Verbal Pain Scale Research Articles

THE EFFECTS OF VIRTUAL REALITY ON PAIN, ANXIETY, AND COMFORT DURING THE CHEST TUBE REMOVAL PROCEDURE: A RANDOMIZED CLINICAL TRIAL

PurposeThe purpose of the current study is to determine the effects of virtual reality on pain, anxiety, and comfort during chest tube removal. Materials and MethodsThe research was conducted in the Cardiovascular Surgery Department of Atatürk University Health Practice and Research Hospital between January 2023 and April 2024. The study was performed as a randomized controlled experimental trial with a pretest-posttest control group. Eighty-two patients (41 in the intervention group and 41 in the control group) were included in the research. Patients in the intervention group watched a video with virtual reality glasses during chest tube removal. The “Descriptive Information Form,” “Visual Analog Scale,” “Verbal Pain Scale,” “State Anxiety Inventory,” and “Comfort Scale” were used to collect data. Number, percentage, mean, standard deviation, chi-square, paired sample t-test, independent sample t-test, Mann-Whitney U test, Wilcoxon test, and linear regression analysis were used in data evaluation. Our study was recorded in the Clinical Trials database with protocol number “NCT06550323.” ResultsThe groups had similar descriptive characteristics (p>0.05). The pre-procedural mean pain, anxiety, and comfort scores were similar in the two groups (p>0.05). The post-procedural mean VAS and verbal pain scores, mean anxiety, and comfort scores of the intervention group were lower in comparison with the control group (p<0.05). ConclusionThe research findings showed that virtual reality significantly reduced pain and anxiety while increasing comfort levels during chest tube removal. Therefore, it is recommended that virtual reality be used during chest tube removal.

Anticipatory Analgesic Effects of Tramadol and Ibuprofen in Impacted Mandibular Third Molar Extraction a Comparative Study

Aim: to assess the effectiveness of analgesia brought about by preoperative tramadol and ibuprofen on surgically removed mandibular third molars. Materials and Methods: Thirty individuals had their lower third molar surgically removed; they were split into three groups of 10 patients each. Group I had an intraoperative 100 mg tramadol injection; Group II received an oral 800 mg Ibuprofen injection; and Group III was a control group that received no prior care. The visual analogue scale (VAS), verbal pain scale (VPS), patient satisfaction (PS), amount of analgesic utilized, time elapsed before starting intake, and patient satisfaction (PS) were used to quantify analgesia after a 24-hour period. Result: On every kind of pain measure, there were notable differences between the tramadol and control groups, with the tramadol group scoring higher. The visual analogue scale (VAS), quantity, and duration of pills required over the course of a 24-hour period were significantly different between the Ibuprofen and control groups. Both the VAS and the VPS showed a substantial difference in favour of the Tramadol group compared to the Ibuprofen group. Conclusions: When impacted lower third molar surgery is performed, preventive usage of tramadol or ibuprofen is an excellent way to manage postoperative discomfort.

2020 Improving pain management in non-verbal patients

Abstract Introduction Identification of pain generally relies on patient self-reporting of symptoms. Patients with limited communication, advanced dementia or learning disabilities are unable to self-report pain. This results in pain being under-recognised and under-treated. Consequences of this are serious and include physical and psychological distress, longer length of stay and worse outcomes.1 Methods Abbey Pain Score (APS) [Figure 1] was introduced on a single Healthcare of the Older Person ward.2,3 It was used as the primary means of assessing pain in non-verbal patients (NVP) in place of the usual verbal pain scale (scored 0-10). [Figures 2 and 3] Ward-based teaching for all doctors, nurses and healthcare assistants was conducted before introduction of the APS. Data was collected for 20 consecutive NVP. Figure 1: Abbey Pain Score (Six items observed &amp; Score) Vocalisation: 0-3; Facial expression: 0-3; Change in body language: 0-3; Behavioural change: 0-3; Physiological change: 0-3; Physical changes: 0-3. Scoring scale: No Pain (0-2); Mild Pain (3-7); Moderate Pain (8-13); Severe (14+). Results At baseline we identified that pain as a symptom was missed in 54 % of NVP using the verbal pain score. With introduction of APS this dropped only slightly at 3 months but there was an increased uptake in scoring NVP on APS. With persistent engagement there was a significant decline in number of patients with un-managed pain needs. Figure 3: Abbey pain score (All patients with any pain) Baseline Pre-intervention: 21 / 39 (54 %); Post-intervention (3 months): 10 / 20 (50 % Post-intervention (12 months): 1 / 19 (5 %) Conclusion ABP is an effective means of addressing pain in NVP. It is simple to implement and can lead to significant improvements in patient care.

Migraine and its childhood equivalents

Migraine is one of the most common causes of primary headache in the pediatric population. In addition to pain manifestations, episodic syndromes are also found in children, which often lack cephalgic manifestations and are difficult to verify in clinical practice.Objective: to determine the characteristics of the migraine and episodic syndromes associated with migraine in children of different age groups.Material and methods. The study included 250 children complaining of headaches (166 girls and 84 boys aged 5 to 18 years, mean age 13 years). The patients were divided into groups: Group 1 – preschool age (5–6 years) and elementary school age (7–10 years) – 20.8% (n=52) of patients; Group 2 – middle school age (11–14 years) – 45.2% (n=113) of patients; Group 3 – high school age (15–18 years) – 34% (n=85) of patients. A structured diagnostic interview was conducted with all study participants (or their parents) and pain and anxiety were assessed using special scales and tests adapted for children (visual analog scale (VAS); Digital Pain Rating Scale (DPS); Verbal Rating Pain Scale (VRPS), Faces Pain Scale (FPS), MIDAS scales, Hands scale, depression scales adapted by T.I. Balashova, Spielberger-Khanin anxiety scale).Results. The average age at onset of headache in the general structure was 11 [9; 13] years. Migraine was diagnosed in 40.4% (n=21) of the patients in Group 1, in 31.9% (n=36) of the patients in Group 2 and in 29.4% (n=25) of the patients in Group 3. An increase in age by 1 year leads to a 1.17-fold decrease in complaints for headache in combination with vomiting. With an increase in the age of the patients by 1 year, excessive sleep is significantly less likely to be a factor provoking headaches. A statistically significant inverse association was found between age and FPS scores (ρ =-0.13, 95% CI: -0.25; -0.002; p=0.0457), VAS (ρ =-0.13, 95% CI: -0.25; -0.004, p=0.0425) and Balashova scale score (ρ =-0.14, 95% CI: -0.26; -0.01, p=0.0327). The mean values for the intensity and severity of headaches decrease with age. Analysis of the prevalence of episodic syndromes associated with migraine revealed that in the general group, intestinal colic in infancy was found in 49.6% (n=124) of cases, in Group 1 – in 51.9% (n=27), in Group 2 – in 47.8% (n=54) and in Group 3 – in 50.6% (n=43) of patients. In the general group, torticollis was found in 14.4% (n=36) of patients, which increased slightly with age. Intermittent abdominal pain was found in a total of 33.2% (n=83) and spontaneous vomiting in 18% of children, and its prevalence decreased with age.Conclusion. The prevalence of migraine in children of different age groups suffering from headache varies between 40.4% and 29.4% of cases. Frequency of gastrointestinal symptoms accompanying a headache attack and the provoking effect of sleep decrease continuously with increasing age. Episodic childhood syndromes associated with migraine may vary in their characteristics between different age groups of pediatric patients.

Transcutaneous electrical nerve stimulation (TENS) versus sham TENS in adult ED patients with abdominal pain: A clinical trial

ObjectiveThere is a growing consensus that the risks of current pharmacologic analgesics warrant consideration of alternative modalities for acute and chronic pain control. The objective of this study was to evaluate the effectiveness of transcutaneous electrical nerve stimulation (TENS) in adult emergency department (ED) patients presenting with abdominal pain. MethodsWe conducted a patient and observer blinded randomized controlled trial comparing TENS to sham TENS. The study was conducted at a large suburban academic ED. Patients with abdominal pain and a verbal numeric pain scale (VNS) of 5 or greater were randomized to TENS or sham TENS applied via 4 skin pads, one in each abdominal quadrant for 30 min. The primary outcome was change in pain scores 30 min after the intervention. Our study had 80% power to detect a between group difference of 1.5 points on the VNS. Results81 patients were randomized to TENS (n = 41) or sham TENS (n = 40). Groups were similar in baseline characteristics. The mean (SD) reductions in pain scores were 1.9 (2.1) and 1.7 (2.6) in patients treated with TENS and sham TENS respectively (P = 0.81). Use of rescue medications in patients with treated with TENS and sham TENS was similar (49 vs 55% respectively, P = 0.66). ConclusionsApplication of TENS to the abdominal wall did not result in more effective pain relief than sham TENS in adult ED patients with abdominal pain.

Pain in older adults with dementia: Brazilian validation of Pain Intensity Measure for Persons with Dementia (PIMD).

Although there are several ways to assess pain in dementia, there is still a need for tools with better items to assess the presence of pain intensity in these individuals. To validate to Brazilian version of the "Pain Intensity Measure for Persons with Dementia - PIMD-p. Older adults, all demented with impaired verbal communication and exposed to potentially painful situations, were selected from an outpatient clinic and long-term care facility (LTCF). The PIMD-p was applied independently by 2 researchers (E1 and E2) on the same day. Within 14 days, the instrument was reapplied by one of the 2 researchers (E3). The pain intensity reported by participants' caregivers and LTCF nurses were recorded on a verbal numeric pain scale. For the statistical analysis, Cronbach's Alpha, Spearman's Coefficient and intraclass correlation Index were calculated. A total of 50 older individuals were selected (mean age 86 years), majority with musculoskeletal pain. The PIMD-p demonstrated good internal consistency according to Cronbach's α (0.838), excellent intra and interobserver reproducibility (0.927 and 0.970, respectively; p < 0.001), and convergent validity (strong significant correlations between reported pain intensities and pain indicators on the PIMD-p (except for expressive eyes; corr = 0.106 and p = 0.462). A ROC curve was plotted to determine the best cut-off for the PIMD-P, and a score of 7.5 predicted moderate-to-severe pain, with 77.8% sensitivity and 95.7% specificity (p < 0.001). The PIMD-p showed satisfactory psychometric properties for measuring intensity of pain in demented older adults with impaired verbal communication.

Surgical Treatment of Stenosing Tenosynovitis: Early and Late Outcomes, Complications

Background. The thickening of A1 pulley of the tendon sheath limits the excursion of flexor tendon. Stenosing tenosynovitis causes finger movements dysfunction and pain. Objective. To analyze early and late outcomes of patients with stenosing tenosynovitis after surgical treatment – anulotomy. Methods. All patients had standard surgical procedure – open anulotomy of A1 pulley. Pain (verbal pain scale), hand and arm function (QuickDASH) and complications were recorded before surgery, after 1 week, 3 months and 6 months post surgery. Results. There were 45 patients, 29 (64%) female, 16 (36%) male. The highest pain score was recorded before surgery median 5 (IQR 5). The lowest pain score median 2 (IQR 2) was recorded after 6 months post surgery. The difference of the results after 1 week, 3 months and 6 months was statistically significant p &lt; 0.001. The worst hand and arm function was before surgery and 1 week post surgery. Accordingly: medians 52 (IQR 33) and 52 (IQR 35). Full hand function recovery was noticed after 6 months post surgery median 0 (IQR 11). The difference is statistically significant p &lt; 0.001. Conclusions. Surgical treatment, open anulotomy is one of the most effective methods for stenosing tenosynovitis. After this procedure pain and hand function improves greatly. However, for some patients it might cause discomfort of the hand because of the scar’s sensitivity and location.

Comparison of three different exercise trainings in patients with chronic neck pain: a randomized controlled study.

Neck pain is a common problem in the general population and second only to low back pain in musculoskeletal problems. The aim of this study is to compare three different types of exercise training in patients with chronic neck pain. This study was conducted on 45 patients with neck pain. Patients were divided into 3 groups: Group 1 (conventional treatment), Group 2 (conventional treatment plus deep cervical flexor training), and Group 3 (conventional treatment plus stabilization of the neck and core region). The exercise programs were applied for four weeks, three days a week. The demographic data, pain intensity (verbal numeric pain scale), posture (Reedco's posture scale), cervical range of motion ([ROM] goniometer), and disability (Neck Disability Index [NDI]) were evaluated. In all groups, a significant improvement was found in terms of pain, posture, ROM, and NDI values in all groups (P < 0.001). Between the groups, analyses showed that the pain and posture improved more in Group 3, while the ROM and NDI improved more in Group 2. In addition to conventional treatment, applying core stabilization exercises or deep cervical flexor muscle training to patients with neck pain may be more effective in reducing pain and disability and increasing ROM than conventional treatment alone.

A comparison of caries removal technique using conventional and disposable airotor

Introduction A variety of methods, including hand instruments, high-speed and low-speed handpieces, chemomechanical techniques, air abrasion, ultrasonic instrumentation, and lasers, could be used to treat dental caries. The development of rotary devices like the micromotor and airotors was prompted by the traditional method of treating caries, which only used hand instruments and was painful and ineffective. Aim To evaluate the efficiency of conventional and disposable airotor in treating dental caries in children aged 6–12 years old. Materials and methods The split-mouth randomized controlled trial was designed on 60 teeth from 30 patients aged 6–12 years, involving caries removal techniques using conventional and disposable airotor. Ericson scale, stop-watch, animated emoji scale, and verbal pain scale were used to evaluate efficacy, time taken, patient acceptance, and pain threshold during caries removal. Results Intergroup comparison in terms of time taken for caries removal, patient acceptance and pain threshold showed a statistically significant difference between the conventional and disposable airotor concerning patient acceptance (P = 0.01) and pain threshold (P = 0.04). No statistically significant difference was found between the groups in caries removal efficacy (P = 0.55). Conclusion Caries removal time and clinical efficacy were almost comparable with disposable and conventional airotor. The disposable airotor had more patient acceptance and less pain threshold when compared to the conventional airotor.

Prospective analysis on carotid endarterectomy: intermediate-deep ultrasound-guided cervical blockade versus general anesthesia.

The best regional anesthesia plan with the best clinical results for Carotid endarterectomy (CEA) has not been defined yet. Prospective multicentric observational study of two non-randomized matched cohorts including patients undergoing elective unilateral CEA (N.=100) between January-October 2021. Main outcomes were cerebral oximetry measurements, verbal numeric pain score assessment, peripheral nerve blockades and in-hospital stay. The main objective is to compare results achieved after carotid endarterectomy (CEA) performed under loco-regional blockade (LRB) versus general anesthesia (GA), in terms of intraoperative hemodynamic and neurologic variability. Patients undergoing LRB were performed under ultrasound (US) guidance and mild sedation. The LRB and GA groups showed no differences in comorbidities and risk factors. However, there was a significant difference in the intraoperative hemodynamic behavior due to the amount of vasoactive drugs used (0% vs. 16% for phenylephrine, P=0.006). The results showed neurological stability through the cerebral oximetry measurements during the procedure except for the left hemisphere de-clamp values, which were higher in the GA group (68.7±9.9 vs. 72.7±8.8; P=0.035). There were also significant differences in the verbal pain scale scores assessed 6 hours and 12 hours after the procedure; better pain control was evidenced in the LRB group (0[0-1] vs. 1[0-3], P=0.01; 1[0.5-2] vs. 0[0-2], P=0.01). An increased transient hypoglossal and laryngeal nerves blockade was observed in the LRB group (30% vs. 4%; P<0.001). The in-hospital length of stay was longer in the GA group (77.2±36.3 hours vs. 129.1±41.1 hours; P<0.001). Although the use of intermediate-deep cervical plexus blockade for CEA confers similar neurologic stability as GA does, there is a difference on the hemodynamic behaviour due to the differences in vasoactive drug consumption. Loco-regional techniques provide a better postoperative pain control and shorten in-hospital length of stay.

Study on peribulbar versus topical anaesthesia in subjects undergoing phacoemulsification

Introduction: Phacoemulsification was first introduced by Charles Kelman in 1967. IOL implantation is done according to the power of lens calculated using various intra ocular lens (IOL) calculation formulae. By customizing the IOL during cataract surgery, we can provide patients with best refractive outcomes, even in high myopes and hypermetropes. Aim and Objective of the study: The objective of the study to compare the efficacy of topical Anaesthesia versus peribulbar anesthesia among the subjects undergoing phacoemulsification. Materials and Methods: Subjects included in the study were conveniently assigned into either peribulbar group (Group P, n = 100) and topical group (Group T, n =100). Group P received 4-5 mL of local anesthetic (equal amounts of 2% xylocaine and 0.5% bupivacaine) into peribulbar space with 1 inch 25-gauge needle. Group T, received 0.5% proparacaine eye drops instilled every 5 minutes half an hour before surgery. No sedation was given. All the patients under went phacoemulsification with IOL implantation. A four-point verbal pain scale was used for analgesia. Patients were asked to grade the pain during different stages of surgery. Akinesia was also assessed on four-point scale.

Usefulness of combined handheld ultrasound and fluoroscopy-guided injection in adhesive capsulitis of the shoulder: A prospective, randomized single blind-pilot study.

BACKGROUND: Ultrasound is increasingly being utilized in the diagnosis and treatment of adhesive capsulitis.OBJECTIVE: To compare the therapeutic effects and advantages of combined handheld ultrasound and fluoroscopy-guided intra-articular corticosteroid injection with those of conventional ultrasound-guided corticosteroid injection in adhesive capsulitis of the shoulder.METHODS: A total of 39 patients diagnosed with adhesive capsulitis of the shoulder were randomly assigned into two groups. Group A patients ( 19) underwent combined handheld ultrasound and fluoroscopy-guided corticosteroid injection and group B patients ( 20) underwent conventional ultrasound-guided corticosteroid injection to the intra-articular space of the shoulder twice. Treatment efficacy was assessed at 2 and 6 weeks after the final injection, based on the verbal numeric pain scale, Shoulder Pain and Disability Index, and range of motion. Secondary outcome measures were the accuracy and procedure time.RESULTS: Both injection methods were effective in the treatment of adhesive capsulitis. No significant differences in treatment efficacy and injection accuracy were observed between the two groups ( 0.05).CONCLUSIONS: This study showed no statistical differences in treatment efficacy between 2 groups. However, the combined use of ultrasound and fluoroscopy can increase the accuracy of injection compared with conventional ultrasound alone.

A neglected treatment in middle school and high school age genital trauma: analgesia management with pain scoring

Purpose: The purpose of this study was to assess analgesic applications accompanied by numerical and verbal pain scores, radiological imaging, and consultation requests for genital traumas, which affect a small percentage of middle and high school students.&#x0D; Materials and Methods: This retrospective study included 237 middle school and high school age, 10-18 years old patients who applied to the emergency department due to genital trauma between January 2019 and December 2020. The types of trauma, radiological imaging, genital organ injuries, analgesia applications, consultations, and verbal and numerical pain scale scores of patients were all evaluated.&#x0D; Results: Of the 237 patients included in the study, 90 (38%) were female, and the mean age was 13.80±2.37 years (range, 10-18 years). Of the patients, 136(57.4%) were admitted with falls, 63(26.6%) traffic accidents, 35(14.8%) penetrating and 3(1.3%) iatrogenic injuries. The numerical pain score was 6.63±1.43 in falls, 6.09±1.66 in traffic accidents, 4.80±1.53 in penetrating injuries, and 3.67±1.15 in iatrogenic traumas. Analgesics were administered to 93(39.2%) of all patients. The severity of pain was mild in 43(18.1%) patients. It was moderate in 140(59.1%) and severe in 54(22.8%). &#x0D; Conclusion: Genital traumas that occur alone are extremely rare and are frequently associated with multiple organ injuries. Genital traumas have a wide variety of etiological causes and complications. In cases of pediatric genital trauma, the use of verbal and numerical pain scales may be beneficial in evaluating patients, determining imaging requirements, and determining analgesia applications.

The Effectiveness of Active External Warming of Patient Concurrently With Ice Application on the Incision Site on Post-Thoracotomy Pain and Analgesic Consumption.

The aim of study is to investigate the effects of active external warming of patient concurrently with application of ice to incision site on thoracotomy pain and analgesic consumption. The research is a quasi-experimental design with control and study groups. The study was conducted in 2018 and 2019. A total of 70 patients were included in the study: 35 in the control group and 35 in the study group. The mean verbal pain scale values were significantly lower in the intervention group (2.85 point) than in the control group (4.57 point; p < .001). Opioid consumption rate was high in control group patients (77.1% tramadol 30 mg; 45.7% morphine sulfate 5 mg) In contrast, the rate of opioid consumption was lower in patients in the intervention group (40% tramadol 30 mg; 17% morphine sulfate 5 mg). Active external warming and ice application on the incision area, could reduce the intensity of thoracotomy pain.

Pre- and post-injection pain in patients undergoing first intracavernosal injection

ABSTRACT Introduction Intracavernosal injections (ICI) are a well-established treatment option with great success rates for men with erectile dysfunction. Unfortunately, the anticipation of pain with injections remains a significant barrier to the use of ICI. Objective This study aims to utilize a standardized verbal pain scale to examine the perception of pre- and post-injection pain in men who are undergoing their first injection with an intracavernosal erectile agent. Thus, inclusion criteria required no previous penile injection of any type, including but not limited to erectile medications and collagenase. Methods We determined a prospective pre-post observational study would be best to examine men undergoing their first ICI. Men who had no previous history of intracavernosal injection of any kind were asked to predict the pain associated with their first ICI with a score of zero to ten. Patients then received a 10 microgram (mcg) injection of prostaglandin E1 (PGE1). Immediately after they received their injection, they were asked to rate the pain they perceived with the injection on the same scale (0-10). The same physician administered pre- and post-injection scales in a standardized fashion. Results A total of 17 of men were asked to rate their pain as discussed in the Methods Section. The average age of men sampled was 61.8 years of age. On review of history, 64.7% of men were found to have used some type of PDE-5 inhibitor before visiting our clinic. The majority of men we saw had erectile dysfunction (70.6%) and/or Peyronie's Disease (58.8%). The average pre-injection prediction pain score was 5.29 +/- 1.90; the average post-injection perceived pain score was 1.21 +/- 0.81. Thus, there was an average decrease of over 4 points in predicted pain versus perceived pain. A two-sample t-test was performed; in addition, a Wilcoxson Signed Rank Test was performed. Both tests showed statistical significance in the difference between pre- and post-injection pain scores (p &amp;lt;0.001). Conclusions We found that patients who are undergoing ICI for their first time have a significantly higher prediction of pain versus perception of pain after the injection. We have utilized this data in our clinic to explain to patients that while the majority of patients predict high pain scores associated with injection, the vast majority of patients report very minimal pain associated with the injection. Patients can be more open-minded to ICI therapy which could help aid them with their erectile status; this can particularly be helpful in patients who want to avoid surgery and in patients who are not good surgical candidates. Disclosure Work supported by industry: no, by N/A.

Vestibuloplasty using an apically-shifted flap in patients with edentulous mandibles

BACKGROUND: One of the most common problems of the dental system in the residential and senile age is the complete absence of teeth. This pathology affects up to 35% of patients aged 5570 years, and at the age of 75 years and older, more than 50% of patients have toothless jaws. A small vestibule of the oral cavity due to atrophy of the alveolar process on the lower jaw is an important reason for unsatisfactory fixation of a complete removable prosthesis, and therefore prosthetics of this group of patients is a complex clinical problem.&#x0D; AIM: Study: to optimize the surgical stage of treatment during the operation of deepening the vestibule of the mouth by the method of apically displaced flap in the complete absence of teeth on the lower jaw by using the gel preparation Emalan (Zelenaya dubrava, Russia) based on collagen.&#x0D; MATERIAL AND METHODS: The results of the study of 28 patients aged 67 to 76 years with complete absence of teeth in the lower jaw, whose treatment was carried out on the basis of the dental clinic Prime Dentistry of Ryazan, were analyzed. The study included elderly and senile patients, according to the WHO age classification. Patients were not assigned by gender. All patients were equally divided into 2 groups.&#x0D; Clinical evaluation of the early postoperative period was carried out for 10 days after surgery on the 2nd, 5th and 10th days. A verbal descriptive pain scale was used to assess the intensity of pain.&#x0D; In order to control the presence of an inflammatory reaction in the postoperative period, local thermometry was performed locally using an infrared scanner.&#x0D; RESULTS: Examination on the 2nd day showed that patients of both the main and comparison groups had slightly pronounced edema of the surrounding soft tissues. No increase in body temperature was recorded in both groups. Assessing the postoperative wound, on the 2nd day, all patients of the comparison group had marked hyperemia and swelling of the mucous membrane in the area of the surgical wound, and in patients of the main group such changes were detected less frequently. On the 5th day, no mucosal edema was observed in patients of the main group, and hyperemia was noted twice. In the comparison group, swelling and hyperemia of the mucous membrane in the wound area were recorded in almost half of the group. Examination of the wound defect on the 10th day showed that in the main group in all patients the wound was epithelized, whereas in the comparison group the signs of epithelization were weakly expressed. When studying the dynamics of local thermal symmetry using an IR scanner, carried out three times: on the eve of the operation, on the 2nd and 5th days after the intervention, a difference in indicators was noted between the main group and the comparison group. Patients assessment of the intensity of pain in the postoperative period using a verbal descriptive pain scale showed the following results. After complete cessation of anesthesia, most patients of the main group had slight discomfort in the wound area. Patients of the comparison group mainly complained of severe pain. On the 2nd day and on the 5th day after surgical intervention, some patients of the comparison group had complaints of mild pain in the wound, all other patients, including patients of the main group, had no pain.&#x0D; CONCLUSION: The use of collagen-based gel preparation Emalan to close wound postoperative defects with open methods of deepening the vestibule of the mouth gives positive results in the healing process of the wound defect in the form of absence or significant reduction of pain syndrome, reduction of inflammatory reaction in the wound and acceleration of epithelization.

Pre- and Post-injection Pain in Patient's Undergoing First Intracavernosal Injection

ABSTRACT Introduction Intracavernosal injections (ICI) are a well-established treatment option with great success rates for men with erectile dysfunction. Unfortunately, the anticipation of pain with injections remains a significant barrier to the use of ICI. Objective This study aims to utilize a standardized verbal pain scale to examine the perception of pre- and post-injection pain in men who are undergoing their first injection with an intracavernosal erectile agent. Thus, inclusion criteria required no previous penile injection of any type, including but not limited to erectile medications and collagenase. Methods We determined a prospective pre-post observational study would be best to examine men undergoing their first ICI. Men who had no previous history of intracavernosal injection of any kind were asked to predict the pain associated with their first ICI with a score of zero to ten. Patients then received a 10 microgram (mcg) injection of prostaglandin E1 (PGE1). Immediately after they received their injection, they were asked to rate the pain they perceived with the injection on the same scale (0-10). The same physician administered pre- and post-injection scales in a standardized fashion. Results A total of 17 of men were asked to rate their pain as discussed in the Methods Section. The average age of men sampled was 61.8 years of age. On review of history, 64.7% of men were found to have used some type of PDE-5 inhibitor before visiting our clinic. The majority of men we saw had erectile dysfunction (70.6%) and/or Peyronie's Disease (58.8%). The average pre-injection prediction pain score was 5.29 +/- 1.90; the average post-injection perceived pain score was 1.21 +/- 0.81. Thus, there was an average decrease of over 4 points in predicted pain versus perceived pain. A two-sample t-test was performed; in addition, a Wilcoxson Signed Rank Test was performed. Both of these tests showed statistical significance in the difference between pre- and post-injection pain scores (p &amp;lt;0.001). Conclusions We found that patients who are undergoing ICI for their first time have a significantly higher prediction of pain versus perception of pain after the injection. We have utilized this data in our clinic to explain to patients that while the majority of patients predict high pain scores associated with injection, the vast majority of patients report very minimal pain associated with the injection. Patients can be more open-minded to ICI therapy which could help aid them with their erectile status; this can particularly be helpful in patients who want to avoid surgery and in patients who are not good surgical candidates. Disclosure No

An Exploratory Study on the Effectiveness of Virtual Reality Analgesia for Children and Adolescents with Kidney Diseases Undergoing Venipuncture.

The current study evaluated the effectiveness of VR analgesia among pediatric and adolescent patients with kidney disease undergoing venipuncture. Patients at an Italian Children’s hospital (N = 82, age range 7–17 years) undergoing venipuncture were randomly assigned to a No VR group (non-medical conversation) vs. a Yes VR group (VR analgesia). After the procedure, patients gave 0–10 Verbal Numeric Pain Scale ratings. Compared with patients in the No VR Group, patients in the Yes VR group reported significantly lower “Pain intensity”(No VR mean = 2.74, SD = 2.76 vs. Yes VR mean = 1.56, SD = 1.83) and the VR group also rated “Pain unpleasantness” significantly lower than the No VR group (No VR mean = 2.41, SD = 0.94 vs. Yes VR mean = 1.17, SD = 1.80). Patients distracted with VR also reported having significantly more fun during the venipuncture procedure. No side effects emerged. In addition to reducing pain intensity, VR has the potential to make venipuncture a more fun and less unpleasant experience for children with CKD, as measured in the present study for the first time. Finally, in exploratory analyses, children aged 7–11 in the VR group reported 55% lower worst pain than control subjects in the same age range, whereas children aged 12 to 17 in the VR group only reported 35% lower worst pain than control subjects. Additional research and development using more immersive VR is recommended.

Efficacy of Combined Dorsal Root Ganglion Pulsed Radiofrequency and Cervical Epidural Steroid Injection on Radicular Neck Pain.

To evaluate the efficacy and safety of combined transforaminal anterior epidural steroid injection (TAESI) and dorsal root ganglion pulsed radiofrequency (DRG-PRF) therapy on the radicular neck pain. The results of 84 patients with cervical radicular pain who underwent combined DRG-PRF and TAESI under fluoroscopy were evaluated retrospectively. Primer outcome is the pain measurements of the patients before and after the procedure at the 1 < sup > st < /sup > , 3 < sup > rd < /sup > , and 6 < sup > th < /sup > months were evaluated with the Verbal Pain Scale (VPS). Our secondary outcome was the evaluation of patient satisfaction in the 1 < sup > st < /sup > , 3 < sup > rd < /sup > , and 6 < sup > th < /sup > months after the interventional treatment, and it was considered significant if it was evaluated as ?good? above 50%. We found statistically significant decrease in the pain scores of the patients in the 1 < sup > st < /sup > , 3 < sup > rd < /sup > , and 6 < sup > th < /sup > months compared to the pre-intervention (VPS 0) (p < 0.001). After the procedure, the patients expressed their satisfaction level as 69.1% at the 1 < sup > st < /sup > month, 71.5% at the 3 < sup > rd < /sup > month, and 72.6% at the 6th month as ?very good/good?. While the operation was mostly performed at the C5-6 level on both sides, it was seen that 61.9% of the operations were applied from the right side and 38.1% from the left side. No adverse effects or fatal neurological complications were observed. Although the efficacy and complications of cervical TAESI and DRG-PRF treatment are controversial in the literature, we think that this combined treatment can provide effective pain palliation in experienced hands with appropriate patient selection, considering the risk / benefit ratio.

Baghdad's first success in Bone Marrow Aspirate Concentrate procedure

Introduction-Bone Marrow Aspirate Concentrate procedure (BMAC) is a novel regenerative technique. Aim-to show BMAC's success in relieving osteoarthritic knee sufferings in Iraqi patients. Methods-It is a retrospective, descriptive investigation of 300 Iraqi patients who suffered from grades 1-3 Kellgren-Lawrence Grading for osteoarthritic knees, aged (35- 64) years, from both genders after oral consent at "Al Zahrawy Center for Stem Cells" in Baghdad over six months. The investigators utilize a verbal pain scale for pain evaluation. Results-Of 300 patients, 195 (65 %) were women; the commoner patients had grade two. Sixty-four (21.3 %) patients discontinue their follow-up. Grade three patients manifest inadequate response. A single injection of BMAC had a good effect on pain score and night stiffness. There were 143 (47 %) patients still suffering in the sixth month, while 95 (31.6 %) patients required extra BMAC. Conclusion-It is the first successful BMAC report in Iraqi patients for relieving osteoarthritic knee sufferings.