Pub Date : 2023-02-23DOI: 10.2174/18763863-v16-230223-2022-11
O. Akpor, V. O. Aina, O. B. Akpor
Stress is an important psychological concept that can affect health, well-being, and job performance in negative dimensions. This study investigates stress levels and coping strategies among nurses in selected hospitals in North Central Nigeria. The study employed a multistage sample technique method. The study design was descriptive and cross-sectional, using a quantitative strategy. Data analysis was carried out using descriptive and inferential study statistics. Finding shows that the minimum age of the participants was 21–30 years, 87% were female, while 41.1% had 1-5 years of working experience. The study revealed that the highest signs and symptoms of stress experienced by the participants included aches and pain (57.5%) and anxiousness (52.5%). The participants experienced moderate stress. The findings revealed that years of experience (r= 0.631, p= 0.000) were observed to be significantly associated with signs and symptoms of stress. The results showed that age (r= -0.243, p= 0.045), religion (r= 0.165, p= 0.032), and experience of memory problems (r= 0.227, p= 0.003) were observed to show significant association with coping strategies. Hence, a conducive work environment should be maintained to promote effective nursing care, while periodic stress assessments and management should be implemented by hospital administrators to aid positive coping strategies among nurses.
{"title":"Occupational Stress Levels and Coping Strategies among Nurses Working in an Urban Metropolis in North Central Nigeria","authors":"O. Akpor, V. O. Aina, O. B. Akpor","doi":"10.2174/18763863-v16-230223-2022-11","DOIUrl":"https://doi.org/10.2174/18763863-v16-230223-2022-11","url":null,"abstract":"\u0000 \u0000 Stress is an important psychological concept that can affect health, well-being, and job performance in negative dimensions.\u0000 \u0000 \u0000 \u0000 This study investigates stress levels and coping strategies among nurses in selected hospitals in North Central Nigeria.\u0000 \u0000 \u0000 \u0000 The study employed a multistage sample technique method. The study design was descriptive and cross-sectional, using a quantitative strategy. Data analysis was carried out using descriptive and inferential study statistics.\u0000 \u0000 \u0000 \u0000 Finding shows that the minimum age of the participants was 21–30 years, 87% were female, while 41.1% had 1-5 years of working experience. The study revealed that the highest signs and symptoms of stress experienced by the participants included aches and pain (57.5%) and anxiousness (52.5%). The participants experienced moderate stress. The findings revealed that years of experience (r= 0.631, p= 0.000) were observed to be significantly associated with signs and symptoms of stress. The results showed that age (r= -0.243, p= 0.045), religion (r= 0.165, p= 0.032), and experience of memory problems (r= 0.227, p= 0.003) were observed to show significant association with coping strategies.\u0000 \u0000 \u0000 \u0000 Hence, a conducive work environment should be maintained to promote effective nursing care, while periodic stress assessments and management should be implemented by hospital administrators to aid positive coping strategies among nurses.\u0000","PeriodicalId":53614,"journal":{"name":"Open Pain Journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43529414","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 : 2023-02-02DOI: 10.2174/18763863-v16-e230202-2022-6
A. Tripathi, R. Shanker
Measuring pain and pain relief are the primary concerns in pain management. Sample size estimation in pain management with non-inferiority (NI) study design and assessment of endpoint specific -NI margins may be challenging as pain and its improvement are measured and reported on different endpoints. Multiple endpoints were reported frequently to measure pain and pain improvement. Sum of pain intensity difference (SPID[0-t]) at a specific time is the recommended endpoint for measurement of pain by the United States Food and Drug Administration. Statistical information on SPID and multiple literature reported other endpoints (preferably from placebo-controlled trials) was collected and compared to identify a suitable NI margin. A difference of 20% was considered as the default NI margin for evaluation, and the sample size was calculated for each endpoint. The sample size based on FDA-recommended primary endpoint SPID, found to be on higher side. This may be a concern for overall clinical operation and availability patients for recruitments in time. Though, the sample size obtained for the minimum clinically important difference (MCID) endpoint was feasible and justifiable from an operational and clinical standpoint. Evaluation and assessment of multiple endpoints before designing an NI study enables rapid decision-making on endpoint selection and increases operational efficiency.
{"title":"Sample Size Estimation for a Non-Inferiority Pain Management Trial","authors":"A. Tripathi, R. Shanker","doi":"10.2174/18763863-v16-e230202-2022-6","DOIUrl":"https://doi.org/10.2174/18763863-v16-e230202-2022-6","url":null,"abstract":"\u0000 \u0000 Measuring pain and pain relief are the primary concerns in pain management. Sample size estimation in pain management with non-inferiority (NI) study design and assessment of endpoint specific -NI margins may be challenging as pain and its improvement are measured and reported on different endpoints.\u0000 \u0000 \u0000 \u0000 Multiple endpoints were reported frequently to measure pain and pain improvement. Sum of pain intensity difference (SPID[0-t]) at a specific time is the recommended endpoint for measurement of pain by the United States Food and Drug Administration. Statistical information on SPID and multiple literature reported other endpoints (preferably from placebo-controlled trials) was collected and compared to identify a suitable NI margin. A difference of 20% was considered as the default NI margin for evaluation, and the sample size was calculated for each endpoint.\u0000 \u0000 \u0000 \u0000 The sample size based on FDA-recommended primary endpoint SPID, found to be on higher side. This may be a concern for overall clinical operation and availability patients for recruitments in time. Though, the sample size obtained for the minimum clinically important difference (MCID) endpoint was feasible and justifiable from an operational and clinical standpoint.\u0000 \u0000 \u0000 \u0000 Evaluation and assessment of multiple endpoints before designing an NI study enables rapid decision-making on endpoint selection and increases operational efficiency.\u0000","PeriodicalId":53614,"journal":{"name":"Open Pain Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45108524","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 : 2023-02-02DOI: 10.2174/18763863-v16-e230202-2022-17
Miki Senoo, Takeo Sugita, Tuwa Iwamoto, I. Fukushi, H. Maeda, H. Arisaka, S. Kuwana
Sevoflurane, a volatile inhaled anesthetic, is used clinically for general anesthesia in humans. However, the mechanism of action of sevoflurane is not fully understood. We used transcranial flavoprotein fluorescence imaging to visualize somatic sensory cortex responses to noxious stimuli in mice without and with sevoflurane inhalation anesthesia at different concentrations to investigate sevoflurane effects in mice. A bipolar stimulating electrode was inserted into the left buccal region of the mouse, and changes in flavoprotein fluorescence intensity in the right somatic sensory cortex were recorded before and after electrical stimulation. Measurements were taken while the mouse was awake, at four levels of sevoflurane concentration (0.5%, 1.0%, 1.5%, and 2.0%; 5 min each), and at 10, 20, and 30 min after the end of sevoflurane inhalation. During awake period, flavoprotein fluorescence intensities in the right sensory cortex were decreased after the onset of electrical stimulation but after 0.9 s, the fluorescence intensity began to increase, reaching a peak value at 2.1 s. This biphasic response was significantly decreased at 0.5% sevoflurane and completely disappeared at sevoflurane concentrations above 1.5%, and was restored 10 min after cessation of the sevoflurane inhalation. Furthermore, low concentrations of sevoflurane have little effect on the reduction of receptive fields or on the conduction of excitation. We conclude that low concentrations of sevoflurane have little effect on the reduction of receptive fields or on the conduction of excitation, and that sevoflurane concentrations above1.5% completely abolishes the sensory cortex response elicited by noxious stimulation.
{"title":"Anesthetic Effects of Sevoflurane on the Mouse Somatosensory Cortex: A Flavoprotein Fluorescence Imaging Study","authors":"Miki Senoo, Takeo Sugita, Tuwa Iwamoto, I. Fukushi, H. Maeda, H. Arisaka, S. Kuwana","doi":"10.2174/18763863-v16-e230202-2022-17","DOIUrl":"https://doi.org/10.2174/18763863-v16-e230202-2022-17","url":null,"abstract":"\u0000 \u0000 Sevoflurane, a volatile inhaled anesthetic, is used clinically for general anesthesia in humans. However, the mechanism of action of sevoflurane is not fully understood. We used transcranial flavoprotein fluorescence imaging to visualize somatic sensory cortex responses to noxious stimuli in mice without and with sevoflurane inhalation anesthesia at different concentrations to investigate sevoflurane effects in mice. \u0000 \u0000 \u0000 \u0000 A bipolar stimulating electrode was inserted into the left buccal region of the mouse, and changes in flavoprotein fluorescence intensity in the right somatic sensory cortex were recorded before and after electrical stimulation. Measurements were taken while the mouse was awake, at four levels of sevoflurane concentration (0.5%, 1.0%, 1.5%, and 2.0%; 5 min each), and at 10, 20, and 30 min after the end of sevoflurane inhalation.\u0000 \u0000 \u0000 \u0000 During awake period, flavoprotein fluorescence intensities in the right sensory cortex were decreased after the onset of electrical stimulation but after 0.9 s, the fluorescence intensity began to increase, reaching a peak value at 2.1 s. This biphasic response was significantly decreased at 0.5% sevoflurane and completely disappeared at sevoflurane concentrations above 1.5%, and was restored 10 min after cessation of the sevoflurane inhalation. Furthermore, low concentrations of sevoflurane have little effect on the reduction of receptive fields or on the conduction of excitation. \u0000 \u0000 \u0000 \u0000 We conclude that low concentrations of sevoflurane have little effect on the reduction of receptive fields or on the conduction of excitation, and that sevoflurane concentrations above1.5% completely abolishes the sensory cortex response elicited by noxious stimulation.\u0000","PeriodicalId":53614,"journal":{"name":"Open Pain Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48121198","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 : 2022-11-03DOI: 10.2174/18763863-v15-e2208250
Ezra Ejegu Mehari, Yosef Belay Bizuneh, D. Y. Fentie, N. R. Arefayne
This study aimed to assess the prevalence and associated factors of acute postoperative pain after emergency abdominal surgery in the first 24 postoperative hours among adult patients. An institutional-based cross-sectional study was conducted on adult patients undergoing emergency abdominal surgery at the University of Gondar Comprehensive Specialized Hospital from March 1 to May 30, 2020. Data were collected by delivering questionnaires through interviews and reviewing the patients’ charts. Data were entered into Epi Info software, version 7.2, and analyzed by SPSS version 20. Logistic regression was applied to point out independent risk factors for postoperative acute pain. Variables with a p-value of < 0.05 were taken as significant. 165 patients participated in the study with a response rate of 98.2%. Among these, 75.8% [95% CI: (69.8%, 82.3%)] of patients experienced moderate to severe acute postoperative pain. Female gender [AOR:3.9, 95%CI: (1.22,12.5)], preoperative anxiety[AOR:4.4,95%CI:(1.74,11.1)],moderate to severe preoperative pain[AOR:5.79,95%CI:(2.08,16.1)], and incision length ≥10cms [AOR: 4.86, 95%(CI:1.88,12.5)], were significantly associated with moderate to severe acute postoperative pain. The prevalence of immediate postoperative pain following emergency abdominal surgery was found to be high in this study. Acute postoperative pain was substantially linked to the female sex, preoperative anxiety, preoperative pain, and an incision length of ≥10 cm. The prevalence of moderate-to-severe acute postoperative pain as well as the factors that contribute to it can be used to develop particular preventive strategies to reduce patient suffering.
{"title":"Prevalence and Factors Associated with Acute Postoperative Pain after Emergency Abdominal Surgery","authors":"Ezra Ejegu Mehari, Yosef Belay Bizuneh, D. Y. Fentie, N. R. Arefayne","doi":"10.2174/18763863-v15-e2208250","DOIUrl":"https://doi.org/10.2174/18763863-v15-e2208250","url":null,"abstract":"This study aimed to assess the prevalence and associated factors of acute postoperative pain after emergency abdominal surgery in the first 24 postoperative hours among adult patients.\u0000 \u0000 \u0000 \u0000 An institutional-based cross-sectional study was conducted on adult patients undergoing emergency abdominal surgery at the University of Gondar Comprehensive Specialized Hospital from March 1 to May 30, 2020. Data were collected by delivering questionnaires through interviews and reviewing the patients’ charts. Data were entered into Epi Info software, version 7.2, and analyzed by SPSS version 20. Logistic regression was applied to point out independent risk factors for postoperative acute pain. Variables with a p-value of < 0.05 were taken as significant.\u0000 \u0000 \u0000 \u0000 165 patients participated in the study with a response rate of 98.2%. Among these, 75.8% [95% CI: (69.8%, 82.3%)] of patients experienced moderate to severe acute postoperative pain. Female gender [AOR:3.9, 95%CI: (1.22,12.5)], preoperative anxiety[AOR:4.4,95%CI:(1.74,11.1)],moderate to severe preoperative pain[AOR:5.79,95%CI:(2.08,16.1)], and incision length ≥10cms [AOR: 4.86, 95%(CI:1.88,12.5)], were significantly associated with moderate to severe acute postoperative pain.\u0000 \u0000 \u0000 \u0000 The prevalence of immediate postoperative pain following emergency abdominal surgery was found to be high in this study. Acute postoperative pain was substantially linked to the female sex, preoperative anxiety, preoperative pain, and an incision length of ≥10 cm. The prevalence of moderate-to-severe acute postoperative pain as well as the factors that contribute to it can be used to develop particular preventive strategies to reduce patient suffering.","PeriodicalId":53614,"journal":{"name":"Open Pain Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45660277","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 : 2022-10-20eCollection Date: 2023-01-01DOI: 10.5114/cipp/151671
Włodzimierz Oniszczenko, Magdalena Oszast
Background: The main goal of our study was to demonstrate the relationship between the strength of excitation (SE) as one of the basic central nervous system (CNS) properties and insomnia, and to determine the role of the mood components as mediators of this relationship. We hypothesized that SE directly and indirectly via arousal-related mood dimensions may be related to insomnia.
Participants and procedure: The study involved 149 people, 85 women and 64 men, aged 18 to 60 (M = 30.11, SD = 11.43) selected from the general population using snowball sampling. The basic properties of the CNS were diagnosed using Pavlovian Temperament Survey. Mood was assessed using the Polish adaptation of UWIST Mood Adjective Checklist. To evaluate insomnia symptoms Athens Insomnia Scale in its Polish adaptation was used.
Results: SE negatively correlated with insomnia (no significant correlations between strength of inhibition and mobility and insomnia). All CNS properties positively correlated with hedonic tone (HT) and energetic arousal (EA), and negatively with tense arousal (TA) as mood dimensions. HT and EA were negatively correlated with insomnia but TA positively correlated with insomnia. Both EA and TA served as mediators in the relationship between SE and insomnia.
Conclusions: The results indicated the relationship between SE and insomnia as well as between SE and EA and TA as mood dimensions related to arousal. Mediation analysis suggests that both EA and TA may serve as mediators of the relationship between SE and insomnia. However, the results of the mediation analysis require careful interpretation.
{"title":"Strength of excitation and insomnia as mediated by mood dimensions.","authors":"Włodzimierz Oniszczenko, Magdalena Oszast","doi":"10.5114/cipp/151671","DOIUrl":"10.5114/cipp/151671","url":null,"abstract":"<p><strong>Background: </strong>The main goal of our study was to demonstrate the relationship between the strength of excitation (SE) as one of the basic central nervous system (CNS) properties and insomnia, and to determine the role of the mood components as mediators of this relationship. We hypothesized that SE directly and indirectly via arousal-related mood dimensions may be related to insomnia.</p><p><strong>Participants and procedure: </strong>The study involved 149 people, 85 women and 64 men, aged 18 to 60 (<i>M</i> = 30.11, <i>SD</i> = 11.43) selected from the general population using snowball sampling. The basic properties of the CNS were diagnosed using Pavlovian Temperament Survey. Mood was assessed using the Polish adaptation of UWIST Mood Adjective Checklist. To evaluate insomnia symptoms Athens Insomnia Scale in its Polish adaptation was used.</p><p><strong>Results: </strong>SE negatively correlated with insomnia (no significant correlations between strength of inhibition and mobility and insomnia). All CNS properties positively correlated with hedonic tone (HT) and energetic arousal (EA), and negatively with tense arousal (TA) as mood dimensions. HT and EA were negatively correlated with insomnia but TA positively correlated with insomnia. Both EA and TA served as mediators in the relationship between SE and insomnia.</p><p><strong>Conclusions: </strong>The results indicated the relationship between SE and insomnia as well as between SE and EA and TA as mood dimensions related to arousal. Mediation analysis suggests that both EA and TA may serve as mediators of the relationship between SE and insomnia. However, the results of the mediation analysis require careful interpretation.</p>","PeriodicalId":53614,"journal":{"name":"Open Pain Journal","volume":"7 1","pages":"58-64"},"PeriodicalIF":1.0,"publicationDate":"2022-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10654329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90079700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-18DOI: 10.2174/18763863-v15-e221018-2022-5
T. El Joumani, H. Rkain, F. Taik, K. Hassouni, R. Abouqal, Sara Bahloul, N. Alami, L. Tahiri, N. Hajjaj-Hassouni, F. Allali
To evaluate the effects of the Covid-19 pandemic on the pain experienced by patients with CIRD, and to analyze the factors associated with this pain. A cross-sectional study was conducted amongst patients with rheumatic diseases using a questionnaire providing information on patients and disease characteristics. Patients were asked to assess the level of pain they have experienced before and during the pandemic, using a single Visual Analogue Scale (VAS) ranging from 0 (no pain) to 10 (greatest pain). Statistical Analysis System IBM SPSS Statistics V20.0.0 was used to analyze the study data. We performed univariate multivariate analysis to search any related factors to pain perception during the COVID-19 pandemic. Qualitative values were analyzed by the chi2 test. Quantitative values were analyzed by the Student test when the measures were normally distributed or by nonparametric tests (Mann–Whitney U) when the measures were not normally distributed (the Kolmogorov–Smirnov test was used to test normality). Amongst the 350 patients who answered the questionnaire online, rheumatoid arthritis represented 62.3%, spondyloarthropathy 34.3%, and undifferentiated CIRD 3.4%. CIRD-related pain was reported by 79.1% of the patients The level of pain, using the VAS of Pain increased significantly during the COVID-19 pandemic (4,6 ± 2,8 and 5,4 ± 3 before and during the pandemic; p<0.001). In the multivariate analysis, the factors causing the pain were: the negative impact of the coronavirus on accessing rheumatology care, the discontinuation of treatment, the disturbed sleep, and the negative psychological impact. This survey showed that the COVID-19 pandemic has increased CIRD-related pain in patients. Factors influencing this pain should be taken into account to help patients cope with their chronic rheumatism in this global health crisis.
{"title":"What are the Factors Related to Experiencing Pain in Patients Affected by Chronic Inflammatory Rheumatic Disease During the Covid-19 Pandemic?","authors":"T. El Joumani, H. Rkain, F. Taik, K. Hassouni, R. Abouqal, Sara Bahloul, N. Alami, L. Tahiri, N. Hajjaj-Hassouni, F. Allali","doi":"10.2174/18763863-v15-e221018-2022-5","DOIUrl":"https://doi.org/10.2174/18763863-v15-e221018-2022-5","url":null,"abstract":"\u0000 \u0000 To evaluate the effects of the Covid-19 pandemic on the pain experienced by patients with CIRD, and to analyze the factors associated with this pain.\u0000 \u0000 \u0000 \u0000 A cross-sectional study was conducted amongst patients with rheumatic diseases using a questionnaire providing information on patients and disease characteristics.\u0000 Patients were asked to assess the level of pain they have experienced before and during the pandemic, using a single Visual Analogue Scale (VAS) ranging from 0 (no pain) to 10 (greatest pain).\u0000 Statistical Analysis System IBM SPSS Statistics V20.0.0 was used to analyze the study data.\u0000 We performed univariate multivariate analysis to search any related factors to pain perception during the COVID-19 pandemic. Qualitative values were analyzed by the chi2 test. Quantitative values were analyzed by the Student test when the measures were normally distributed or by nonparametric tests (Mann–Whitney U) when the measures were not normally distributed (the Kolmogorov–Smirnov test was used to test normality).\u0000 \u0000 \u0000 \u0000 Amongst the 350 patients who answered the questionnaire online, rheumatoid arthritis represented 62.3%, spondyloarthropathy 34.3%, and undifferentiated CIRD 3.4%. CIRD-related pain was reported by 79.1% of the patients\u0000 The level of pain, using the VAS of Pain increased significantly during the COVID-19 pandemic (4,6 ± 2,8 and 5,4 ± 3 before and during the pandemic; p<0.001).\u0000 In the multivariate analysis, the factors causing the pain were: the negative impact of the coronavirus on accessing rheumatology care, the discontinuation of treatment, the disturbed sleep, and the negative psychological impact.\u0000 \u0000 \u0000 \u0000 This survey showed that the COVID-19 pandemic has increased CIRD-related pain in patients. Factors influencing this pain should be taken into account to help patients cope with their chronic rheumatism in this global health crisis.\u0000","PeriodicalId":53614,"journal":{"name":"Open Pain Journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41778285","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 : 2022-08-03DOI: 10.2174/18763863-v15-e2206100
Muhammad Ramli Ahmad, M. D. Datu, Rezki Hardiyanti, Jokevin Prasetyadhi
Effective postoperative multimodal analgesia facilitates early physical rehabilitation to maximize the postoperative range of motion and prevent joint adhesions following total knee arthroplasty (TKA). Adductor canal block has been reported as a supplement to multimodal analgesia protocols in patients undergoing TKA. The use of ultrasound (US) guidance has improved the success rates of the blocks compared with blind approaches. This report described two elderly patients undergoing TKA with ACB as postoperative pain management, resulting in adequate pain control during the postoperative period. Adductor canal block can be used to optimize multimodal analgesia by reducing opioid requirements and enhancing recovery after TKA.
{"title":"Adductor Canal Block (ACB) provides Adequate Postoperative Analgesia in Patients Undergoing Total Knee Arthroplasty (TKA): Case Report","authors":"Muhammad Ramli Ahmad, M. D. Datu, Rezki Hardiyanti, Jokevin Prasetyadhi","doi":"10.2174/18763863-v15-e2206100","DOIUrl":"https://doi.org/10.2174/18763863-v15-e2206100","url":null,"abstract":"\u0000 \u0000 Effective postoperative multimodal analgesia facilitates early physical rehabilitation to maximize the postoperative range of motion and prevent joint adhesions following total knee arthroplasty (TKA). Adductor canal block has been reported as a supplement to multimodal analgesia protocols in patients undergoing TKA. The use of ultrasound (US) guidance has improved the success rates of the blocks compared with blind approaches.\u0000 \u0000 \u0000 \u0000 This report described two elderly patients undergoing TKA with ACB as postoperative pain management, resulting in adequate pain control during the postoperative period.\u0000 \u0000 \u0000 \u0000 Adductor canal block can be used to optimize multimodal analgesia by reducing opioid requirements and enhancing recovery after TKA.\u0000","PeriodicalId":53614,"journal":{"name":"Open Pain Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48943514","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 : 2022-07-19DOI: 10.2174/18763863-v15-e2205300
M. Chang, M. Boudier‐Revéret, In-Sik Park, Yoo Jin Choo
Pain from complex regional pain syndrome (CRPS) is frequently refractory to various treatment methods. Here, we present a case wherein foot pain from CRPS I was managed by applying an insole made from poron (a soft polyurethane foam and highly absorbent material for shock reduction), a sponge upper padding, and a post-operative shoe. A 47-year-old female patient with CRPS I on her left foot complained of pain for a few months, which was aggravated while standing and walking [numeric rating scale (NRS): 8]. She had a history of a linear fracture in the distal portion of the left 1st metatarsal bone 5 months ago, and the pain from CRPS started 2 months after the fracture. We believed that the aggravated pain during standing and walking was allodynia. We utilized a poron insole, a sponge upper padding, and a post-operative shoe to reduce the pressure and friction loading on her left foot. 1 month after this intervention, the patients’ pain during standing and walking was found to have reduced from NRS 8 to NRS 3. At her 3- and 6-month follow-ups, the degree of pain was sustained at NRS 3. We believe that the reduction of allodynia using materials, which can absorb mechanical pressure and friction of the foot, can help manage pain from CRPS.
{"title":"The Management of Complex Regional Pain Syndrome-associated Foot Pain using a Poron Insole, a Sponge Upper Padding, and a Post-operative Shoe: A Case Report","authors":"M. Chang, M. Boudier‐Revéret, In-Sik Park, Yoo Jin Choo","doi":"10.2174/18763863-v15-e2205300","DOIUrl":"https://doi.org/10.2174/18763863-v15-e2205300","url":null,"abstract":"\u0000 \u0000 Pain from complex regional pain syndrome (CRPS) is frequently refractory to various treatment methods. Here, we present a case wherein foot pain from CRPS I was managed by applying an insole made from poron (a soft polyurethane foam and highly absorbent material for shock reduction), a sponge upper padding, and a post-operative shoe.\u0000 \u0000 \u0000 \u0000 A 47-year-old female patient with CRPS I on her left foot complained of pain for a few months, which was aggravated while standing and walking [numeric rating scale (NRS): 8]. She had a history of a linear fracture in the distal portion of the left 1st metatarsal bone 5 months ago, and the pain from CRPS started 2 months after the fracture. We believed that the aggravated pain during standing and walking was allodynia. We utilized a poron insole, a sponge upper padding, and a post-operative shoe to reduce the pressure and friction loading on her left foot. 1 month after this intervention, the patients’ pain during standing and walking was found to have reduced from NRS 8 to NRS 3. At her 3- and 6-month follow-ups, the degree of pain was sustained at NRS 3.\u0000 \u0000 \u0000 \u0000 We believe that the reduction of allodynia using materials, which can absorb mechanical pressure and friction of the foot, can help manage pain from CRPS.\u0000","PeriodicalId":53614,"journal":{"name":"Open Pain Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45325261","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 : 2022-04-01DOI: 10.2174/18763863-v15-e2202070
M. Carta, F. Velluzzi, M. Monticone, Cesar Ivan Aviles Gonzalez, L. Minerba, M. Pau, M. Musu, L. Atzori, C. Ferreli, A. Cauli, Sérgio Machado, E. Pintus, Dario Fortin, F. Romano, M. P. Penna, A. Preti, Giulia Cossu
Chronic Pain (CP) is a crucial determinant for disability in older adults. CP amplifies the impact of other common age-related diseases and increases cardiovascular risk. Physical exercise can improve CP. Randomized Controlled Trials (RCTs) with high-intensity exercise in older adults excluded people with Moderate Chronic Illness (MCI) and CP. This study aimed at evaluating in an RCT whether moderate exercise training can improve chronic pain in a sample of older adults, including people with MCI, and if any modification persists over time. A sample of 120 older adults was randomly selected for a moderate-intensity exercise program or cultural activities (control group). Chronic pain was assessed at t0, at t12 (end of the trial), and t48 weeks, by means of the Italian version of the SIP-Roland Scale. Seventy-nine participants completed the follow-up (age 72.3±4.7, women 55.3%). At the end of RCT, an improvement in the SIP scale score was found in the exercise group (p=0.035), showing a lower score than the control group; this difference was not maintained at 48 weeks (p=0.235). Our study highlighted that a moderate-intensity exercise intervention reduced chronic pain in older adults, but this effect disappeared at follow-up after 36 weeks from the end of the training program. These findings suggested that such kinds of programs, easily accessible to old people even with MCI, should be implemented and supported over time, thus promoting active aging and preventing CP of age-related diseases. Clinical Trial Registration: Clinical.Trials.gov.NCT03858114
{"title":"Exercise Improves the Impact of Chronic Pain in Older Adults: Results of an RCT","authors":"M. Carta, F. Velluzzi, M. Monticone, Cesar Ivan Aviles Gonzalez, L. Minerba, M. Pau, M. Musu, L. Atzori, C. Ferreli, A. Cauli, Sérgio Machado, E. Pintus, Dario Fortin, F. Romano, M. P. Penna, A. Preti, Giulia Cossu","doi":"10.2174/18763863-v15-e2202070","DOIUrl":"https://doi.org/10.2174/18763863-v15-e2202070","url":null,"abstract":"\u0000 \u0000 Chronic Pain (CP) is a crucial determinant for disability in older adults. CP amplifies the impact of other common age-related diseases and increases cardiovascular risk. Physical exercise can improve CP. Randomized Controlled Trials (RCTs) with high-intensity exercise in older adults excluded people with Moderate Chronic Illness (MCI) and CP.\u0000 \u0000 \u0000 \u0000 This study aimed at evaluating in an RCT whether moderate exercise training can improve chronic pain in a sample of older adults, including people with MCI, and if any modification persists over time.\u0000 \u0000 \u0000 \u0000 A sample of 120 older adults was randomly selected for a moderate-intensity exercise program or cultural activities (control group). Chronic pain was assessed at t0, at t12 (end of the trial), and t48 weeks, by means of the Italian version of the SIP-Roland Scale.\u0000 \u0000 \u0000 \u0000 Seventy-nine participants completed the follow-up (age 72.3±4.7, women 55.3%). At the end of RCT, an improvement in the SIP scale score was found in the exercise group (p=0.035), showing a lower score than the control group; this difference was not maintained at 48 weeks (p=0.235).\u0000 \u0000 \u0000 \u0000 Our study highlighted that a moderate-intensity exercise intervention reduced chronic pain in older adults, but this effect disappeared at follow-up after 36 weeks from the end of the training program. These findings suggested that such kinds of programs, easily accessible to old people even with MCI, should be implemented and supported over time, thus promoting active aging and preventing CP of age-related diseases.\u0000 Clinical Trial Registration: Clinical.Trials.gov.NCT03858114\u0000","PeriodicalId":53614,"journal":{"name":"Open Pain Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43422282","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 : 2022-02-08DOI: 10.2174/18763863.v15-21122900
.. Isngadi, Djudjuk R. Basuki, Eko Nofiyanto, R. Laksono
This study aimed to compare the outcome of multimodal analgesia using transversus abdominis plane block combined with ketorolac and multimodal analgesia oral paracetamol combined with ketorolac in postoperative pain after cesarean section. Post-caesarean section pain resulted in prolonged recovery time, inhibited early breastfeeding initiation, and prolonged hospitalization. Multimodal analgesia is an important component of post-cesarean section pain management but has not been established in many Indonesian hospitals. This study was a retrospective, observational analytic study on 46 patients who received low-dose sub-arachnoid block anesthesia. A total of 24 subjects received bilateral transversus abdominis plane block employing ultrasonography-guided lateral approach, with Ropivacaine 0.25% in a total volume of 30cc combined with intravenous ketorolac 30 mg/8 h (Group B). A total of 22 subjects received oral paracetamol 500 mg/6 h combined with intravenous ketorolac 30 mg/8 h (Group A). Numeric Rating Scale (NRS), length of hospitalization, and mobilization time were analyzed using the T-test at a significance level of p<0.05 (confidence interval of 95%). The NRS and mean time to start mobilization of patients who received transversus abdominis plane block combined with ketorolac were significantly better than patients who received paracetamol combined with ketorolac (p<0.05). There was no significant difference in the length of hospitalization between the two techniques (p>0.05). Both modalities resulted in improvement in pain intensity over the mild pain range. Multimodal analgesia transversus abdominis plane block combined with ketorolac is superior to paracetamol combined with ketorolac for postoperative pain management after cesarean section.
{"title":"Multimodal Analgesia Transversus Abdominis Plane Block-Ketorolac Combination being Superior to Paracetamol-Ketorolac as Postoperative Pain Management after Cesarean Section in an Indonesian Hospital","authors":".. Isngadi, Djudjuk R. Basuki, Eko Nofiyanto, R. Laksono","doi":"10.2174/18763863.v15-21122900","DOIUrl":"https://doi.org/10.2174/18763863.v15-21122900","url":null,"abstract":"\u0000 \u0000 This study aimed to compare the outcome of multimodal analgesia using transversus abdominis plane block combined with ketorolac and multimodal analgesia oral paracetamol combined with ketorolac in postoperative pain after cesarean section.\u0000 \u0000 \u0000 \u0000 Post-caesarean section pain resulted in prolonged recovery time, inhibited early breastfeeding initiation, and prolonged hospitalization. Multimodal analgesia is an important component of post-cesarean section pain management but has not been established in many Indonesian hospitals.\u0000 \u0000 \u0000 \u0000 This study was a retrospective, observational analytic study on 46 patients who received low-dose sub-arachnoid block anesthesia. A total of 24 subjects received bilateral transversus abdominis plane block employing ultrasonography-guided lateral approach, with Ropivacaine 0.25% in a total volume of 30cc combined with intravenous ketorolac 30 mg/8 h (Group B). A total of 22 subjects received oral paracetamol 500 mg/6 h combined with intravenous ketorolac 30 mg/8 h (Group A). Numeric Rating Scale (NRS), length of hospitalization, and mobilization time were analyzed using the T-test at a significance level of p<0.05 (confidence interval of 95%).\u0000 \u0000 \u0000 \u0000 The NRS and mean time to start mobilization of patients who received transversus abdominis plane block combined with ketorolac were significantly better than patients who received paracetamol combined with ketorolac (p<0.05). There was no significant difference in the length of hospitalization between the two techniques (p>0.05). Both modalities resulted in improvement in pain intensity over the mild pain range.\u0000 \u0000 \u0000 \u0000 Multimodal analgesia transversus abdominis plane block combined with ketorolac is superior to paracetamol combined with ketorolac for postoperative pain management after cesarean section.\u0000","PeriodicalId":53614,"journal":{"name":"Open Pain Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45593160","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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