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Bernardes LS, Fernandes AM, de Carvalho MA, Ottolia J, Hamani M, Oliveira I, Kubota GT, Aparecida da Silva V, Veloso A, Burlachini de Cavalho MH, de Amorin Filho AG, Arenholt LTS, Leutscher PC, de Andrade DC. ASSESSMENT OF HUMAN FETUSES UNDERGOING ACUTE PAIN: VALIDATION OF THE FETAL-7 SCALE. J Pain 2024:104527. [PMID: 38599264 DOI: 10.1016/j.jpain.2024.104527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 03/24/2024] [Accepted: 04/02/2024] [Indexed: 04/12/2024]
Abstract
Improvements in fetal ultrasound have allowed for the diagnosis and treatment of fetal diseases in the uterus, often though surgery. However, little attention has been drawn to the assessment of fetal pain. To address this gap, a fetal pain scoring system, known as the Fetal-7 scale, was developed. The present study is a full validation of the Fetal-7 scale. The validation involved two steps: i. four fetuses with indication of surgery were evaluated in three conditions perioperatively: acute pain, rest, and under loud sound stimulation. Facial expressions were assessed by 30 raters using screenshots from 4D high-definition ultrasound films; ii., assessment of sensitivity and specificity of the Fetal-7 scale in 54 healthy fetuses and two fetuses undergoing acute pain after preoperative anesthetic intramuscular injection. There was high internal consistency with Cronbach's alpha (α) of 0.99. Intra-rater reliability of the Fetal-7 scale (test-retest) calculated by intraclass correlation coefficient (ICC) was 0.95, and inter-rater reliability was 0.99. The scale accurately differentiated between healthy fetuses at rest and those experiencing acute pain (sensitivity of 100% and specificity of 94.4%). The Fetal-7 scale is a valid tool for assessing acute pain-related behavior in third trimester fetuses and may be of value in guiding analgesic procedures efficacy in these patients. Further research is warranted to explore the presence of post-operative pain in fetuses and its effects afterbirth. PERSPECTIVE: Recordings with three-dimension ultrasound of human fetuses undergoing pre-operative anesthetic injections revealed complex facial expressions during acute pain, similar to those collected in newborns. This study presented the validation process and cut-off value of the Fetal-7 scale, paving the way for the study of pain before birth in humans.
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Affiliation(s)
- Lisandra Stein Bernardes
- Center for Clinical Research, North Denmark Regional Hospital, Hjoerring, Denmark; Gynecology and Obstetrics Department, University of Sao Paulo, Brazil; SEPACO Maternity Hospital, São Paulo, Brazil; Department of Gynecology and Obstetrics, North Denmark Regional Hospital, Hjoerring, Denmark.
| | - Ana Mércia Fernandes
- Pain Center, Department of Neurology, University of Sao Paulo, Brazil; Center for Clinical Research, North Denmark Regional Hospital, Hjoerring, Denmark
| | - Mariana Azevedo de Carvalho
- Gynecology and Obstetrics Department, University of Sao Paulo, Brazil; SEPACO Maternity Hospital, São Paulo, Brazil
| | - Juliana Ottolia
- Gynecology and Obstetrics Department, University of Sao Paulo, Brazil; SEPACO Maternity Hospital, São Paulo, Brazil
| | - Michele Hamani
- Pain Center, Department of Neurology, University of Sao Paulo, Brazil
| | - Inaeh Oliveira
- Pain Center, Department of Neurology, University of Sao Paulo, Brazil
| | | | | | - Adriano Veloso
- Computational Science Department, Universidade Federal de Minas Gerais, Brazil
| | | | | | - Louise Thomsen Schmidt Arenholt
- Center for Clinical Research, North Denmark Regional Hospital, Hjoerring, Denmark; Department of Gynecology and Obstetrics, North Denmark Regional Hospital, Hjoerring, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Peter Christian Leutscher
- Center for Clinical Research, North Denmark Regional Hospital, Hjoerring, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Daniel Ciampi de Andrade
- Center for Neuroplasticity and Pain, Health Science and Technology, Faculty of Medicine, Aalborg University, Denmark; Pain Center, Department of Neurology, University of Sao Paulo, Brazil
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Gofeld M, Smith KJ, Bhatia A, Djuric V, Leblang S, Rebhun N, Aginsky R, Miller E, Skoglind B, Hananel A. Fluoroscopy-guided high-intensity focused ultrasound neurotomy of the lumbar zygapophyseal joints: a prospective, open-label study. Reg Anesth Pain Med 2024:rapm-2024-105345. [PMID: 38580339 DOI: 10.1136/rapm-2024-105345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 03/22/2024] [Indexed: 04/07/2024]
Abstract
OBJECTIVE The objective of this study is to investigate safety and effectiveness of a fluoroscopy-guided high-intensity focused ultrasound (HIFU) system for thermal ablation of the lumbar medial branch nerves. METHODS This dual center prospective cohort study enrolled 30 participants with lumbar zygapophyseal joint syndrome. Each participant previously had a positive response to either a single diagnostic analgesic block or radiofrequency ablation (RFA). The primary effectiveness outcome was individual responder rate, defined as a reduction of two points or more on the pain intensity numerical rating scale without an increase in opioid intake, or a reduction in opioid intake without an increase in pain at 6 months after the intervention. The primary safety outcome was procedure-related or device-related adverse events (AEs). Secondary outcome variables included MRI evidence of tissue ablation, Oswestry Disability Index, 12-Item Short Form Health Survey, Brief Pain Inventory, and Patient Global Impression of Change. RESULTS The individual responder rate was 89.7% at 2 days, 89.7% at 7 days, 72.4% at 14 days, 82.1% at 30 days, 59.3% at 90 days and 82.6% at 180 days. The average Numeric Rating Scale for pain severity decreased from 7.1 at baseline to 3.0 (N=29) after 2 days, 3.0 (N=29) after 7 days, 3.1 (N=29) after 14 days, 3.2 (N=28) after 30 days, 4.3 (N=27) after 90 days, and 3.3 (N=23) after 180 days. All participants tolerated the procedure well with no significant side effects or complications. CONCLUSIONS Fluoroscopy-guided HIFU neurotomy achieved clinical responses comparable with RFA, and there were no significant device-related or procedure-related AEs. TRIAL REGISTRATION NUMBER NCT04129034.
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Affiliation(s)
| | | | - Anuj Bhatia
- Anesthesia and Pain Management, University of Toronto and University Health Network - Toronto Western Hospital, Toronto, Ontario, Canada
| | - Vladimir Djuric
- McMaster University Medical Centre, Hamilton, Ontario, Canada
| | - Suzanne Leblang
- Focused Ultrasound Foundation, Charlottesville, Virginia, USA
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Suhaini NAM, Pauzi MF, Juhari SN, Bakar NAA, Moon JY. Evaluation of the antinociceptive activities of natural propolis extract derived from stingless bee Trigona thoracica in mice. Korean J Pain 2024; 37:141-150. [PMID: 38557655 PMCID: PMC10985486 DOI: 10.3344/kjp.23318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 01/11/2024] [Accepted: 01/11/2024] [Indexed: 04/04/2024] Open
Abstract
Background : Stingless bee propolis is a popular traditional folk medicine and has been employed since ancient times. This study aimed to evaluate the antinociceptive activities of the chemical constituents of aqueous propolis extract (APE) collected by Trigona thoracica in a nociceptive model in mice. Methods : The identification of chemical constituents of APE was performed using high-performance liquid chromatography (HPLC). Ninety-six male Swiss mice were administered APE (400 mg/kg, 1,000 mg/kg, and 2,000 mg/kg) before developing nociceptive pain models. Then, the antinociceptive properties of each APE dose were evaluated in acetic acid-induced abdominal constriction, hot plate test, and formalin-induced paw licking test. Administration of normal saline, acetylsalicylic acid (ASA, 100 mg/kg, orally), and morphine (5 mg/kg, intraperitoneally) were used for the experiments. Results : HPLC revealed that the APE from Trigona thoracica contained p-coumaric acid (R2 = 0.999) and caffeic acid (R2 = 0.998). Although all APE dosages showed inhibition of acetic acid-induced abdominal constriction, only 2,000 mg/kg was comparable to the result of ASA (68.7% vs. 73.3%, respectively). In the hot plate test, only 2,000 mg/kg of APE increased the latency time significantly compared to the control. In the formalin test, the durations of paw licking were significantly reduced at early and late phases in all APE groups with a decrease from 45.1% to 53.3%. Conclusions : APE from Trigona thoracica, containing p-coumaric acid and caffeic acid, exhibited antinociceptive effects, which supports its potential use in targeting the prevention or reversal of central and peripheral sensitization that may produce clinical pain conditions.
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Affiliation(s)
| | - Mohd Faeiz Pauzi
- Faculty of Medicine, Universiti Sultan Zainal Abidin, Kuala Terengganu, Malaysia
- Department of Anaesthesiology and Intensive Care, Hospital Pengajar Universiti Sultan Zainal Abidin, Kuala Nerus, Malaysia
| | | | | | - Jee Youn Moon
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea
- Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Korea
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Lirk P, Schreiber KL. Lessons learnt in evidence-based perioperative pain medicine: changing the focus from the medication and procedure to the patient. Reg Anesth Pain Med 2024:rapm-2023-105235. [PMID: 38355216 DOI: 10.1136/rapm-2023-105235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 02/01/2024] [Indexed: 02/16/2024]
Abstract
Over time, the focus of evidence-based acute pain medicine has shifted, from a focus on drugs and interventions (characterized by numbers needed to treat), to an appreciation of procedure-specific factors (characterized by guidelines and meta-analyses), and now anesthesiologists face the challenge to integrate our current approach with the concept of precision medicine. Psychometric and biopsychosocial markers can potentially guide clinicians on who may need more aggressive perioperative pain management, or who would respond particularly well to a given analgesic intervention. The challenge will be to identify an easily assessable set of parameters that will guide perioperative physicians in tailoring the analgesic strategy to procedure and patient.
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Affiliation(s)
- Philipp Lirk
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Kristin L Schreiber
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Park I, Park JH, Shin HJ, Na HS, Koo BW, Ryu JH, Oh AY. Postoperative analgesic effects of the quadratus lumborum block in pediatric patients: a systematic review and meta-analysis. Korean J Pain 2024; 37:59-72. [PMID: 38123185 PMCID: PMC10764215 DOI: 10.3344/kjp.23268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 11/22/2023] [Accepted: 12/04/2023] [Indexed: 12/23/2023] Open
Abstract
Background This study assessed the postoperative analgesic efficacy and safety of the quadratus lumborum block (QLB) in pediatric patients. Methods Electronic databases were searched for studies comparing the QLB to conventional analgesic techniques in pediatric patients. The primary outcome was the need for rescue analgesia 12 and 24 hours after surgery. Secondary outcomes covered the Face-Legs-Activity-Cry-Consolability Scale (FLACC) scores at various time points; parental satisfaction; time to the first rescue analgesia; hospitalization time; block execution time; block failure rates, and adverse events. Results Sixteen randomized controlled trials were analyzed involving 1,061 patients. The QLB significantly reduced the need for rescue analgesia both at 12 and 24 hours after surgery (12 hours, relative risk [RR]: 0.45; 95% confidence interval [CI]: 0.01, 0.88; 24 hours, RR: 0.51; 95% CI: 0.31, 0.70). In case of 24 hours after surgery, type 1 QLB significantly reduced the need for rescue analgesia (RR: 0.56; 95% CI: 0.36, 0.76). The QLB also exhibited lower FLACC scores at 1 hour (standardized mean difference [SMD]: -0.87; 95% CI: -1.56, -0.18) and 6 hours (SMD: -1.27; 95% CI: -2.33, -0.21) following surgery when compared to non-QLB. Among QLBs, type 2 QLB significantly extended the time until the first rescue analgesia (SMD: 1.25; 95% CI: 0.84, 1.67). No significant differences were observed in terms of parental satisfaction, hospitalization time, block execution time, block failure, or adverse events between QLB and non-QLB groups. Conclusions The QLB provides non-inferior analgesic efficacy and safety to conventional methods in pediatric patients.
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Affiliation(s)
- Insun Park
- Department of Anaesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jae Hyon Park
- Department of Radiology, The Armed Forces Daejeon Hospital, Daejeon, Korea
| | - Hyun-Jung Shin
- Department of Anaesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hyo-Seok Na
- Department of Anaesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Bon-Wook Koo
- Department of Anaesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jung-Hee Ryu
- Department of Anaesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Anaesthesiology and Pain Medicine, Seoul National University College of Medicines, Seoul, Korea
| | - Ah-Young Oh
- Department of Anaesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Anaesthesiology and Pain Medicine, Seoul National University College of Medicines, Seoul, Korea
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Hajhashemi V, Sadeghi H, Madab FK. Anti-inflammatory and antinociceptive effects of sitagliptin in animal models and possible mechanisms involved in the antinociceptive activity. Korean J Pain 2024; 37:26-33. [PMID: 38123184 PMCID: PMC10764209 DOI: 10.3344/kjp.23262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 11/24/2023] [Accepted: 12/03/2023] [Indexed: 12/23/2023] Open
Abstract
Background Sitagliptin is an antidiabetic drug that inhibits dipeptidyl peptidase-4 enzyme. This study aimed to investigate the antinociceptive and anti-inflammatory effects of sitagliptin in formalin and carrageenan tests and determine the possible mechanism(s) of its antinociceptive activity. Methods Male Swiss mice (25-30 g) and male Wistar rats (180-220 g) were used for formalin and carrageenan tests, respectively. In the formalin test, paw licking time and in the carrageenan test, paw thickness were considered as indexes of pain behavior and inflammation respectively. Three doses of sitagliptin (2.5, 5, and 10 mg/kg) were used in these tests. Also, several antagonists and enzyme inhibitors were used to evaluate the role of adrenergic, serotonergic, dopaminergic, and opioid receptors as well as the NO/cGMP/KATP pathway in the antinociceptive effect of sitagliptin (5 mg/kg). Results Sitagliptin showed significant antinociceptive and anti-inflammatory effects in the formalin and carrageenan tests respectively. In the carrageenan test, all three doses of sitagliptin significantly (P < 0.001) reduced paw thickness. Pretreatment with yohimbine, prazosin, propranolol, naloxone, and cyproheptadine could not reverse the antinociceptive effect of sitagliptin (5 mg/Kg), which indicates that adrenergic, opioid, and serotonin receptors (5HT2) are not involved in the antinociceptive effects. L-NAME, methylene blue, glibenclamide, ondansetron, and sulpiride were able to reverse this effect. Conclusions NO/cGMP/KATP, 5HT3 and D2 pathways play an important role in the antinociceptive effect of sitagliptin. Additionally significant anti-inflammatory effects observed in the carrageenan test might contribute in reduction of pain response in the second phase of the formalin test.
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Affiliation(s)
- Valiollah Hajhashemi
- Department of Pharmacology and Isfahan Pharmaceutical Sciences Research Center, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hossein Sadeghi
- Department of Pharmacology, Faculty of Medicine, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Fatemeh Karimi Madab
- Department of Pharmacology and Isfahan Pharmaceutical Sciences Research Center, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
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Ansanello W, Dos Reis FJJ, Tozzo MC, Zatiti SCA, Meulders A, Vlaeyen JWS, de Oliveira AS. Reliability and Validity of the Avoidance of Daily Activities Photo Scale for Patients With Shoulder Pain (ADAP Shoulder Scale). Phys Ther 2023; 103:pzad101. [PMID: 37690060 DOI: 10.1093/ptj/pzad101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 05/08/2023] [Accepted: 07/16/2023] [Indexed: 09/12/2023]
Abstract
OBJECTIVE The Avoidance of Daily Activities Photo Scale for Patients With Shoulder Pain (ADAP Shoulder Scale) was developed to assess pain-related avoidance behavior during daily activities in people with shoulder pain. However, its measurement properties must be verified according to international guidelines. As such, this study investigated the following 4 measurement properties of the ADAP Shoulder Scale: reliability, measurement errors, convergent validity, and floor and ceiling effects. METHODS The sample comprised 100 individuals with chronic shoulder pain (43 men and 57 women; mean duration of symptoms of 29.7 [SD = 89.0] months; mean age of 44.9 [SD = 15.9] years). The mean test-retest reliability range was 5 days via the intraclass correlation coefficient (ICC). Measurement errors included the standard error of measurement and the minimal detectable change. Convergent validity was analyzed by applying the Pearson correlation with the Tampa Scale for Kinesiophobia, Pain Catastrophizing Scale, and Shoulder Pain and Disability Index. RESULTS The ADAP Shoulder Scale showed excellent test-retest reliability, both in all domains and in the total score [ICC(2,1) = 0.94; 95% CI = 0.92-0.96]. The standard errors of measurement for the free-movement, high-effort, and self-care domains were 8.1%, 6.0%, and 7.6%, respectively. The minimal detectable change for the total score of the ADAP Shoulder Scale was 16.0%. The total score of the ADAP Shoulder Scale was low to moderately correlated with the total scores of the Tampa Scale for Kinesiophobia (r = 0.52), Pain Catastrophizing Scale (r = 0.30), and Shoulder Pain and Disability Index (r = 0.72). No floor or ceiling effects were detected in the total score. CONCLUSION The ADAP Shoulder Scale is a reliable, valid instrument for assessing avoidance behavior in adults who have chronic shoulder pain and are not athletes. IMPACT This study provides evidence that the ADAP Shoulder Scale is appropriate for clinical and practical use in people with chronic shoulder pain.
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Affiliation(s)
- Walter Ansanello
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Felipe José Jandre Dos Reis
- Physical Therapy Department, Instituto Federal do Rio de Janeiro (IFRJ), Postgraduation Program - Clinical Medicine Department of Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
- Pain in Motion Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Marcela Camargo Tozzo
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Salomão Chade Assan Zatiti
- Department of Orthopaedic Surgery, Hospital Especializado de Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil
| | - Ann Meulders
- Research Group Health Psychology, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- Experimental Health Psychology, Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands
| | - Johan W S Vlaeyen
- Research Group Health Psychology, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- Experimental Health Psychology, Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands
| | - Anamaria Siriani de Oliveira
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
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Orhurhu V, Hussain N, Karri J, Mariano ER, Abd-Elsayed A. Perioperative and anesthetic considerations for the management of neuromodulation systems. Reg Anesth Pain Med 2023; 48:327-336. [PMID: 37080581 DOI: 10.1136/rapm-2022-103660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 10/04/2022] [Indexed: 04/22/2023]
Abstract
The use of neuromodulation systems is increasing for the treatment of various pathologies ranging from movement disorders to urinary incontinence to chronic pain syndromes. While the type of neuromodulation devices varies, they are largely categorized as intracranial (eg, deep brain stimulation), neuraxial (eg, spinal cord stimulation, dorsal root ganglion stimulation, and intrathecal drug delivery systems), or peripheral (eg, sacral nerve stimulation and peripheral nerve stimulation) systems. Given the increasing prevalence of these systems in the overall population, it is important for anesthesiologists, surgeons, and the perioperative healthcare team to familiarize themselves with these systems and their unique perioperative considerations. In this review, we explore and highlight the various neuromodulation systems, their general perioperative considerations, and notable special circumstances for perioperative management.
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Affiliation(s)
- Vwaire Orhurhu
- Anesthesiology, University of Pittsburgh Medical Center, Williamsport, Pennsylvania, USA
- Pain Medicine, MVM Health, East Stroudsburg, Pennsylvania, USA
| | - Nasir Hussain
- Department of Anesthesiology, Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Jay Karri
- Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas, USA
| | - Edward R Mariano
- Anesthesiology and Perioperative Care Service, VA Palo Alto Health Care System, Palo Alto, California, USA
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Alaa Abd-Elsayed
- Department of Anesthesia, Divsion of Pain Medicine, University of Wisconsin Madison School of Medicine and Public Health, Madison, Wisconsin, USA
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Li J, Wen Z, Lou Y, Chen J, Gao L, Li X, Wang F. Soluble epoxide hydrolase inhibitor promotes the healing of oral ulcers. Clinics (Sao Paulo) 2023; 78:100208. [PMID: 37148830 DOI: 10.1016/j.clinsp.2023.100208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 04/14/2023] [Accepted: 04/18/2023] [Indexed: 05/08/2023] Open
Abstract
OBJECTIVE Oral ulcers are a lesion in the oral mucosa that impacts chewing or drinking. Epoxyeicosatrienoic Acids (EETs) have enhanced angiogenic, regenerative, anti-inflammatory, and analgesic effects. The present study aims to evaluate the effects of 1-Trifluoromethoxyphenyl-3-(1-Propionylpiperidin-4-yl) Urea (TPPU), a soluble epoxide hydrolase inhibitor for increasing EETs level, on the healing of oral ulcers. METHODS The chemically-induced oral ulcers were established in Sprague Dawley rats. The ulcer area was treated with TPPU to evaluate the healing time and pain threshold of ulcers. The expression of angiogenesis and cell proliferation-related protein in the ulcer area was detected using immunohistochemical staining. The effects of TPPU on migration and angiogenesis capability were measured with scratch assay and tube formation. RESULTS Compared with the control group, TPPU promoted wound healing of oral ulcers with a shorter healing time, and raised pain thresholds. Immunohistochemical staining showed that TPPU increased the expression of angiogenesis and cell proliferation-related protein with reduced inflammatory cell infiltration in the ulcer area. TPPU enhanced cell migration and tube-forming potential in vitro. CONCLUSIONS The present results support the potential of TPPU with multiple biological effects for the treatment of oral ulcers by targeting soluble epoxide hydrolase.
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Affiliation(s)
- Juanjuan Li
- School of Stomatology, Dalian Medical University, Dalian, China; The Affiliated Stomatological Hospital of Dalian Medical University School of Stomatology, Dalian, China
| | - Zihan Wen
- School of Stomatology, Dalian Medical University, Dalian, China
| | - Yue Lou
- School of Stomatology, Dalian Medical University, Dalian, China
| | - Jili Chen
- School of Stomatology, Dalian Medical University, Dalian, China; Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Lu Gao
- School of Stomatology, Dalian Medical University, Dalian, China; The Affiliated Stomatological Hospital of Dalian Medical University School of Stomatology, Dalian, China; Academician Laboratory of Immune and Oral Development & Regeneration, Dalian Medical University, Dalian, China
| | - Xiaojie Li
- School of Stomatology, Dalian Medical University, Dalian, China; The Affiliated Stomatological Hospital of Dalian Medical University School of Stomatology, Dalian, China.
| | - Fu Wang
- School of Stomatology, Dalian Medical University, Dalian, China; The Affiliated Stomatological Hospital of Dalian Medical University School of Stomatology, Dalian, China; Academician Laboratory of Immune and Oral Development & Regeneration, Dalian Medical University, Dalian, China.
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Zinboonyahgoon N, Luansritisakul C. Neuropathic pain feature in cancer-induced bone pain: does it matter? a prospective observational study. Korean J Pain 2023; 36:253-267. [PMID: 36973971 PMCID: PMC10043784 DOI: 10.3344/kjp.22392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 02/13/2023] [Accepted: 02/25/2023] [Indexed: 03/29/2023] Open
Abstract
Background Cancer-induced bone pain (CIBP) is considered to have both nociceptive and neuropathic components. However, the prevalence, risk factors, and impact of the neuropathic components are yet poorly understood. Methods We estimate the prevalence of neuropathic pain (NP) features in patients with CIBP at a tertiary care pain clinic setting using the Douleur Neuropathique 4 questionnaire and evaluate their associated factors and their impact after 4 weeks of treatment using the Brief Pain Inventory questionnaire and the Edmonton Symptom Assessment System. Results A total of 133 patients were recruited. The estimated prevalence of NP was 30.8% (95% confidence interval: 23.6%-39.1%). Initially, the patients with NP had significantly higher average pain scores (6.00 vs. 5.05, P = 0.006), higher total interference scores (5.84 vs. 4.89, P = 0.033), and symptom distress scores (35.88 vs. 26.52, P = 0.002). After 4 weeks of treatment, patients in both groups reported significantly decreased pain intensity and improved quality of life. However, the patients with NP still reported significantly higher average pain (4.61 vs. 3.58, P = 0.048), trending toward higher total interference scores (3.52 vs. 2.99, P = 0.426), and symptom distress scores (23.30 vs. 20.77, P = 0.524). From multivariate analysis, the independent risk factors for NP were younger age, pain in the extremities, and higher average pain scores. Conclusions NP are common in patients with CIBP. These conditions negatively affect pain intensity and the patient's quality of life before and after treatment.
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Affiliation(s)
- Nantthasorn Zinboonyahgoon
- Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Choopong Luansritisakul
- Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Bellosta-López P, Doménech-García V, Palsson TS, Herrero P, Christensen SWM. Long-term consistency of clinical sensory testing measures for pain assessment. Korean J Pain 2023; 36:173-183. [PMID: 36973968 PMCID: PMC10043786 DOI: 10.3344/kjp.23011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 03/08/2023] [Accepted: 03/10/2023] [Indexed: 03/29/2023] Open
Abstract
Background Understanding the stability of quantitative sensory tests (QSTs) over time is important to aid clinicians in selecting a battery of tests for assessing and monitoring patients. This study evaluated the short- and long-term reliability of selected QSTs. Methods Twenty healthy women participated in three experimental sessions: Baseline, 2 weeks, and 6 months. Measurements included pressure pain thresholds (PPT) in the neck, upper back, and leg; Pressure-cuff pain tolerance around the upper-arm; conditioned pain modulation during a pressure-cuff stimulus; and referred pain following a suprathreshold pressure stimulation. Intraclass correlation coefficients (ICC) and minimum detectable change (MDC) were calculated. Results Reliability for PPT was excellent for all sites at 2 weeks (ICC, 0.96-0.99; MDC, 22-55 kPa) and from good to excellent at 6 months (ICC, 0.88-0.95; MDC, 47-91 kPa). ICC for pressure-cuff pain tolerance indicated excellent reliability at both times (0.91-0.97). For conditioned pain modulation, reliability was moderate for all sites at 2 weeks (ICC, 0.57-0.74; MDC, 24%-35%), while it was moderate at the neck (ICC, 0.54; MDC, 27%) and poor at the upper back and leg at 6 months. ICC for referred pain areas was excellent at 2 weeks (0.90) and good at 6 months (0.86). Conclusions PPT, pressure pain tolerance, and pressure-induced referred pain should be considered reliable procedures to assess the pain-sensory profile over time. In contrast, conditioned pain modulation was shown to be unstable. Future studies prospectively analyzing the pain-sensory profile will be able to better calculate appropriate sample sizes.
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Affiliation(s)
| | | | - Thorvaldur Skuli Palsson
- Department of Physiotherapy and Occupational Therapy, Aalborg University Hospital, Aalborg, Denmark
| | - Pablo Herrero
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
| | - Steffan Wittrup Mcphee Christensen
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
- Department of Physiotherapy, University College of Northern Denmark, Aalborg, Denmark
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12
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Gumuscu BH, Kisa EP, Kara Kaya B, Muammer R. Comparison of three different exercise trainings in patients with chronic neck pain: a randomized controlled study. Korean J Pain 2023; 36:242-252. [PMID: 36941087 PMCID: PMC10043788 DOI: 10.3344/kjp.22371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 02/06/2023] [Accepted: 02/25/2023] [Indexed: 03/22/2023] Open
Abstract
Background 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. Methods 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. Results 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. Conclusions 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.
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Affiliation(s)
- Besta Hazal Gumuscu
- Department of Physiotheraphy and Rehabilitation, Institute of Health Sciences, Yeditepe University, Istanbul, Turkiye
| | - Eylul Pinar Kisa
- Department of Physiotherapy and Rehabilitation, Faculty of Health Science, Biruni University, Istanbul, Turkiye
| | - Begum Kara Kaya
- Department of Physiotherapy and Rehabilitation, Faculty of Health Science, Biruni University, Istanbul, Turkiye
| | - Rasmi Muammer
- Department of Physiotherapy and Rehabilitation, Faculty of Health Science, Yeditepe University, Istanbul, Turkiye
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13
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Şentürk İA, Şentürk E, Üstün I, Gökçedağ A, Yıldırım NP, İçen NK. High-impact chronic pain: evaluation of risk factors and predictors. Korean J Pain 2023; 36:84-97. [PMID: 36581599 PMCID: PMC9812691 DOI: 10.3344/kjp.22357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/12/2022] [Accepted: 12/16/2022] [Indexed: 12/31/2022] Open
Abstract
Background The concept of high-impact chronic pain (HICP) has been proposed for patients with chronic pain who have significant limitations in work, social life, and personal care. Recognition of HICP and being able to distinguish patients with HICP from other chronic pain patients who do not have life interference allows the necessary measures to be taken in order to restore the physical and emotional functioning of the affected persons. The aim was to reveal the risk factors and predictors associated with HICP. Methods Patients with chronic pain without life interference (grade 1 and 2) and patients with HICP were compared. Significant data were evaluated with regression analysis to reveal the associated risk factors. Receiving operating characteristic (ROC) analysis was used to evaluate predictors and present cutoff scores. Results One thousand and six patients completed the study. From pain related cognitive processes, fear of pain (odds ratio [OR], 0.92; 95% confidence interval [CI], 0.87-0.98; P = 0.007) and helplessness (OR, 1.06; 95% CI, 1.01-1.12; P = 0.018) were found to be risk factors associated with HICP. Predictors of HICP were evaluated by ROC analysis. The highest discrimination value was found for pain intensity (cut-off score > 6.5; 83.8% sensitive; 68.7% specific; area under the curve = 0.823; P < 0.001). Conclusions This is the first study in our geography to evaluate HICP with measurement tools that evaluate all dimensions of pain. Moreover, it is the first study in the literature to evaluate predictors and cut-off scores using ROC analysis for HICP.
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Affiliation(s)
- İlteriş Ahmet Şentürk
- Department of Pain Medicine, Bagcilar Education and Research Hospital, Istanbul, Turkiye
| | - Erman Şentürk
- Department of Psychiatry, Üsküdar University NP Feneryolu Medical Center, Istanbul, Turkiye,Correspondence: Erman Şentürk Department of Psychiatry, Üsküdar University NP Feneryolu Medical Center, Ahmet Mithat Efendi Cad. No:17 (Bağdat Cad. Sahil Yolu Kalamış Mevkii) - 34726 Fenerbahçe – Kadıköy, Istanbul, Turkiye, Tel: +902164181500, Fax: +902164181530, E-mail:
| | - Işıl Üstün
- Department of Physical Medicine and Rehabilitation, Dr. Sadi Konuk Education and Research Hospital, Istanbul, Turkiye
| | - Akın Gökçedağ
- Department of Neurosurgery, Dr. Sadi Konuk Education and Research Hospital, Istanbul, Turkiye
| | - Nilgün Pulur Yıldırım
- Department of Neurology, Bagcilar Education and Research Hospital, Istanbul, Turkiye
| | - Nilüfer Kale İçen
- Department of Neurology, Bagcilar Education and Research Hospital, Istanbul, Turkiye
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14
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Holder CR, Schenker ML, Baker JL, Giordano NA. Defense and Veterans Pain Rating Scale scores associated with longer PROMIS measures. Reg Anesth Pain Med 2022:rapm-2022-104010. [PMID: 36517201 DOI: 10.1136/rapm-2022-104010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 11/29/2022] [Indexed: 12/15/2022]
Affiliation(s)
| | - Mara L Schenker
- Grady Memorial Hospital, Atlanta, Georgia, USA
- Department of Orthopaedics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - J'Lynn L Baker
- Mercer University School of Medicine, Macon, Georgia, USA
| | - Nicholas A Giordano
- Emory University Nell Hodgson Woodruff School of Nursing, Atlanta, Georgia, USA
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15
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Hajhashemi V, Khodarahmi G, Asadi P, Rajabi H. Evaluation of the antinociceptive effects of a selection of triazine derivatives in mice. Korean J Pain 2022; 35:440-446. [PMID: 36175343 PMCID: PMC9530681 DOI: 10.3344/kjp.2022.35.4.440] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 08/01/2022] [Accepted: 08/12/2022] [Indexed: 11/24/2022] Open
Abstract
Background The authors showed in a previous study that some novel triazine derivatives had an anti-inflammatory effect. The present study was designed to evaluate the antinociceptive effect of five out of nine compounds including two vanillin-triazine (5c and 5d) and three phenylpyrazole-triazine (10a, 10b, 10e) derivatives which showed the best anti-inflammatory effect. Methods Male Swiss mice (25–30 g) were used. To assess the antinociceptive effect, acetic acid-writhing, formalin, and hot plate tests were used after intraperitoneal injection of each compound. Results All compounds significantly (P < 0.001) reduced acetic acid-induced writhing at tested doses (50, 100, and 200 mg/kg). Also, the percent inhibition of writhing in the acetic acid test showed that at the maximum tested dose of these compounds (200 mg/kg), the order of potencies is as follows 10b > 10a > 10e > 5d > 5c. In the formalin test, compounds 5d, 10a, and 10e showed an antinociceptive effect in the acute phase and all compounds were effective in the chronic phase. In the hot plate test, compounds 5c, 5d, and 10a demonstrated an antinociceptive effect. Conclusions The results clearly showed that both vanillin-triazine and phenylpyrazole-triazine derivatives had an antinociceptive effect. Also, some compounds which showed activity in the early phase of formalin test as well as in the hot plate test could control acute pain in addition to chronic or inflammatory pain.
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Affiliation(s)
- Valiollah Hajhashemi
- Department of Pharmacology and Toxicology, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ghadamali Khodarahmi
- Department of Medicinal Chemistry, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parvin Asadi
- Department of Medicinal Chemistry, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamed Rajabi
- Department of Pharmacology and Toxicology, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
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16
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Doménech-García V, Peirotén AR, Imaz ML, Palsson TS, Herrero P, Bellosta-López P. Not just sensitization: sympathetic mechanisms contribute to expand experimental referred pain. Korean J Pain 2022; 35:240-249. [PMID: 35768979 PMCID: PMC9251400 DOI: 10.3344/kjp.2022.35.3.240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 03/09/2022] [Accepted: 03/22/2022] [Indexed: 01/09/2023] Open
Abstract
Background Widespread pain partially depends upon sensitization of central pain mechanisms. However, mechanisms controlling pain distribution are not completely known. The present study sought to assess skin temperature variations in the area of experimentally-induced pain and potential sex differences. Methods Pressure-pain thresholds (PPTs) were measured on the right infraspinatus muscle. At the end of Day 0, all participants performed an eccentric exercise of the shoulder external rotators to induce muscle soreness 24 hours after. On Day 1, participants indicated on a body chart the area of pain induced by 60 seconds of suprathreshold pressure stimulation (STPS; PPT + 20%) on the right infraspinatus muscle. Skin temperature variations in the area of referred pain were recorded with an infrared thermography camera, immediately before and after the STPS. Results Twenty healthy, pain-free individuals (10 females) participated. On Day 0, the pre-STPS temperature was higher than the post-STPS temperature on the arm (P = 0.001) and forearm (P = 0.003). On Day 1, the pre-STPS temperature was higher than the post-STPS temperature on the shoulder (P = 0.015), arm (P = 0.001), and forearm (P = 0.010). On Day 0, the temperature decrease after STPS in females was greater than in males on the forearm (P = 0.039). On Day 1, a greater temperature decrease was found amongst females compared with males at the shoulder (P = 0.018), arm (P = 0.046), and forearm (P = 0.005). Conclusions These findings indicate that sympathetic vasomotor responses contribute to expand pressure-induced referred pain, especially among females.
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Affiliation(s)
- Víctor Doménech-García
- Department of Physiotherapy, Faculty of Health Sciences, Universidad San Jorge, Villanueva de Gállego (Zaragoza), Spain
| | - Alberto Rubio Peirotén
- Department of Physiotherapy, Faculty of Health Sciences, Universidad San Jorge, Villanueva de Gállego (Zaragoza), Spain
| | - Miren Lecea Imaz
- Department of Physiotherapy, Faculty of Health Sciences, Universidad San Jorge, Villanueva de Gállego (Zaragoza), Spain
| | - Thorvaldur Skuli Palsson
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Pablo Herrero
- Department of Physiatry and Nursing, Faculty of Health Sciences, IIS Aragon, University of Zaragoza, Zaragoza, Spain
| | - Pablo Bellosta-López
- Department of Physiotherapy, Faculty of Health Sciences, Universidad San Jorge, Villanueva de Gállego (Zaragoza), Spain
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17
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Bleicher J, Brooke BS, Bayless K, Anderson Z, Beckstrom J, Zhang C, Presson AP, Huang LC, Buys MJ. Postoperative opioid prescribing, use and pain trends following general surgery procedures: a retrospective cohort study among veterans comparing non-opioid versus chronic opioid users. Reg Anesth Pain Med 2022; 47:rapm-2021-103382. [PMID: 35523480 PMCID: PMC10473845 DOI: 10.1136/rapm-2021-103382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 04/25/2022] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Understanding postoperative opioid use patterns among different populations is key to developing opioid stewardship programs. METHODS We performed a retrospective cohort study on opioid prescribing, use, and pain after general surgery procedures for patients cared for by a transitional pain service at a veterans administration hospital. Discharge opioid prescription quantity, 90-day opioid prescription, and patient reported outcome pain measures were compared between chronic opioid users and non-opioid users (NOU). Additionally, 90-day total opioid use was evaluated for NOU. RESULTS Of 257 patients, 34 (13%) were on chronic opioid therapy, over 50% had a mental health disorder, and 29% had a history and/or presence of a substance use disorder. NOU were prescribed a median (IQR) of 10 (7, 12) tablets at discharge, while chronic opioid users were prescribed 6 (0, 12) tablets (p<0.001). 90-day opioid prescription (not including baseline opioid prescription for chronic users) was 10 (7, 15) and 6 (0, 12) tablets, respectively (p=0.001). There were no differences in changes in pain intensity or pain interference scores during recovery between groups. Median 90-day opioid use post discharge for NOU was 4 (0, 10) pills. DISCUSSION Non-opioid and chronic opioid users required very few opioid pills following surgery, and patients on chronic opioid therapy quickly returned to their baseline opioid use after a small opioid prescription at discharge. There was no difference in pain recovery between groups. Opioid prescribing guidelines should include patients on chronic opioid therapy and could consider recommending a more conservative prescribing approach.
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Affiliation(s)
- Josh Bleicher
- Surgery, University of Utah Health Hospitals and Clinics, Salt Lake City, Utah, USA
| | - Benjamin Sands Brooke
- Surgery, University of Utah Health Hospitals and Clinics, Salt Lake City, Utah, USA
- Surgery, VA Salt Lake City Health Care System, Salt Lake City, Utah, USA
| | - Kimberlee Bayless
- Anesthesiology, VA Salt Lake City Health Care System, Salt Lake City, Utah, USA
| | - Zachary Anderson
- Anesthesiology, VA Salt Lake City Health Care System, Salt Lake City, Utah, USA
| | - Julie Beckstrom
- Surgery, University of Utah Health Hospitals and Clinics, Salt Lake City, Utah, USA
| | - Chong Zhang
- Internal Medicine-Epidemiology, University of Utah Health Sciences Center, Salt Lake City, Utah, USA
| | - Angela P Presson
- Internal Medicine-Epidemiology, University of Utah Health Sciences Center, Salt Lake City, Utah, USA
| | - Lyen C Huang
- Surgery, University of Utah Health Hospitals and Clinics, Salt Lake City, Utah, USA
| | - Michael Jacob Buys
- Anesthesiology, University of Utah Health Hospitals and Clinics, Salt Lake City, Utah, USA
- Anesthesia, VA Salt Lake City Health Care System, Salt Lake City, Utah, USA
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18
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Kuhlmann L, Teo K, Olesen SS, Phillips AE, Faghih M, Tuck N, Afghani E, Singh VK, Yadav D, Windsor JA, Drewes AM. Development of the Comprehensive Pain Assessment Tool Short Form for Chronic Pancreatitis: Validity and Reliability Testing. Clin Gastroenterol Hepatol 2022; 20:e770-e783. [PMID: 34089847 DOI: 10.1016/j.cgh.2021.05.055] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 05/23/2021] [Indexed: 01/27/2023]
Abstract
BACKGROUND & AIMS Pain is the foremost complication to chronic pancreatitis (CP), but no validated questionnaires for assessment exist. The COMPAT questionnaire includes all relevant pain dimensions in CP, but a short form is needed to make it usable in clinical practice. METHODS The full COMPAT questionnaire was completed by 91 patients and systematically reduced to 6 questions. Pain severity and analgesic use were merged, leaving 5 pain dimensions. The pain dimension ratings were normalized to a 0-100 scale, and the weighted total score was calculated, where 3 dimensions were weighted double. Reliability of the short form was tested in a test-retest study in 76 patients, and concurrent validity tested against the Brief Pain Inventory and Izbicki pain questionnaire. Convergent validity was verified using confirmatory factor analysis, and criterion validity tested against quality-of-life and hospitalization rates. RESULTS The COMPAT-SF questionnaire consisted of the following pain dimensions: a) pain severity, b) pain pattern, c) factors provoking pain, d) widespread pain, and e) a qualitative pain-describing dimension. Quality of life correlated with the total score and all pain dimensions (P <.05). The total score, pain severity, pain pattern, and factors provoking pain were correlated with hospitalization rates (P <.05). The total score correlated with the Izbicki and Brief Pain Inventory scores (P <.0001). The reliability of the questionnaire in patients in a stable phase was good with an interclass correlation coefficient of 0.89. CONCLUSION The COMPAT-SF questionnaire includes the most relevant aspects of pain in CP and is a feasible, reliable, and valid pain assessment instrument recommended to be used in future trials.
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Affiliation(s)
- Louise Kuhlmann
- Centre for Pancreatic Diseases & Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark; Department of Internal Medicine, Randers Regional Hospital, Randers, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Keith Teo
- Department of Surgery, School of Medicine, Faculty of Medicine and Health Science, University of Auckland, New Zealand
| | - Søren Schou Olesen
- Centre for Pancreatic Diseases & Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Anna Edwards Phillips
- Division of Gastroenterology, Hepatology, and Nutrition, UPMC, Pittsburgh, Pennsylvania
| | - Mahya Faghih
- Division of Gastroenterology, Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Natalie Tuck
- The Auckland Regional Pain Service, Auckland District Health Board, Auckland, New Zealand
| | - Elham Afghani
- Division of Gastroenterology, Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Vikesh K Singh
- Division of Gastroenterology, Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Dhiraj Yadav
- Division of Gastroenterology, Hepatology, and Nutrition, UPMC, Pittsburgh, Pennsylvania
| | - John A Windsor
- Department of Surgery, School of Medicine, Faculty of Medicine and Health Science, University of Auckland, New Zealand
| | - Asbjørn Mohr Drewes
- Centre for Pancreatic Diseases & Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
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Sencan S, Yolcu G, Bilim S, Kenis-Coskun O, Gunduz OH. Comparison of treatment outcomes in chronic coccygodynia patients treated with ganglion impar blockade versus caudal epidural steroid injection: a prospective randomized comparison study. Korean J Pain 2022; 35:106-113. [PMID: 34966017 PMCID: PMC8728552 DOI: 10.3344/kjp.2022.35.1.106] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 10/05/2021] [Accepted: 10/06/2021] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Coccygodynia is one of the chronic, refractory painful musculoskeletal disorders. Interventional procedures are applied to patients unresponsive to initial treatment in coccygodynia. This study aims to compare the treatment outcomes of ganglion impar block (GIB) and caudal epidural steroid injection (CESI) in patients with chronic coccygodynia. METHODS This study was a prospective randomized comparison study conducted between June 2019 and January 2021. Patients diagnosed with chronic coccygodynia were randomly divided into two groups: the GIB group and the CESI group. The severity of pain, presence of neuropathic pain, and quality of life were evaluated using the Numeric Rating Scale, Leeds Assessment of the Neuropathic Symptoms and Signs Scale, and Short Form-12 Health Survey (SF-12), respectively. RESULTS A total of 34 patients in each group were included in the final analyses. While there was a significant decrease in pain intensity in both groups in the 3-month follow-up, this decrease was more significant in the GIB group at the 3rd week. There was a significant improvement in the SF-12 physical score and the number of patients with neuropathic pain in both groups in the 3rd week, but this improvement was not observed in the 3rd month. CONCLUSIONS Although GIB may provide more pain relief in short term, both GIB and CESI are useful treatment methods in coccygodynia unresponsive to more conservative treatments.
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Affiliation(s)
- Savas Sencan
- Division of Pain Medicine, Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Gunay Yolcu
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Serhad Bilim
- Pain Clinic, Adıyaman Education and Research Hospital, Adıyaman, Turkey
| | - Ozge Kenis-Coskun
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Osman Hakan Gunduz
- Division of Pain Medicine, Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Marmara University, Istanbul, Turkey
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20
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Fakhri S, Jafarian S, Majnooni MB, Farzaei MH, Mohammadi-Noori E, Khan H. Anti-nociceptive and anti-inflammatory activities of the essential oil isolated from Cupressus arizonica Greene fruits. Korean J Pain 2022; 35:33-42. [PMID: 34966010 PMCID: PMC8728547 DOI: 10.3344/kjp.2022.35.1.33] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/11/2021] [Accepted: 09/11/2021] [Indexed: 01/13/2023] Open
Abstract
Background Cupressus arizonica Greene is a coniferous tree with great importance in fragrance and pharmaceutical industries. Essential oils from C. arizonica (EC) have shown potential antioxidant, and anti-microbial activities. This study aimed at investigating the anti-nociceptive and anti-inflammatory effects/mechanisms of EC. Methods The EC was evaluated for anti-nociceptive and anti-inflammatory activities on male Wistar rats using a formalin test and carrageenan-induced paw edema, respectively. Also, we pre-treated some of the animals with naloxone and flumazenil in the formalin test to find out the possible contributions of opioid and benzodiazepine receptors to EC anti-nociceptive effects. Finally, gas chromatography/mass spectrometry (GC/MS) analysis was used to identify the EC’s constituents. Results EC in intraperitoneal doses of 0.5 and 1 g/kg significantly decrease the nociceptive responses in both early and late phases of the formalin test. From a mechanistic point of view, flumazenil administration 20 minutes before the most effective dose of EC (1 g/kg) showed a meaningful reduction in the associated anti-nociceptive responses during the early and late phases of the formalin test. Naloxone also reduced the anti-nociceptive role of EC in the late phase. Furthermore, EC at the doses of 1, 0.5, and 0.25 g/kg significantly reduced paw edema from 0.5 hours after carrageenan injection to 4 hours. GC/MS analysis showed that isolated EC is a monoterpene-rich oil with the major presence of α-pinene (71.92%), myrcene (6.37%), δ-3-carene (4.68%), β-pinene (3.71%), and limonene (3.34%). Conclusions EC showed potent anti-nociceptive and anti-inflammatory activities with the relative involvement of opioid and benzodiazepine receptors.
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Affiliation(s)
- Sajad Fakhri
- Pharmaceutical Sciences Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Safoora Jafarian
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Mohammad Hosein Farzaei
- Pharmaceutical Sciences Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ehsan Mohammadi-Noori
- Pharmaceutical Sciences Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Regenerative Medicine Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Haroon Khan
- Department of Pharmacy, Abdul Wali Khan University Mardan, Mardan, Pakistan
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Tiwari VK, Nanda S, Arya S, Kumar U, Sharma R, Kumaran SS, Bhatia R. Correlating cognition and cortical excitability with pain in fibromyalgia: a case control study. Adv Rheumatol 2021; 61:10. [PMID: 33602339 DOI: 10.1186/s42358-021-00163-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 01/02/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Fibromyalgia is a chronic pain disorder characterized by widespread musculoskeletal symptoms, primarily attributed to sensitization of somatosensory system carrying pain. Few reports have investigated the impact of fibromyalgia symptoms on cognition, corticomotor excitability, sleepiness, and the sleep quality - all of which can deteriorate the quality of life in fibromyalgia. However, the existing reports are underpowered and have conflicting directions of findings, limiting their generalizability. Therefore, the present study was designed to compare measures of cognition, corticomotor excitability, sleepiness, and sleep quality using standardized instruments in the recruited patients of fibromyalgia with pain-free controls. METHODS Diagnosed cases of fibromyalgia were recruited from the Rheumatology department for the cross-sectional, case-control study. Cognition (Mini-Mental State Examination, Stroop color-word task), corticomotor excitability (Resting motor threshold, Motor evoked potential amplitude), daytime sleepiness (Epworth sleepiness scale), and sleep quality (Pittsburgh sleep quality index) were studied according to the standard procedure. RESULTS Thirty-four patients of fibromyalgia and 30 pain-free controls were recruited for the study. Patients of fibromyalgia showed decreased cognitive scores (p = 0.05), lowered accuracy in Stroop color-word task (for color: 0.02, for word: 0.01), and prolonged reaction time (< 0.01, < 0.01). Excessive daytime sleepiness in patients were found (< 0.01) and worsened sleep quality (< 0.01) were found. Parameters of corticomotor excitability were comparable between patients of fibromyalgia and pain-free controls. CONCLUSIONS Patients of fibromyalgia made more errors, had significantly increased reaction time for cognitive tasks, marked daytime sleepiness, and impaired quality of sleep. Future treatment strategies may include cognitive deficits and sleep disturbances as an integral part of fibromyalgia management.
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Affiliation(s)
- Vikas Kumar Tiwari
- Pain Research and TMS Laboratory, Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Srishti Nanda
- Pain Research and TMS Laboratory, Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Suvercha Arya
- Pain Research and TMS Laboratory, Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Uma Kumar
- Department of Rheumatology, All India Institute of Medical Sciences, New Delhi, India
| | - Ratna Sharma
- Stress and Cognition Electroimaging Laboratory, Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Senthil S Kumaran
- Department of Nuclear Magnetic Resonance and MRI Facility, All India Institute of Medical Sciences, New Delhi, India
| | - Renu Bhatia
- Pain Research and TMS Laboratory, Department of Physiology, All India Institute of Medical Sciences, New Delhi, India.
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22
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Gholami M, Torabi Davan S, Gholami M, Bolandparvaz S, Gholami M, Chamanpara P, Shayan L. Effects of Topical Sesame Oil Extracted from Tahini ( Ardeh) on Pain Severity in Trauma Patients: A Randomized Double-Blinded Placebo-Controlled Clinical Trial. Bull Emerg Trauma 2020; 8:179-185. [PMID: 32944578 PMCID: PMC7468223 DOI: 10.30476/beat.2020.82561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Objective To investigate the effects of sesame oil extracted from tahini (Ardeh) on pain severity in patients with upper or lower limbs trauma. Methods This double-blinded randomized clinical trial study was conducted on 120 patients with upper or lower trauma in Shahid Rajaee Hospital, Shiraz, Iran, from May the 1st through November 30th, 2016. The patients were randomly assigned to two groups using block randomization. The intervention group received topical sesame oil extracted from tahini (Ardeh) and the placebo group received cooking oil. Pain severity, pain sensitivity and heaviness of painful site were assessed. Results Overall, we included 90 patients with traumatic limb injuries in this study who were randomized to two study groups. The mean age of the patients was 28.3 ± 6.8 (ranging from 25 to 35) years and there were 63 (70%) men and 27 (30%) women among the patients. In the sesame oil group, the mean changes in the pain severity (-1.53 ± 0.57, P<0.001), pain sensitivity (-1.45 ± 0.64, P<0.001) and heaviness of painful site (-1.56 ± 0.68, P<0.001) were significantly lower when compared to the placebo group in the second day of the intervention. None of the patients experience adverse drug effects. Conclusion Our findings suggest that the topical use of sesame oil extracted from Tahini has a pain reliever effect on the skin after bruising and it helps prevent skin discoloration in patients with traumatic injuries of limbs.
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Affiliation(s)
- Maryam Gholami
- Clinical Research Development Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sedigheh Torabi Davan
- Transplantation Unit, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Gholami
- Intensive Care Unit, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shahram Bolandparvaz
- Trauma Research Center, Department of Surgery, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehrnaz Gholami
- School of Management and Medical Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; Cognitive Neuroscience, Institute for Cognitive Science Studies, Shahid Beheshti University, Tehran, Iran; Cognitive Science (Brain, Mind, and Education), Shahid Chamran University of Ahvaz, Ahvaz, Iran
| | - Parisa Chamanpara
- Clinical Research Development Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Leila Shayan
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
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23
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Ersek M, Herr K, Hilgeman MM, Neradilek MB, Polissar N, Cook KF, Nash P, Snow AL, McDarby M, Nelson FX. Developing a Pain Intensity Measure for Persons with Dementia: Initial Construction and Testing. Pain Med 2020; 20:1078-1092. [PMID: 30285252 DOI: 10.1093/pm/pny180] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The goal of this study was to identify a limited set of pain indicators that were most predicive of physical pain. We began with 140 items culled from existing pain observation tools and used a modified Delphi approach followed by statistical analyses to reduce the item pool. METHODS Through the Delphi Method, we created a candidate item set of behavioral indicators. Next, trained staff observed nursing home residents and rated the items on scales of behavior intensity and frequency. We evaluated associations among the items and expert clinicians' assessment of pain intensity. SETTING Four government-owned nursing homes and 12 community nursing homes in Alabama and Southeastern Pennsylvania. PARTICIPANTS Ninety-five residents (mean age = 84.9 years) with moderate to severe cognitive impairment. RESULTS Using the least absolute shrinkage and selection operator model, we identified seven items that best predicted clinicians' evaluations of pain intensity. These items were rigid/stiff body or body parts, bracing, complaining, expressive eyes, grimacing, frowning, and sighing. We also found that a model based on ratings of frequency of behaviors did not have better predictive ability than a model based on ratings of intensity of behaviors. CONCLUSIONS We used two complementary approaches-expert opinion and statistical analysis-to reduce a large pool of behavioral indicators to a parsimonious set of items to predict pain intensity in persons with dementia. Future studies are needed to examine the psychometric properties of this scale, which is called the Pain Intensity Measure for Persons with Dementia.
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Affiliation(s)
- Mary Ersek
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania.,University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania
| | - Keela Herr
- University of Iowa College of Nursing, Iowa City, Iowa
| | - Michelle M Hilgeman
- Tuscaloosa VA Medical Center, Tuscaloosa, Alabama.,Alabama Research Institute on Aging and Department of Psychology, University of Alabama, Tuscaloosa, Alabama.,Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham, Birmingham, Alabama
| | | | - Nayak Polissar
- The Mountain-Whisper-Light Statistics, Seattle, Washington
| | - Karon F Cook
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | | | - A Lynn Snow
- Tuscaloosa VA Medical Center, Tuscaloosa, Alabama.,Alabama Research Institute on Aging and Department of Psychology, University of Alabama, Tuscaloosa, Alabama
| | | | - Francis X Nelson
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania
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Ersek M, Neradilek MB, Herr K, Hilgeman MM, Nash P, Polissar N, Nelson FX. Psychometric Evaluation of a Pain Intensity Measure for Persons with Dementia. Pain Med 2020; 20:1093-1104. [PMID: 30204895 DOI: 10.1093/pm/pny166] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The goal of this study was to conduct initial psychometric analyses of a seven-item pain intensity measure for persons with dementia (PIMD) that was developed using items from existing pain observational measures. DESIGN AND METHODS We evaluated validity by examining associations with an expert clinician's pain intensity rating (ECPIR) and an established pain observation tool (Mobilization Observation Behaviour Intensity Dementia [MOBID]). We also examined correlations between the PIMD and known correlates of pain: depression, sleep disturbances, agitation, painful diagnoses, and caregiver pain reports. We examined the differences between PIMD scores for "at rest" and "during movement" observations. We assessed reliability by calculating Cronbach's alpha and estimating inter-rater reliability using intraclass correlations (ICCs). Finally, we examined whether six additional "recent changes in behavior" items improved the PIMD's ability to predict expert clinicians' pain ratings. SETTING Sixteen nursing homes located in Alabama, Georgia, Pennsylvania, and New Jersey. PARTICIPANTS One hundred ninety residents with moderate to severe cognitive impairment, mean age of 84 years, 49.5% female, and 70% white. RESULTS PIMD during movement scores were highly correlated with the ECPIR and overall MOBID scores. As expected, there were large differences between at rest and during movement PIMD scores. Associations of PIMD with known correlates of pain were generally low and statistically nonsignificant. Internal consistency was supported with a Cronbach alpha of 0.72 and an inter-rater ICC of 0.82 for during movement PIMD scores. CONCLUSIONS Initial evaluation of the PIMD supports its validity and reliability. Additional testing is needed to evaluate the tool's sensitivity to changes in pain intensity.
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Affiliation(s)
- Mary Ersek
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania.,University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania
| | | | - Keela Herr
- University of Iowa College of Nursing, Iowa City, Iowa
| | - Michelle M Hilgeman
- Tuscaloosa VA Medical Center, Tuscaloosa, Alabama.,Department of Psychology, Alabama Research Institute on Aging, The University of Alabama, Tuscaloosa, Alabama.,Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | | | - Nayak Polissar
- The Mountain-Whisper-Light Statistics, Seattle, Washington
| | - Francis X Nelson
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania
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25
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Şahiner Y, Yağan Ö, Akdağlı Ekici A, Ekici M, Demir E. The effect of atropine in preventing catheter-related pain and discomfort in patients undergoing transurethral resection due to bladder tumor; prospective randomized, controlled study. Korean J Pain 2020; 33:176-182. [PMID: 32235018 PMCID: PMC7136298 DOI: 10.3344/kjp.2020.33.2.176] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 12/11/2019] [Accepted: 12/16/2019] [Indexed: 12/19/2022] Open
Abstract
Background Catheter-related bladder discomfort (CRBD) has been observed in many patients undergoing a urethral catheterization. CRBD may be so severe that the patients require additional analgesics. Muscarinic receptors are involved in the mechanism of CRBD. The aim of this study is to determine the effects of the antimuscarinic properties of atropine, which is frequently used in current practice on CRBD, by comparing it with sugammadex which has no antimuscarinic effects. Methods Sixty patients selected for transurethral resection due to bladder tumors were randomized into 2 groups: an atropine group and a sugammadex group, with no antimuscarinic effect. The patients were given rocuronium (0.6 mg/kg) as a neuromuscular-blocker. In addition to the frequency and severity of CRBD postoperatively at 0, 1, 6, 12, and 24 hours, postoperative numeric rating scale (NRS) scores, and postoperative nausea and vomiting were examined. Results The incidence of CRBD was significantly lower in the atropine group in all postoperative measurements. The score was found to be significantly lower in the atropine group when NRS measurements were performed at all time periods (P < 0.01). There was no difference between the groups in terms of nausea and vomiting (P > 0.05). Conclusions Atropine is a cheap, easy-to-access, safe-to-use drug for reducing CRBD symptoms, without any observed adverse effects. Since it not only reduces CRBD symptoms but also has a positive effect on postoperative pain, it can be used safely to increase patient comfort in patients receiving general anesthesia and a urinary catheter.
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Affiliation(s)
- Yeliz Şahiner
- Department of Anesthesiology and Reanimation, Erol Olçok Training and Research Hospital, Hitit University Faculty of Medicine, Çorum, Turkey
| | - Özgür Yağan
- Department of Anesthesiology and Reanimation, Erol Olçok Training and Research Hospital, Hitit University Faculty of Medicine, Çorum, Turkey
| | - Arzu Akdağlı Ekici
- Department of Anesthesiology and Reanimation, Erol Olçok Training and Research Hospital, Hitit University Faculty of Medicine, Çorum, Turkey
| | - Musa Ekici
- Department of Urology, Erol Olçok Training and Research Hospital, Hitit University Faculty of Medicine, Çorum, Turkey
| | - Emre Demir
- Department of Biostatistics, Hitit University Faculty of Medicine, Çorum, Turkey
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26
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Park CS, Park EJ. [Identification of Knowledge Structure of Pain Management Nursing Research Applying Text Network Analysis]. J Korean Acad Nurs 2020; 49:538-549. [PMID: 31672948 DOI: 10.4040/jkan.2019.49.5.538] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 06/27/2019] [Accepted: 06/27/2019] [Indexed: 11/09/2022]
Abstract
PURPOSE This study aimed to explore and compare the knowledge structure of pain management nursing research, between Korea and other countries, applying a text network analysis. METHODS 321 Korean and 6,685 international study abstracts of pain management, published from 2004 to 2017, were collected. Keywords and meaningful morphemes from the abstracts were analyzed and refined, and their co-occurrence matrix was generated. Two networks of 140 and 424 keywords, respectively, of domestic and international studies were analyzed using NetMiner 4.3 software for degree centrality, closeness centrality, betweenness centrality, and eigenvector community analysis. RESULTS In both Korean and international studies, the most important, core-keywords were "pain," "patient," "pain management," "registered nurses," "care," "cancer," "need," "analgesia," "assessment," and "surgery." While some keywords like "education," "knowledge," and "patient-controlled analgesia" found to be important in Korean studies; "treatment," "hospice palliative care," and "children" were critical keywords in international studies. Three common sub-topic groups found in Korean and international studies were "pain and accompanying symptoms," "target groups of pain management," and "RNs' performance of pain management." It is only in recent years (2016~17), that keywords such as "performance," "attitude," "depression," and "sleep" have become more important in Korean studies than, while keywords such as "assessment," "intervention," "analgesia," and "chronic pain" have become important in international studies. CONCLUSION It is suggested that Korean pain-management researchers should expand their concerns to children and adolescents, the elderly, patients with chronic pain, patients in diverse healthcare settings, and patients' use of opioid analgesia. Moreover, researchers need to approach pain-management with a quality of life perspective rather than a mere focus on individual symptoms.
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Affiliation(s)
- Chan Sook Park
- Department of Nursing, Konkuk University Glocal Campus, Chungju, Korea
| | - Eun Jun Park
- Department of Nursing, Konkuk University Glocal Campus, Chungju, Korea.
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27
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De Carvalho DE, de Luca K, Funabashi M, Breen A, Wong AYL, Johansson MS, Ferreira ML, Swab M, Neil Kawchuk G, Adams J, Hartvigsen J. Association of Exposures to Seated Postures With Immediate Increases in Back Pain: A Systematic Review of Studies With Objectively Measured Sitting Time. J Manipulative Physiol Ther 2020; 43:1-12. [PMID: 32081511 DOI: 10.1016/j.jmpt.2019.10.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 10/28/2019] [Accepted: 10/30/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The purpose of this study was to conduct a systematic review of studies to determine whether sitting time measured objectively (by laboratory controlled time trial, direct observation, or wearable sensor) is associated with the immediate increase in low back pain (LBP) (determined by pain scale rating) in people >18 years of age. METHODS Four databases (PubMed, EMBASE, SPORTDiscus, and Cumulative Index to Nursing and Allied Health Literature) were searched from inception to September 1, 2018. Randomized controlled trials and cohort and cross-sectional studies, where objectively measured sitting time was temporally matched with a measure of LBP in adults, were included. Studies without a control session conducted on a separate day were excluded. Screening, full-text review, data extraction, and risk of bias assessment (Quality In Prognosis Studies) of included papers were performed independently by 2 reviewers, with a third available to resolve disagreements. RESULTS In total, 609 articles were identified, 361 titles/abstracts were screened,75 full-text articles were assessed for eligibility, and 10 met the inclusion criteria. All but 1 reported sitting time to be associated with an immediate increase in LBP. Six of these reported clinically relevant pain levels (n = 330). Half of the included studies were rated as having a low risk of bias and the remaining were rated as having a moderate risk of bias. CONCLUSION Prolonged sitting increases immediate reporting of LBP in adults; however, no conclusion between sitting and clinical episodes of LBP can be made. Based upon these findings, we recommend that future prospective studies should match objectively measured sitting with temporally related pain measurements to determine whether prolonged sitting can trigger a clinical episode of LBP.
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Affiliation(s)
- Diana E De Carvalho
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada.
| | - Katie de Luca
- Department of Chiropractic, Faculty of Science and Engineering, Macquarie University, Sydney, New South Wales, Australia
| | - Martha Funabashi
- Division of Research, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
| | - Alexander Breen
- Centre for Biomechanics Research, AECC University College, Bournemouth, United Kingdom
| | - Arnold Y L Wong
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - Melker S Johansson
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark; Musculoskeletal Disorders and Physical Workload, The National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Manuela L Ferreira
- Institute of Bone and Joint Research, The Kolling Institute, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Michelle Swab
- Health Science Library, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - Gregory Neil Kawchuk
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Jon Adams
- Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Jan Hartvigsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark; Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark
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Camacho-Conde JA, Campos-Arillo VM. The phenomenology of pain in Parkinson's disease. Korean J Pain 2020; 33:90-96. [PMID: 31888323 PMCID: PMC6944372 DOI: 10.3344/kjp.2020.33.1.90] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 11/28/2019] [Accepted: 12/02/2019] [Indexed: 01/02/2023] Open
Abstract
Background Parkinson's disease (PD) is a neurodegenerative disorder that is the second most common disorder after Alzheimer's disease. PD includes both "motor" and "non-motor" symptoms, one of which is pain. The aim of this study was to investigate the clinical characteristics of pain in patients with PD. Methods This cross-sectional study included 250 patients diagnosed with PD, 70% of which had mild to moderate PD (stages 2/3 of Hoehn and Yahr scale). The average age was 67.4 years, and the average duration since PD diagnosis was 7.1 years. Relevant data collected from PD patients were obtained from their personal medical history. Results The prevalence of pain was found to be high (82%), with most patients (79.2%) relating their pain to PD. Disease duration was correlated with the frequency of intense pain (R: 0.393; P < 0.05). PD pain is most frequently perceived as an electrical current (64%), and two pain varieties were most prevalent (2.60 ± 0.63). Our findings confirm links between pain, its evolution over time, its multi-modal character, the wide variety of symptoms of PD, and the female sex. Conclusions Our results demonstrated that the pain felt by PD patients is mainly felt as an electrical current, which contrasts with other studies where the pain is described as burning and itching. Our classification is innovative because it is based on anatomy, whereas those of other authors were based on syndromes.
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Elberry AA, Sharkawi SMZ, Wahba MR. Antinociceptive and anti-inflammatory effects of N-acetylcysteine and verapamil in Wistar rats. Korean J Pain 2019; 32:256-263. [PMID: 31569917 PMCID: PMC6813896 DOI: 10.3344/kjp.2019.32.4.256] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 07/06/2019] [Accepted: 07/11/2019] [Indexed: 02/07/2023] Open
Abstract
Background Antinociceptive anti-inflammatory drugs have many adverse effects. The goal of this investigation is to study the probable anti-inflammatory and analgesic effects of verapamil and N-acetylcysteine (NAC) in experimental rats. Methods Adult male Wistar rats were randomly divided into 4 groups in the antinociceptive study, each containing 6 rats; the normal control group, which received saline (1 mL/kg); the diclofenac group, which received diclofenac sodium (5 mg/kg); the NAC group, which received NAC (125 mg/kg); and the verapamil group, which received verapamil (8 mg/kg). In the anti-inflammatory study, 5 groups were used, the 4 previous groups with the addition of an edema control group, received saline and were subjected to formalin test. Hot plate latency time was recorded for antinociceptive evaluation. Paw edema thickness and biochemical parameters were recorded for anti-inflammatory evaluation. Results Administration of NAC showed significant prolongation of hot plate latency time at 1 hour when compared to the control group while verapamil showed a significant prolongation of hot plate latency time at 1 and 2 hours when compared to the control group and NAC group values. Administration of NAC and verapamil significantly decreased paw edema thickness at 2, 4, and 8 hours when compared to edema control values. Regarding biochemical markers, NAC and verapamil significantly decreased serum nitric oxide synthase, C-reactive protein, and cyclooxygenase- 2 levels compared to the edema control value. In accordance, a marked improvement of histopathological findings was observed with both drugs. Conclusions NAC and verapamil have antinociceptive and anti-inflammatory effects comparable to diclofenac sodium.
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Affiliation(s)
| | | | - Mariam Rofaiel Wahba
- Department of Pharmacology, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
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30
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Wang-Price S, Zafereo J, Brizzolara K, Mackin B, Lawson L, Seeger D, Lawson S. Psychometric Properties of Pressure Pain Thresholds Measured in 2 Positions for Adults With and Without Neck-Shoulder Pain and Tenderness. J Manipulative Physiol Ther 2019; 42:416-424. [PMID: 31337510 DOI: 10.1016/j.jmpt.2018.11.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Revised: 06/11/2018] [Accepted: 11/02/2018] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The purpose of this study was to determine the psychometric properties of pressure pain threshold (PPT) testing in adults with and without neck-shoulder pain and tenderness and to compare the differences in PPT measurements between the seated and prone positions. METHODS Thirty asymptomatic adults and 30 symptomatic patients with intermittent neck-shoulder pain and tenderness completed the study. A pressure algometer was used to assess PPTs at specific points on the middle deltoid, levator scapulae, and upper trapezius muscles of the dominant side of the asymptomatic individuals and the painful side of the patients. Four trials were performed on each muscle in both the seated and prone positions. To determine between-day reliability, a subset of the participants returned to repeat the testing. RESULTS The intraclass correlation coefficients showed good to excellent within-session reliability and fair to excellent between-day reliability of PPT measurements in both the seated and prone positions for both groups. There were significant differences between groups for all muscles in both positions (P < .05) except for the upper trapezius muscle in the prone position. In addition, significant differences were found between the 2 testing positions for the middle deltoid and upper trapezius muscles in the symptomatic group and for the middle deltoid muscle in the asymptomatic group. CONCLUSION The results of the study suggest that PPT testing could be useful for distinguishing individuals with and without neck-shoulder pain and tenderness. Further, the patient's position should be considered when testing PPT, specifically at the middle deltoid or upper trapezius muscles.
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Affiliation(s)
- Sharon Wang-Price
- School of Physical Therapy, Texas Woman's University, Dallas, Texas.
| | - Jason Zafereo
- Department of Physical Therapy, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Kelli Brizzolara
- School of Physical Therapy, Texas Woman's University, Dallas, Texas
| | - Brendan Mackin
- School of Physical Therapy, Texas Woman's University, Dallas, Texas
| | - Larry Lawson
- School of Physical Therapy, Texas Woman's University, Dallas, Texas
| | - Dayna Seeger
- School of Physical Therapy, Texas Woman's University, Dallas, Texas
| | - Shannon Lawson
- School of Physical Therapy, Texas Woman's University, Dallas, Texas
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Mejin M, Keowmani T, Rahman SA, Liew J, Lai J, Chua M, Wan IC. Prevalence of pain and treatment outcomes among cancer patients in a Malaysian palliative care unit. Pharm Pract (Granada) 2019; 17:1397. [PMID: 31015879 PMCID: PMC6463407 DOI: 10.18549/pharmpract.2019.1.1397] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 01/27/2019] [Indexed: 11/17/2022] Open
Abstract
Background: Pain remains one of the most common and debilitating symptoms of advanced cancer. To date, there is a lack of studies on pain and its treatment among Malaysian palliative care patients. Objective: This study aimed to explore the prevalence of pain and its treatment outcomes among adult cancer patients admitted to a palliative care unit in Sabah, Malaysia. Methods: Of 327 patients screened (01/09/15-31/12/17), 151 patients with assessed self-reported pain scores based on the numerical rating scale of 0-10 (current, worst and least pain within the past 24 hours) upon admission (baseline), 24, 48 and 72 hours post-admission and discharge were included. Pain severity and pain score reductions were analysed among those who experienced pain upon admission or in the past 24 hours. Treatment adequacy was measured by the Pain Management Index (PMI) among discharged patients. The PMI was constructed upon worst scores categorised as 0 (no pain), 1 (1-4, mild pain), 2 (5-6, moderate pain), or 3 (7-10, severe pain) which is then subtracted from the most potent level of prescribed analgesic drug scored as 0 (no analgesia), 1 (non-opioid), 2 (weak opioid) or 3 (strong opioid). PMI≥0 indicated adequate treatment. Results: Upon admission, 61.1% [95%CI 0.54:0.69] of 151 patients presented with pain. Of 123 patients who experienced pain upon admission or in the past 24 hours, 82.1% had moderate to severe worst pain. Throughout patients’ ward stay until discharge, there was an increased prescribing of analgesics and adjuvants compared to baseline, excluding weak opioids, with strong opioids as the mainstay treatment. For all pain score types (current, worst and least pain within the past 24 hours), means decreased at each time point (24, 48 and 72 hours post-admission and discharge) from baseline, with a significant decrease at 24 hours post-admission (p<0.001). Upon discharge (n=100), treatment adequacy significantly improved (PMI≥0 100% versus 68% upon admission, p<0.001). Conclusions: Accounting for pain’s dynamic nature, there was a high prevalence of pain among cancer patients in the palliative care unit. Continuous efforts incorporating comprehensive pain assessments, evidence-based treatments and patient education are necessary to provide adequate pain relief and end-of-life comfort care.
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Affiliation(s)
- Melissa Mejin
- Department of Pharmacy, Queen Elizabeth Hospital. Kota Kinabalu, Sabah (Malaysia).
| | - Thamron Keowmani
- Clinical Research Centre, Department of Pharmacy, Queen Elizabeth Hospital. Kota Kinabalu, Sabah (Malaysia).
| | | | - Jerry Liew
- Department of Pharmacy, Queen Elizabeth Hospital. Kota Kinabalu, Sabah (Malaysia).
| | - Jacqueline Lai
- Department of Pharmacy, Queen Elizabeth Hospital. Kota Kinabalu, Sabah (Malaysia).
| | - Morna Chua
- Nursing Unit, Palliative Care Unit, Queen Elizabeth Hospital. Kota Kinabalu, Sabah (Malaysia).
| | - Ilmiyah Che Wan
- Palliative Care Unit, Queen Elizabeth Hospital. Kota Kinabalu, Sabah (Malaysia).
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Wammen Rathenborg FL, Zdaniuk B, Brotto LA. What Do Different Measures of Pain Tell Us? A Comparison in Sexually Active Women With Provoked Vestibulodynia. J Sex Med 2019; 16:278-88. [PMID: 30655181 DOI: 10.1016/j.jsxm.2018.12.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 11/23/2018] [Accepted: 12/03/2018] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Studies of pain measurement in women with provoked vestibulodynia (PVD) use various methods of capturing pain intensity. The degree to which these different measures of pain correspond with one another is not known. AIM To compare 3 different measures of pain intensity in sexually active women with PVD participating in a clinical treatment study. METHODS A total of 64 women (mean age 30.9 years) provided baseline measures of pain intensity using (i) a numeric rating scale that provided a self-report of pain during recalled vaginal penetration; (ii) the pain subscale of the female sexual function index; and (iii) pain elicited with a vulvalgesiometer, an objective method of eliciting pain. MAIN OUTCOME MEASURE Correlations among these 3 measures of pain were moderate in size (range r = 0.39-0.61). Moreover, the numeric rating scale of pain was more likely to be associated with self-reported measures of pain catastrophizing and pain hypervigilance than were scores on the pain subscale of the female sexual function index or scores from the vulvalgesiometer. CLINICAL IMPLICATIONS Overall, there was a moderate level of correlation between different often-used measures of pain in women with PVD. These findings suggest that, in addition to measuring a common dimension, these different measures tap into different aspects of women's experiences with vulvovaginal pain, and researchers should consider how the chosen measure addresses their primary research question when selecting pain measures in future PVD research. STRENGTHS & LIMITATIONS A strength of this study was the large sample size (n = 64 sexually active women) who had received confirmed clinical diagnoses of PVD. 1 limitation of the findings is that our self-report outcome measures are based on retrospective ratings of pain over 4 weeks, and it is possible that other variables, such as mood, could have impacted scores on these measures. CONCLUSION This study showed statistically significant and moderate correlations among 3 different pain measures widely used in PVD research and treatment. In addition, only 1 pain measure showed a significant independent association with emotion function measures. These findings provide a rationale for including multiple measures of pain and emotional function in treatment outcome studies of PVD. Wammen Rathenborg FL, Zdaniuk B, Brotto LA. What Do Different Measures of Pain Tell Us? A Comparison in Sexually Active Women With Provoked Vestibulodynia. J Sex Med 2019;16:278-288.
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Kardeh B, Ashraf A, Kardeh S. Possible Role of Myopia as a Risk Factor for Mechanical Neck Pain in Medical Students : A Pilot Study. Galen Med J 2019; 8:e1287. [PMID: 34466484 PMCID: PMC8343712 DOI: 10.31661/gmj.v8i0.1287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Revised: 08/18/2018] [Accepted: 09/16/2018] [Indexed: 11/16/2022] Open
Abstract
Background Mechanical neck pain (MNP) is a common health concern. Some studies suggested a relationship between neck pain and visual activity. We assessed the role of myopia as a contributing factor in the development of chronic MNP. Materials and Methods All medical students at Shiraz University School of Medicine, who were 18 to 22 years old, were invited to participate in this retrospective case-control study from March 2016 to March 2017. Numeric Pain Rating Scale (NPRS) was used to assess the average neck pain severity over the past 6 months in order to enroll participants as the case (≥3) or control (<3) groups. Demographic data and medical profile were obtained. After identifying eligible cases, we assigned age- and sex-matched controls, who also met the study criteria. Subsequently, participants completed the Neck Disability Index (NDI) and Neck Pain and Disability Scale (NPDS) questionnaires and were evaluated for myopia severity. Variables were compared between the case and control groups as well as within the case group. P-value<0.05 was considered statistically significant. Results From over 700 medical students, around 150 cooperated. Eventually, 31 eligible cases (and 31 controls) were studied. NDI and NPDS were significantly higher in the case group (P<0.001). However, no significant differences were noticed between the groups regarding the severity (P=0.123) and the duration (P=0.417) of myopia. Also, the correlation of myopia severity with NDPS (ρ=0.159, P=0.216) and NDI (ρ=0.201, P=0.116) was non-significant within the case group. Conclusion Our findings have not supported the influential role of myopia in the development of chronic MNP.
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Affiliation(s)
- Bahareh Kardeh
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Ashraf
- Shiraz Geriatric Research Center, Shiraz Burn Research Center, and Department of Physical Medicine and Rehabilitation, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sina Kardeh
- Cellular and Molecular Medicine Student Research Group, Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
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Antunes F, Gemelgo C. [Letter to the Editor: The Opioid Prescribing Scenario in Portugal. A Contribution towards Good Clinical Practice]. ACTA MEDICA PORT 2018; 31:796-797. [PMID: 30684380 DOI: 10.20344/amp.11663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 12/12/2018] [Indexed: 11/20/2022]
Affiliation(s)
- Filipe Antunes
- Unidade de Dor Crónica. Hospital de Braga. Braga; Serviço de Medicina Física e de Reabilitação. Hospital de Braga. Braga. Portugal
| | - Claudia Gemelgo
- Serviço de Medicina Física e de Reabilitação. Hospital de Braga. Braga Portugal
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Nazari R, Pahlevan Sharif S, Allen KA, Sharif Nia H, Yee BL, Yaghoobzadeh A. Behavioral Pain Indicators in Patients with Traumatic Brain Injury Admitted to an Intensive Care Unit. J Caring Sci 2018; 7:197-203. [PMID: 30607360 PMCID: PMC6311629 DOI: 10.15171/jcs.2018.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Accepted: 06/12/2018] [Indexed: 11/17/2022] Open
Abstract
Introduction: A consistent approach to pain assessment for patients admitted to intensive care unit (ICU) is a major difficulty for health practitioners due to some patients' inability, to express their pain verbally. This study aimed to assess pain behaviors (PBs) in traumatic brain injury (TBI) patients at different levels of consciousness. Methods: This study used a repeated-measure, within-subject design with 35 patients admitted to an ICU. The data were collected through observations of nociceptive and non-nociceptive procedures, which were recorded through a 47-item behavior-rating checklist. The analyses were performed by SPSS ver.13 software. Results: The most frequently observed PBs during nociceptive procedures were facial expression levator contractions (65.7%), sudden eye openings (34.3%), frowning (31.4%), lip changes (31.4%), clear movement of extremities (57.1%), neck stiffness (42.9%), sighing (31.4%), and moaning (31.4%). The number of PBs exhibited by participants during nociceptive procedures was significantly higher than those observed before and 15 minutes after the procedures. Also, the number of exhibited PBs in patients during nociceptive procedures was significantly greater than that of exhibited PBs during the non-nociceptive procedure. The results showed a significant difference between different levels of consciousness and also between the numbers of exhibited PBs in participants with different levels of traumatic brain injury severity. Conclusion: The present study showed that most of the behaviors that have been observed during painful stimulation in patients with traumatic brain injury included facial expressions, sudden eye opening, frowning, lip changes, clear movements of extremities, neck stiffness, and sighing or moaning.
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Affiliation(s)
- Roghieh Nazari
- Department of Nursing, Amol Faculty of Nursing and Midwifery, Mazandaran
University of Medical Sciences, Sari, Iran
| | - Saeed Pahlevan Sharif
- Department, Taylor’s Business School, Taylor’s University Malaysia, Subang Jaya,
Malaysia
| | - Kelly A Allen
- Melbourne Graduate School of Education, University of Melbourne, Melbourne,
Australia
| | - Hamid Sharif Nia
- Department of Nursing, Amol Faculty of Nursing and Midwifery, Mazandaran
University of Medical Sciences, Sari, Iran
| | - Bit-Lian Yee
- Department of Nursing, Open University Malaysia, Kuala Lumpur, Malaysia
| | - Ameneh Yaghoobzadeh
- Department of Geriatric Nursing, School of Nursing and Midwifery, Tehran
University of Medical Sciences, Tehran, Iran
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Neiva C. Letter to The Editor: Access to Opioids, A Global Challenge - Impressions of The Brazilian Scenario. ACTA MEDICA PORT 2018; 31:698. [PMID: 30521466 DOI: 10.20344/amp.11489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 10/30/2018] [Indexed: 11/20/2022]
Affiliation(s)
- Carolina Neiva
- Serviço de Cuidados Paliativos. Instituto de Assistência ao Servidor Público Estadual. São Paulo. Brazil
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Barão C, Mendes V. Letter to the Editor: The Opioid Prescribing Scenario in Portugal from a Primary Care Perspective. ACTA MEDICA PORT 2018; 31:698-699. [PMID: 30521467 DOI: 10.20344/amp.11499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 11/02/2018] [Indexed: 11/20/2022]
Affiliation(s)
- Cátia Barão
- Unidade de Saúde Familiar Andreas. Agrupamento de Centros de Saúde do Oeste Sul. Mafra. Portugal
| | - Vanessa Mendes
- Unidade de Saúde Familiar Dafundo. Agrupamento de Centros de Saúde de Lisboa Ocidental e Oeiras. Oeiras. Portugal
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Reis-Pina P, Lawlor PG, Barbosa A. Moderate to Severe Cancer Pain: Are We Taking Serious Action? The Opioid Prescribing Scenario in Portugal. ACTA MEDICA PORT 2018; 31:451-453. [PMID: 30332367 DOI: 10.20344/amp.10999] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 07/14/2018] [Accepted: 07/17/2018] [Indexed: 11/20/2022]
Affiliation(s)
- Paulo Reis-Pina
- Palliative Care Unit. Casa de Saúde da Idanha. Sintra; Faculdade de Medicina. Universidade de Lisboa. Lisbon, Portugal
| | - Peter G Lawlor
- Bruyère Research Institute. Bruyère Continuing Care. Ottawa Hospital Research Institute. The Ottawa Hospital. Ottawa. Ontario. Canada; Division of Palliative Care. Department of Medicine. University of Ottawa. Ottawa. Ontario. Canada
| | - António Barbosa
- Faculdade de Medicina. Universidade de Lisboa. Lisbon. Portugal; Department of Psychiatry. Centro Hospitalar Lisboa Norte. Lisbon. Portugal; Centre of Bioethics & Palliative Care Studies Division. Faculdade de Medicina. Universidade de Lisboa. Lisbon. Portugal
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Sirintawat N, Sawang K, Chaiyasamut T, Wongsirichat N. Pain measurement in oral and maxillofacial surgery. J Dent Anesth Pain Med 2017; 17:253-263. [PMID: 29349347 PMCID: PMC5766084 DOI: 10.17245/jdapm.2017.17.4.253] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 11/28/2017] [Accepted: 11/30/2017] [Indexed: 12/04/2022] Open
Abstract
Regardless of whether it is acute or chronic, the assessment of pain should be simple and practical. Since the intensity of pain is thought to be one of the primary factors that determine its effect on a human's overall function and sense, there are many scales to assess pain. The aim of the current article was to review pain intensity scales that are commonly used in dental and oral and maxillofacial surgery (OMFS). Previous studies demonstrated that multidimensional scales, such as the McGill Pain Questionnaire, Short form of the McGill Pain Questionnaire, and Wisconsin Brief Pain Questionnaire were suitable for assessing chronic pain, while unidimensional scales, like the Visual Analogue Scales (VAS), Verbal descriptor scale, Verbal rating scale, Numerical rating Scale, Faces Pain Scale, Wong-Baker Faces Pain Rating Scale (WBS), and Full Cup Test, were used to evaluate acute pain. The WBS is widely used to assess pain in children and elderly because other scales are often difficult to understand, which could consequently lead to an overestimation of the pain intensity. In dental or OMFS research, the use of the VAS is more common because it is more reliable, valid, sensitive, and appropriate. However, some researchers use NRS to evaluate OMFS pain in adults because this scale is easier to use than VAS and yields relatively similar pain scores. This review only assessed pain scales used for post-operative OMFS or dental pain.
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Affiliation(s)
- Nattapong Sirintawat
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Kamonpun Sawang
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Teeranut Chaiyasamut
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Natthamet Wongsirichat
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
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Sequeira MI, Sousa N, Fragoso M, Silva A, Pereira F, Azevedo L. [Single Centre Prospective Study of Systematic Pain Evaluation in Portuguese Patients with Metastatic Prostate Cancer]. ACTA MEDICA PORT 2017; 30:796-804. [PMID: 29279072 DOI: 10.20344/amp.8820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2017] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Pain is one of the most common symptoms reported by cancer patients and is associated with decreased quality of life. Assessment of pain with standardized questionnaires reduces variability in its interpretation and may increase effectiveness of medical interventions. Prostate cancer is the most frequent male neoplasm in Portugal. We designed this study to evaluate the impact of a standardized pain questionnaire on pain management in patients with metastatic prostate cancer. MATERIAL AND METHODS Single centre prospective observational study of patients with metastatic prostate cancer. The study was designed to evaluate the benefit of systematically evaluating pain with Brief Pain Inventory-Short Form prior to a scheduled medical oncology consult. Patients reporting pain were reassessed one week later by telephone. To assess the benefit two consecutive cohorts were established based on communication of questionnaire results to the treating physician. RESULTS We recruited 207 patients of which 60% reported pain. Statistically significant decrease in mean pain intensity one week after the scheduled appointment was noted (3.95 vs 3.01; p < 0.001). Patients whose Brief Pain Inventory-Short Form was provided to their oncologist experienced greater reduction in pain, which was non-significant (p = 0.227). Using Brief Pain Inventory-Short Form assessment resulted in a higher probability of pain control (43.5% vs 30.9%; p = 0.193). DISCUSSION The prevalence of pain founded was higher than described in the literature, probably because our sample was less selected than the published in clinical trials. After the scheduled appointment, there was a statistically significant reduction in mean pain intensity, but the explicit use of this questionnaire was not associated with a statistically significant reduction of pain. CONCLUSION Patients with metastatic prostate cancer have a high prevalence of pain. Evaluation and treatment by medical oncologists is associated with a reduction of mean pain intensity. The use of Brief Pain Inventory-Short Form was associated with a non-significant increased reduction of pain.
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Affiliation(s)
- Maria Inês Sequeira
- Serviço de Oncologia Médica. Instituto Português de Oncologia do Porto Francisco Gentil. Porto. Portugal
| | - Nuno Sousa
- Serviço de Oncologia Médica. Instituto Português de Oncologia do Porto Francisco Gentil. Porto. Portugal
| | - Maria Fragoso
- Serviço de Oncologia Médica. Instituto Português de Oncologia do Porto Francisco Gentil. Porto. Portugal
| | - Alexandra Silva
- Enfermagem. Instituto Português de Oncologia do Porto Francisco Gentil. Porto. Portugal
| | - Filipa Pereira
- Serviço de Oncologia Médica. Instituto Português de Oncologia do Porto Francisco Gentil. Porto. Portugal
| | - Luís Azevedo
- MEDCIDS/CINTESIS - Departamento de Medicina da Comunidade, Informação e Decisão em Saúde. Faculdade de Medicina. Universidade do Porto. Porto. Portugal
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Soccal Schwertner D, Oliveira R, Ramos Marinho AP, Benetti M, Silva Beltrame T, Capistrano R. Reliability, Stability and Validity of the Brazilian Adaptation of the Oliveira Questionnaire on Low Back Pain in Young People. ACTA MEDICA PORT 2017; 30:691-698. [PMID: 29268062 DOI: 10.20344/amp.8270] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 06/08/2017] [Indexed: 11/20/2022]
Abstract
INTRODUCTION The objective of this study was to adapt the Brazilian version, and verify the validity, reliability and internal consistency of the Oliveira questionnaire on low back pain in young people. MATERIAL AND METHODS The questionnaire was translated from European Portuguese into Brazilian Portuguese by means of translation and re-translation. The validity of the contents was determined by experts who analyzed the clarity and pertinence of the questions. Fifteen young people aged 15 to 18 took part in the pre-test step (qualitative analysis), 40 in the test-retest (reliability) and 679 in the evaluation of internal consistency. The intra-class correlation coefficient and Spearman's correlation coefficient were used in the reliability analysis (test-retest), and Cronbach's alpha to determine the internal consistency (stability). RESULTS In the translation phase the questionnaire was modified and considered suitable, observing similarity and equivalence of the two versions. After being corrected by the experts in the validation of the contents, the instrument was considered suitable and valid, and in the pre-test, the young people suggested some modifications to make the questionnaire more succinct. With respect to reliability, the values for the intra-class correlation coefficient were between 0.512 - acceptable and 1 - excellent and Spearman's correlation coefficient varied between 0.525 and 1, classifying the instrument as reproducible. The internal consistency was considered acceptable with a 0.757 Cronbach's alpha. DISCUSSION The Oliveira questionnaire was choosen since it has been used in several Portuguese studies; moreover, it addresses the need to raise data regarding low back pain and associated risk factors. CONCLUSIONS The Brazilian version of the Oliveira questionnaire on low back pain in young people showed valid and reliable cultural adaptation, with good reliability and stability.
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Affiliation(s)
- Debora Soccal Schwertner
- Laboratory of Motor Behavior. Faculdade de Motricidade Humana. Universidade de Lisboa. Lisboa. Portugal; Department of Physiotherapy. Universidade do Estado de Santa Catarina. Florianópolis
| | - Raul Oliveira
- Laboratory of Motor Behavior. Faculdade de Motricidade Humana. Universidade de Lisboa. Lisboa. Portugal
| | - Ana Paula Ramos Marinho
- Postgraduate Program in Human Science Movement. Center of Health Sciences and Sport. Universidade do Estado de Santa Catarina. Florianópolis. Brasil
| | - Magnus Benetti
- Postgraduate Program in Human Science Movement. Center of Health Sciences and Sport. Universidade do Estado de Santa Catarina. Florianópolis. Brasil
| | - Thais Silva Beltrame
- Postgraduate Program in Human Science Movement. Center of Health Sciences and Sport. Universidade do Estado de Santa Catarina. Florianópolis. Brasil
| | - Renata Capistrano
- Postgraduate Program in Human Science Movement. Center of Health Sciences and Sport. Universidade do Estado de Santa Catarina. Florianópolis. Brasil
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Dargie E, Gilron I, Pukall CF. Self-Reported Neuropathic Pain Characteristics of Women With Provoked Vulvar Pain: A Preliminary Investigation. J Sex Med 2017; 14:577-591. [PMID: 28325536 DOI: 10.1016/j.jsxm.2017.02.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 02/08/2017] [Accepted: 02/19/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND Provoked vestibulodynia (PVD) is a common chronic genital pain condition affecting approximately 12% of premenopausal women. Although parallels have been drawn between PVD and neuropathic pain (NP), no studies have examined self-reported NP characteristics in PVD. AIM To explore pain symptoms that resemble NP reported by those with PVD and compare responses with those with an established NP condition. METHODS Women with provoked vulvar pain (PVP; n = 65) completed online questionnaires designed to assess characteristics of NP. Responses were compared with those of women with postherpetic neuralgia (PHN; n = 30). OUTCOMES In addition to a range of descriptive questions, participants completed the McGill Pain Questionnaire, the Self-Complete Leeds Assessment of Neuropathic Signs and Symptoms (S-LANSS), the Neuropathic Pain Symptom Inventory (NPSI), and the Pain Quality Assessment Scale (PQAS). RESULTS PVP exhibits some neuropathic characteristics, typically evoked pain (as opposed to the more constant pain of PHN) indicative of allodynia and hyperalgesia. Specifically, women with PVP scored, on average, higher than the NP cutoff on the S-LANSS, and there were no significant differences between women with PVP and those with PHN on some NPSI subscales. However, women with PHN reported more NP symptoms on the PQAS, S-LANSS, and other NPSI subscales. CLINICAL IMPLICATIONS Validated NP questionnaires could be of particular use for health care professionals who need a more efficient way to assess symptoms of patients with PVP and should be included in future studies investigating the mechanisms and treatment of this pain. STRENGTHS AND LIMITATIONS This study takes a unique approach to the examination of PVP by using multiple validated NP measures to compare pain characteristics with those of a group of participants with PHN, an established NP condition. However, it is limited by self-reported data not confirmed with clinical examination, small size of the PHN group, and the severity of the pain experienced in the PVP group. CONCLUSION Women with PVP report some symptoms suggestive of NP characteristics, and future research should use NP measures in addition to physical examinations to further investigate the mechanisms that maintain this pain condition. Dargie E, Gilron I, Pukall CF. Self-Reported Neuropathic Pain Characteristics of Women With Provoked Vulvar Pain: A Preliminary Investigation. J Sex Med 2017;14:577-591.
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Affiliation(s)
- Emma Dargie
- Department of Psychology, Queen's University, Kingston, ON, Canada
| | - Ian Gilron
- Department of Anesthesiology and Perioperative Medicine, Queen's University, School of Medicine, Kingston, ON, Canada
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Song PH, Ko YH. Lateral decubitus position vs. lithotomy position: which is the best way to minimize patient's pain perception during transrectal prostate biopsy? Int Braz J Urol 2017; 43:462-469. [PMID: 28191793 PMCID: PMC5462136 DOI: 10.1590/s1677-5538.ibju.2015.0479] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 02/29/2016] [Indexed: 11/25/2022] Open
Abstract
Introduction Considering the distinctive nature in terms of psychological stress and anal tone of position which is generally selected between lithotomy and left lateral decubitus (LLD), we postulated its effect on pain perception during biopsy, and investigated their association. Materials and Methods A prospective study for comparison of two biopsy positions which were perform in a different working day was conducted for 208 men (lithotomy position=86, LLD=122). The decision on the position was made solely based on the patient’s preference for the biopsy day, and all procedures were performed according to the identical protocol (12-core biopsy with intrarectal lidocaine gel), probe, and needle. The maximal degree of pain during the entire process was assessed using a visual analogue scale (VAS), immediately after biopsy. After propensity matching, a total of 152 patients were finally selected (lithotomy group=76, LLD=76), then peri-biopsy parameters were compared. Results Between groups, no differences were observed across all variables including age, obesity, prostate volume, serum PSA, international prostate symptom score, and cancer detection rate, except mean (±standard deviation) VAS score (3.89±2.01 vs. 4.58±2.22, p=0.049). VAS score showed significant association solely with patient’s position (Pearson’s coefficient=-0.165, p=0.042). In multiple linear regression models regarding the effect of clinical variables on VAS score, patient position was a single independent predictor favoring lithotomy position to decrease perceived pain (B=-0.928, p=0.024). Conclusions These data suggest lithotomy position as a proper way to perform transrectal prostate biopsy with routine use of topical lidocaine gel in comparison with conventional LLD position.
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Affiliation(s)
- Phil Hyun Song
- Department of Urology, College of Medicine, Yeungnam University, Daegu, Korea
| | - Young Hwii Ko
- Department of Urology, College of Medicine, Yeungnam University, Daegu, Korea
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Shafie L, Barghi H, Parirokh M, Ebrahimnejad H, Nakhae N, Esmaili S. Postoperative Pain following Pulpotomy of Primary Molars with Two Biomaterials: A Randomized Split Mouth Clinical Trial. Iran Endod J 2017; 12:10-14. [PMID: 28179916 PMCID: PMC5282371 DOI: 10.22037/iej.2017.02] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 08/18/2016] [Accepted: 09/07/2016] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The aim of this randomized clinical trial split-mouth study was to compare the postoperative pain following use of mineral trioxide aggregate (MTA) and calcium-enriched mixture (CEM) cement as pulpotomy agents in carious primary molars. METHODS AND MATERIALS Forty-seven children aged between 6-10 years old were enrolled in this study. Each child had two cariously involved primary molar in need of pulpotomy. After caries removal and preparing access cavity in one of the carious teeth, either MTA or CEM cement was randomly used as the pulpotomy agent, while the other cariously involved primary molar tooth was capped with the other material in a separate visit. After covering the radicular pulp with one of the capping materials the teeth were permanently restored with stainless steel crown (SSC). Postoperative pain was recorded by using Wong-Baker faces pain rating scale (Wong-Baker FPRS) up to seven days following the treatment. Data was analyzed using the Wilcoxon, McNemar, and chi square tests. RESULTS Forty-five patients fulfilled the treatment procedure and returned the Wong-Baker FPRS forms. Overall 65.6% of the patients reported pain irrespective of the pulpotomy agents used. There was no significant difference in postoperative pain between the teeth that received either MTA or CEM cement as pulpotomy agents in the first, second and the third day (P=0.805, P=0.942, P=0.705, respectively) following the procedure. The trend of the pain scores showed decreasing manner during the study period for the teeth in either groups of MTA or CEM cement. There was no significant difference between the two groups in the number of analgesics used following the treatment (P>0.05). CONCLUSION The findings of the present study showed that a majority of the children felt pain following pulpotomy and SSC placement; however, there was no significant difference in pain reported when either MTA or CEM cement was used as pulpotomy agents.
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Affiliation(s)
- Leili Shafie
- Pedodontist, Fellowship in Sedation and Hospital Dentistry, Kerman, Iran;
| | - Hamide Barghi
- Department of Pediatric Dentistry, Dental School, Shiraz University of Medical Sciences, Shiraz, Iran;
| | - Masoud Parirokh
- Department of Pediatric Dentistry, Dental School, Shiraz University of Medical Sciences, Shiraz, Iran;
| | - Hamed Ebrahimnejad
- Department of Oral and Maxillofacial Radiology, Dental School, Kerman University of Medical Sciences, Kerman, Iran;
| | - Nozar Nakhae
- Kerman Neuroscience Research Center ,Kerman ,Iran;
| | - Sara Esmaili
- Department of Pediatric Dentistry, Dental School, Shiraz University of Medical Sciences, Shiraz, Iran
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Mendonça Araújo F, Alves Menezes M, Martins de Araújo A, Abner Dos Santos Sousa T, Vasconcelos Lima L, Ádan Nunes Carvalho E, Melo DeSantana J. Validation of a New Placebo Interferential Current Method: A New Placebo Method of Electrostimulation. Pain Med 2017; 18:86-94. [PMID: 27048345 DOI: 10.1093/pm/pnw039] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objective The present study aimed to investigate if a new placebo device for interferential current (IFC) that delivers current during only the first 40 seconds of stimulation is effective at promoting adequate subject blinding. Methods Seventy-five subjects were recruited and enrolled into three groups: active IFC, inactive placebo, and new placebo. Pressure pain threshold (PPT), cutaneous sensory threshold (CST), and pain intensity were measured before and after the intervention. After the final assessment, the subjects and the investigator who applied the current were asked about the type of stimulation administered. Results None of the placebo forms studied resulted in significant changes to PPT, CST, or pain intensity. The subjects stimulated with active IFC at high intensities (> 17 mA) of stimulation showed higher PPT and CST and lower pain intensity than subjects stimulated at low intensities ( p < 0.03). The new placebo method blinded the investigator in 100% of cases of IFC and 60% of subjects stimulated, whereas for inactive placebo, the investigator was blinded at a rate of 0% and 34% of subjects. Conclusion The new method of placebo IFC was effective for blinding of research investigators and most of the active IFC-treated subjects, promoting an appropriate placebo method.
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Affiliation(s)
- Fernanda Mendonça Araújo
- Departamento de Fisioterapia, Universidade Federal de Sergipe, Aracaju, Se, Brazil.,Programa de Pós-Graduação em Ciências Fisiológicas, Universidade Federal de Sergipe, Aracaju, Se, Brazil
| | - Mayara Alves Menezes
- Departamento de Fisioterapia, Universidade Federal de Sergipe, Aracaju, Se, Brazil
| | | | - Thiago Abner Dos Santos Sousa
- Departamento de Fisioterapia, Universidade Federal de Sergipe, Aracaju, Se, Brazil.,Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, Se, Brazil
| | - Lucas Vasconcelos Lima
- Departamento de Fisioterapia, Universidade Federal de Sergipe, Aracaju, Se, Brazil.,Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, Se, Brazil
| | - Elyson Ádan Nunes Carvalho
- Departamento de Engenharia Elétrica, Programa de Pós-Graduação em Engenharia Elétrica, Universidade Federal de Sergipe, Aracaju, Se, Brazil
| | - Josimari Melo DeSantana
- Departamento de Fisioterapia, Universidade Federal de Sergipe, Aracaju, Se, Brazil.,Programa de Pós-Graduação em Ciências Fisiológicas, Universidade Federal de Sergipe, Aracaju, Se, Brazil.,Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, Se, Brazil
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Ata N, Erdur O, Görgülü MH, Yilmaz E. Effects of two different local anaesthetic methods vs no anaesthesia on pain scores for intratympanic injections. J Laryngol Otol 2016; 130:1153-7. [PMID: 27821219 DOI: 10.1017/S0022215116009336] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This study compared the pain associated with the intratympanic injection combined with various local anaesthetics vs without anaesthesia. METHODS The study included 40 patients (aged 18-78 years) who received intratympanic steroid injections for sudden idiopathic hearing loss or tinnitus. Each patient underwent all three injection methods at one-week intervals. Patients received one of two local anaesthetics (lidocaine injection or lidocaine spray) or no anaesthesia before intratympanic injection, and used a visual analogue scale to indicate the pain level after 5 and 45 minutes. RESULTS Five minutes after injection, patients who did not receive anaesthesia and those who received lidocaine spray reported lower pain scores than those who received a lidocaine injection (p < 0.05). There was no difference in pain scores for all three methods at 45 minutes after intratympanic injection. CONCLUSION Neither of the local anaesthetics was found to be superior to having no anaesthesia.
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Mohammadi SS, Abdi M, Movafegh A. Comparing Transcervical Intrauterine Lidocaine Instillation with Rectal Diclofenac for Pain Relief During Outpatient Hysteroscopy: A Randomized Controlled Trial. Oman Med J 2015; 30:157-61. [PMID: 26171120 DOI: 10.5001/omj.2015.35] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2015] [Accepted: 04/04/2015] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES There are a number of potential advantages to performing hysteroscopy in an outpatient setting. However, the ideal approach, using local uterine anesthesia or rectal non-steroidal anti-inflammatory drugs, has not been determined. Our objective was to compare the efficacy of intrauterine lidocaine instillation with rectal diclofenac for pain relief during diagnostic hysteroscopy. METHODS We conducted a double-blind randomized controlled trial on 70 nulliparous women with primary infertility undergoing diagnostic hysteroscopy. Subjects were assigned into one of two groups to receive either 100mg of rectal diclofenac or 5mL of 2% intrauterine lidocaine. The intensity of pain was measured by a numeric rating scale 0-10. Pain scoring was performed during insertion of the hysteroscope, during visualization of the intrauterine cavity, and during extrusion of the hysteroscope. RESULTS There were no statistically significant differences between the groups with regard to the mean pain score during intrauterine visualization (p=0.500). The mean pain score was significantly lower during insertion and extrusion of the hysteroscope in the diclofenac group (p=0.001 and p=0.030, respectively). Nine patients in the lidocaine group and five patients in diclofenac group needed supplementary intravenous propofol injection for sedation (p=0.060). CONCLUSIONS Rectal diclofenac appears to be more effective than intrauterine lidocaine in reducing pain during insertion and extrusion of hysteroscope, but there are no significant statistical and clinical differences between the two methods with regard to the mean pain score during intrauterine inspection.
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Affiliation(s)
- Sussan S Mohammadi
- Department of Anesthesiology, Tehran University of Medical Sciences, Tehran, Iran
| | - Mina Abdi
- Department of Anesthesiology, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Movafegh
- Department of Anesthesiology, Tehran University of Medical Sciences, Tehran, Iran
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Yang HC, Cho HH, Jo SY, Jang CH, Cho YB. Donor-site morbidity following minimally invasive costal cartilage harvest technique. Clin Exp Otorhinolaryngol 2015; 8:13-9. [PMID: 25729490 PMCID: PMC4338086 DOI: 10.3342/ceo.2015.8.1.13] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Revised: 01/08/2014] [Accepted: 02/03/2014] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVES Autologous costal cartilage is a promising alternative for mastoid obliteration. However, donor-site morbidities of the chest wall limit the use of this graft. To address this issue, we have developed a minimally-invasive technique of harvesting costal cartilage and report donor site morbidity associated with the procedure. METHODS Donor site morbidities were evaluated for 151 patients who underwent costal cartilage harvest, canal wall down mastoidectomy, and mastoid obliteration. Pain and cosmetic concern were evaluated via visual analogue scale (VAS). Scars were evaluated via the modified Vancouver Scar Scale (VSS) and the Patient and Observer Scar Assessment Scale (POSAS). Postoperative complications were assessed during the follow-up period. RESULTS The mean duration of noticeable pain was 5.3 days post operation. The mean VAS score for pain was 3.0 of 10 on the first day after the operation and gradually declined. At the 6 months post operation, the mean VAS cosmetic score at the costal cartilage harvest site was 0.6 of 10. The mean VSS score was 9.5 out of 10 total, and the mean POSAS score was 23.27 out of 110 total. CONCLUSION The minimally-invasive chopped costal cartilage harvest technique resulted in acceptable pain, cosmetic concern, and postoperative complications for most patients. There were no major postoperative complications. Costal cartilage is an acceptable donor for mastoid obliteration in canal wall down mastoidectomy, especially in the context of the extremely low donor site morbidity of the minimally-invasive technique presented in the study.
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Affiliation(s)
- Hyung Chae Yang
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School, Gwangju, Korea
| | - Hyong-Ho Cho
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School, Gwangju, Korea
| | - Si Young Jo
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School, Gwangju, Korea
| | - Chul Ho Jang
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School, Gwangju, Korea
| | - Yong Beom Cho
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School, Gwangju, Korea
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Soares ADS, Couceiro TCDM, Lima LC, Flores FLL, Alcoforado EMB, Filho RDOC. Association of pain catastrophizing with the incidence and severity of acute and persistent perineal pain after natural childbirth: longitudinal cohort study. Braz J Anesthesiol 2014; 63:317-21. [PMID: 24565237 DOI: 10.1016/j.bjane.2012.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2012] [Accepted: 12/05/2012] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Vaginal birth delivery may result in acute and persistent perineal pain postpartum. This study evaluated the association between catastrophizing, a phenomenon of poor psychological adjustment to pain leading the individual to magnify the painful experience making it more intense, and the incidence and severity of perineal pain and its relationship to perineal trauma. METHOD Cohort study conducted with pregnant women in labor. We used the pain catastrophizing scale during hospitalization and assessed the degree of perineal lesion and pain severity in the first 24 hours and after 8 weeks of delivery using a numerical pain scale. RESULTS We evaluated 55 women, with acute pain reported by 69.1%, moderate/severe pain by 36.3%, and persistent pain by 14.5%. Catastrophizing mean score was 2.15 ± 1.24. Catastrophizing patients showed a 2.90 relative risk (RR) for perineal pain (95% CI: 1.08-7.75) and RR: 1.31 for developing persistent perineal pain (95% CI: 1.05-1.64). They also showed a RR: 2.2 for developing acute and severe perineal pain (95% CI: 1.11-4.33). CONCLUSIONS The incidence of acute and persistent perineal pain after vaginal delivery is high. Catastrophizing pregnant women are at increased risk for developing acute and persistent perineal pain, as well as severe pain. Perineal trauma increased the risk of persistent perineal pain.
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Affiliation(s)
| | - Tânia Cursino de Menezes Couceiro
- Holder of Superior Title in Anesthesiology (TSA); Master in Neuroscience, Universidade Federal de Pernambuco, Recife; Coordinator, IMIP, Recife, PE, Brazil.
| | - Luciana Cavalcanti Lima
- PhD in Anesthesiology, Universidade Estadual Paulista Júlio de Mesquita Filho, São Paulo; Professor & Coordinator, Faculdade Pernambucana de Saúde, Recife, PE, Brazil
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Erdivanli B, Altun M, Sezen OK, Colakoğlu SA. Anti-nociceptive, analgesic and pathohistological effects of intrathecal dexmedetomidine and bupivacaine in rats. Braz J Anesthesiol 2013; 63:183-7. [PMID: 24565124 DOI: 10.1016/j.bjane.2012.02.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2011] [Accepted: 02/27/2012] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND AND OBJECTIVES This study investigates analgesic and nociceptive effects of adding dexmedetomidine to bupivacaine neuraxial anesthesia through Tail-flick (TF) and Hot-plate (HP) tests and the pathohistological changes on spinal nerves and nerve roots through light microscopy. METHODS Forty anesthetized, male Sprague-Dawley rats were intrathecally catheterized. Basal values of TF and HP tests were measured before and after catheterization. Thirty-six successfully catheterized rats were assigned to four groups. Group B received 10 μg bupivacaine, Group BD3 received 10 μg bupivacaine + 3 μg dexmedetomidine, Group BD10 received 10 μg bupivacaine + 10 μg dexmedetomidine and Control group received 10 μL volume of artificial cerebrospinal fluid. TF and HP tests were performed between the 5(th) and 300(th) minutes of drug administration. Twenty-four hours after administration of drugs, rats were sacrificed and spinal cord and nerve roots were removed for pathological investigation. RESULTS Baseline values of the TF and HP tests were not statistically different among the groups (6.8 ± 0.15 s). TF and HP latencies in the Control group did not change significantly during the study. TF and HP test results showed that adding 3 and 10 μg dexmedetomidine caused a dose- dependent increase in duration and amplitude of analgesic and nociceptive effect of bupivacaine (TF: 37.52 ± 1.08%, 57.86 ± 1.16% respectively, HP: 44.24 ± 1.15%, 68.43 ± 1.24% respectively). CONCLUSIONS There were no apparent pathohistological changes at least 24 hours after the intrathecal administration of a single dose of dexmedetomidine 3 μg and 10 μg. Dexmedetomidine added to bupivacaine for spinal block improves analgesia and prolongs block duration.
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Affiliation(s)
- Başar Erdivanli
- MD, Rize Research and Education Hospital, Department of Anesthesiology and Intensive Care.
| | - Murat Altun
- MD, Zonguldak Divriği Research and Education Hospital, Department of Anesthesiology and Intensive Care
| | - Ozlem K Sezen
- MD, Dr. Lütfi Kırdar Research and Education Hospital, II. Department of Anesthesiology and Intensive Care
| | - Serhan A Colakoğlu
- MD, Dr. Lütfi Kırdar Research and Education Hospital, II. Department of Anesthesiology and Intensive Care
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