PE-VAS) (p = 0.82) and during canal instrumentation (CI-VAS) (p = 0.55), there was no statistically significant difference in pain perception between the groups. The coefficients indicate a positive correlation between the VAS and onset time, indicating a positive reduction in the VAS following the administration of LA. Conclusions: Hemophilic patients exhibited a clinically longer average onset time for LA. However, the difference among the three groups with regard to the overall pain perception after LA administration, during and after pulp exposure, and during canal instrumentation was statistically insignificant.

Comparison of pain perception in patients undergoing manual cataract surgery versus refractive laser-assisted cataract surgery

ObjectifsMesurer la perception de la douleur pendant la chirurgie manuelle de la cataracte comparativement à la chirurgie de la cataracte au laser femtoseconde (CCLF) de même que la perception de la douleur chez des patients qui font l'objet d'une anesthésie à 2 moments différents de la CCLF. Nous avons également évalué les facteurs liés à la perception de la douleur dans ces différents groupes. NatureÉtude comparative de cohorte prospective portant sur une démarche chirurgicale choisie par les patients. ParticipantsPatients devant subir une chirurgie de la cataracte bilatérale séquentielle retardée dans un centre de chirurgie ambulatoire en Ontario. MéthodesLes patients ont été répartis en 3 groupes : une cohorte devant subir une chirurgie manuelle de la cataracte (n = 30) et 2 cohortes devant subir une CCLF, dont l'une soumise à une neuroleptanalgésie tout juste avant le drapage opératoire en vue de la phacoémulsification (cohorte CCLF standard; n = 38) et l'autre, à une neuroleptanalgésie avant le recours au laser femtoseconde (cohorte CCLF hâtive; n = 35). Les paramètres de mesure comprenaient les scores de douleur sur une échelle visuelle analogique au jour postopératoire 0 et à la semaine postopératoire 1. Au nombre des paramètres secondaires, citons les scores d'anxiété, les scores de coopération de la part des patients selon le chirurgien ou l'anesthésiologiste, les variables oculaires et les signes vitaux peropératoires. RésultatsOn n'a pas noté de différence significative quant à la perception de la douleur au jour postopératoire 0 et à la semaine postopératoire 1 entre la cohorte chirurgie manuelle de la cataracte et la cohorte CCLF standard (p = 0,94 et p = 0,72, respectivement), ni entre la cohorte CCLF hâtive et la cohorte CCLF standard (p = 0,76 et p = 0,67, respectivement). Les scores de douleur des patients étaient plus élevés pendant l'intervention touchant le deuxième œil que pendant l'intervention touchant le premier œil. ConclusionsLe type de chirurgie de la cataracte de même que le moment où a lieu l'anesthésie dans le cas de la CCLF n'ont pas d'incidence sur la perception de la douleur en période postopératoire. L'intervention touchant le deuxième œil est associée à des scores de douleur plus élevés que l'intervention touchant le premier œil.

Comparación de parámetros inflamatorios gingivales y percepción del dolor en el sondaje periodontal- Un estudio transversal, Parte II

Background: Probing of the periodontal pocket is an essential part of the diagnosis of periodontal disease and 15-77% of untreated periodontal patients experience pain during probing. Therefore, the objective of this study is to evaluate the pain perceived by patients with dental plaque-induced gingivitis and chronic periodontitis during periodontal probing and the main objective includes the evaluation of the relationship between pain perceived during periodontal probing and gingival inflammatory parameters. Material and Methods: A total of 475 participants were recruited into the study. The patients were divided into two groups: Group-A (Gingivitis Group - 275 patients) and Group-B (Chronic Periodontitis Group - 200 patients). Clinical parameters included analysis of bleeding on probing, simplified gingival index, pocket depth on probing, and clinical attachment level. Pain score was recorded using the HP VAS scale and all patients participated in the study after a detailed explanation of the study protocol. Results: A significant difference in pain perception was noted between groups, highlighting the role of the degree of inflammation in the examination of periodontal parameters. Conclusion: Within the limitations of the present study, we can conclude that pain perception is directly correlated with the degree of inflammation in periodontitis rather than plaque-induced gingivitis during periodontal probing. Therefore, some form of adjuvant topical anesthesia may be considered in order to reduce pain levels in severely inflamed patients, to encourage continued acceptance of supportive periodontal therapy.

Evaluation of Perceived Pain, Discomfort, Functional Impairments, and Satisfaction When Relieving Crowded Lower Anterior Teeth in Young Adult Patients Using Corticision-Assisted Fixed Orthodontic Treatment: A Randomized Controlled Trial.

BackgroundNo previous trial (randomized and controlled) studied the levels of pain, discomfort, and acceptability associated with acceleration of dental movement during orthodontic treatment using corticision. The purpose of this study is to compare the pain, discomfort, ease of procedure, patient satisfaction, and analgesic use during corticision-assisted (without extraction) decrowding of the lower anterior teeth with the traditional orthodontic method.Materials and MethodsFifty-two patients (38 females, 14 males; mean age: 21.38 ± 1.05) were randomly distributed into two groups: the corticision group (CORT, n=26) and the control group (CONT, n=26). Corticision was applied by a surgical blade and a hammer at three anterior regions on the lower jaw using three radiological guides. The levels of pain, discomfort, swelling and chewing difficulties were registered on a visual analog scale (VAS) at one, seven, and 14 days after applying the first wire (0.14-inch NiTi archwire). Questionnaires were administered to assess the level of satisfaction, ease of the procedure, and the number of analgesics patients took. Mann-Whitney U tests were used to detect significant differences between the two groups. The Chi-Square test was used to study the significance of differences in taking analgesics during the first week of treatment.ResultsOne day following the intervention, there were no statistically significant differences between the two groups concerning pain levels, discomfort, and difficulties of mastication (P=0.293, P=0.166, P=0.538; respectively), but there was a statistically significant difference in the perceived swelling (P=0.012). On the seventh and 14th days of assessment, there were no statistically significant differences between the two groups regarding the previous variables. In the CORT group, the proportion of patients who were satisfied with treatment was approximately 94%, the proportion of those who found the treatment easy was 96%, 84% of patients wanted to repeat the procedure, and 92% of them would recommend this procedure to a friend.ConclusionsThere were no statistically significant differences in pain perception, discomfort, difficulties with mastication, and analgesic consumption between the interventional group and the control group. The perception of swelling was greater in the experiment group (the corticision group) at 24 hours following the first archwire engagement, and then it gradually decreased. Patients in both groups showed high levels of satisfaction following leveling and alignment. Those in the experimental groups showed a high level of willingness to undergo the same procedure again and a high level to recommend this procedure to a friend.

Effect of Low-Level Laser Therapy on Bone Formation in Rapid Palatal Expansion: A Systematic Review.

Introduction: Crossbite is a common malocclusion with a 7-23% prevalence rate. Treatment is based on the expansion of the mid-palatal suture (MPS) with Rapid Palatal Expansion(RPE) followed by a retention period to reach new bone maturation, enough to maintain the results stable. This systematic review was conducted to evaluate the effectiveness of low-level laser therapy (LLLT) in increasing bone formation in MPS. Methods: This article was written by the PRISMA checklist. Electronically, 3 databases, namely PubMed, Scopus, and Embase, were searched with the keywords selected based on PICO. Time (2010-2021) and language restrictions were performed. Results: 528 articles, out of which 374 studies were screened, were found, and 9 full-text articles were subsequently included considering these inclusion criteria: randomized clinical trial (RCT) that examines the efficacy of LLLT in rapid palatal expansion (RPE), age under 15 years, non-surgical RPE with a tooth-supported appliance, and low-intensity laser application. Finally, 4 articles were appraised by Cochrane version 5.2.0 with 7 domains. 3 of 4 articles showed LLLT has a significant impact on bone formation. One of them showed no significant difference in pain perception and bone density between the laser and non-laser groups. Conclusion: While many studies have assessed the effect of LLLT on bone formation in animal models, high-quality clinical trials are missing in this regard. The available clinical trials suggest a positive effect of LLLT on sutural bone formation after RPE.

Both Gender and Agonistic Experience Affect Perceived Pain during the Cold Pressor Test.

Background. Differences in pain perception in athletes have recently been highlighted in the literature. Objectives. To compare gender ratings of perceived pain in athletes with low and high agonistic experiences (N = 200) using the Cold Pressor Test (CPT). Methods. A three-way repeated measures ANOVA to assess both the effects of the athletes’ gender and lower vs. higher agonistic experiences in the intensity of perceived pain at the beginning of the cold box hand immersion (L0) and after a 90 s interval (L1). Results. There was a statistically significant interaction effect between the level of the agonistic experience and gender in the two moments: p < 0.001; ηp2 = 0.266; F(1,49) = 9.771. Simple main effects analysis showed a significative difference for females at L0: F(1,99) = 93.567, p < 0.025, partial η2 = 0.302) and for males at L1: F(1,99) = 173.420, p < 0.025, partial η2 = 0.666. At the initial moment of CPT, the female athletes showed significantly higher perceived intensity than males, regardless of their experience level. After a 90 s interval, a significantly lower pain perception effect associated with the increased competitive experience of male athletes was observed. Female athletes did not appear to benefit from the experience effect on their pain tolerance. Conclusions. The study confirmed a significant difference in pain perception associated with the athletes’ gender and agonistic experience. Separate explanations related to the pattern of pain inhibition and the acquired reduction in pain sensitivity are reported.

Effect of back massage on pain perception during first stage of labor among primi mothers in a teaching hospital

Introduction: Labor pain is experienced and endured by every childbearing woman, and pain relief measures are often neglected. Thus, this study aimed to identify the effect of back massage on pain perception during the first stage of labor among primi mothers at Patan Hospital. Method: A quasi experimental study was conducted among 56 primi mothers (28 experimental and 28 control groups) selected purposively in the active room of the maternity ward. Mothers who met the inclusion criteria were assigned non-randomly into experimental (received usual labor care and mustard oil back massage) and control groups (received usual labor care). The Visual Analogue Scale (VAS) was used to assess labor pain before and after 15 minutes of intervention in both groups, and the data was analyzed by descriptive and inferential statistics using SPSS version 16 software. Result: The mean score of pain perceived by mothers before intervention in the experimental group was 68.21 mm, and the control group was 69.39 mm. There was a significant difference in pain perception before and after back massage in the experimental group (p&lt;0.001). Similarly, a significant difference was found after intervention in the experimental and control groups (p&lt;0.001). Conclusion: Back massage was effective in reducing labor pain. The findings of the study might be helpful to those planning to include labor pain relief measures in maternity wards.

Postoperative Pain Management Using Supplemental Bupivacaine After Mandibular Orthognathic Surgery: A Triple-Blind Randomized Controlled Clinical Trial

The objective of this triple-blind, randomized, placebo-controlled trial was to assess the clinical analgesic efficacy of 0.5% bupivacaine in acute postoperative pain management after bilateral sagittal split ramus osteotomy (BSSO). Patients were randomly allocated into the experimental (0.5% bupivacaine with 1:200000 epinephrine) or control group (normal saline - placebo) using block randomization. The interventions were administered at the inferior alveolar nerve block and buccal nerve block sites bilaterally after the BSSO surgery. Analgesic efficacy was assessed in terms of the patient's pain perception measured by a numerical rating scale (0 to 10), rescue drug requirement, and duration of analgesia for 24 hours after the surgery. The statistical analysis was blinded to the allocation groups, and P-value of <.05 was considered as a significant difference for all tests. In total, 28 patients underwent BSSO (ie, 14 in each group). There was no significant difference in pain perception of patients injected with 0.5% bupivacaine and those administered with placebo during the 24 hours after the surgery (P > .05). Three patients in the bupivacaine group took the rescue drug after the surgery (mean duration - 268 minutes) and 1 patient in the placebo group took the rescue drug after 27 minutes. Postoperative use of bupivacaine did not show a superior analgesic efficacy when compared with normal saline in controlling acute postoperative pain after BSSO.

A PILOT STUDY ON EFFECTIVENESS OF SELECTED INTERVENTIONS ON PAIN PERCEPTION AND PARENTAL SATISFACTION AMONG INFANTS RECEIVING IMMUNIZATIONS AT PUBLIC HEALTH CENTRE, CHENNAI.

An experimental post test only control design was used to assess the effectiveness of selected interventions on pain perception and parental satisfaction among infants receiving immunizations at Public Health Centre, Chennai. Using simple random sampling method, the total of 40 infants were allocated in four groups where each group had 10 infants. The interventions provided are oral sucrose for Experimental group I, 4 S’s technique for experimental group II, oral sucrose with 4 S’s technique for Experimental group III and routine care for Control group. The data collection tool consists of demographic profile, modified riley pain scale and parental satisfaction likert scale were used to collect data. The result of the study revealed that mean pain perception of experimental group III (3.21) was less than the experimental group I (4.08), experimental group II (3.40) and control group (4.22). There was no statistical difference between experimental group II and experimental group III at the level of 0.693 and also between experimental group I and control group at the level of 1.000 when other groups had statistically significant difference in pain perception. In mean parental satisfaction, the experimental group III (43.20) had high parental satisfaction than the experimental group I (39.80), experimental group II (41.90) and control group (38.60).Hence the pilot study concluded that 4S’s technique was the effective intervention for infant immunizations.

Comparison of Relationship between Pain Perception and Attitude towards Orthodontic Treatment in Population Undergoing Fixed Orthodontic Treatment in North India

Introduction: Gender and age of subjects were correlated with the general attitude toward orthodontic treatment. Approximately, 90% to 95% of patients undergoing orthodontic treatment experience pain during the whole procedure. The aim of the study was to investigate the relationship between pain perception and attitude towards orthodontic treatment. Material and method: Total of 100 subjects were selected for the study from the age group of 21-25 years of age, they were divided into two groups according to gender that is 50 male and 50 females subjects, further divided into subgroups consisting 25 treated and 25 untreated. Result: There was a statistically significant difference (P = 0.003) in the attitude of untreated and treated groups. A two-sample t-test revealed, there was no statistically significant difference in pain perception of males and females in the untreated group (P = 0.64) and treated group (P = 0.23). Conclusion: Gender had no effect on the pain perception or attitude of the patients toward treatment. A more positive attitude was found in patients who experienced less pain during orthodontic treatment.

Pain in Separation of the Molars among the Orthodontic patients

Introduction: Pain has been the most common and foremost reason for discontinuing the orthodontic treatment. The patients usually experience pain in Orthodontic treatment during separator placement, wire placement, headgear wear, and rapid palatal expansion. Placement of orthodontic separators (brass wire, elastomeric, spring-type steel separators, and latex elastics) results in a painful experience. Therefore the purpose of the study is to assess the pain perception among the patients seeking orthodontic treatment.&#x0D; Methods: This study was carried out amongst 120 (53 male and 67 female) patients seeking orthodontic treatment. Elastomeric separators were placed mesially and distally to the first molars and the participants were given a self-administrated Universal pain assessment Tool to document perceived pain and pain upon chewing, using a visual analog scale for seven days. Total scores were calculated and descriptive statistics in the form of a number (mean) and percentage were calculated.&#x0D; Results: This study showed a mean score for perceived pain of each day to be 7.16, 7.1, 6.05, 4.67, 3.69, 2.88, and 2.27 respectively with a mean of 4.831 +/- 1.273. Similarly, the mean score for pain on chewing was 8.21, 7.53, 6.62, 5.19, 4.38, 3.65, and 3 with a mean of 5.5119 +/- 1.269.&#x0D; Conclusions: There was a significant difference in pain perception among the male and female participants, females having higher pain perception. There was a significant difference in pain perception between the Adolescent and Adult in both normal life and during eating.

Pain perception following epithelialized gingival graft harvesting: a randomized clinical trial.

The aim of this study was to compare the effects of a hemostatic collagen sponge and a collagen sponge sealed with a bio-adhesive material on the palatal donor sites with the purpose of minimizing postoperative pain after epithelialized gingival graft (EGG) harvesting. The present study consisted of 44 EGGs harvested in 44 patients. In the control group, a hemostatic collagen sponge was applied over the palatal wound, while the test group was treated with additional cyanoacrylate. Patients were observed for 14days, evaluating the pain level by using the visual analogic scale. The consumption of analgesic during the postoperative period, the willingness for retreatment and the characteristic of the graft were also analyzed. Statistically significant differences in pain perception were found between test and control groups in each of the studied days (p < 0.01). Analgesic consumption was lower in the test group (p < 0.01). Graft width < 14mm was found to be associated with lower discomfort (p < 0.01). Adding an additional layer of cyanoacrylate over a hemostatic collagen sponge on the palatal wound following EGG harvesting was found to be successful in minimizing the postoperative discomfort and the need for analgesics. Postoperative pain after palatal tissue harvesting can be successfully minimized if the donor site open wound is protected with an external layer of cyanoacrylate over a collagen sponge.