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Does Postgraduate Education Deepen Temporomandibular Disorders Insights for Dental Professionals? 研究生教育能否加深牙科专业人员对颞下颌关节紊乱症的认识?
IF 2.5 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-10-14 eCollection Date: 2024-01-01 DOI: 10.1155/2024/3582362
Zejin Liu, Jie Xiang, Yi Liu, Xueman Zhou, Yating Yi, Jun Wang, Xin Xiong

Objective: This study aims to investigate the impact of postgraduate education on the comprehension of Temporomandibular Disorders (TMDs) among dental professionals. Methods: A cross-sectional observational study was conducted, involving 348 dental professionals, including students and practicing dentists, categorized based on their educational background into two groups: bachelor's degree or lower (Group B) and master's degree or higher (Group M). Questionnaires were utilized to assess attitudes and knowledge across four TMDs-related domains. Statistical analysis was performed to compare responses between groups and identify differences in TMDs comprehension. Results: Among the 348 respondents, who participated in the study, 183 were students and 165 were practicing dentists, yielding a response rate of 79% (348/440). In the dentist group, 11 statements across every TMDs-related domain exhibited statistically significant differences in responses between Group B and Group M (p < 0.05). Only 2 responses from Group M conflicted with the standard answers, whereas Group B had 9 conflicting responses. In the student group, 11 statements also showed statistically significant differences between Group B and Group M (p < 0.05). Group M had no conflicting responses with the standard answers, while Group B had 7 conflicting responses. Conclusions: Postgraduate education deepened dental professionals' understanding of TMDs. Students improved more in the domains of "diagnosis" and "treatment and prognosis," whereas practicing dentists enhanced more in the "etiology" domain. To further advance postgraduate education, there is a need for more systematic course designs for TMDs, emphasizing the enhancement of knowledge related to examination methods and treatment options.

研究目的本研究旨在调查研究生教育对牙科专业人员理解颞下颌关节紊乱症(TMDs)的影响。研究方法根据教育背景分为两组:学士学位或以下(B 组)和硕士学位或以上(M 组)。调查问卷用于评估与 TMD 相关的四个领域的态度和知识。我们进行了统计分析,以比较各组之间的回答,并确定在 TMDs 理解方面的差异。结果:在参与研究的 348 名受访者中,183 人为学生,165 人为执业牙医,回复率为 79%(348/440)。在牙医组中,B 组和 M 组在每个 TMD 相关领域的 11 个语句的回答在统计学上存在显著差异(p < 0.05)。M 组只有 2 个回答与标准答案相冲突,而 B 组有 9 个回答与标准答案相冲突。在学生组中,B 组和 M 组之间也有 11 项陈述在统计学上存在显著差异(p < 0.05)。M 组的回答与标准答案没有冲突,而 B 组有 7 个冲突的回答。结论研究生教育加深了牙科专业人员对 TMD 的理解。学生在 "诊断 "和 "治疗与预后 "方面的进步更大,而执业牙医在 "病因学 "方面的进步更大。为了进一步推动研究生教育,需要对 TMDs 进行更系统的课程设计,强调加强与检查方法和治疗方案相关的知识。
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引用次数: 0
Blockade of Piezo2 Pathway Attenuates Inflammatory and Neuropathic Pain in the Orofacial Area. 阻断 Piezo2 通路可减轻口面部的炎症性疼痛和神经性疼痛
IF 2.5 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-09-27 eCollection Date: 2024-01-01 DOI: 10.1155/2024/9179928
Min-Jeong Jo, Jo-Young Son, Yu-Mi Kim, Jin-Sook Ju, Min-Kyoung Park, Min-Kyung Lee, Dong-Kuk Ahn

Although previous studies suggest that Piezo2 regulates chronic pain in the orofacial area, few studies have reported the direct evidence of Piezo2's involvement in inflammatory and neuropathic pain in the orofacial region. In this study, we used male Sprague Dawley rats to investigate the role of the Piezo2 pathway in the development of inflammatory and neuropathic pain. The present study used interleukin (IL)-1β-induced pronociception as an inflammatory pain model. Subcutaneous injection of IL-1β produced significant mechanical allodynia and thermal hyperalgesia. Subcutaneous injection of a Piezo2 inhibitor significantly blocked mechanical allodynia and thermal hyperalgesia induced by subcutaneously injected IL-1β. Furthermore, the present study also used a neuropathic pain model caused by the misplacement of a dental implant, leading to notable mechanical allodynia as a consequence of inferior alveolar nerve injury. Western blot analysis revealed increased levels of Piezo2 in the trigeminal ganglion and the trigeminal subnucleus caudalis after inferior alveolar nerve injury. Furthermore, subcutaneous and intracisternal injections of a Piezo2 inhibitor blocked neuropathic mechanical allodynia. These results suggest that the Piezo2 pathway plays a critical role in the development of inflammatory and neuropathic pain in the orofacial area. Therefore, blocking the Piezo2 pathway could be the foundation for developing new therapeutic strategies to treat orofacial pain conditions.

尽管之前的研究表明 Piezo2 调节口面部区域的慢性疼痛,但很少有研究报道 Piezo2 参与口面部区域炎症性和神经性疼痛的直接证据。本研究以雄性 Sprague Dawley 大鼠为研究对象,探讨了 Piezo2 通路在炎症性疼痛和神经性疼痛发生过程中的作用。本研究使用白细胞介素(IL)-1β诱导的前驱痛作为炎症性疼痛模型。皮下注射IL-1β可产生明显的机械异感和热痛。皮下注射 Piezo2 抑制剂可明显阻断皮下注射 IL-1β 引起的机械异感和热痛。此外,本研究还使用了一种由牙科植入物错位引起的神经性疼痛模型,该模型因下齿槽神经损伤而导致明显的机械异感。Western 印迹分析显示,下牙槽神经损伤后,三叉神经节和三叉神经尾下部核中的 Piezo2 水平升高。此外,皮下注射和胸腔内注射 Piezo2 抑制剂可阻断神经性机械异感。这些结果表明,Piezo2 通路在口面部炎症性和神经性疼痛的发展过程中起着至关重要的作用。因此,阻断 Piezo2 通路可为开发治疗口面部疼痛的新疗法奠定基础。
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引用次数: 0
Efficacy of Gasserian Ganglion High-Voltage, Long-Duration Pulsed Radiofrequency Combined With Block on Acute/Subacute Zoster-Related Trigeminal Neuralgia. Gasserian 神经节高电压、长持续脉冲射频结合阻滞疗法对急性/亚急性带状疱疹相关三叉神经痛的疗效。
IF 2.5 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-09-19 eCollection Date: 2024-01-01 DOI: 10.1155/2024/1992483
Yinghao Song, Ziheng Yu, Jingjing Guan, Haisheng Wu, Qiaoling Liu, Min Yuan, Xinzhi Cheng, Bingyu Ling

Background: Trigeminal postherpetic neuralgia (TPHN) is a severe chronic pain that can lead to various socioeconomic consequences. Therefore, it is necessary to explore optimal treatment options for acute/subacute herpes zoster (HZ)-related trigeminal neuralgia and prevent the further development of TPHN. High-voltage, long-duration pulsed radiofrequency (HL-PRF) of the Gasserian ganglion is a new surgical intervention used to treat PHN. A ganglion block has been reported to possess anti-inflammatory effects and potential analgesic benefits. Methods: We included 83 patients with HZ-related acute/subacute trigeminal neuralgia admitted from January 1, 2021, to June 1, 2023, and received Gasserian ganglion HL-PRF combined with block. A 6-month follow-up was conducted, including Numerical Rating Scale (NRS) scores, Pittsburgh Sleep Quality Index (PSQI), the incidence of TPHN, the dosage of anticonvulsants and analgesics, efficacy, and adverse events. Results: All patients showed a significant decrease in postoperative NRS scores (p < 0.05). The NRS scores of the acute HZ group were consistently lower than those of the subacute HZ group at different time points (p < 0.01). The overall incidence of TPHN from the onset of HZ to 12 weeks is 21.68%. The incidence of TPHN in the acute phase group was 12.77%, significantly lower than the 33.33% in the subacute phase group (p=0.024). The effective rate was 74.7% in all patients, at 3 months after the treatment. The effective rate was 82.98% in the acute phase group and 63.89% in the subacute phase group, showing a statistically significant difference (p=0.047). The PSQI score of the acute group was consistently lower than that of the subacute group (p < 0.01). The dosage of analgesics and anticonvulsants used in the acute HZ group was lower than that in the subacute group (p < 0.01). All patients did not experience serious adverse reactions. Conclusions: Gasserian ganglion HL-PRF combined with block can be an effective and safe technique to relieve the pain of acute/subacute zoster-related trigeminal neuralgia and prevent the incidence of TPHN.

背景:三叉神经带状疱疹后遗神经痛(TPHN)是一种严重的慢性疼痛,可导致各种社会经济后果。因此,有必要探索急性/亚急性带状疱疹(HZ)相关三叉神经痛的最佳治疗方案,防止 TPHN 进一步发展。对 Gasserian 神经节进行高压、长时间脉冲射频(HL-PRF)治疗是一种用于治疗 PHN 的新型外科干预方法。据报道,神经节阻滞具有抗炎作用和潜在的镇痛效果。方法:我们纳入了自 2021 年 1 月 1 日至 2023 年 6 月 1 日期间收治的 83 例 HZ 相关急性/亚急性三叉神经痛患者,他们都接受了 Gasserian 神经节 HL-PRF 联合阻滞术。进行了为期 6 个月的随访,包括数字评定量表 (NRS) 评分、匹兹堡睡眠质量指数 (PSQI)、TPHN 发生率、抗惊厥药和镇痛药的用量、疗效和不良事件。结果所有患者的术后 NRS 评分均有明显下降(P < 0.05)。在不同时间点,急性 HZ 组的 NRS 评分始终低于亚急性 HZ 组(P < 0.01)。从 HZ 发病到 12 周期间,TPHN 的总发病率为 21.68%。急性期组的 TPHN 发生率为 12.77%,明显低于亚急性期组的 33.33%(P=0.024)。治疗 3 个月后,所有患者的有效率为 74.7%。急性期组的有效率为 82.98%,亚急性期组的有效率为 63.89%,差异有统计学意义(P=0.047)。急性期组的 PSQI 评分始终低于亚急性期组(P < 0.01)。急性 HZ 组镇痛药和抗惊厥药的用量低于亚急性组(P < 0.01)。所有患者均未出现严重不良反应。结论Gasserian 神经节 HL-PRF 联合阻滞疗法可以有效、安全地缓解急性/亚急性带状疱疹相关三叉神经痛的疼痛,并预防 TPHN 的发生。
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引用次数: 0
Monitoring Everyday Upper Extremity Function in Patients with Complex Regional Pain Syndrome: A Secondary, Retrospective Analysis from ncRNAPain. 监测复杂性区域疼痛综合征患者的日常上肢功能:来自 ncRNAPain 的二次回顾性分析。
IF 2.5 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-08-24 eCollection Date: 2024-01-01 DOI: 10.1155/2024/9993438
Gudrun-Karin Kindl, Ann-Kristin Reinhold, Fabiola Escolano-Lozano, Johannes Degenbeck, Frank Birklein, Heike L Rittner, Karolin Teichmüller

Objective: Complex regional pain syndrome (CRPS) represents a rare complication following injury to a limb. The DASH questionnaire (disability of arm, shoulder, and hand) evaluates everyday arm function. We assessed the DASH and its subitems in comparison to patients with brachial plexus lesions or fracture controls, analysed it over time, and in relation to active range of motion (ROM), to determine patients' impairment and trajectory.

Methods: The dataset included 193 patients with upper extremity CRPS from the noncoding RNA (ncRNA) Pain cohort, 36 fracture controls, and 12 patients with traumatic brachial plexus lesions. For the clinical and psychological characterisation, questionnaires and a goniometer for the measurement of ROM were utilized. Thirty-three patients were followed up after approximately 2.5 years of guideline treatment.

Results: CRPS patients had a similar mean DASH of 54.7 (standard deviation (S.D.) ±21) as brachial plexus lesion patients (M = 51.4, S.D. ± 16.1) but different significantly from fracture controls (M = 21.2, S.D. ± 21.1). Pain and older age were predictors of the DASH. Activities requiring force or impact on the arm, shoulder, or hand were mostly affected in patients with CRPS. After 2.5 years of standard treatment, the mean DASH score fell to 41.3 (S.D. ± 25.2), weakness in leisure activities was recuperated, pain feelings were lessened, and ROM, e.g., wrist flexion, recovered by 36°. Two-thirds of patients improved in both the DASH and the ROM.

Conclusions: CRPS is as disabling as a complete loss of arm function in brachial plexus lesions and exhibits only partial recovery. Developing QuickDASH versions for CRPS patients could reduce the load of questions in clinical studies. It would be prudent to consider the unexpected age dependency of the DASH in future studies. This trial is registered with DRKS00008964.

目的:复杂性区域疼痛综合征(CRPS)是一种罕见的肢体损伤后并发症。DASH问卷(手臂、肩部和手部残疾)可评估日常手臂功能。我们对 DASH 及其子项目进行了评估,并与臂丛神经损伤患者或骨折对照组进行了比较,分析了其随时间变化的情况以及与主动运动范围 (ROM) 的关系,以确定患者的损伤情况和轨迹:数据集包括非编码 RNA(ncRNA)疼痛队列中的 193 名上肢 CRPS 患者、36 名骨折对照组患者和 12 名外伤性臂丛神经损伤患者。在临床和心理特征分析方面,采用了调查问卷和动态关节角度计测量ROM。经过约2.5年的指导治疗后,对33名患者进行了随访:CRPS患者的DASH平均值为54.7(标准差(S.D. )±21),与臂丛神经损伤患者(M = 51.4,S.D. ±16.1)相似,但与骨折对照组(M = 21.2,S.D. ±21.1)有显著差异。疼痛和年龄较大是DASH的预测因素。在 CRPS 患者中,需要手臂、肩部或手部受力或撞击的活动大多受到影响。经过 2.5 年的标准治疗后,DASH 平均得分降至 41.3(标准偏差 ± 25.2),休闲活动中的无力感得到恢复,疼痛感减轻,腕关节活动度(如腕关节屈曲)恢复了 36°。三分之二的患者在DASH和ROM方面都有所改善:结论:CRPS 与臂丛神经损伤导致的手臂功能完全丧失一样具有致残性,并且仅表现出部分恢复。为 CRPS 患者开发 QuickDASH 版本可以减少临床研究中的问题。在未来的研究中,应谨慎考虑 DASH 意外的年龄依赖性。该试验的注册号为 DRKS00008964。
{"title":"Monitoring Everyday Upper Extremity Function in Patients with Complex Regional Pain Syndrome: A Secondary, Retrospective Analysis from ncRNAPain.","authors":"Gudrun-Karin Kindl, Ann-Kristin Reinhold, Fabiola Escolano-Lozano, Johannes Degenbeck, Frank Birklein, Heike L Rittner, Karolin Teichmüller","doi":"10.1155/2024/9993438","DOIUrl":"10.1155/2024/9993438","url":null,"abstract":"<p><strong>Objective: </strong>Complex regional pain syndrome (CRPS) represents a rare complication following injury to a limb. The DASH questionnaire (disability of arm, shoulder, and hand) evaluates everyday arm function. We assessed the DASH and its subitems in comparison to patients with brachial plexus lesions or fracture controls, analysed it over time, and in relation to active range of motion (ROM), to determine patients' impairment and trajectory.</p><p><strong>Methods: </strong>The dataset included 193 patients with upper extremity CRPS from the noncoding RNA (ncRNA) Pain cohort, 36 fracture controls, and 12 patients with traumatic brachial plexus lesions. For the clinical and psychological characterisation, questionnaires and a goniometer for the measurement of ROM were utilized. Thirty-three patients were followed up after approximately 2.5 years of guideline treatment.</p><p><strong>Results: </strong>CRPS patients had a similar mean DASH of 54.7 (standard deviation (S.D.) ±21) as brachial plexus lesion patients (<i>M</i> = 51.4, S.D. ± 16.1) but different significantly from fracture controls (<i>M</i> = 21.2, S.D. ± 21.1). Pain and older age were predictors of the DASH. Activities requiring force or impact on the arm, shoulder, or hand were mostly affected in patients with CRPS. After 2.5 years of standard treatment, the mean DASH score fell to 41.3 (S.D. ± 25.2), weakness in leisure activities was recuperated, pain feelings were lessened, and ROM, e.g., wrist flexion, recovered by 36°. Two-thirds of patients improved in both the DASH and the ROM.</p><p><strong>Conclusions: </strong>CRPS is as disabling as a complete loss of arm function in brachial plexus lesions and exhibits only partial recovery. Developing QuickDASH versions for CRPS patients could reduce the load of questions in clinical studies. It would be prudent to consider the unexpected age dependency of the DASH in future studies. This trial is registered with DRKS00008964.</p>","PeriodicalId":19913,"journal":{"name":"Pain Research & Management","volume":"2024 ","pages":"9993438"},"PeriodicalIF":2.5,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11366060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142110738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assessment of Clinical Analgesic Levels and Serum Biomarkers in Patients with Rheumatoid Arthritis: A Randomized Controlled Trial Comparing the Efficacy of Diclofenac and Methotrexate Combined Therapy with Extracorporeal Shockwave Therapy. 类风湿性关节炎患者临床镇痛水平和血清生物标志物评估:比较双氯芬酸和甲氨蝶呤联合疗法与体外冲击波疗法疗效的随机对照试验》。
IF 2.5 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-08-21 eCollection Date: 2024-01-01 DOI: 10.1155/2024/6687987
Mei Zhang, Zhongyuan Ma, Rinkiko Suguro, Menglin Zhu, Esther Xinyi Chen, Xin Dong, Meixiu Chen, Linling Cheng, Bolun Su, Yizhun Zhu

Background: Rheumatoid arthritis (RA) is one of the most common forms of arthritis. Extracorporeal shockwave therapy (ESWT) has been identified as a viable alternative therapeutic approach in light of the present protracted clinical course of pharmacological treatment, and changes in levels of marker proteins in the blood samples of RA patients can be utilized to assess treatment outcomes.

Methods: A randomized controlled trial was conducted involving forty patients diagnosed with rheumatoid arthritis (RA) who were assigned randomly to two groups. The first group received a combination of diclofenac and methotrexate (MTX) consisting of 25 mg of diclofenac administered thrice daily and 15 mg of MTX administered once weekly. Individual follow-up assessments were carried out after 7 and 14 days. Meanwhile, patients in the second group underwent two sessions of Extracorporeal Shockwave Therapy (ESWT), with a 7-day interval between sessions. Evaluations were conducted on day 7 and day 14. Patients who displayed pain control and stability were advised to continue the treatment, whereas those who had inflammation and discomfort were administered specific medications, and their progress was closely monitored until day 28. Blood samples were collected from both groups prior to treatment, after the first treatment, and after the second treatment. Four marker proteins (NRP-1, CELF-6, COX-2, and RGS-1) and two inflammatory cytokines (IL-6 and IL-17) were measured using western blot and RT-PCR techniques. A statistical analysis was conducted on the levels of specific proteins and inflammatory factors before and after treatment to evaluate its impact.

Result: Both groups exhibited statistically significant differences in the serum level of target biomarkers before and after the intervention. However, the ESWT group demonstrated a more noticeable effect, while the diclofenac + MTX group exhibited a delayed anti-inflammatory effect compared to ESWT.

Conclusion: Both treatments significantly improved joint function, relieved pain, and reduced inflammation in patients. However, ESWT demonstrated a more prominent clinical analgesic effect compared to the combination treatment of diclofenac and MTX. Furthermore, ESWT produced a more immediate and noteworthy anti-inflammatory impact by regulating NRP-1 expression, a trophic factor receptor that facilitates vascular endothelial cell migration and tissue repair through angiogenesis, and regulating RGS-1 to limit inflammatory signal transmission and immune cell activation.

背景:类风湿性关节炎(RA)是最常见的关节炎之一。体外冲击波疗法(ESWT)被认为是一种可行的替代治疗方法,因为目前的临床药物治疗疗程较长,而类风湿关节炎患者血液样本中标记蛋白水平的变化可用于评估治疗效果:我们进行了一项随机对照试验,将 40 名确诊为类风湿性关节炎(RA)的患者随机分配到两组。第一组接受双氯芬酸和甲氨蝶呤(MTX)联合治疗,包括每天三次服用 25 毫克双氯芬酸和每周一次服用 15 毫克 MTX。7 天和 14 天后分别进行随访评估。与此同时,第二组患者接受了两次体外冲击波疗法(ESWT),两次治疗间隔 7 天。第 7 天和第 14 天进行评估。对于疼痛得到控制且病情稳定的患者,建议他们继续接受治疗;而对于出现炎症和不适的患者,则给予他们特定的药物治疗,并在第 28 天前密切监测他们的病情进展。两组患者在治疗前、第一次治疗后和第二次治疗后都采集了血液样本。使用 Western 印迹和 RT-PCR 技术检测了四种标记蛋白(NRP-1、CELF-6、COX-2 和 RGS-1)和两种炎症细胞因子(IL-6 和 IL-17)。对治疗前后特定蛋白质和炎症因子的水平进行了统计分析,以评估其影响:结果:两组目标生物标志物的血清水平在干预前后均有显著的统计学差异。然而,ESWT 组的疗效更明显,而双氯芬酸 + MTX 组的抗炎效果则比 ESWT 组延迟:结论:两种治疗方法都能明显改善患者的关节功能、缓解疼痛并减轻炎症。结论:两种治疗方法都能明显改善患者的关节功能,缓解疼痛,减轻炎症。然而,与双氯芬酸和 MTX 联合治疗相比,ESWT 的临床镇痛效果更为突出。此外,ESWT通过调节NRP-1(一种营养因子受体,可通过血管生成促进血管内皮细胞迁移和组织修复)的表达,以及调节RGS-1以限制炎症信号传递和免疫细胞激活,产生了更直接、更显著的抗炎效果。
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引用次数: 0
Potential S1 Nerve Root Blocks Associated with Sacroiliac Joint Injections. 与骶髂关节注射相关的潜在 S1 神经根阻滞。
IF 2.5 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-07-30 eCollection Date: 2024-01-01 DOI: 10.1155/2024/8064804
Andrew Ng, Jesse Lou, Dajie Wang

Background: Sacroiliac (SI) joint dysfunction is a common cause of lower back pain. The diagnosis of SI joint pain remains challenging. Sacroiliac joint injection remains the gold standard of diagnosis of SI joint pain as well as providing therapeutic effect. One complication related to SI joint injection is temporary numbness and weakness of the leg.

Objectives: To evaluate the anatomy of the SI joint and the flow of the contrast in the sacroiliac joint and to understand how local anesthetic can affect the nerve roots and cause temporary weakness and numbness of the leg. Study Design. Retrospective case series. Setting. Academic medical center.

Methods: Patients who underwent SI joint injection with three-dimensional cone beam computed tomography with fluoroscopy (3D-CBCT) imaging were identified through retrospective review of two providers' case log from the electronic medical record. The cone beam CT images were reviewed to study the contrast spread and flow in the SI joint.

Results: 27/32 patients with the mean age of 56 years (range 39-87 years), 20 females, and 7 males were included in this study. After reviewing cone beam CT images, 4/27 (14.8%) patients showed contrast spread in the SI joint and spread into the S1 posterior neuroforamen. The remainder 23/27 (85.2%) patients had contrast localized in the SI joint. Limitations. Small population size, retrospective review of medical records.

Conclusion: Our results indicate that the injection of lower concentration of local anesthetic with less volume may be necessary to decrease the risk of S1 nerve root block and epidural block. Furthermore, to improve the specificity of a diagnostic SI injection, an appropriate evaluation should be considered to rule out any S1 nerve pathology as a significant pain generator.

背景:骶髂关节(SI)功能障碍是下背部疼痛的常见原因。骶髂关节疼痛的诊断仍然具有挑战性。骶髂关节注射仍是诊断 SI 关节痛的金标准,并能提供治疗效果。骶髂关节注射的并发症之一是暂时性腿部麻木和无力:评估骶髂关节的解剖结构和对比剂在骶髂关节内的流动情况,了解局麻药如何影响神经根并导致暂时性腿部无力和麻木。研究设计。回顾性病例系列。地点: 学术医疗中心。学术医疗中心:通过回顾性审查电子病历中两名医疗人员的病例记录,确定接受了带透视的三维锥形束计算机断层扫描(3D-CBCT)成像的 SI 关节注射的患者。结果显示:27/32 名患者的平均年龄为 56 岁(39-87 岁),其中女性 20 人,男性 7 人。锥形束 CT 图像显示,4/27(14.8%)例患者的 SI 关节出现造影剂扩散,并扩散至 S1 后神经孔。其余 23/27 例(85.2%)患者的造影剂局限于 SI 关节。局限性。人群规模小,回顾性审查医疗记录:我们的研究结果表明,要降低 S1 神经根阻滞和硬膜外阻滞的风险,可能需要注射较低浓度、较少容量的局麻药。此外,为了提高诊断性 SI 注射的特异性,应考虑进行适当的评估,以排除任何 S1 神经病变作为重要的疼痛诱因。
{"title":"Potential S1 Nerve Root Blocks Associated with Sacroiliac Joint Injections.","authors":"Andrew Ng, Jesse Lou, Dajie Wang","doi":"10.1155/2024/8064804","DOIUrl":"10.1155/2024/8064804","url":null,"abstract":"<p><strong>Background: </strong>Sacroiliac (SI) joint dysfunction is a common cause of lower back pain. The diagnosis of SI joint pain remains challenging. Sacroiliac joint injection remains the gold standard of diagnosis of SI joint pain as well as providing therapeutic effect. One complication related to SI joint injection is temporary numbness and weakness of the leg.</p><p><strong>Objectives: </strong>To evaluate the anatomy of the SI joint and the flow of the contrast in the sacroiliac joint and to understand how local anesthetic can affect the nerve roots and cause temporary weakness and numbness of the leg. <i>Study Design</i>. Retrospective case series. <i>Setting</i>. Academic medical center.</p><p><strong>Methods: </strong>Patients who underwent SI joint injection with three-dimensional cone beam computed tomography with fluoroscopy (3D-CBCT) imaging were identified through retrospective review of two providers' case log from the electronic medical record. The cone beam CT images were reviewed to study the contrast spread and flow in the SI joint.</p><p><strong>Results: </strong>27/32 patients with the mean age of 56 years (range 39-87 years), 20 females, and 7 males were included in this study. After reviewing cone beam CT images, 4/27 (14.8%) patients showed contrast spread in the SI joint and spread into the S1 posterior neuroforamen. The remainder 23/27 (85.2%) patients had contrast localized in the SI joint. <i>Limitations</i>. Small population size, retrospective review of medical records.</p><p><strong>Conclusion: </strong>Our results indicate that the injection of lower concentration of local anesthetic with less volume may be necessary to decrease the risk of S1 nerve root block and epidural block. Furthermore, to improve the specificity of a diagnostic SI injection, an appropriate evaluation should be considered to rule out any S1 nerve pathology as a significant pain generator.</p>","PeriodicalId":19913,"journal":{"name":"Pain Research & Management","volume":"2024 ","pages":"8064804"},"PeriodicalIF":2.5,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11303053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141897968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Psychometric Properties of the Arabic Version of the Pain Resilience Scale among Lebanese Adults with Chronic Musculoskeletal Pain. 患有慢性肌肉骨骼疼痛的黎巴嫩成年人疼痛恢复能力量表阿拉伯语版的心理计量特性。
IF 2.5 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-07-29 eCollection Date: 2024-01-01 DOI: 10.1155/2024/7361038
Melissa Makhoul, Samar Noureddine, Huda Abu-Saad Huijer, Laila Farhood, Souha Fares, Imad Uthman, Douglas J French, Christopher R France

Background: The Pain Resilience Scale (PRS), which measures behavioral perseverance and the ability to regulate emotions and cognition despite ongoing pain, lacks an Arabic version.

Objectives: This study aimed to translate, culturally adapt, and validate an Arabic version of the Pain Resilience Scale (PRS-A) among Lebanese adults.

Methods: Phase 1 involved translation and cross-cultural adaptation of the PRS into Arabic. Phase 2 examined the reliability and validity of the PRS-A. A convenience sample of 154 Lebanese adults with chronic musculoskeletal pain completed the PRS-A and self-report measures of pain catastrophizing, pain self-efficacy, pain intensity and interference, depression and anxiety, and quality of life.

Results: The PRS-A yielded a two-factor structure with factor 1 representing "cognitive/affective positivity" and factor 2 representing "behavioral perseverance," accounting for 41.93% and 15.15% of the variance in pain resilience, respectively. Total PRS-A score (M = 33.20 and SD = 9.90) showed significant correlations with pain catastrophizing (M = 27.65, SD = 13.03, and r = -0.52), pain self-efficacy (median = 9.00, IQR = 4, and rho = 0.61), pain intensity (M = 4.50, SD = 2.25, and r = -0.28), pain interference (M = 4.30, SD = 2.89, and r = -0.56), physical (M = 34.95, SD = 9.52, and r = 0.34) and mental (M = 40.08, SD = 12.49, and r = 0.58) health functioning, anxiety (median = 7.00, IQR = 7, and rho = -0.57), and depression (median = 4.00, IQR = 6, and rho = -0.58). PRS-A subscale was also significantly related to all measures except pain intensity, which was correlated with cognitive/affective positivity (r = -0.33) but not behavioral perseverance (r = -0.09). Cronbach's alpha for the PRS-A was 0.87.

Conclusion: The PRS-A demonstrated validity and acceptable reliability among Arab-speaking individuals with chronic musculoskeletal pain, suggesting its potential utility for assessing pain resilience within this population.

背景:疼痛恢复力量表(PRS)用于测量在持续疼痛情况下的行为毅力以及调节情绪和认知的能力:疼痛恢复力量表(PRS)用于测量在持续疼痛的情况下的行为毅力以及调节情绪和认知的能力,但该量表缺乏阿拉伯语版本:本研究旨在翻译阿拉伯语版疼痛恢复力量表(PRS-A),对其进行文化适应性调整,并在黎巴嫩成年人中进行验证:方法:第一阶段包括将 PRS 翻译成阿拉伯语并进行跨文化改编。第二阶段对 PRS-A 的信度和效度进行了检验。154 名患有慢性肌肉骨骼疼痛的黎巴嫩成年人完成了 PRS-A 和疼痛灾难化、疼痛自我效能感、疼痛强度和干扰、抑郁和焦虑以及生活质量的自我报告测量:PRS-A产生了双因子结构,因子1代表 "认知/情感积极性",因子2代表 "行为毅力",分别占疼痛恢复力变异的41.93%和15.15%。PRS-A 总分(M = 33.20,SD = 9.90)与疼痛灾难化(M = 27.65,SD = 13.03,r = -0.52)、疼痛自我效能(中位数 = 9.00,IQR = 4,rho = 0.61)、疼痛强度(M = 4.50,SD = 2.25,r = -0.28)、疼痛干扰(M = 4.30,SD = 2.89,r = -0.56)、身体(M = 34.95,SD = 9.52,r = 0.34)和心理(M = 40.08,SD = 12.49,r = 0.58)健康功能、焦虑(中位数 = 7.00,IQR = 7,rho = -0.57)和抑郁(中位数 = 4.00,IQR = 6,rho = -0.58)。PRS-A 子量表与所有测量指标都有显著相关性,但疼痛强度除外,疼痛强度与认知/情感积极性相关(r = -0.33),但与行为毅力无关(r = -0.09)。PRS-A的Cronbach's alpha为0.87:PRS-A在讲阿拉伯语的慢性肌肉骨骼疼痛患者中表现出有效性和可接受的可靠性,表明它在评估该人群的疼痛恢复能力方面具有潜在的实用性。
{"title":"Psychometric Properties of the Arabic Version of the Pain Resilience Scale among Lebanese Adults with Chronic Musculoskeletal Pain.","authors":"Melissa Makhoul, Samar Noureddine, Huda Abu-Saad Huijer, Laila Farhood, Souha Fares, Imad Uthman, Douglas J French, Christopher R France","doi":"10.1155/2024/7361038","DOIUrl":"10.1155/2024/7361038","url":null,"abstract":"<p><strong>Background: </strong>The Pain Resilience Scale (PRS), which measures behavioral perseverance and the ability to regulate emotions and cognition despite ongoing pain, lacks an Arabic version.</p><p><strong>Objectives: </strong>This study aimed to translate, culturally adapt, and validate an Arabic version of the Pain Resilience Scale (PRS-A) among Lebanese adults.</p><p><strong>Methods: </strong>Phase 1 involved translation and cross-cultural adaptation of the PRS into Arabic. Phase 2 examined the reliability and validity of the PRS-A. A convenience sample of 154 Lebanese adults with chronic musculoskeletal pain completed the PRS-A and self-report measures of pain catastrophizing, pain self-efficacy, pain intensity and interference, depression and anxiety, and quality of life.</p><p><strong>Results: </strong>The PRS-A yielded a two-factor structure with factor 1 representing \"cognitive/affective positivity\" and factor 2 representing \"behavioral perseverance,\" accounting for 41.93% and 15.15% of the variance in pain resilience, respectively. Total PRS-A score (<i>M</i> = 33.20 and SD = 9.90) showed significant correlations with pain catastrophizing (<i>M</i> = 27.65, SD = 13.03, and <i>r</i> = -0.52), pain self-efficacy (median = 9.00, IQR = 4, and rho = 0.61), pain intensity (<i>M</i> = 4.50, SD = 2.25, and <i>r</i> = -0.28), pain interference (<i>M</i> = 4.30, SD = 2.89, and <i>r</i> = -0.56), physical (<i>M</i> = 34.95, SD = 9.52, and <i>r</i> = 0.34) and mental (<i>M</i> = 40.08, SD = 12.49, and <i>r</i> = 0.58) health functioning, anxiety (median = 7.00, IQR = 7, and rho = -0.57), and depression (median = 4.00, IQR = 6, and rho = -0.58). PRS-A subscale was also significantly related to all measures except pain intensity, which was correlated with cognitive/affective positivity (<i>r</i> = -0.33) but not behavioral perseverance (<i>r</i> = -0.09). Cronbach's alpha for the PRS-A was 0.87.</p><p><strong>Conclusion: </strong>The PRS-A demonstrated validity and acceptable reliability among Arab-speaking individuals with chronic musculoskeletal pain, suggesting its potential utility for assessing pain resilience within this population.</p>","PeriodicalId":19913,"journal":{"name":"Pain Research & Management","volume":"2024 ","pages":"7361038"},"PeriodicalIF":2.5,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11300090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Exploring the Analgesic Initiation Mechanism of Tuina in the Dorsal Root Ganglion of Minor CCI Rats via the TRPV1/TRPA1-cGMP Pathway. 探索推拿通过 TRPV1/TRPA1-cGMP 通路在 CCI 小鼠背根神经节中的镇痛启动机制
IF 2.5 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-07-24 eCollection Date: 2024-01-01 DOI: 10.1155/2024/2437396
Zhenjie Yang, Chula Sa, Tianyuan Yu, Jinping Chen, Runlong Zhang, Yingqi Zhang, Jiayue Liu, Hanyu Zhang, Jiawei Sun

Tuina is a treatment method in traditional Chinese medicine which has analgesic effects and effectively alleviates the symptoms of neuropathic pain (NP). Transient receptor potential vanilloid type 1 (TRPV1) and transient receptor potential ankyrin type 1 (TRPA1) play major roles in transmitting nociceptive sensory signals in the nociceptive primary sensory dorsal root ganglion (DRG) nerve. The nitric oxide (NO)/cyclic guanosine 3',5'-monophosphate(cGMP) pathway exerts both nociceptive and antinociceptive effects in various chronic pain models. TRPV1 and TRPA1 mediate the influx of calcium, which stimulates the generation of NO. Subsequently, NO activates the NO/cGMP/protein kinase G (PKG) signaling pathway, thereby improving hyperalgesia. In the present study, oa rat model of NP with minor chronic constriction injury (CCI) of the right sciatic nerve of NP was established. The results of behavioral testing showed that, after a one-time tuina intervention, the mechanical withdrawal threshold (MWT) and thermal withdrawal latency (TWL) were prolonged to varying degrees in the tuina group compared with the model group. Similarly, the expression of TRPV1, TRPA1, NO, soluble guanylate cyclase β (sGCβ), cGMP, and PKG1 was significantly decreased in the DRG of the tuina and tuina + TRPV1/TRPA1 antagonist group was significantly decreased. These findings suggest that the tuina intervention can effectively improve the symptoms of thermal and mechanical allodynia caused by peripheral nerve injuries. Tuina exerts immediate analgesic effects through the TRPV1/TRPA1-NO-cGMP-PKG signaling pathway.

推拿是传统中医的一种治疗方法,具有镇痛作用,能有效缓解神经病理性疼痛(NP)的症状。瞬时受体电位类香草素 1 型(TRPV1)和瞬时受体电位淀粉样蛋白 1 型(TRPA1)在痛觉初级感觉背根神经节(DRG)神经的痛觉感觉信号传递中起主要作用。在各种慢性疼痛模型中,一氧化氮(NO)/环鸟苷-3',5'-单磷酸(cGMP)通路可产生痛觉和抗痛觉效应。TRPV1 和 TRPA1 介导钙的流入,从而刺激 NO 的生成。随后,NO 会激活 NO/cGMP/ 蛋白激酶 G(PKG)信号通路,从而改善痛觉减退。本研究建立了大鼠 NP 右坐骨神经轻微慢性收缩损伤(CCI)模型。行为测试结果表明,与模型组相比,经过一次性推拿干预后,推拿组大鼠的机械退缩阈值(MWT)和热退缩潜伏期(TWL)均有不同程度的延长。同样,推拿组和推拿+TRPV1/TRPA1拮抗剂组的DRG中TRPV1、TRPA1、NO、可溶性鸟苷酸环化酶β(sGCβ)、cGMP和PKG1的表达均显著降低。这些研究结果表明,推拿干预能有效改善周围神经损伤引起的热觉和机械异感症状。推拿通过TRPV1/TRPA1-NO-cGMP-PKG信号通路发挥即时镇痛作用。
{"title":"Exploring the Analgesic Initiation Mechanism of Tuina in the Dorsal Root Ganglion of Minor CCI Rats via the TRPV1/TRPA1-cGMP Pathway.","authors":"Zhenjie Yang, Chula Sa, Tianyuan Yu, Jinping Chen, Runlong Zhang, Yingqi Zhang, Jiayue Liu, Hanyu Zhang, Jiawei Sun","doi":"10.1155/2024/2437396","DOIUrl":"10.1155/2024/2437396","url":null,"abstract":"<p><p>Tuina is a treatment method in traditional Chinese medicine which has analgesic effects and effectively alleviates the symptoms of neuropathic pain (NP). Transient receptor potential vanilloid type 1 (TRPV1) and transient receptor potential ankyrin type 1 (TRPA1) play major roles in transmitting nociceptive sensory signals in the nociceptive primary sensory dorsal root ganglion (DRG) nerve. The nitric oxide (NO)/cyclic guanosine 3',5'-monophosphate(cGMP) pathway exerts both nociceptive and antinociceptive effects in various chronic pain models. TRPV1 and TRPA1 mediate the influx of calcium, which stimulates the generation of NO. Subsequently, NO activates the NO/cGMP/protein kinase G (PKG) signaling pathway, thereby improving hyperalgesia. In the present study, oa rat model of NP with minor chronic constriction injury (CCI) of the right sciatic nerve of NP was established. The results of behavioral testing showed that, after a one-time tuina intervention, the mechanical withdrawal threshold (MWT) and thermal withdrawal latency (TWL) were prolonged to varying degrees in the tuina group compared with the model group. Similarly, the expression of TRPV1, TRPA1, NO, soluble guanylate cyclase <i>β</i> (sGC<i>β</i>), cGMP, and PKG1 was significantly decreased in the DRG of the tuina and tuina + TRPV1/TRPA1 antagonist group was significantly decreased. These findings suggest that the tuina intervention can effectively improve the symptoms of thermal and mechanical allodynia caused by peripheral nerve injuries. Tuina exerts immediate analgesic effects through the TRPV1/TRPA1-NO-cGMP-PKG signaling pathway.</p>","PeriodicalId":19913,"journal":{"name":"Pain Research & Management","volume":"2024 ","pages":"2437396"},"PeriodicalIF":2.5,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11300051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Knowledge and Practice of Neonatal Pain Management and Associated Factors among Health Care Providers in Neonatal Intensive Care Units of Public Hospitals in North Shoa Zone, Amhara Regional State, Ethiopia, 2023. 埃塞俄比亚阿姆哈拉地区州北肖亚区公立医院新生儿重症监护室医护人员的新生儿疼痛管理知识和实践及相关因素,2023 年。
IF 2.5 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-07-22 eCollection Date: 2024-01-01 DOI: 10.1155/2024/9997231
Abraraw Admasu Jember, Eyosiyas Yeshialem Asefa, Abdurahman Mohammed Ahmed, Addis Yeshitila Kidane

Background: Neonatal pain has been underrecognized and undertreated in many settings with the youngest children and neonates suffering the greatest consequences. Despite recent advancements in the assessment and therapy of children's pain, a knowledge-to-practice gap still exists especially in developing nations including our country Ethiopia.

Objectives: To assess knowledge, practice, and associated factors towards neonatal pain management among health care professionals working at neonatal intensive care units of public hospitals in North Shoa Zone, Amhara regional state, Ethiopia.

Method: Facility-based cross-sectional study design was conducted among health care professionals working at NICU in all public hospitals in North Shoa Zone, from May 9, 2023, to May 23, 2023. Data were collected using a self-administered questionnaire from 123 health care professionals working at NICUs in eleven public hospitals. The collected data were checked and entered into EPI data version 3.1 and then exported to SPSS version 25 for further descriptive and logistic regression analysis. Data are summarized using descriptive statistics and presented using narrations, tables, and graphs.

Result: The study reveals that 48% of health care professionals possessed adequate knowledge, while only 5.7% demonstrated good practices in neonatal pain management. Factors significantly associated with better neonatal pain management practices included having good knowledge of neonatal pain management (AOR = 3.36, 95% CI [1.19-9.49]), a higher educational level (AOR = 4.48, 95% CI [1.62-13.88]), and the availability of a pain scale assessment tool in the neonatal unit (AOR = 3.91, 95% CI [1.50-10.20]). Moreover, the type of profession, specifically being a nurse (AOR = 0.23, 95% CI [0.08-0.66]), was significantly associated with knowledge of neonatal pain management.

Conclusion: Health care professionals' knowledge and practice regarding neonatal pain management are insufficient. Multisectoral collaboration is essential to enhance their knowledge and skills and improve the availability of pain scale assessment tools and supportive materials.

背景:在许多情况下,新生儿疼痛一直未得到充分认识和治疗,其中最年幼的儿童和新生儿所承受的后果最为严重。尽管最近在儿童疼痛的评估和治疗方面取得了进展,但从知识到实践的差距仍然存在,尤其是在包括我国埃塞俄比亚在内的发展中国家:评估埃塞俄比亚阿姆哈拉州北肖亚区公立医院新生儿重症监护室医护人员对新生儿疼痛管理的知识、实践和相关因素:从 2023 年 5 月 9 日至 2023 年 5 月 23 日,对北肖亚区所有公立医院新生儿重症监护室的医护人员进行了基于设施的横断面研究。研究采用自填式调查问卷的方式收集数据,调查对象为 11 家公立医院新生儿重症监护室的 123 名医护人员。收集到的数据经核对后输入 EPI 数据 3.1 版,然后导出到 SPSS 25 版进行进一步的描述性分析和逻辑回归分析。数据采用描述性统计方法进行总结,并以叙述、表格和图表的形式呈现:研究显示,48% 的医护人员拥有足够的新生儿疼痛管理知识,而只有 5.7% 的医护人员表现出良好的新生儿疼痛管理实践。与更好的新生儿疼痛管理实践明显相关的因素包括:具备良好的新生儿疼痛管理知识(AOR = 3.36,95% CI [1.19-9.49])、较高的教育水平(AOR = 4.48,95% CI [1.62-13.88])以及新生儿科室有疼痛量表评估工具(AOR = 3.91,95% CI [1.50-10.20])。此外,职业类型,特别是护士(AOR = 0.23,95% CI [0.08-0.66])与新生儿疼痛管理知识有显著相关性:结论:医护人员在新生儿疼痛管理方面的知识和实践不足。结论:医护人员在新生儿疼痛管理方面的知识和实践不足,多部门合作对提高他们的知识和技能以及改善疼痛量表评估工具和辅助材料的可用性至关重要。
{"title":"Knowledge and Practice of Neonatal Pain Management and Associated Factors among Health Care Providers in Neonatal Intensive Care Units of Public Hospitals in North Shoa Zone, Amhara Regional State, Ethiopia, 2023.","authors":"Abraraw Admasu Jember, Eyosiyas Yeshialem Asefa, Abdurahman Mohammed Ahmed, Addis Yeshitila Kidane","doi":"10.1155/2024/9997231","DOIUrl":"10.1155/2024/9997231","url":null,"abstract":"<p><strong>Background: </strong>Neonatal pain has been underrecognized and undertreated in many settings with the youngest children and neonates suffering the greatest consequences. Despite recent advancements in the assessment and therapy of children's pain, a knowledge-to-practice gap still exists especially in developing nations including our country Ethiopia.</p><p><strong>Objectives: </strong>To assess knowledge, practice, and associated factors towards neonatal pain management among health care professionals working at neonatal intensive care units of public hospitals in North Shoa Zone, Amhara regional state, Ethiopia.</p><p><strong>Method: </strong>Facility-based cross-sectional study design was conducted among health care professionals working at NICU in all public hospitals in North Shoa Zone, from May 9, 2023, to May 23, 2023. Data were collected using a self-administered questionnaire from 123 health care professionals working at NICUs in eleven public hospitals. The collected data were checked and entered into EPI data version 3.1 and then exported to SPSS version 25 for further descriptive and logistic regression analysis. Data are summarized using descriptive statistics and presented using narrations, tables, and graphs.</p><p><strong>Result: </strong>The study reveals that 48% of health care professionals possessed adequate knowledge, while only 5.7% demonstrated good practices in neonatal pain management. Factors significantly associated with better neonatal pain management practices included having good knowledge of neonatal pain management (AOR = 3.36, 95% CI [1.19-9.49]), a higher educational level (AOR = 4.48, 95% CI [1.62-13.88]), and the availability of a pain scale assessment tool in the neonatal unit (AOR = 3.91, 95% CI [1.50-10.20]). Moreover, the type of profession, specifically being a nurse (AOR = 0.23, 95% CI [0.08-0.66]), was significantly associated with knowledge of neonatal pain management.</p><p><strong>Conclusion: </strong>Health care professionals' knowledge and practice regarding neonatal pain management are insufficient. Multisectoral collaboration is essential to enhance their knowledge and skills and improve the availability of pain scale assessment tools and supportive materials.</p>","PeriodicalId":19913,"journal":{"name":"Pain Research & Management","volume":"2024 ","pages":"9997231"},"PeriodicalIF":2.5,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11286314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141793042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Continuous Intra-Incisional Bupivacaine for Postoperative Analgesia after Hip Nailing Surgery: A Randomized Clinical Trial. 髋关节置钉手术后持续椎管内布比卡因术后镇痛:随机临床试验。
IF 2.5 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-07-22 eCollection Date: 2024-01-01 DOI: 10.1155/2024/2357709
Arash Farbood, Sanaz Abbasi, Naeimehossadat Asmarian, Mahsa Banifatemi, Vida Naderi-Boldaji, Zeinabsadat Fattahi Saravi

Background: The effectiveness of continuous wound infiltration (CWI) as a postoperative pain-control technique has been shown in many surgical procedures. This study investigates the effect of CWI of local anesthetic on postoperative pain control in intertrochanteric fracture patients undergoing hip nailing surgery.

Methods: In this randomized clinical trial, 48 patients who were scheduled for hip nailing surgery were randomly assigned to receive (n = 24) or not receive (n = 24) bupivacaine infusion through a catheter inside the surgical wound, postoperatively. Pain intensity (NRS), required dose of morphine, and drug-related complications within 24 hours of the intervention were assessed and compared.

Results: Pain intensity was significantly lower in the bupivacaine group both during the recovery room stay and in the ward in the first 24 hours after the procedure (P < 0.001). In the recovery room, the control group patients had a higher morphine consumption compared to the bupivacaine group (P < 0.001) and requested it earlier than the bupivacaine group (60 (45-60) vs. 360 (195-480) minutes) (P < 0.001). In the ward, all control group patients used the PCA morphine pump, while only 54% of the bupivacaine group self-administered morphine through the pump, with a significantly lower total morphine consumption (1 (0-2) vs. 10 (5-14) mg, P < 0.001). None of the patients in the bupivacaine group required additional morphine, while 37.5% of the control requested additional morphine (P=0.002). Altogether, the control group had a higher total morphine consumption compared to the bupivacaine group in the first 24 hours (10.5 (6-15.5) vs. 1 (0-2) mg, P < 0.001).

Conclusion: CWI of bupivacaine helps better pain reduction during the early postoperative hours while it reduces opioid consumption, minimizes nausea and vomiting, and improves patient satisfaction.

背景:连续伤口浸润(CWI)作为一种术后疼痛控制技术的有效性已在许多外科手术中得到证实。本研究探讨了局麻药 CWI 对接受髋关节钉手术的转子间骨折患者术后疼痛控制的影响:在这项随机临床试验中,48 名计划接受髋关节钉手术的患者被随机分配到接受(24 人)或不接受(24 人)术后通过手术伤口内的导管输注布比卡因。对干预后 24 小时内的疼痛强度(NRS)、所需吗啡剂量和药物相关并发症进行了评估和比较:结果:布比卡因组在术后 24 小时内,无论是在恢复室还是在病房,疼痛强度都明显降低(P < 0.001)。在恢复室,对照组患者的吗啡消耗量高于布比卡因组(P<0.001),并且比布比卡因组更早要求使用吗啡(60(45-60)分钟对 360(195-480)分钟)(P<0.001)。在病房中,所有对照组患者都使用了 PCA 吗啡泵,而布比卡因组仅有 54% 的患者通过吗啡泵自行注射吗啡,吗啡总用量显著较低(1(0-2)毫克 vs 10(5-14)毫克,P < 0.001)。布比卡因组没有一名患者需要额外使用吗啡,而对照组则有 37.5% 的患者需要额外使用吗啡(P=0.002)。总之,与布比卡因组相比,对照组在头24小时的吗啡总用量更高(10.5(6-15.5)毫克 vs. 1(0-2)毫克,P < 0.001):布比卡因的CWI有助于在术后早期更好地减轻疼痛,同时减少阿片类药物的用量,最大限度地减少恶心和呕吐,提高患者满意度。
{"title":"Continuous Intra-Incisional Bupivacaine for Postoperative Analgesia after Hip Nailing Surgery: A Randomized Clinical Trial.","authors":"Arash Farbood, Sanaz Abbasi, Naeimehossadat Asmarian, Mahsa Banifatemi, Vida Naderi-Boldaji, Zeinabsadat Fattahi Saravi","doi":"10.1155/2024/2357709","DOIUrl":"10.1155/2024/2357709","url":null,"abstract":"<p><strong>Background: </strong>The effectiveness of continuous wound infiltration (CWI) as a postoperative pain-control technique has been shown in many surgical procedures. This study investigates the effect of CWI of local anesthetic on postoperative pain control in intertrochanteric fracture patients undergoing hip nailing surgery.</p><p><strong>Methods: </strong>In this randomized clinical trial, 48 patients who were scheduled for hip nailing surgery were randomly assigned to receive (<i>n</i> = 24) or not receive (<i>n</i> = 24) bupivacaine infusion through a catheter inside the surgical wound, postoperatively. Pain intensity (NRS), required dose of morphine, and drug-related complications within 24 hours of the intervention were assessed and compared.</p><p><strong>Results: </strong>Pain intensity was significantly lower in the bupivacaine group both during the recovery room stay and in the ward in the first 24 hours after the procedure (<i>P</i> < 0.001). In the recovery room, the control group patients had a higher morphine consumption compared to the bupivacaine group (<i>P</i> < 0.001) and requested it earlier than the bupivacaine group (60 (45-60) vs. 360 (195-480) minutes) (<i>P</i> < 0.001). In the ward, all control group patients used the PCA morphine pump, while only 54% of the bupivacaine group self-administered morphine through the pump, with a significantly lower total morphine consumption (1 (0-2) vs. 10 (5-14) mg, <i>P</i> < 0.001). None of the patients in the bupivacaine group required additional morphine, while 37.5% of the control requested additional morphine (<i>P</i>=0.002). Altogether, the control group had a higher total morphine consumption compared to the bupivacaine group in the first 24 hours (10.5 (6-15.5) vs. 1 (0-2) mg, <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>CWI of bupivacaine helps better pain reduction during the early postoperative hours while it reduces opioid consumption, minimizes nausea and vomiting, and improves patient satisfaction.</p>","PeriodicalId":19913,"journal":{"name":"Pain Research & Management","volume":"2024 ","pages":"2357709"},"PeriodicalIF":2.5,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11286318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141793041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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Pain Research & Management
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