Background: Venipuncture pain is an uncomfortable suffering to the patient. It creates anxiety, fear and dissatisfaction. The ketoprofen transdermal patch is a proven treatment for musculoskeletal and arthritic pain. We planned this study to evaluate the efficacy of the ketoprofen patch to reduce venipuncture pain. Methods: Two hundred adult patients, aged 18-60 years, of either sex, ASA grade I or II, were enrolled. Presuming that therapy would decrease venipuncture pain by 30%, a power calculation with ${\alpha}=0.05$ and ${\beta}=0.80$ required enrollment of at least 24 patients into each group. However, 100 patients in each group were recruited. Group I (Control) received a placebo patch; Group II (Ketoprofen) received a 20 mg ketoprofen patch. A selected vein on the dorsum of the patient's non-dominant hand was cannulated with 18 g intravenous cannula 1 h after the application of the respective patch. Assessment of pain was done by a 10 cm visual analogue scale (VAS) of 0-10, where 0 depicts "no pain" and 10 is "the worst imaginable pain". The venipuncture site was assessed for the presence of skin erythema, swelling and rashes at 12 h, 24 h and at the time of decannulation. Results: Incidence of pain was 100% (94/94) in the control group as compared to 93% (85/91) in the ketoprofen group. The severity of the venipuncture pain was 6 (2) and 2 (2) for control and ketoprofen groups respectively (P < 0.05). Conclusions: Application of a ketoprofen patch at the proposed site of venipuncture one hour before the attempt is effective and safe for attenuating venipuncture pain.
Purpose: A survey was done on knowledge of pain and pain interventions by clinical nurses in Deagu city and Kyoungbuk province. Method: The participants in this study were 209 nurses who worked in Daegu city, and 190 nurses who worked in Kyoungbuk province. The data were collected from August 5, to September 15, 2002. The data were analyzed with SPSS WIN 10.0 program using numbers, percentages, averages and standard deviation with t-test and ANOVA. Result: Out of a total of 30 points on general knowledge of pain, the clinical nurses had a high score of 28, and a low of 10. The average was 18.6 (SD=3.14). Of the participants, 57.9% reported not having had any pain education and 67.9% agreed that education is a necessity. Of pharmacological interventions, Tylenol had the highest score at 3.44 out of a possible 4 points. The most frequent route for giving medication was intramuscular injection (42.6%) and for 62.7%, there was a decision by the physician for routine medication or prn. On reactions after medication, moderate relief had the highest frequency (41.9%), and for side effects after the medication, feeling of nausea was most frequent (70.4%). Of the nonpharmacological approaches to pain relief, ice bag had the highest score with 2.95 out of a possible 4. Judgement to give medication was made by the nurse for 50.1% of the participants and 647% reported a little relief from pain. Conclusion: Based upon the results, continuing education and developing a better education programs (including pain mechanism, pain assessment, pharmacological interventions and nonpharmacological interventions) are needed for systematic pain management. Nurses need a high level of knowledge of pain, to be active in pharmacological interventions and nonpharmacological interventions.
Background: Epidural neural blockade with local anesthetics combined with steroids has been in clinical trials for patients with low back pain. But pain treatment of low back pain remains somewhat problematic. Many patients with low back pain have epidural fibrosis and adhesions proved with magnetic resonance imaging(MRI) examination. These findings might play an important role in the origin of back pain. Present study was aims to investigate the effect of epidural adhesiolysis in patients with low back pain. Methods: We investigated 76 patients suspected with epidural fibrosis and adhesion was suspected. Nerve pathology was demonstrated and epidural fibrosis suspected or proved with MRI examination. 17G needle specially designed by Racz was inserted at sacral hiatus and catheter was inserted untill its tip was located at lesion site under fluoroscopic guidance. Injection of contrast dye was achieved and prospected spread of agents. Injection of 0.25% bupivacaine, triamcinolone, and 10% hypertonic saline via catheter were carried out daily for 3 days. Evaluation included assessment of pain relief (Numerical Rating Scale; NRS) post-epidural adhesiolysis 3 days, 1 week, and 3 months. We also looked for complication of epidural adhesiolysis. Results: Statistical analysis(Friedman nonparametric repeated measures test and Dune's multiple comparison test) demonstrated NRS was significantly less during 3 months after epidural adhesiolysis(P<0.05). Especially, there is a extremely significance in post-epidural adhesiolysis 3 days (P<0.001). Only four patients reported any complications the most common symptom among three persistent headache but disappeared after a few months without residual sequelae. Conclusion: We conclude epidural adhesiolysis is a safe and effective method of pain therapy for low back pain with proven lumbo-sacral fibrosis and adhesion. A direct visualization by epiduroscopy may be more useful to the resulting functional changes after epidural adhesiolysis.
Sencan, Savas;Edipoglu, Ipek Saadet;Celenlioglu, Alp Eren;Yolcu, Gunay;Gunduz, Osman Hakan
The Korean Journal of Pain
/
제33권3호
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pp.226-233
/
2020
Background: We aimed to compare interlaminar epidural steroid injections (ILESI) and bilateral transforaminal epidural steroid injections (TFESI) on pain intensity, functional status, depression, walking distance, and the neuropathic component in patients with lumbar central spinal stenosis (LCSS). Methods: The patients were divided into either the ILESI or the bilateral TFESI groups. Prime outcome measures include the numerical rating scale (NRS), Oswestry disability index (ODI), Beck depression inventory (BDI), and pain-free walking distance. The douleur neuropathique en 4 questions score was used as a secondary outcome measure. Results: A total of 72 patients were finally included. NRS, ODI, and BDI scores showed a significant decline in both groups in all follow-ups. Third-month NRS scores were significantly lower in the ILESI group (P = 0.047). The percentages of decrease in the ODI and BDI scores between the baseline and the third week and third month were significantly higher in the ILESI group (P = 0.017, P = 0.001 and P = 0.048, P = 0.030, respectively). Pain-free walking distance percentages from the baseline to the third week and third month were significantly higher in the ILESI group (P = 0.036, P < 0.001). The proportion of patients with neuropathic pain in the bilateral TFESI group significantly decreased in the third week compared to the baseline (P = 0.020). Conclusions: Both ILESI and TFESI are reliable treatment options for LCSS. ILESI might be preferred because of easier application and more effectiveness. However, TFESI might be a better option in patients with more prominent neuropathic pain.
Sencan, Savas;Yolcu, Gunay;Bilim, Serhad;Kenis-Coskun, Ozge;Gunduz, Osman Hakan
The Korean Journal of Pain
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제35권1호
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pp.106-113
/
2022
Background: Coccygodynia is one of the chronic, refractory painful musculoskeletal disorders. Interventional procedures are applied to patients unresponsive to initial treatment in coccygodynia. This study aims to compare the treatment outcomes of ganglion impar block (GIB) and caudal epidural steroid injection (CESI) in patients with chronic coccygodynia. Methods: This study was a prospective randomized comparison study conducted between June 2019 and January 2021. Patients diagnosed with chronic coccygodynia were randomly divided into two groups: the GIB group and the CESI group. The severity of pain, presence of neuropathic pain, and quality of life were evaluated using the Numeric Rating Scale, Leeds Assessment of the Neuropathic Symptoms and Signs Scale, and Short Form-12 Health Survey (SF-12), respectively. Results: A total of 34 patients in each group were included in the final analyses. While there was a significant decrease in pain intensity in both groups in the 3-month follow-up, this decrease was more significant in the GIB group at the 3rd week. There was a significant improvement in the SF-12 physical score and the number of patients with neuropathic pain in both groups in the 3rd week, but this improvement was not observed in the 3rd month. Conclusions: Although GIB may provide more pain relief in short term, both GIB and CESI are useful treatment methods in coccygodynia unresponsive to more conservative treatments.
Background: This study was conducted to examine the correlation of VDT, posture and shoulder function among each group divided by according to the neck pain disorder index (NDI) scores for female patients with neck pain. Design: Cross-sectional study. Methods: Fifty adult women with neck pain voluntarily participated in this study and the neck pain disorder index questionnaire, VDT syndrome assessment tool questionnaire, craniovertebral angle, thoracic kyphosis angle, round shoulder posture, pectoralis minor length, shoulder joint hypermobility, and serratus anterior strength tests were conducted respectively. Subjects were divided into two groups where 21 subjects were allocated to the mild pain group whom have rated below 14 points on the NDI scores, and 29 subjects were in the severe pain group, whom have rated above 15 on the NDI score. Results: The study found that in the mean difference between variables in each group, VDT syndrome showed a higher mean score in the severe pain group than the mild pain group (p<0.05). In the group correlation and regression analysis, the mild pain group showed a significant negative correlation between the craniovertebral angle and round shoulder posture (r=-0.467, p<0.05), and the round shoulder posture for craniovertebral angle was shown to have significant positive influence (B=10.162, p<0.05). The severe pain group showed that the NDI and the VDT syndrome had a significant amount of correlation (r=0.520, p<0.01), the VDT syndrome showed significant positive influence (B=0.330, p<0.05), and the craniovertebral angle showed significant negative influence (B=-0.809, p<0.05). It was also shown that shoulder joint hypermobility had a significant negative correlation with the serratus anterior strength (r=-0.437, p<0.01), and that serratus anterior strength had a significant negative influence on shoulder joint hypermobility (B=-4.175, p<0.05). Conclusion: This study is of clinical significance in that it presented variables that should be considered depending on the degree of neck pain in treating patients with neck pain and that it presented patients with not only posture but also the function of the shoulder joint as factors to consider.
Purpose: The purpose of this study was to investigate the effects of psychosocial interventions on pain in cancer patients. Methods: Eight studies published between 1980 and 2012 in Korean and ten studies published between 2002 and 2012 in English met the inclusion criteria with a total of 1539 participants. Methodological quality assessed by Cochrane's Risk of Bias for randomized studies and Risk of Bias Assessment tool for non randomized studies. The data were analyzed by the RevMan 5.2 program of Cochrane library. Results: Overall, study quality was moderate to high. Effect sizes were heterogeneous and subgroup analysis was done. Cognitive behavioral therapy (CBT) were effective for pain (ES= -0.35; 95% CI= -0.56, -0.13). Pain education studies measured with NRS and VAS were effective for pain (ES= -0.77; 95% CI= -1.01, -0.52). Publication bias was not detected. Conclusion: This study support the use of psychosocial interventions administered to cancer patients for their pain management. However, more well-designed studies are needed.
Purpose: The purpose of this study was to identify patterns and trends of studies, analyze the research, and improve direction of nursing research related to the neonatal pain relief intervention in Korea. Method: The studies were selected from dissertation, nursing journals and others in Korea. Result: Until 1995, there were no studies related to the neonatal pain relief intervention. The most studies have been increased rapidly after 2005. Pure of true experimental design of research design was used 5, Quasi experimental design was 7, preexperimental design was 7. Participants were preterm baby was 8, full-term baby was 9, and preterm and full-term baby was 2. Utilization of instruments as follows: NIPS, PIPP, ABSS, NFCS, pulse oximeter, EKG monitoring, and stethoscope. Contents of the research studies were classified 4 different types, such as studies of about the effect of auditory stimulation, taste stimulation, tactile stimulation, and topical anesthetic cream. The results of 25 studies were effective for the neonatal pain relief, but the results of 5 studies weren't. Conclusion: In the future studies need to develop the various instrument which is assessment of neonatal pain. It is important to the integrated by meta analysis. Additionally, we should develop protocol nursing intervention for the effective pain release.
Background: Evaluation of the effectiveness of caudal epidural injection on pain, spine mobility, disease activity, and activity of daily living in axial spondyloarthritis (SpA) patients. Methods: A total sample of 47 patients were registered in this study. They were randomly assigned into 2 groups; Group I received caudal epidural injections, ultrasound-guided, with 1% lidocaine hydrochloride mixed with triamcinolone, whereas Group II did not receive any injections. All participants fulfilled the ASAS criteria for axial SpA. Outcome measures were as follows: visual analogue scale, Oswestry disability index (ODI), modified Schober test, lateral lumbar flexion, and Ankylosing Spondylitis Disease Activity Score (ASDAS) with assessment at baseline, 2 weeks, and 8 weeks post-treatment. This clinical trial was registered on clinicaltrials.gov under the number NCT04143165. Results: There was a significant difference between both groups regarding pain, ODI, spine mobility and ASDAS scores in favor of group I. This effect was at its maximum after 2 weeks. Despite the decline of this effect after 2 months, the difference between the groups remained significant. Higher disease activity, younger age, and shorter disease duration were associated with better outcomes. Conclusions: Epidural injection of lidocaine and triamcinolone is a cost effective and a practical technique for controlling pain, as well as improving the function of the spine and disease activity scores in axial SpA patients with acceptable complications and relatively sustained effect.
Objectives: This study aimed to evaluate the effectiveness of final irrigation with cold saline solution after endodontic treatment compared with saline solution at room temperature against postoperative pain following endodontic treatment. Materials and Methods: A broad search was performed in the PubMed, Web of Science, Scopus, Cochrane Library, Virtual Health Library (LILACS), and Grey Literature databases. Two independent reviewers performed data extraction, risk of bias using the Cochrane methodology, and certainty of evidence using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. Results: Eight studies were included in qualitative synthesis. Intracanal cryotherapy favored the reduction of postoperative pain in the systematic review. Four studies were included in meta-analyses. The meta-analysis showed that intracanal cryotherapy reduced postoperative pain in teeth with symptomatic apical periodontitis (SAP) at 24 hours. There was no association between intracanal cryotherapy and control (room temperature) groups in teeth with normal periapical tissue with respect to postoperative pain at 24 hours and 48 hours. Conclusions: Intracanal cryotherapy was effective in reducing postoperative pain after endodontic treatment in teeth with SAP.
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