Rahul S. Pillai, N. S. S. Paul, G. D. Davis, Sahya S. Dev
Multimorbidity is defined as the coexistence of two or more chronic health conditions in the same individual. It is associated with an increased number of hospital visits, polypharmacy, adverse drug events, increased treatment costs, increased burden on the families, poor functional status, poor quality of life, and an increased risk of death. The objective of the study is to determine the prevalence of multimorbidity and associated sociodemographic factors among elderly population in a rural area in south Kerala. This cross-sectional study was conducted among elderly population residing in the field practice area of a rural health training center of a medical college in South Kerala for a duration of 3 months from October 2019 to December 2019. Data were collected by interview of the subjects by the investigator. Charlson comorbidity index was used to assess the morbidity status of the subjects. The self-reported prevalence of multimorbidity among the study participants was 86.4% (95% confidence interval: 82.5–90.3). In this, 42.8% had mild, 22.4% had severe, and 21.4% had moderate multimorbidity. Hypertension was the most common (53.1%) morbidity among the participants, followed by rheumatic diseases (42.7%) and diabetes mellitus (41%). Multimorbidity among the study participants was found to be significantly associated with their age, occupation status, and smoking habit among them. Multimorbidity among elderly population deserves much more attention than it has at present, and hence, there is an urgent need to focus on it with emphasis on the need to strengthen the health-care facilities for them, with respect to early identification and holistic management of their morbidities under one roof.
{"title":"Prevalence of Multimorbidity and Associated Sociodemographic Factors among Elderly Population in a Rural Area in South Kerala","authors":"Rahul S. Pillai, N. S. S. Paul, G. D. Davis, Sahya S. Dev","doi":"10.4103/ijpn.ijpn_56_23","DOIUrl":"https://doi.org/10.4103/ijpn.ijpn_56_23","url":null,"abstract":"Multimorbidity is defined as the coexistence of two or more chronic health conditions in the same individual. It is associated with an increased number of hospital visits, polypharmacy, adverse drug events, increased treatment costs, increased burden on the families, poor functional status, poor quality of life, and an increased risk of death. The objective of the study is to determine the prevalence of multimorbidity and associated sociodemographic factors among elderly population in a rural area in south Kerala. This cross-sectional study was conducted among elderly population residing in the field practice area of a rural health training center of a medical college in South Kerala for a duration of 3 months from October 2019 to December 2019. Data were collected by interview of the subjects by the investigator. Charlson comorbidity index was used to assess the morbidity status of the subjects. The self-reported prevalence of multimorbidity among the study participants was 86.4% (95% confidence interval: 82.5–90.3). In this, 42.8% had mild, 22.4% had severe, and 21.4% had moderate multimorbidity. Hypertension was the most common (53.1%) morbidity among the participants, followed by rheumatic diseases (42.7%) and diabetes mellitus (41%). Multimorbidity among the study participants was found to be significantly associated with their age, occupation status, and smoking habit among them. Multimorbidity among elderly population deserves much more attention than it has at present, and hence, there is an urgent need to focus on it with emphasis on the need to strengthen the health-care facilities for them, with respect to early identification and holistic management of their morbidities under one roof.","PeriodicalId":32328,"journal":{"name":"Indian Journal of Pain","volume":"38 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139191012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pain management intraoperatively and postoperatively in the pediatric age group is a matter of concern. On the one hand, children are poorer at precisely conveying the extent of pain all the while being more susceptible to pain-related complications such as laryngospasm. On the other hand, children are less suited to use of potent opioids due to associated complications which can often lead to catastrophe. Therefore, a multimodal approach is desirable to optimize pain management in children. A nerve block is a highly effective and popular modality nowadays. In this single-blinded, parallel group, monocentric, and randomized protocol study, we have compared the efficacy of pain control achieved in the use of nonsteroidal anti-inflammatory drugs as analgesic versus iliohypogastric ilioinguinal (IIIH) nerve block in herniotomy in pediatric age group. The parallel-group prospective study recruited 104 participants who were randomly allocated into two groups of 52 each, such that both groups received 1 mcg/kg fentanyl and sevoflurane during induction of GA. For analgesia, Group 2 was given diclofenac suppository intraoperative after induction of GA. Group 1 was given IIIH nerve block under nerve stimulator guidance for perioperative analgesia. Both groups were studied for the following parameters which included: time to get the 1st dose of rescue analgesic, total dose of rescue analgesic, visual analog scale (VAS) score, and hemodynamic parameters. We observed that Group 1 showed a statistically significant difference in the form of longer duration of analgesia after surgery (9.67 ± 1.80 h vs. 6.35 ± 0.84 h) and lower total dose of rescue analgesic requirement (69.23 ± 2 [22.77] vs. 106.23 ± 2 [21.49]) while having a better hemodynamic profile and lower cumulative VAS score (7.71 ± 1.39 vs. 12.04 ± 1.72). Based on the above findings, we deduce that preincisional nerve stimulator-guided IIIH block by levobupivacaine (0.25%, 0.3 ml/kg) and rectal diclofenac (2 mg/kg) is both safe approaches to provide postoperative analgesia in pediatric inguinal herniotomy under general anesthesia. However, nerve stimulator-guided IIIH nerve block by levobupivacaine is a safe and better choice as it provides more intense analgesia for a longer duration compared to diclofenac suppository in the immediate postoperative period.
儿科术中和术后的疼痛管理是一个值得关注的问题。一方面，儿童较难准确表达疼痛的程度，同时也更容易出现喉痉挛等与疼痛相关的并发症。另一方面，由于相关并发症往往会导致灾难，儿童不太适合使用强效阿片类药物。因此，最好采用多模式方法来优化儿童疼痛治疗。神经阻滞是一种高效且广受欢迎的方法。在这项单盲、平行组、单中心和随机方案研究中，我们比较了在儿科疝气切除术中使用非甾体类抗炎药作为镇痛剂与髂腹股沟（IIIH）神经阻滞的疼痛控制效果。 这项平行分组的前瞻性研究招募了 104 名参与者，将他们随机分配到两组，每组 52 人，两组在诱导 GA 时均接受 1 毫克/千克芬太尼和七氟醚。镇痛方面，第 2 组在诱导 GA 后术中使用双氯芬酸栓剂。第 1 组在神经刺激器引导下进行 IIIH 神经阻滞，用于围手术期镇痛。我们对两组患者的以下参数进行了研究，包括：获得第一剂镇痛药的时间、镇痛药总剂量、视觉模拟量表（VAS）评分和血液动力学参数。 我们观察到，第 1 组的术后镇痛时间更长（9.67 ± 1.80 小时 vs. 6.35 ± 0.84 小时），所需的抢救镇痛药总剂量更低（69.23 ± 2 [22.77] vs. 106.23 ± 2 [21.49]），同时血液动力学状况更好，累积 VAS 评分更低（7.71 ± 1.39 vs. 12.04 ± 1.72），这在统计学上有显著差异。 根据上述研究结果，我们推断，在小儿腹股沟疝气切除术的全身麻醉中，切口前神经刺激器引导的左旋布比卡因（0.25%，0.3 毫升/千克）和直肠双氯芬酸（2 毫克/千克）IIIH 阻滞都是提供术后镇痛的安全方法。然而，在神经刺激器引导下使用左旋布比卡因进行 IIIH 神经阻滞是一种安全且更好的选择，因为与双氯芬酸栓剂相比，左旋布比卡因在术后即刻提供的镇痛强度更高，持续时间更长。
{"title":"Randomized Comparative Study of Analgesic Effects of Ilioinguinal and Iliohypogastric Nerve Block with Levobupivacaine (0.25%) versus Diclofenac Suppository in Pediatric Patients Undergoing Inguinal Herniotomy under General Anesthesia","authors":"Sayantan Mukhopadhyay, Dipasri Bhattacharya, Sagar Rai, Gautam Piplai, Kumar Shailendra","doi":"10.4103/ijpn.ijpn_105_22","DOIUrl":"https://doi.org/10.4103/ijpn.ijpn_105_22","url":null,"abstract":"Pain management intraoperatively and postoperatively in the pediatric age group is a matter of concern. On the one hand, children are poorer at precisely conveying the extent of pain all the while being more susceptible to pain-related complications such as laryngospasm. On the other hand, children are less suited to use of potent opioids due to associated complications which can often lead to catastrophe. Therefore, a multimodal approach is desirable to optimize pain management in children. A nerve block is a highly effective and popular modality nowadays. In this single-blinded, parallel group, monocentric, and randomized protocol study, we have compared the efficacy of pain control achieved in the use of nonsteroidal anti-inflammatory drugs as analgesic versus iliohypogastric ilioinguinal (IIIH) nerve block in herniotomy in pediatric age group. The parallel-group prospective study recruited 104 participants who were randomly allocated into two groups of 52 each, such that both groups received 1 mcg/kg fentanyl and sevoflurane during induction of GA. For analgesia, Group 2 was given diclofenac suppository intraoperative after induction of GA. Group 1 was given IIIH nerve block under nerve stimulator guidance for perioperative analgesia. Both groups were studied for the following parameters which included: time to get the 1st dose of rescue analgesic, total dose of rescue analgesic, visual analog scale (VAS) score, and hemodynamic parameters. We observed that Group 1 showed a statistically significant difference in the form of longer duration of analgesia after surgery (9.67 ± 1.80 h vs. 6.35 ± 0.84 h) and lower total dose of rescue analgesic requirement (69.23 ± 2 [22.77] vs. 106.23 ± 2 [21.49]) while having a better hemodynamic profile and lower cumulative VAS score (7.71 ± 1.39 vs. 12.04 ± 1.72). Based on the above findings, we deduce that preincisional nerve stimulator-guided IIIH block by levobupivacaine (0.25%, 0.3 ml/kg) and rectal diclofenac (2 mg/kg) is both safe approaches to provide postoperative analgesia in pediatric inguinal herniotomy under general anesthesia. However, nerve stimulator-guided IIIH nerve block by levobupivacaine is a safe and better choice as it provides more intense analgesia for a longer duration compared to diclofenac suppository in the immediate postoperative period.","PeriodicalId":32328,"journal":{"name":"Indian Journal of Pain","volume":"36 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139193768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01DOI: 10.4103/ijpn.ijpn_125_23
R. Sharma, Suyashi Sharma
{"title":"Exploring the Potential of Exosomes in Chronic Pain Management: Focus on Osteoarthritis, Neuropathic Pain, and Beyond","authors":"R. Sharma, Suyashi Sharma","doi":"10.4103/ijpn.ijpn_125_23","DOIUrl":"https://doi.org/10.4103/ijpn.ijpn_125_23","url":null,"abstract":"","PeriodicalId":32328,"journal":{"name":"Indian Journal of Pain","volume":"48 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139194193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Medha Phadke, Varsha Kurhade, Kashinath A Bangar, N. Page
Trigeminal neuralgia (TN) is characterized by sudden, severe, brief, stabbing, usually unilateral, and recurrent pain within one or more branches of the trigeminal nerve. It is divided into three types: (1) primary or classical TN, which requires demonstration of morphologic changes in the trigeminal nerve root from vascular compression, (2) secondary to other identifiable neurologic causes such as multiple sclerosis and intracranial space-occupying lesion, and (3) idiopathic, in which the etiology is unknown. Treatment and prognosis depend on the type. We present this case of an elderly woman with an unusual presentation of TN in a previously diagnosed case. The episodes were increasing in severity and duration, not responding to medical management, allodynia and constant pain was present, and they were accompanied by uncontrolled hypertension. These features strongly suggested other likely causes such as intracranial space-occupying lesions, multiple sclerosis, and central pain. Expert consultations from physicians and neurologists were sought for control of hypertension and reaching a diagnosis. Magnetic resonance angiogram of the brain was done and a diagnosis of classical TN with persistent background facial pain was established. The treatment was successfully done by radiofrequency ablation of the Gasserian ganglion. The pain and blood pressure responded to the treatment.
{"title":"Acute on Chronic Presentation of Trigeminal Neuralgia","authors":"Medha Phadke, Varsha Kurhade, Kashinath A Bangar, N. Page","doi":"10.4103/ijpn.ijpn_71_22","DOIUrl":"https://doi.org/10.4103/ijpn.ijpn_71_22","url":null,"abstract":"Trigeminal neuralgia (TN) is characterized by sudden, severe, brief, stabbing, usually unilateral, and recurrent pain within one or more branches of the trigeminal nerve. It is divided into three types: (1) primary or classical TN, which requires demonstration of morphologic changes in the trigeminal nerve root from vascular compression, (2) secondary to other identifiable neurologic causes such as multiple sclerosis and intracranial space-occupying lesion, and (3) idiopathic, in which the etiology is unknown. Treatment and prognosis depend on the type. We present this case of an elderly woman with an unusual presentation of TN in a previously diagnosed case. The episodes were increasing in severity and duration, not responding to medical management, allodynia and constant pain was present, and they were accompanied by uncontrolled hypertension. These features strongly suggested other likely causes such as intracranial space-occupying lesions, multiple sclerosis, and central pain. Expert consultations from physicians and neurologists were sought for control of hypertension and reaching a diagnosis. Magnetic resonance angiogram of the brain was done and a diagnosis of classical TN with persistent background facial pain was established. The treatment was successfully done by radiofrequency ablation of the Gasserian ganglion. The pain and blood pressure responded to the treatment.","PeriodicalId":32328,"journal":{"name":"Indian Journal of Pain","volume":"575 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139195528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pradeep Jain, Bhuwan C. Panday, Naresh Dua, H. Usmani
Pain is known as an uncomfortable, sensory, and emotional experience, which is produced by imitating actual or potential tissue injury. Pain has a more profound effect on a patient’s life than any other neurological perturbation. Realizing the importance of pain, it is now considered the fifth vital sign. The declaration of pain relief as a patient’s basic human right and pain as a disease state reflects the importance of pain relief. Although it is a complex and tedious task, it gives the ultimate satisfaction when a patient’s agony is relieved. This article focuses on the current status of pain education, awareness, challenges, means to improve pain education, encouraging qualified pain specialists, and strategies for fostering growth before a wave of pain overwhelms the nation.
{"title":"Pain Education in India: Hope or Hype?","authors":"Pradeep Jain, Bhuwan C. Panday, Naresh Dua, H. Usmani","doi":"10.4103/ijpn.ijpn_28_23","DOIUrl":"https://doi.org/10.4103/ijpn.ijpn_28_23","url":null,"abstract":"Pain is known as an uncomfortable, sensory, and emotional experience, which is produced by imitating actual or potential tissue injury. Pain has a more profound effect on a patient’s life than any other neurological perturbation. Realizing the importance of pain, it is now considered the fifth vital sign. The declaration of pain relief as a patient’s basic human right and pain as a disease state reflects the importance of pain relief. Although it is a complex and tedious task, it gives the ultimate satisfaction when a patient’s agony is relieved. This article focuses on the current status of pain education, awareness, challenges, means to improve pain education, encouraging qualified pain specialists, and strategies for fostering growth before a wave of pain overwhelms the nation.","PeriodicalId":32328,"journal":{"name":"Indian Journal of Pain","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139193072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01DOI: 10.4103/ijpn.ijpn_116_22
Komal Garg, Samridhi Nanda
Trigeminal neuralgia (TN) is a sudden, unilateral, recurrent, and intense paroxysmal pain in the region of distribution of one or more branches of the trigeminal nerve. TN can be effectively treated by minimally invasive techniques such as microvascular decompression, balloon compression, and conventional radiofrequency thermocoagulation of the Gasserian ganglion. The three divisions of the trigeminal nerve can also be individually targeted for pain relief. Pulsed radiofrequency (PRF) is an alternate technique for treating pain along specific branches and has been proven to be a minimally invasive, safe, and effective interventional treatment choice for such patients. A 36-year-old female presented with pain on the left side of the cheek and upper lip part in the infraorbital nerve distribution (V2) and was diagnosed with TN. A neurological examination and magnetic resonance imaging were done. Medical treatment was prescribed initially but showed minimal improvement. Her pain was assessed using the Numeric Pain Rating Score. PRF ablation (PRFA) was done using short bursts of radiofrequency for 2 min each cycle with silent phases in between. Adequate pain relief was achieved with no complications postprocedure.
{"title":"Percutaneous Sonoguided Pulsed Radiofrequency Ablation for Managing Pain associated with Trigeminal Neuralgia","authors":"Komal Garg, Samridhi Nanda","doi":"10.4103/ijpn.ijpn_116_22","DOIUrl":"https://doi.org/10.4103/ijpn.ijpn_116_22","url":null,"abstract":"Trigeminal neuralgia (TN) is a sudden, unilateral, recurrent, and intense paroxysmal pain in the region of distribution of one or more branches of the trigeminal nerve. TN can be effectively treated by minimally invasive techniques such as microvascular decompression, balloon compression, and conventional radiofrequency thermocoagulation of the Gasserian ganglion. The three divisions of the trigeminal nerve can also be individually targeted for pain relief. Pulsed radiofrequency (PRF) is an alternate technique for treating pain along specific branches and has been proven to be a minimally invasive, safe, and effective interventional treatment choice for such patients. A 36-year-old female presented with pain on the left side of the cheek and upper lip part in the infraorbital nerve distribution (V2) and was diagnosed with TN. A neurological examination and magnetic resonance imaging were done. Medical treatment was prescribed initially but showed minimal improvement. Her pain was assessed using the Numeric Pain Rating Score. PRF ablation (PRFA) was done using short bursts of radiofrequency for 2 min each cycle with silent phases in between. Adequate pain relief was achieved with no complications postprocedure.","PeriodicalId":32328,"journal":{"name":"Indian Journal of Pain","volume":"105 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139194362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Varsha Kurhade, Rupali Vaijnath Bawage, Kashinath A Bangar, N. Page, Gayatri Bangar, Sandip Baheti
The objective is to assess the incidence of cervical angina as presentation of cervical spine pathologies. Data were collected retrospectively from patients’ medical records from January 2018 to December 2022 who presented to our pain clinic with chest pain, neck pain, upper extremity pain and tingling numbness. A total of 168 patients with cervical spine pathologies were identified. Those having chest pains were analyzed subsequently treated with pharmacotherapy, intramuscular stimulation (IMS). Cervical epidural adhesiolysis was performed depending on spine pathology based on clinical picture, severity of symptoms and radiological findings. Among 168 patients 25 had chest pain. Out of 25 patients, 18 (72%) had chest pain as presenting symptom and 7 (28%) patients had associated chest pain. All 25 patients had cervical radiculopathy with or without nerve compression. Nerve root involved were C4 in 4 patients, C5 in 16 patients, C6 in 22 patients, and C7 in 8 patients, commonly involved were C5 and C6 with C4-C5 and C5-C6 prolapsed intervertebral disc. Thirteen patients (52%) were treated with pharmacotherapy and physiotherapy; seven (28%) patients had 2–3 sessions of IMS with pharmacotherapy. Five patients (20%) had undergone cervical epidural adhesiolysis, where conservative management failed. Even though cervical angina is an underdiagnosed disease, pain physicians and spine surgeons should be familiar with it for diagnosis and treatment. Cervical angina is associated with broad range of cervical spinal pathologies; the most common is cervical disc herniation. It can be easily diagnosed with high level of suspicion and treated with pharmacotherapy, IMS, and cervical epidural adhesiolysis.
{"title":"Cervical Angina as a Neglected Symptom of Cervical Spine Pathologies: Retrospective Observational Study","authors":"Varsha Kurhade, Rupali Vaijnath Bawage, Kashinath A Bangar, N. Page, Gayatri Bangar, Sandip Baheti","doi":"10.4103/ijpn.ijpn_68_23","DOIUrl":"https://doi.org/10.4103/ijpn.ijpn_68_23","url":null,"abstract":"The objective is to assess the incidence of cervical angina as presentation of cervical spine pathologies. Data were collected retrospectively from patients’ medical records from January 2018 to December 2022 who presented to our pain clinic with chest pain, neck pain, upper extremity pain and tingling numbness. A total of 168 patients with cervical spine pathologies were identified. Those having chest pains were analyzed subsequently treated with pharmacotherapy, intramuscular stimulation (IMS). Cervical epidural adhesiolysis was performed depending on spine pathology based on clinical picture, severity of symptoms and radiological findings. Among 168 patients 25 had chest pain. Out of 25 patients, 18 (72%) had chest pain as presenting symptom and 7 (28%) patients had associated chest pain. All 25 patients had cervical radiculopathy with or without nerve compression. Nerve root involved were C4 in 4 patients, C5 in 16 patients, C6 in 22 patients, and C7 in 8 patients, commonly involved were C5 and C6 with C4-C5 and C5-C6 prolapsed intervertebral disc. Thirteen patients (52%) were treated with pharmacotherapy and physiotherapy; seven (28%) patients had 2–3 sessions of IMS with pharmacotherapy. Five patients (20%) had undergone cervical epidural adhesiolysis, where conservative management failed. Even though cervical angina is an underdiagnosed disease, pain physicians and spine surgeons should be familiar with it for diagnosis and treatment. Cervical angina is associated with broad range of cervical spinal pathologies; the most common is cervical disc herniation. It can be easily diagnosed with high level of suspicion and treated with pharmacotherapy, IMS, and cervical epidural adhesiolysis.","PeriodicalId":32328,"journal":{"name":"Indian Journal of Pain","volume":"56 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139192494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Background: Tapentadol is known for its opioid-sparing effect, reducing adverse effects associated with opioids, particularly gastrointestinal issues. However, limitations in the oral formulation warrant exploration of alternatives like tapentadol nasal spray for enhanced efficacy and patient experience. Aims and Objectives: This investigator-initiated trial aimed to assess the safety of tapentadol nasal spray (45mg/dose, administered four times daily) compared to intravenous tramadol (50mg twice daily) in patients with post-operative moderate to severe pain over a 3-day period. Materials and Methods: A randomized, open-label real-world trial enrolled 600 patients. Pain management efficacy, sleep scores, and patient comfort and convenience were evaluated. Results: Tapentadol nasal spray demonstrated superior pain reduction compared to intravenous tramadol. Sleep scores were significantly better with tapentadol nasal spray. The nasal route provided enhanced comfort, convenience, safety, and efficacy, offering rapid pain relief. Conclusion: Tapentadol nasal spray presents a favorable option for post-operative pain management, offering improved pain reduction, better sleep outcomes, and enhanced patient comfort. The nasal delivery method proves efficient and patient-friendly, marking a significant advancement in achieving early and sustained pain relief.
{"title":"Head-to-Head Comparison of Tapentadol Nasal Spray and Intravenous Tramadol for Managing Postoperative Moderate-to-Severe Pain: An Observational Study","authors":"Sunil Shetty, Sachin Kale, Shikhar Singh, Shobhan Mandal, Vidur Sharma, Varmit Shah, Komal Sabbani, Aloukika Paresh Patil","doi":"10.4103/ijpn.ijpn_58_23","DOIUrl":"https://doi.org/10.4103/ijpn.ijpn_58_23","url":null,"abstract":"Abstract Background: Tapentadol is known for its opioid-sparing effect, reducing adverse effects associated with opioids, particularly gastrointestinal issues. However, limitations in the oral formulation warrant exploration of alternatives like tapentadol nasal spray for enhanced efficacy and patient experience. Aims and Objectives: This investigator-initiated trial aimed to assess the safety of tapentadol nasal spray (45mg/dose, administered four times daily) compared to intravenous tramadol (50mg twice daily) in patients with post-operative moderate to severe pain over a 3-day period. Materials and Methods: A randomized, open-label real-world trial enrolled 600 patients. Pain management efficacy, sleep scores, and patient comfort and convenience were evaluated. Results: Tapentadol nasal spray demonstrated superior pain reduction compared to intravenous tramadol. Sleep scores were significantly better with tapentadol nasal spray. The nasal route provided enhanced comfort, convenience, safety, and efficacy, offering rapid pain relief. Conclusion: Tapentadol nasal spray presents a favorable option for post-operative pain management, offering improved pain reduction, better sleep outcomes, and enhanced patient comfort. The nasal delivery method proves efficient and patient-friendly, marking a significant advancement in achieving early and sustained pain relief.","PeriodicalId":32328,"journal":{"name":"Indian Journal of Pain","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134991468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chronic pubic pain is a commonly occurring problem in young males who are engaged in high-intensity physical activities such as sportsmen and army recruits among others. We would like to discuss a similar case of pubalgia which occurred in a 20-year-old male who is an avid athlete. The patient had reported multiple times to the hospital and was admitted and evaluated thoroughly. He was kept on nonsteroidal anti-inflammatory drugs and pregabalin for about a month. Despite this aggressive pain management, the patient continued to have continuous pain in his left groin. Due to his pain and inability to perform physically, the patient went into depression. After a thorough clinical evaluation, we offered the patient an ultrasound-guided iliohypogastric and ilioinguinal nerve block which resulted in the complete disappearance of his symptoms within a week, and he was able to return back to his regular training.
{"title":"Chronic Pubalgia in a Young Adult Managed by Iliohypogastric and Ilioinguinal Nerve Blocks","authors":"S. Paul, J. J. M. Kumar, Amit Dua, Debashish Paul","doi":"10.4103/ijpn.ijpn_69_22","DOIUrl":"https://doi.org/10.4103/ijpn.ijpn_69_22","url":null,"abstract":"Chronic pubic pain is a commonly occurring problem in young males who are engaged in high-intensity physical activities such as sportsmen and army recruits among others. We would like to discuss a similar case of pubalgia which occurred in a 20-year-old male who is an avid athlete. The patient had reported multiple times to the hospital and was admitted and evaluated thoroughly. He was kept on nonsteroidal anti-inflammatory drugs and pregabalin for about a month. Despite this aggressive pain management, the patient continued to have continuous pain in his left groin. Due to his pain and inability to perform physically, the patient went into depression. After a thorough clinical evaluation, we offered the patient an ultrasound-guided iliohypogastric and ilioinguinal nerve block which resulted in the complete disappearance of his symptoms within a week, and he was able to return back to his regular training.","PeriodicalId":32328,"journal":{"name":"Indian Journal of Pain","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139335190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nishant Gaurav, S. Gautam, Anil Agarwal, S. Dhiraaj
The efficiency of pain management depends on appropriate pain assessment. Postoperative pain assessment is done by acute pain service (APS) team; patients may also assess their pain scores with the help of a patient’s pain assessment format. The present study has evaluated the efficacy of patient’s pain assessment format by comparing it with pain assessment done by the APS team. Thirty-five patients undergoing abdominal surgery were enrolled in this study; postoperative pain assessment was done by patient’s pain assessment format and APS team for a period of 3 days after surgery. The primary outcome measure was postoperative pain score and the secondary outcome measures were postoperative nausea and vomiting, abdominal distension, pruritus, numbness, paresthesia, or weakness in the legs. Results were analyzed by the Mann–Whitney U-test and Fisher’s exact test. P <0.05 was considered as statistically significant. Pain scores and incidence of side effects assessed by the patient’s pain assessment format were comparable to those assessed by the APS team; however, the first reading of pain scores after surgery assessed by the patient’s pain assessment format was significantly higher than that assessed by the APS team (P < 0.05). Pain scores assessed by the patient’s pain assessment format were comparable to the pain scores assessed by the APS team. Hence, we recommend the use of patient’s pain assessment format as a valid tool for the assessment of postoperative pain by the APS team.
{"title":"Evaluation of Patient’s Pain Assessment Format for Postoperative Pain in Patients Undergoing Abdominal Surgery: A Prospective Observational Study","authors":"Nishant Gaurav, S. Gautam, Anil Agarwal, S. Dhiraaj","doi":"10.4103/ijpn.ijpn_94_22","DOIUrl":"https://doi.org/10.4103/ijpn.ijpn_94_22","url":null,"abstract":"The efficiency of pain management depends on appropriate pain assessment. Postoperative pain assessment is done by acute pain service (APS) team; patients may also assess their pain scores with the help of a patient’s pain assessment format. The present study has evaluated the efficacy of patient’s pain assessment format by comparing it with pain assessment done by the APS team. Thirty-five patients undergoing abdominal surgery were enrolled in this study; postoperative pain assessment was done by patient’s pain assessment format and APS team for a period of 3 days after surgery. The primary outcome measure was postoperative pain score and the secondary outcome measures were postoperative nausea and vomiting, abdominal distension, pruritus, numbness, paresthesia, or weakness in the legs. Results were analyzed by the Mann–Whitney U-test and Fisher’s exact test. P <0.05 was considered as statistically significant. Pain scores and incidence of side effects assessed by the patient’s pain assessment format were comparable to those assessed by the APS team; however, the first reading of pain scores after surgery assessed by the patient’s pain assessment format was significantly higher than that assessed by the APS team (P < 0.05). Pain scores assessed by the patient’s pain assessment format were comparable to the pain scores assessed by the APS team. Hence, we recommend the use of patient’s pain assessment format as a valid tool for the assessment of postoperative pain by the APS team.","PeriodicalId":32328,"journal":{"name":"Indian Journal of Pain","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139335132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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