Wong-Baker Faces Pain Scale Research Articles

Evaluation of vincristine-induced peripheral neuropathy in children with cancer: Turkish validity and reliability study

BackgroundThe evaluation of peripheral neuropathy in children receiving Vincristine treatment is challenging. This study examined the Turkish validity and reliability of the Total Neuropathy Score-Pediatric Vincristine (TNS-PV) measurement tool, which can measure Vincristine-induced peripheral neuropathy symptoms in children with cancer. MethodsA total of 53 children aged 5–17 years who received Vincristine treatment in two pediatric hematology-oncology centers participated in the study. Data was collected using the Total Neuropathy Score-Pediatric Vincristine (TNS-PV), the Common Terminology Criteria for Adverse Events (CTCAE), the Wong-Baker FACES Pain Scale, and the Adolescent Pediatric Pain Tool (APPT). The correlation between the TNS-PV total score and other scales and the inter-rater reliability coefficient was evaluated. FindingsOf the children, 81.1% were diagnosed with ALL and 13.2% with Ewing Sarcoma. Cronbach's alpha values of form A and B of the TNS-PV scale were 0.628 and 0.639, respectively. As the cumulative Vincristine dose increased, the children's scores on TNS-PV were higher. A moderate and significant positive correlation was found between the TNS-PV form A total score and the worst subjective symptoms a, b (A), strength, tendon reflexes, and autonomic / constipation (r = 0.441, r = 0.545, r = 0.472, r = 0.536, p < 0.01). DiscussionThe TNS-PV form B total score was found to have a moderate level, significant correlation with CTCAE sensory neuropathy score and Wong-Baker FACES Pain Scale, and a high level, significant positive correlation with CTCAE motor neuropathy score. Application to practiceThe TNS-PV is valid and reliable for measuring Vincristine-induced peripheral neuropathy in practice in Turkish children 5 years and older.

A Descriptive Study to Assess Level of Stress, Anxiety, and Pain Among Hospitalized Children Admitted in the Pediatric Surgery Unit of APC, PGIMER, Chandigarh 2020−2022

Background Hospitalization is stressful for children. Hospitalized children suffer from stress due to the negative change in their life. Children facing medical procedures often experience pain and anxiety. Physical, psychological, social, cultural, and environmental factors all influence child behavior, which is especially challenging for children as compared to adults. Both pharmacological and non-pharmacological approaches can be used to manage distress among children. There are several ways to reduce stress, anxiety, and pain among hospitalized children. Puzzles, books, comics, crossword, video games, televisions, toys, phone, and so on. all are effective ways through which child can be engaged. Aim To assess the level of stress, anxiety, and pain among hospitalized children admitted in the Pediatric Surgery Unit, APC, PGIMER, Chandigarh, India. Methods A descriptive study was conducted on 60 hospitalized children. Purposive sampling was used to recruit the sample. The data were collected through interview schedule consisting of socio-demographic profile, clinical profile, and questionnaire on stress, anxiety and pain. Results The findings of the study revealed that all the children were having moderate stress, whereas majority of the children (91.7%) were having moderate anxiety, and only 8.3% of the children were having severe anxiety. During the assessment it was also found that almost 55% were having pain score 4, that is, Hurts little bit as assessed by Wong baker face pain scale. Conclusion Children who were being hospitalized were having varied degrees of stress, anxiety, and pain. Therefore, some diversional therapy should be planned to reduce their distress.

Evaluation of the effectiveness of sucrose versus xylitol application in minimizing pain related to dental injection in 5-7-year-old children - A randomized controlled pilot study.

Oral application of sweet-tasting solutions has found to be effective in minimizing pain on dental injection in children. Xylitol has never been tested in this regard. The aim of this study was to compare the effectiveness of prior application of sucrose versus xylitol solution in minimizing pain on dental injection in 5-7-year-old children. This study was a randomized controlled clinical trial. Informed consent was taken. A total of 30 children who required maxillary buccal infiltration injection were selected. The children were randomly allocated into the sucrose group, xylitol group, or control group by lottery method. In the sucrose and xylitol groups, 30% sucrose or 30% xylitol solution was applied on the lateral surface of the tongue for 2 min. In the control group, distilled water was applied. In all the groups, the topical anesthetic was applied at the site of injection followed by buccal infiltration. A video was taken during injection, and the sound eye-motor (SEM) scale was recorded by a blinded examiner. Patients were asked to self-evaluate using the Wong-Baker Faces Pain Scale (WBFPS). Mann-Whitney test was used to analyze the data. There was a statistically significant difference in the WBFPS and the SEM score between the sucrose and the control group (P < 0.05) and the xylitol and control group (P < 0.05). No statistically significant difference was found between the sucrose and xylitol group. The application of xylitol solution before dental injection was as effective as sucrose solution in minimizing pain during the injection.

Efficacy of benzocaine and lidocaine bioadhesive patches in various minor oral surgical procedures in children - An evaluative study.

The key to successful management of a child in the dental clinic depends greatly on providing painless anaesthesia. Topical anaesthesia using bioadhesive patches may be a breakthrough in this field. The purpose of the study was to compare the efficacy of Benzocaine and Lidocaine bioadhesive patches in reducing pain associated with various minor oral surgical procedures in children. Hundred subjects, aged 6-9 years, requiring various minor oral surgical procedures such as extractions of primary teeth, nerve blocks, mucocele excision or drainage of abscesses were divided equally into Groups 1 and 2. In Group 1, custom fabricated Benzocaine patches were placed for 5 minutes at the target site prior to the procedure, and in Group 2, Lidocaine patches were used in the same manner. Each subject completed a visual analogue scale (VAS) and Wong-Baker Faces pain scale (FPS) after each procedure. Pulse rate and saturation of peripheral oxygen were assessed using pulse oximeter. The duration of the study was from September 2014 to September 2015. The statistical analysis was done using paired t test, ANOVA and Bonferroni post hoc analysis. P value less than 0.05 were considered as statistically significant. A significant difference in pain scores was observed favouring the use of Benzocaine over Lidocaine patches (P < 0.05). However, no significant differences in pulse oximeter readings were observed. A statistically significant reduction in pain rating scores was observed in the Benzocaine group after a five-minute application of the patch.

Assessment of pain in paediatric dental patients during administration of local anesthesia with and without the use of audiovisual distraction

Infants and children who experience pain in early life, show long-term changes in terms of pain perception and related behaviors. Local anesthesia is integral to the practice of painless dentistry but the pain of injection itself is deterrent to successful administration of local anesthesia and can be a most anxiety-provoking procedure. Distraction as a behavior management technique is successfully known to reduce pain and manage children's dental behavior by diverting their attention away from painful stimuli during invasive dental procedure. This study aimed to compare the pain associated with local anesthetic injection delivered with and without the use of distraction as a behavior management technique in 6-8-year-old children. In this randomized, clinical, in vivo study with a split-mouth design we compared the pain of 30 children (6-8-year-old), requiring dental treatment necessitating the use of local anesthesia bilaterally in either of their maxillary and mandibular arches. Treatment was done in two visits, 1 week apart. Children were randomly assigned to receive the distraction (iPad) at one visit while no distraction in other visits. Two different pain assessment scales were used: Wong-Baker faces pain scale (FPS) and FPS-Revised. The Chi-square test was used for statistical analysis. P ≤ 0.05 was considered to be statistical significance. Children who received local anesthesia with audiovisual distraction had lower pain rating scores than those who received local anesthesia with no distraction. Audiovisual distraction significantly reduces pain associated with injection of local anesthesia.

Evaluation of the effectiveness of photobiomodulation therapy as an alternative method to local anesthesia injection in pediatric dentistry.

The idea of receiving local anesthesia (LA) via an injection is a major source of dental fear and anxiety. In children, dental anxiety is considered the main reason for avoiding dental treatments. Moreover, there are potential complications during/after LA administration. Thus, it is necessary to search for painless, low-risk, and nonpharmacological anesthetic approaches. This study was performed to evaluate the effectiveness of photobiomodulation (PBM) therapy as an alternative method to LA injection for conventional restorative treatments in pediatric patients. This was a split-mouth randomized clinical study. The study included 15 children between 6 and 12 years old. Each child had 2 similar contralateral caries lesions in the first permanent molars in the same jaw, total (30) teeth. For each child, one tooth was treated under conventional LA injection and the other was treated under PBM-based anesthesia. The Wong-Baker's Faces Pain Scale was used for reporting the pain and discomfort levels at the end of the treatments. Data statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS) version 20. Mann-Whitney U-test was used to compare between the groups. The PBM-based anesthesia group recorded a mean pain score of 2.27 ± 1.28. The conventional LA group recorded a mean pain score of 1.73 ± 0.7. The difference between the groups was not statistically significant (P = 0.168). PBM-based anesthesia may be an optional alternative to LA injection for conventional restorative treatments in children with dental anxiety, needle phobia, or special needs, and it deserves further studies and improvement.

Effectiveness of stress ball and relaxation exercises on polymerase chain reaction (RRT-PCR) test-induced fear and pain in adolescents in Türkiye

PurposeThis study aimed to determine the effectiveness of stress balls and relaxation exercises in relieving PCR test-induced fear and pain in adolescents. Design and methodsA randomized controlled experimental study with a parallel-group design was conducted. The sample size was determined by G*Power analysis, and 32 adolescents were included in each group accordingly. The data were collected using the Adolescent and Parent Information Form, The Children's Fear Scale, and The Wong-Baker Faces Pain Scale. Descriptive statistics, t-test, paired t-test, ANOVA, and Tukey's forward analysis were used to analyze the data. ResultsThe mean age was 14.93 ± 2.07 years for the adolescents, 43.58 ± 4.50 years for the mothers, and 48.25 ± 4.92 years for the fathers. Adolescents were stratified according to age, gender, and fear of invasive procedures, and homogeneity was ensured in their distribution to the groups. The pre-procedural level of fear was moderate in each group with no significant difference (p > 0.05). However, a significant difference was found between the groups in terms of both post-procedure levels of fear and pain. The pre-procedural fear of the adolescents in the control group (3.91 ± 0.29) did not change much after the procedure (3.91 ± 0.30), while there was a decrease in the other groups. The least post-procedure fear (0.09 ± 0.29) and pain (0.44 ± 0.67) were found to be in the relaxation exercise group. Conclusions and practice implicationsRelaxation exercise is the most effective method to reduce fear and pain during the PCR procedure. It is recommended to use it during the PCR procedure for being easily accessible, applicable, and cost-effective.Clinical Trials ID: NCT05250544.

Prevalence and Factors Associated with Low Back Pain among Patients with Type 2 Diabetes Mellitus (T2DM)

This study investigated the prevalence and associated factors of low back pain (LBP) among T2DM. LBP was assessed using the Standardized Nordic Questionnaire, Wong-Baker Face Pain Scale for pain intensity and disability level was evaluated using the Revised Oswestry Low Back Pain Disability Questionnaire. 55.3% of the T2DM participants suffered LBP in the last 12 months. Employment status (Χ2=4.088, p=0.043), education level (Χ2=8.572, p=0.018) and fasting plasma glucose (FPG) level (Χ2=6.381, p=0.041) were significantly associated with the occurrence of LBP. The current study found that the prevalence of LBP was high among T2DM patients. Keywords: Low back pain; type 2 diabetes mellitus; prevalence; disability eISSN: 2398-4287 © 2022. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open-access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under the responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians/Africans/Arabians), and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning &amp; Surveying, Universiti Teknologi MARA, Malaysia. DOI: https://doi.org/10.21834/ebpj.v7i21.3702

The Effects of Listening to the Qur'an in the Postoperative Management of the Patients Undergoing Laparoscopic Cholecystectomy in the Day Surgery Unit

PurposeTo determine if listening to verses of the Qur'an during the immediate postoperative period has an effect on patients’ anxiety levels, the number of opioids used to control pain, and the length of stay (LOS) in the Post Anesthesia Care Unit (PACU). DesignRandomized Control Trial. Adult Muslim patients who had undergone a laparoscopic cholecystectomy through the Day Surgery Unit were randomly selected using computer-generated sequence into two groups, interventional and control groups. MethodsThe control group listened to the natural environment and received Fentanyl for pain relief, and the interventional group listened to the Qur'an recitation and received Fentanyl for pain relief. A total of 112 (79.4%) participants completed the study. The level of the pain and anxiety was measured using the Wong-Baker Faces pain scale and Spielberger State-Trait Anxiety Inventory, respectively. Statistical analysis was conducted using SAS version 9.3 (Statistical Analysis System, SAS Institute Inc, Cary, North Carolina). FindingsThis study compared the effects of Qur'an audio therapy on patients' anxiety levels, opioid consumption, pain, and LOS in the PACU. The findings showed that by listening to chosen verses from the Qur'an in the recovery period post-anaesthesia, anxiety scores were significantly reduced (P = .0001), opiate use was reduced (P = .0081), and overall PACU LOS was also reduced (P = .0083). ConclusionsAdding the use of listening to the Qur'an as a complementary therapy is a simple and cost-effective measure to reduce the need for narcotics in the PACU, and reduce the overall PACU length of stay. This intervention benefits the patient, the PACU, and reduces health care organization costs.

Comparing the Influence of Conventional and Rotary Instrumentation Techniques on the Behavior of the Children: A Randomized Clinical Trial.

BackgroundPulpectomy has gained popularity in the pediatric dental practice for preserving the primary teeth in its position until exfoliation. There has been a paradigm shift from using manual instrumentation to rotary instrumentation for canal preparation in primary teeth. While studies show that there is a reduction in the instrumentation time with the use of rotary instruments which in turn influences the behavior of the child, its direct effect on the behavior of the children has not been evaluated.AimTo compare the behavior of the children during manual and rotary instrumentation for pulpectomy in the primary molars.Materials and methodsA single-blinded randomized clinical trial was conducted in 88 children in any one of the mandibular primary molars indicated for pulpectomy. The canal preparation was done using manual K files and rotary ProTaper (44 children in each group). The influence of these instrumentation techniques on the children was assessed with three different scales- Frankl Behavior Rating Scale; Venham Interval Rating Scale; Wong Baker FACES Pain Scale for evaluating the behavior, anxiety, and the pain experienced by the children, respectively during canal preparation.ResultsA total of 88 participants, comprising 50 females and 38 males, participated in the study. An equal distribution of the participants with respect to age (p = 0.064), gender (p = 0.389), and teeth (p = 0.877) was observed between the groups. More cooperative behavior (p < 0.001); lesser anxiety levels (p < 0.001); lower intensity of pain (p < 0.001) were recorded in the children instrumented using Rotary files.ConclusionThe present study concludes that it is preferable to use rotary instrumentation for primary canal preparation in pediatric practice as it has a more positive influence on the behavior of the children, which eventually determines the success of the treatment.Clinical significanceWith rise in the use of rotary files for pulpectomy in primary teeth, the present paper demonstrates the influence of rotary instrumentation technique for canal preparation during pulpectomy on the behavior of the children in a dental chair. This paper throws light for the pedodontists to effectively perform pulpectomy in children with ease without leaving a psychological impact on the children.How to cite this articleGovindaraju L, Subramanian EMG, Jeevanandan G. Comparing the Influence of Conventional and Rotary Instrumentation Techniques on the Behavior of the Children: A Randomized Clinical Trial. Int J Clin Pediatr Dent 2021;14(S-2):S179–S185.

The correlation between clinical and radiological severity of osteoarthritis of the knee.

Introduction: Primary osteoarthritis (OA) is a common cause of knee pain. Appropriate management of knee OA is based on clinical and radiological findings. Pain, deformity, and functional impairments are major clinical factors considered along with radiological findings when making management decisions. Differences in management strategies might exist due to clinical and radiological factors. This study aims at finding possible associations between clinical and radiological observations. Methods: A prospective cross-sectional study of 52 patients with primary osteoarthritis of the knee managed conservatively at a tertiary hospital arthroplasty clinic was conducted for three months. English speaking patients with primary OA were identified and included in this study. Pain and functional impairment were assessed using Wong-Baker Faces pain scale, The Knee Society Score (KSS), and Western Ontario and McMaster Osteoarthritis Index (WOMAC). The Body Mass Index (BMI) of all participants was measured. Standard two views plain radiographs were used for radiographic grading of the OA. Anonymized radiographs were presented to two senior consultant orthopaedic surgeons who graded the OA using Kellgren and Lawrence (KL) and Ahlbäck classification systems. The severity of the functional impairment and pain score was then compared to the radiological grading. Results: The average age of our participants was 63 ± 9 years. Their average BMI was 34.9 ± 8.4 kg/m2, median self-reported pain, total WOMAC, and pain WOMAC scores were 8, 60, and 13, respectively. We observed no significant correlation between BMI and pain scores. Inter-rater reliability for KL and Ahlbäck grading was strong. There was no significant correlation between WOMAC scores and the radiological grades. Conclusion: There was no correlation between pain and functional scores, patient factors and radiological severity of OA of the knee.

Medical Clowning: A Cost-Effective Way to Reduce Stress Among Children Undergoing Invasive Procedures.

BackgroundDistraction techniques like medical clowning and the use of soap bubbles can aid in reducing children’s stress levels while undergoing invasive medical procedures. Such complementary therapies are not a common practice in Pakistan, and data exploring the potential benefits of complementary therapies are sparse. This study aimed to determine whether distractions like medical clowns and soap bubbles could reduce anxiety and pain perceived by children undergoing invasive medical procedures in a hospital in Pakistan.Material and methodsWe conducted a randomized controlled trial of 76 pediatric patients (aged six to 12 years) whose treatment required a peripheral intravenous (IV) catheter insertion at the pediatric ward of the Fauji Foundation Hospital in Rawalpindi, Pakistan, from March 2016 to June 2016. Peripheral IV catheter insertion was required for all patients as part of their treatments (no participants received IV catheter placement solely for this study). Our sample size was selected via random sampling, and we excluded patients whose parents or legal guardians did not consent for their inclusion. Study participants were randomly assigned to either a clown group (n=38) or a control group (n=38). The patients in the clown group underwent IV catheter placement while interacting with the medical student clown and soap bubbles in the presence of a parent. Patients in the control group underwent IV catheter placement with support provided only by the parent. We assessed the patient’s distress and anxiety before, during, and after the procedure. We used the Observation Scale of Behavioral Distress (OSBD), before and after the procedure with the short version of self-reported Spielberger’s State-Trait Anxiety Inventory-Children (STAI-C), the visual analog anxiety scale (VAS), and pain experienced with the Wong-Baker Faces pain scale (FPS) only after the procedure. Additionally, we collected demographic information. The hospital's ethical review committee approved our study design.ResultsOf the 76 study participants, 53.9% were male and 46.1% were female. Most patients lived in a rural setting (67%). Mean values of the FPS, OSBD, and STAI-C for the clown group (3.21, 6.23, and 8.52, respectively) were all lower than those for the control group (8.00, 18.02, and 15.29, respectively; p<.001); however, the difference was not statistically significant for children older than 10 years. After IV catheter placement, the mean VAS score for the clown group was also significantly lower than that for the control group (2.84 vs. 8.92, respectively; p<.001).ConclusionThe use of distractions via medical clowns and soap bubbles was an effective nonpharmacological method of reducing anxiety and perceived pain in children undergoing invasive medical procedures. Therefore, proceduralists could use such techniques as powerful, noninvasive, and cost-effective complementary and alternative medicine tools in pediatric treatment settings in Pakistan. Further studies on the potential benefits of the aforementioned techniques are warranted.

ANESTHETIC EFFICACY OF 4% ARTPHARMADENT VERSUS 2% MEPECAINE-L FOR INFILTRATION ANESTHESIA IN EXTRACTION OF BADLY DECAYED LOWER FIRST PRIMARY MOLARS: A PILOT STUDY

Aim: The present study aimed to compare the efficacy of 4% Artpharmadent anesthetic solution compared to 2% Mepecaine-L anesthetic solution in extraction of badly decayed mandibular first primary molar for infiltration in children aged from 6 to 8 years. Methodology: Twenty children with 20 badly decayed mandibular first primary molars indicated for extraction divided randomly into two equal groups (n= 10), group A received 4% Artpharmadent and group B received 2% Mepecaine-L anesthetic solution for infiltration. Intra-operative pain, the need for supplemental injection during extraction, adverse effects following the anesthetic injection, and the clinical success of the treatment were evaluated for both groups. Results: Both groups showed nearly similar results regarding intraoperative pain using Wong-Baker Face Pain Scale (WBFPS), and Sound, eyes, and motor (SEM) scale, regarding the need for supplemental injection during the extraction, and the adverse effects following the anesthetic injection (non-significant difference statistically). Conclusions: Both the 4% Artpharmadent and 2% Mepecaine-L are equally effective in controlling intraoperative pain during the extraction of mandibular molars and both are safe when used in children.

The effectiveness of Cyperus rotundus essential oil in reducing the side effects of laser hair removal.

In many ailments, Cyperus rotundus is an effective and safe treatment option. Flavonoids in the oil have anti-inflammatory and analgesic properties. There have been no randomized controlled trials comparing topical C.rotundus oil to the available allopathic modalities for treating post-hair removal laser side effects. Participants in this study were prospectively evaluated for the efficacy of C.rotundus essential oil, compared with hydrocortisone and saline, in managing pain and erythema after laser hair removal. Eligible participants (n=153) were randomly assigned to one of three study groups: topical C.rotundus oil (group 1), hydrocortisone (group 2), or saline (group 3). The following methods were used to assess the results: The Wong-Baker FACES Pain Scale was used to rate pain. Erythema was graded on a six-point scale: "no erythema," "slight erythema," "marked erythema," "severe erythema without vesicles," and "severe erythema with vesicles." In terms of anti-inflammatory effects, C.rotundus oil and hydrocortisone did not differ significantly (p>0.05). However, statistically significant differences in the analgesic effect (P.05) were observed, favoring the oil. Cyperus rotundus essential oil is a safe and cost-effective treatment for post-laser pain and erythema.

MP43-15 PROVIDER VARIATION IN PAIN SCORES DURING FREEHAND TRANSPERINEAL PROSTATE BIOPSY UNDER LOCAL ANESTHESIA

You have accessJournal of UrologyProstate Cancer: Detection & Screening IV (MP43)1 Sep 2021MP43-15 PROVIDER VARIATION IN PAIN SCORES DURING FREEHAND TRANSPERINEAL PROSTATE BIOPSY UNDER LOCAL ANESTHESIA Ajith Dupati, Ji Qi, Stephanie Ferrante, John M. DiBianco, Adam Walker, John T. Wei, Chandy Ellimoottil, Lindsey A. Herrel, Richard C. Wu, Arvin K. George, and Brian R. Stork Ajith DupatiAjith Dupati More articles by this author , Ji QiJi Qi More articles by this author , Stephanie FerranteStephanie Ferrante More articles by this author , John M. DiBiancoJohn M. DiBianco More articles by this author , Adam WalkerAdam Walker More articles by this author , John T. WeiJohn T. Wei More articles by this author , Chandy EllimoottilChandy Ellimoottil More articles by this author , Lindsey A. HerrelLindsey A. Herrel More articles by this author , Richard C. WuRichard C. Wu More articles by this author , Arvin K. GeorgeArvin K. George More articles by this author , and Brian R. StorkBrian R. Stork More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002064.15AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Transperineal prostate (TP) biopsy minimizes the risk of post-biopsy infectious complications. We aim to examine provider-level variation and factors associated with pain/discomfort during TP biopsy. METHODS: A standardized, immediate post-procedure patient-reported survey was administered to men undergoing TP biopsy. Patient-reported pain overall and for each subdomain including positioning, probe insertion, anesthetic administration, and prostate sampling were evaluated using the validated Wong-Baker FACES pain scale. Bivariate analyses were performed to determine association of age, race, BMI, and Charlson Comorbidity Index (CCI) with pain during biopsy. Provider-level variation was assessed for overall pain and at each portion of the procedure among urologists who performed at least 10 biopsies. RESULTS: A total of 198 patients undergoing TP biopsy with 8 urologists completed the survey. The median score for overall pain during the procedure was 4 (IQR 2-5), and anesthetic administration demonstrated the highest pain scores across all the subdomains (Median=3 [IQR 2-6]). Age, race, BMI, and CCI score were not significantly associated with overall pain scores. Provider-level variation for overall pain during TP biopsy is presented in Figure 1. Only during local anesthetic administration was significant variation observed across providers (Figure 2, p=0.012). CONCLUSIONS: In-office freehand TP biopsy under local anesthesia is well tolerated with only mild to moderate discomfort. Significant variation in pain scores during administration of local anesthesia exists between providers. Standardization and optimization of local anesthetic technique appears to offer the greatest opportunity to reduce patient reported pain scores during biopsy. Source of Funding: Data collected through the Michigan Urological Surgery Improvement Collaborative (MUSIC) which is funded by Blue Cross Blue Shield of Michigan (BCBSM) © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e787-e788 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ajith Dupati More articles by this author Ji Qi More articles by this author Stephanie Ferrante More articles by this author John M. DiBianco More articles by this author Adam Walker More articles by this author John T. Wei More articles by this author Chandy Ellimoottil More articles by this author Lindsey A. Herrel More articles by this author Richard C. Wu More articles by this author Arvin K. George More articles by this author Brian R. Stork More articles by this author Expand All Advertisement Loading ...

Virtual Reality: Is It Helping Children Cope with Fear and Pain During Vaccination?

BackgroundVirtual reality (VR) is an innovative distraction technology in health care, but little is known about this topic in Saudi Arabia. The aim of this study was to assess the effectiveness of using VR to reduce pain and fear among children during vaccination.MethodsIt is a cross-sectional study design. A total of 104 children (ages 4–6 years) receiving routine vaccinations in a single primary health care in Eastern Region, Saudi Arabia, participated in the study and grouped to a VR technology intervention group or vaccination as usual without VR distraction. The primary outcome is the difference in the child’s self-rated fear and pain scores between those who have been vaccinated with or without VR distraction, measured by the two validated international facial expressions scales Wong–Baker FACES Pain Scale and Children’s Fear Scale.ResultsIn the two-month study period, 53 children were vaccinated using the VR technology and 50 children were vaccinated without VR. Bivariate analysis showed a significantly lower pain score among the VR group (noverline {bf{it{x}}} n=1.36, SD 2.06) compared with the group without VR (noverline {bf{it{x}}} n=6.90, SD 3.47) (P-value < 0.001). Similarly, fear score was lower in the VR group (noverline {bf{it{x}}} n=0.64, SD 0.92) compared with the group without VR (noverline {bf{it{x}}} n=2.88, SD1.55) (P < 0.001). In multivariable regression models adjusted for age and gender, children vaccinated using the VR technology had significantly lower pain and fear scores compared with those who were vaccinated as usual without VR distraction.ConclusionVR technology showed a positive impact on reducing pain and fear among children aged 4–6 years during vaccination. Policymakers are encouraged to expand the use of this distraction tool in primary health centers to improve the vaccination experience among children.

Assessement of Pain Response during Caries Removal using Conventional Tungsten Carbide Bur and a Chemomechanical Caries Removal Agent (Brix Gel) : An In Vivo Study

Aim: The present study aimed to assess the pain response during caries removal using conventional tungsten carbide bur and a chemomechanical caries removal agent(CMCR) – Brix 3000 gel using Wong Baker Faces pain scale. Materials and methods: In this study twenty patients in the age group of 20 to 50 years with site 1 size 2 and 3(Mount and Hume’s classification) dentinal caries in the permanent maxillary and mandibular molars were randomly selected and distributed to 2 experimental groups. In Group A Tungsten carbide round burs was used while in Group B Brix 3000 gel was applied into the cavity for caries excavation. Dentin excavation was stopped until a hard dentin was detected with nonflexible blunt probe. Finally a caries detector dye is used to assess complete removal of infected dentin. Results: The scores obtained from the scale was analysed using Mann whitney U test which didn’t show any significant difference between the two methods of caries excavation. Conclusion: Although the results did not indicate marked difference in the pain perception, carious tissue removal using Brix 3000 gel can be used as an alternative to conventional drilling method as it removes only the carious dentine with less application of pressure. Key Words Caries Detector, Chemomechanical, Dental anxiety, Pain Perception, Papain, Tungsten Carbide.

Assessement of Pain Response during Caries Removal using Conventional Tungsten Carbide Bur and a Chemomechanical Caries Removal Agent (Brix Gel) : An In Vivo Study

Aim: The present study aimed to assess the pain response during caries removal using conventional tungsten carbide bur and a chemomechanical caries removal agent(CMCR) – Brix 3000 gel using Wong Baker Faces pain scale. Materials and methods: In this study twenty patients in the age group of 20 to 50 years with site 1 size 2 and 3(Mount and Hume’s classification) dentinal caries in the permanent maxillary and mandibular molars were randomly selected and distributed to 2 experimental groups. In Group A Tungsten carbide round burs was used while in Group B Brix 3000 gel was applied into the cavity for caries excavation. Dentin excavation was stopped until a hard dentin was detected with nonflexible blunt probe. Finally a caries detector dye is used to assess complete removal of infected dentin. Results: The scores obtained from the scale was analysed using Mann whitney U test which didn’t show any significant difference between the two methods of caries excavation. Conclusion: Although the results did not indicate marked difference in the pain perception, carious tissue removal using Brix 3000 gel can be used as an alternative to conventional drilling method as it removes only the carious dentine with less application of pressure. Key Words Caries Detector, Chemomechanical, Dental anxiety, Pain Perception, Papain, Tungsten Carbide.

Use of Virtual Reality Distraction to Reduce Child Pain and Fear during Painful Medical Procedures in Children with Physical Disabilities in Uganda: A Feasibility Study.

This study explored the acceptability and feasibility of the use of low-cost virtual reality (VR) glasses, and the Wong-Baker Faces Pain Scale and Children's Fear Scale scales, for pain and fear reduction in children admitted at the septic ward of CoRSU Rehabilitation Hospital in Uganda. In total, 79 children aged 4-17 years of age were offered to watch cartoons using VR glasses while undergoing painful dressing procedures. Before and after the procedure, children were asked to index current pain; children and their caregivers were asked to rate anticipated fear. Focus group discussions with 13 children, 10 caregivers and 9 nurses explored acceptability and feasibility. Quantitative data were analyzed using STATA15, NVIVO12 was used for qualitative data analysis. The VR glasses were accepted by 76 (96%) of the children. Children, caregivers, and nurses mentioned the glasses were helpful in distracting children from the medical procedure and felt the use of the glasses helped reduce child fear and pain. Nurses felt it made their work easier. The Wong-Baker Faces Pain Scale was an acceptable and feasible method to measure pain, while the Children's Fear Scale was more difficult to interpret for our study population as they felt the faces on the scale were hard to read and identify with. The use of VR glasses may offer an acceptable and effective pain and fear reduction method in resource-constrained settings and should be further explored in a randomized controlled trial.

Hypnosis and progressive muscle relaxation for anxiolysis and pain control during extraction procedure in 8-12-year-old children: a randomized control trial.

IntroductionHypnosis (H) and Progressive Muscle Relaxation (PMR) have proven to be effective in a variety of medical settings; there is a paucity of their practical application in paediatric dentistry. The study aimed to comparatively evaluate the role of H and PMR on anxiety, heart rate (HR), oxygen saturation (SPO2), blood pressure (BP), pain, and analgesic requirement during extraction in children.Materials and methodsSixty children aged 8–12 years undergoing primary molar extractions were randomly allocated to three groups—H, PMR, and control (C). The anxiety (proposed Visual Facial Anxiety scale), HR, and SPO2 were measured pre/post-operatively with/without interventions (H, PMR, C) at 4 intervals. The BP and pain (Wong-Baker faces pain scale) were recorded pre- and post-operatively. Need for analgesic post-operatively was assessed.ResultsStatistically significant reduction in anxiety was noted post-extraction in H (0.30 ± 0.80), PMR (0.50 ± 0.69) (p < 0.001*). HR showed a statistically significant drop after H, PMR application. (p < 0.001*) No significant difference in SPO2 was noted in the three groups (p > 0.05). Pain control was well achieved using H (85%), PMR (70%); BP was well-regulated in the H, PMR compared to C group (p < 0.001*). Need for analgesics was reduced in H (45%), PMR (50%) versus C (100%). Both techniques H, PMR were comparable in all measures.ConclusionHypnosis and PMR are effective techniques for anxiolysis and pain control in paediatric dental patients.