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Wang Y, Sun J, Yu K, Liu X, Liu L, Miao H, Li T. Virtual reality exposure reduce acute postoperative pain in female patients undergoing laparoscopic gynecology surgery: A Randomized Control Trial (RCT) study. J Clin Anesth 2024; 97:111525. [PMID: 38870701 DOI: 10.1016/j.jclinane.2024.111525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/28/2024] [Accepted: 06/08/2024] [Indexed: 06/15/2024]
Abstract
STUDY OBJECTIVE Few studies have focused on the effect of virtual reality (VR) exposure on postoperative acute pain in adult female patients undergoing gynecology surgery. DESIGN A randomized control trial (RCT) study. SETTING At Beijing Fuxing Hospital. PATIENTS 115 patients aged between 20 and 60 years, American Society of Anesthesiologists (ASA) physical status I - II were consecutively enrolled and randomly divided into VR group (n = 58) or control group (n = 57). INTERVENTIONS Patients in the VR group received 15 min of VR video viewing before surgery. MEASUREMENTS The primary outcome was acute postoperative pain at 8 h which was measured by the Visual Analogue Scale (VAS) scores. The secondary outcomes including the use of analgesic drugs, the incidence of moderate pain and postoperative recovery which were recorded 24 h after surgery. The Hospital Anxiety and Depression Scale (HADS) was also used to evaluate patients' emotional status before surgery. MAIN RESULTS The VAS scores at 30 min [2 (1,2) vs. 3 (2,3)], 2 h [2 (2,3) vs. 4 (3,4)], 4 h [3 (2,4) vs. 4 (4,5)], 8 h [3 (2,4) vs. 4 (4,5)], 12 h [2 (2,3) vs. 4 (3,4)], 24 h [1 (1,2) vs. 3 (2,3)] after surgery. Generalized estimation equation (GEE) indicated that VR intervention was negatively correlated with postoperative VAS values (β = -0.830, S.E = 0.199, 95%CI (-1.220,-0.439), Wald χ2 = 17.359, p<0.05), in the meanwhile, VR also lower the incidence of moderate pain (VAS > 4) at 8 h postoperatively (12.1% vs 31.0%, p = 0.013). However, the 24 h tramadol usage remained unchanged. Patients in the VR group had better sleep quality (6.33 ± 2.3 vs. 4.12 ± 2.5, p < 0.001) and lower incidence of nausea (43.1% vs. 63.2%, p < 0.05), dizziness (0% vs. 14.0%, p < 0.05), and headache (12.1% vs. 29.8%, p < 0.05). VR could reduce the median HADS scores (9.81 ± 6.1 vs 3.14 ± 3.9, p < 0.001) and blood pressure preoperatively. CONCLUSIONS VR intervention can reduce acute postoperative pain with better postoperative recovery and lower preoperative anxiety level in adult female patients undergoing laparoscopic gynecology surgery.
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Affiliation(s)
- Ying Wang
- Department of anesthesiology, Beijing Fuxing Hospital, Capital Medical University, Beijing 100038, China
| | - Jian Sun
- Department of anesthesiology, Beijing Fuxing Hospital, Capital Medical University, Beijing 100038, China
| | - Kang Yu
- Department of anesthesiology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Xiao Liu
- Department of anesthesiology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Lei Liu
- Department of Science and Technology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Huihui Miao
- Department of anesthesiology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China.
| | - Tianzuo Li
- Department of anesthesiology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China.
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Elrahman YOA, Abdelkader HM, Ahmed MAB, Eldarawy AAEW, Selim A. The Effect of Platelet-Rich Plasma on the Healing of Nasal Mucosa After Surgery of the Nose: A Randomized Clinical Trial. Indian J Otolaryngol Head Neck Surg 2024; 76:2973-2980. [PMID: 39130325 PMCID: PMC11306662 DOI: 10.1007/s12070-024-04683-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 04/01/2024] [Indexed: 08/13/2024] Open
Abstract
Purpose To investigate the effect of platelet-rich plasma (PRP) on the healing of nasal mucosa after surgery of the nose. Methods This prospective, randomized, Comparative Analytic study was conducted on 40 patients. Patients were randomly allocated into two groups: Group A, subjected to PRP, and Group B, who were not subjected to PRP after nasal surgery. The outcome of both Techniques was analyzed and compared. Results Significant differences were found in dryness, encrustations, and postoperative healing days in the PRP group. However, no significant differences between the two groups were observed in primary bleeding, secondary bleeding, nasal synechiae, pain, healing time, return to physical activity, and patient satisfaction. Conclusion Our study detects the potential hopeful effect of PRP on postoperative wound healing of nasal mucosa, dryness, and nasal crustations. According to these results, the application of PRP post-nasal surgery can be considered an effective method for maintaining post-nasal surgery Mucosa.
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Affiliation(s)
| | | | | | - Alaa Abd El Wahab Eldarawy
- Resident doctor at Otorhinolaryngology Department, Faculty of Medicine, Al-Azhar University, Assiut, MBChB Egypt
| | - Ahmed Selim
- Resident doctor at Otorhinolaryngology Department, Faculty of Medicine, Al-Azhar University, Assiut, MBChB Egypt
- Medical Research Group of Egypt (MRGE), Negida Academy, Arlington, MA USA
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Lovasi O, Gaál P, Frank K, Lám J. Acute Pain Services and pain-related patient-reported outcomes in Hungarian hospitals. Perioper Med (Lond) 2024; 13:18. [PMID: 38475942 DOI: 10.1186/s13741-024-00373-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 03/01/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Postoperative pain management is an important part of surgical care, where Acute Pain Service offers added value in terms of patient outcomes and costs. The technology, however, has hardly been adopted in Hungary, with only two hospitals operating Acute Pain Service and whose performance has not been evaluated yet. This research compared pain management outcomes of surgical, orthopedic, and traumatology patients in Hungarian hospitals with and without Acute Pain Service. METHODS We recruited 348 patients, 120 in the APS group and 228 in the control group, whose experience was surveyed with an adapted version of the American Pain Society Patient Outcome Questionnaire. The questionnaire covered pain intensity, pain interference with physical and emotional functions, side effects, patient satisfaction, information received, and participation in treatment decisions. The differences were analyzed by Fisher's exact test and Mann-Whitney U test. RESULTS The APS group showed better results with lower pain intensity scores regarding worst postoperative pain (χ2 = 18.919, p = 0.0043). They reported less pain interference with activities in bed (χ2 = 21.978, p = 0.0006) and out of bed (χ2 = 14.341, p = 0.0129). Furthermore, patients in the APS group experienced fewer pain-management-related side effects, like nausea (χ2 = 15.240, p = 0.0101), drowsiness (χ2 = 26.965, p = 0.0001), and dizziness (χ2 = 13.980, p = 0.0124). However, patient information (χ2 = 3.480, p = 0.0945) and patient satisfaction (χ2 = 5.781, p = 0.2127) did not differ significantly between the two groups. CONCLUSIONS Our findings confirm earlier international evidence on the benefits of Acute Pain Service in postoperative pain management and support the wider adoption of the technology in Hungarian hospitals. Nevertheless, close attention should be paid to patient information and involvement as better outcomes alone do not necessarily increase patient satisfaction.
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Affiliation(s)
- Orsolya Lovasi
- School of PhD Studies, Semmelweis University, Üllői Út 26, 1085, Budapest, Hungary.
| | - Péter Gaál
- Health Services Management Training Center, Semmelweis University, Budapest, Hungary
- Department of Applied Social Sciences, Sapientia Hungarian University of Transylvania, Targu Mures, Romania
| | - Krisztián Frank
- Szekszárd District Office of the Government Office of Tolna County, Szekszárd, Hungary
| | - Judit Lám
- Health Services Management Training Center, Semmelweis University, Budapest, Hungary
- NEVES Society for Patient Safety, Budapest, Hungary
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Gurmu M, Mulugeta H, Zemedkun A, Girma T, Destaw B, Tadessa M, Adamu Y, Hailu S. Postoperative analgesic effects of intravenous dexamethasone for patients undergoing cesarean delivery under spinal anesthesia at Dilla University Referral Hospital, Ethiopia, 2023: a double-blind randomized controlled trial. Ann Med Surg (Lond) 2024; 86:232-239. [PMID: 38222682 PMCID: PMC10783290 DOI: 10.1097/ms9.0000000000001563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 11/20/2023] [Indexed: 01/16/2024] Open
Abstract
Background The use of cesarean section (CS) worldwide has increased to unprecedented levels. In Ethiopia, the CS delivery rate is above the rate recommended by the WHO. The postoperative pain experience is moderate to severe in most patients during their postoperative period. The administration of intravenous dexamethasone is thought to have an analgesic effect after surgery even though the analgesic profile of preoperatively administered dexamethasone is less addressed. Objective This study aimed to assess the postoperative analgesic effect of preoperative intravenous dexamethasone for patients undergoing cesarean delivery under spinal anesthesia at Dilla University Referral Hospital, Southern Ethiopia. Methodology A double-blinded randomized controlled trial (RCT) was done on 112 patients undergoing elective CS under spinal anesthesia who were allocated randomly into normal saline and dexamethasone groups. Total analgesic consumption, time to first analgesic request, and postoperative pain score with the numerical rating scale (NRS) were followed for 24 h in both groups. Shapiro-Wilk tests were used to check normality. Independent samples t-test was used for the comparison of means between groups, Mann-Whitney U test for non-normally distributed data, and χ 2 test for categorical variables, and P-value <0.05 was considered statistically significant with a power of 80%. Result The finding of this study showed that the postoperative pain score of the dexamethasone group was significantly lower than the normal saline group at 2, 4, 6, 12, 18, and 24 h with a statistically significant P-value <0.05. There was also a significant difference in the time to the first rescue analgesic request between the two groups, with the dexamethasone group (median=347.5 min) and the normal saline group (median=230 min) with P=0.001. Conclusion and recommendation The authors conclude that preoperative administration of 8 mg of dexamethasone prolongs the first analgesic request time, decreases postoperative tramadol and diclofenac consumption, and decreases the postoperative pain score. The authors recommend that researchers conduct further RCTs with a different dose of dexamethasone and on a multicenter basis.
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Affiliation(s)
| | | | | | | | | | | | | | - Seyoum Hailu
- Department of Anesthesiology, Dilla University, Dilla, Ethiopia
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Long G, Liu C, Liang T, Zhan X. The efficacy of thoracolumbar interfascial plane block for lumbar spinal surgeries: a systematic review and meta-analysis. J Orthop Surg Res 2023; 18:318. [PMID: 37095532 PMCID: PMC10127357 DOI: 10.1186/s13018-023-03798-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 04/13/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND The intent of this meta-analysis was to examine the efficacy of thoracolumbar interfascial plane block (TLIP) for pain control after lumbar spinal surgery. METHODS Randomized controlled trials (RCTs) published on PubMed, CENTRAL, Scopus, Embase, and Web of Science databases up to February 10, 2023, comparing TLIP with no or sham block or wound infiltration for lumbar spinal surgeries were included. Pain scores, total analgesic consumption, and postoperative nausea and vomiting (PONV) were analyzed. RESULTS Seventeen RCTs were eligible. Comparing TLIP with no block or sham block, the meta-analysis showed a significant decrease of pain scores at rest and movement at 2 h, 8 h, 12 h, and 24 h. Pooled analysis of four studies showed a significant difference in pain scores at rest between TLIP and wound infiltration group at 8 h but not at 2 h, 12 h, and 24 h. Total analgesic consumption was significantly reduced with TLIP block as compared to no block/sham block and wound infiltration. TLIP block also significantly reduced PONV. GRADE assessment of the evidence was moderate. CONCLUSION Moderate quality evidence indicates that TLIP blocks are effective in pain control after lumbar spinal surgeries. TLIP reduces pain scores at rest and movement for up to 24 h, reduces total analgesic consumption, and the incidence of PONV. However, evidence of its efficacy as compared to wound infiltration of local anesthetics is scarce. Results should be interpreted with caution owing low to moderate quality of the primary studies and marked heterogeneity.
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Affiliation(s)
- Guanghua Long
- Spine and Osteopathy Ward, The First Affiliated Hospital of Guangxi Medical University, 6 Shuangyong Road, Nanning, Guangxi, China
| | - Chong Liu
- Spine and Osteopathy Ward, The First Affiliated Hospital of Guangxi Medical University, 6 Shuangyong Road, Nanning, Guangxi, China
| | - Tuo Liang
- Spine and Osteopathy Ward, The First Affiliated Hospital of Guangxi Medical University, 6 Shuangyong Road, Nanning, Guangxi, China
| | - Xinli Zhan
- Spine and Osteopathy Ward, The First Affiliated Hospital of Guangxi Medical University, 6 Shuangyong Road, Nanning, Guangxi, China.
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Lovasi O, Lám J, Frank K, Schutzmann R, Gaál P. The First Comprehensive Survey of the Practice of Postoperative Pain Management in Hungarian Hospitals - a Descriptive Study. Pain Manag Nurs 2023; 24:342-349. [PMID: 36642581 DOI: 10.1016/j.pmn.2022.12.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 11/20/2022] [Accepted: 12/10/2022] [Indexed: 01/15/2023]
Abstract
BACKGROUND Pain management is a key issue in health care. Providers adopt promising technological developments, like Acute Pain Service, at differing speeds, with countries, such as the USA and Germany taking the lead. Where Hungary stands is unknown, as the practice of pain management has not yet been comprehensively reviewed in that country. AIM To explore the practice of postoperative pain management in Hungarian hospitals by addressing the questions of who is responsible for it, who measures pain and how, what kind of pain relief technologies are used, and who takes care of patients during duty hours. METHODS We carried out a survey covering Hungarian hospitals with operational license for surgery, traumatology, orthopedics and anesthesiology between December 2019 and March 2020. The response rate was 72%, and we analyzed 135 questionnaires. RESULTS We identified only 2 hospitals with an Acute Pain Service. In the majority of hospitals, the attending physician orders pain relief therapy. During duty hours the surgeon on duty takes care of pain management in 52.1% of the cases. Among pain relief therapies, intravenous infusions (74.1%) and oral medication (67.4%) are the most frequent. Ward nurses measure postoperative pain (77.8%) with unidimensional scales. According to 59.7% of the respondents, pain is not measured and documented at rest. Written protocols are available in 34.4% of the departments. CONCLUSIONS Compared with other countries, pain management in Hungary lags behind with significant room for improvement. Development and implementation of pain management protocols with appropriate education is the key intervention point.
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Affiliation(s)
- Orsolya Lovasi
- School of PhD Studies, Semmelweis University, Budapest, Hungary.
| | - Judit Lám
- Health Services Management Training Centre, Semmelweis University, Budapest, Hungary
| | - Krisztián Frank
- Szekszárd District Office of the Government Office of Tolna County, Szekszárd, Hungary
| | - Réka Schutzmann
- School of PhD Studies, Semmelweis University, Budapest, Hungary
| | - Péter Gaál
- Health Services Management Training Centre, Semmelweis University, Budapest, Hungary; Sapientia Hungarian University of Transylvania, Faculty of Technical and Human Sciences, Department of Applied Social Sciences, Targu Mures, Romania
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Chen MC, Yeh TF, Wu CC, Wang YR, Wu CL, Chen RL, Shen CH. Three-year hospital-wide pain management system implementation at a tertiary medical center: Pain prevalence analysis. PLoS One 2023; 18:e0283520. [PMID: 37053144 PMCID: PMC10101381 DOI: 10.1371/journal.pone.0283520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 03/12/2023] [Indexed: 04/14/2023] Open
Abstract
We developed a pain management system over a 3-year period. In this project, "Towards a pain-free hospital", we combined evidence-based medicine and medical expertise to develop a series of policies. The intervention mainly included the development of standard procedures for inpatient pain management, the implementation of hospital-wide pain medicine education and training, the establishment of a dashboard system to track pain status, and regular audits and feedback. This study aimed to gain an understanding of the changes in the prevalence of pain in inpatients under the care of the pain management system. The subjects of the survey are inpatients over 20 years old, and who had been hospitalized in the general ward for at least 3 days. The patients would be excluded if they were unable to respond to the questions. We randomly selected eligible patients in the general ward. Our trained interviewers visited inpatients to complete the questionnaires designed by our pain care specialists. A total of 3,094 inpatients completed the survey from 2018 to 2020. During the three-year period, the prevalence of pain was 69.5% (2018) (reference), 63.3% (2019) (OR:0.768, p<0.01), and 60.1% (2020) (OR:0.662, p <0.001). The prevalence rates of pain in patients undergoing surgery during the 3-year period were 81.4% (2018), 74.3% (2019), and 68.8% (2020), respectively. As for care-related causes of pain, injection, change in position/chest percussion, and rehabilitation showed a decreasing trend over the 3-year period of study. Our pain management system provided immediate professional pain management, and achieved a good result in the management of acute moderate to severe pain, especially perioperative pain. Studies on pain prevalence and Pain-Free Hospitals are scarce in Asia. With the aid of the policies based on evidence-based medicine and the dashboard information system, from 2018 to 2020, the prevalence of pain has decreased year by year.
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Affiliation(s)
- Ming-Chuan Chen
- Department of Anesthesiology, Taichung Veterans General Hospital, Taichung, Taiwan
- Department of Anesthesiology, Chiayi Branch, Taichung Veterans General Hospital, Chiayi, Taiwan
| | - Te-Feng Yeh
- Department of Healthcare Administration, Central Taiwan University of Science and Technology, Taichung, Taiwan
| | - Chih-Cheng Wu
- Department of Anesthesiology, Taichung Veterans General Hospital, Taichung, Taiwan
- Department of Financial Engineering, Providence University, Taichung, Taiwan
- Department of Data Science and Big Data Analytics, Providence University, Taichung, Taiwan
| | - Yan-Ru Wang
- Department of Healthcare Administration, Central Taiwan University of Science and Technology, Taichung, Taiwan
| | - Chieh-Liang Wu
- Center of Smart Healthcare, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Ruei-Ling Chen
- Department of Nursing, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Ching-Hui Shen
- Department of Anesthesiology, Taichung Veterans General Hospital, Taichung, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
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Cesare M, D’agostino F, Maurici M, Zega M, Zeffiro V, Cocchieri A. Standardized Nursing Diagnoses in a Surgical Hospital Setting: A Retrospective Study Based on Electronic Health Data. SAGE Open Nurs 2023; 9:23779608231158157. [PMID: 36824318 PMCID: PMC9941607 DOI: 10.1177/23779608231158157] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/06/2022] [Accepted: 01/30/2023] [Indexed: 02/22/2023] Open
Abstract
Introduction In electronic health records (EHRs), standardized nursing terminologies (SNTs), such as nursing diagnoses (NDs), are needed to demonstrate the impact of nursing care on patient outcomes. Unfortunately, the use of NDs is not common in clinical practice, especially in surgical settings, and is rarely included in EHRs. Objectives The aim of the study was to describe the prevalence and trend of NDs in a hospital surgical setting by also analyzing the relationship between NDs and hospital outcomes. Methods A retrospective study was conducted. All adult inpatients consecutively admitted to one of the 15 surgical inpatient units of an Italian university hospital across 1 year were included. Data, including the Professional Assessment Instrument and the Hospital Discharge Register, were collected retrospectively from the hospital's EHRs. Results The sample included 5,027 surgical inpatients. There was a mean of 6.3 ± 4.3 NDs per patient. The average distribution of NDs showed a stable trend throughout the year. The most representative NANDA-I ND domain was safety/protection. The total number of NDs on admission was significantly higher for patient whose length of stay was longer. A statistically significant correlation was observed between the number of NDs on admission and the number of intra-hospital patient transfers. Additionally, the mean number of NDs on admission was higher for patients who were later transferred to an intensive care unit compared to those who were not transferred. Conclusion NDs represent the key to understanding the contribution of nurses in the surgical setting. NDs collected upon admission can represent a prognostic factor related to the hospital's key outcomes.
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Affiliation(s)
- Manuele Cesare
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Fabio D’agostino
- Unicamillus, Saint Camillus International University of Health Sciences, Rome, Italy
| | - Massimo Maurici
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Maurizio Zega
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Valentina Zeffiro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Antonello Cocchieri
- Section of Hygiene, Woman and Child Health and Public Health, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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Agrawal S, Szmit M, Wełna M, Rudnicki J, Agrawal A, Goździk W. Transcutaneous electrical acupoint stimulation to reduce opioid consumption in patients undergoing inguinal hernia repair: protocol for a randomized controlled trial. Trials 2022; 23:1064. [PMID: 36581999 PMCID: PMC9801607 DOI: 10.1186/s13063-022-07019-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 12/15/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The purpose of this study is to evaluate the efficacy and safety of transcutaneous electrical acupoint stimulation (TEAS) in the postoperative treatment of patients undergoing inguinal hernia repair compared with sham and no treatment group. METHODS This study is a protocol for a three-armed, single-blinded, placebo-controlled randomized controlled trial. Ninety participants scheduled for inguinal hernia repair will be randomly assigned to the TEAS group (n = 30), sham group (n = 30), and control group (n = 30). The TEAS group will receive treatment using four portable coin-sized electro-stimulators at both local and distal acupuncture points. The sham group will receive sham treatment with mock electrostimulation. The treatment groups will receive mixed frequency stimulation (alternating at 2 and 100 Hz every 3 s) in continuous mode for 30 min at intervals of 2 h for 24 h postoperatively. The control group will receive postoperative pain control using patient-controlled analgesia (PCA) device. The primary outcome is the total morphine dose received in the postoperative period (mg) using PCA 24 h after surgery. The number of PCA demands (i.e., times the button will be pressed) and delivered bolus doses, score on the Visual Analogue Scale, opioid-related side effects, the requirement for supplemental medications, score on the Hospital Anxiety and Depression Scale (HADS), and blood levels of stress hormones cortisol and prolactin. DISCUSSION The results of this trial will determine whether TEAS with intensified stimulation protocol is a safe and effective option for reducing analgesic consumption and postoperative pain. TRIAL REGISTRATION ISRCTN76428396. Registered on 05 October 2020. https://www.isrctn.com/ISRCTN76428396.
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Affiliation(s)
- Siddarth Agrawal
- grid.4495.c0000 0001 1090 049XDepartment of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Wroclaw, Poland ,grid.4495.c0000 0001 1090 049XDepartment of Pathology, Wroclaw Medical University, Wroclaw, Poland
| | - Mateusz Szmit
- grid.4495.c0000 0001 1090 049XDepartment of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Wroclaw, Poland
| | - Marek Wełna
- grid.4495.c0000 0001 1090 049XDepartment of Anaesthesiology and Intensive Therapy, Wroclaw Medical University, Wroclaw, Poland
| | - Jerzy Rudnicki
- grid.4495.c0000 0001 1090 049XDepartment of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Wroclaw, Poland
| | - Anil Agrawal
- grid.4495.c0000 0001 1090 049XSecond Department of General and Oncological Surgery, Wroclaw Medical University, Borowska 213 St, 50-556 Wroclaw, Poland
| | - Waldemar Goździk
- grid.4495.c0000 0001 1090 049XDepartment of Anaesthesiology and Intensive Therapy, Wroclaw Medical University, Wroclaw, Poland
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Al Sadah ZM, Alfaraj NH, AlAlwan NE, Al Dhaif LH, Khidr AM, Fallatah SM. Assessment of patients' satisfaction with the postanesthesia care unit service at University Hospital in Al Khobar, KSA. J Taibah Univ Med Sci 2022; 18:217-224. [PMID: 36817216 PMCID: PMC9926208 DOI: 10.1016/j.jtumed.2022.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 07/06/2022] [Accepted: 09/16/2022] [Indexed: 11/06/2022] Open
Abstract
Objectives The quality of health care is individually and subjectively reflected through patients' level of satisfaction, as well as the optimality and effectiveness of the provided postoperative pain management. The provision of postanesthesia care unit (PACU) service in hospitals has led to overall positive outcomes, in addition to the enhancement of patients' satisfaction with the provided pain management service. This study assessed patients' level of satisfaction with PACU service at a university hospital and discussed different factors that might have contributed to the level of satisfaction. Methods A prospective cross-sectional study was carried out among patients after being discharged from PACU. The study took place at King Fahad Hospital of the University in Al Khobar, KSA between November 2021 and February 2022. The data were collected using a three-section predesigned questionnaire. Results Two hundred patients were included in this study. Nearly all patients (95.5%) were satisfied with the provided pain management service. Almost all patients (99.5%) indicated that the PACU staff was courteous and professional during the entire pain management service. More patients complained about pain before using analgesia and this difference was statistically significant (Z = 8.642; p < 0.001). The satisfaction rate was significantly higher in the older age group (>45 years) (Z = 2.114; p = 0.035), in patients with American Society of Anesthesiology (ASA) 3 physical status (H = 13.130; p = 0.001), and those with a previous surgical history (Z = 2.139; p = 0.032). Conclusion This study concluded that the level of patients' satisfaction with PACU service was high, and established a statistically significant association with age, ASA score, and previous surgical history. Healthcare providers should consider patient education and effective communication to increase patients' satisfaction level and improve the overall quality of care.
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Key Words
- ASA, American Society of Anesthesiology
- Analgesia
- Anesthesia
- BMI, Body Mass Index
- GA, General anesthesia
- ICU, Intensive care unit
- IRB, Institutional Review Board (IRB)
- IV, Intravenous
- KFHU, King Fahad Hospital of the University
- OR, Operating room
- PACU, Postanesthesia care unit
- Patient satisfaction
- Postanesthesia care unit
- Preoperative education
- SCRELC, Standing Committee for Research Ethics on Living Creatures
- SPSS, Statistical Packages for Software Sciences
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Affiliation(s)
- Zhra M. Al Sadah
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, KSA,Corresponding address: Zhra Muneer Al Sadah, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, KSA.
| | - Noor H. Alfaraj
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, KSA
| | - Noor E. AlAlwan
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, KSA
| | - Lamees H. Al Dhaif
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, KSA
| | - Alaa M. Khidr
- Department of Anesthesia, King Fahad Hospital of the University, Al Khobar, KSA
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Patient satisfaction with post-operative pain management and associated factors among surgical patients at Tikur Anbessa Specialized Hospital: Cross-sectional study. Ann Med Surg (Lond) 2022; 79:104087. [PMID: 35860062 PMCID: PMC9289483 DOI: 10.1016/j.amsu.2022.104087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 06/23/2022] [Accepted: 06/23/2022] [Indexed: 11/24/2022] Open
Abstract
Background Objective Method Result Conclusion Patient satisfaction with postoperative pain management was suboptimal. ASA status, pain, analgesic techniques & management were significantly associated. Patient satisfaction also associated with empathy, patient education, & communication.
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Liu Y, Huang L, Xu G, Tian H, Zhou Z, Huang F, Liang F. The Application of Acupuncture Therapy for Postoperative Pain Over the Past 20 Years: A Bibliometric Analysis. J Pain Res 2022; 15:2085-2104. [PMID: 35923845 PMCID: PMC9343020 DOI: 10.2147/jpr.s371399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 07/16/2022] [Indexed: 11/25/2022] Open
Abstract
Purpose The purpose of this study is to analyze and visualize the research trends on acupuncture therapy for postoperative pain over the past 20 years to identify hotspots and frontiers, and provide new research ideas. Methods A search of the Web of Science database, with a time frame of 2001–01-01 to 2022–02-28, was conducted to collect literatures related to acupuncture therapy for postoperative pain. A bibliometric analysis and visualization of results was performed using CiteSpace software for the volume of annual publications, journals, countries, institutions, authors, keywords, and references. Results A total of 840 literatures were eventually included in the analysis. The number of publications has fluctuated upwards each year over the past 20 years and reached a peak in the latest three years. Evidence-Based Complementary and Alternative Medicine was the journal with the most relevant publications and Pain was the most frequently cited journal. The country with the highest volume of publications was China, and the USA contributed most to the international collaboration. The most prolific and influential authors were Inhyunk Ha and Han JS respectively. The most frequent keyword was “acupuncture”. References with highest frequency or centrality were both systematic evaluations focusing on different acupuncture therapies for postoperative pain relief. Conclusion The field of acupuncture therapy for postoperative pain is currently in a period of high growth. China and the USA have made the largest contribution to the volume of publications. The most influential institutions and authors are mainly from China and South Korea. The overall collaborative network needs to be strengthened. Electroacupuncture and auricular acupuncture (therapeutic techniques), low back surgery (types of surgery), and “postoperative pain, nausea and vomiting” are research hotspots in this field. Improvement of postoperative life quality, proof of clinical efficacy and evidence-based evaluation are the current research trends and frontiers.
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Affiliation(s)
- Yilin Liu
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Liuyang Huang
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Guixing Xu
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Hao Tian
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Zhuo Zhou
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Fengyuan Huang
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Fanrong Liang
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine/Clinical Research Center for Acupuncture and Moxibustion in Sichuan Province, Chengdu, People’s Republic of China
- Correspondence: Fanrong Liang, Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine/Clinical Research Center for Acupuncture and Moxibustion in Sichuan Province, Chengdu, People’s Republic of China, Tel +86 136 0805 8216, Fax +86-028-87683962, Email
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Disceken FM, Kose G. Association of preoperative pain beliefs with postoperative pain levels in abdominal surgery patients. J Clin Nurs 2021; 30:3249-3258. [PMID: 33973286 DOI: 10.1111/jocn.15831] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 04/15/2021] [Accepted: 04/19/2021] [Indexed: 01/18/2023]
Abstract
AIMS AND OBJECTIVES This study aimed to analyse the association of preoperative pain beliefs with postoperative pain levels in abdominal surgery patients. BACKGROUND Postoperative pain is related to not only clinical and demographic characteristics but also pain beliefs. The perception, intensity and expression of pain as a subjective experience varies among individuals and cultures. Personal beliefs about pain play an important role in pain experiences and responses. DESIGN This cross-sectional study consisted of 126 abdominal surgery patients admitted to the General Surgery and Gynecological Surgery Clinics between September 2018-January 2019. The STROBE (Strengthening The Reporting of Observational Studies in Epidemiology) checklist was used as a guideline for this study. METHODS Data were collected through descriptive information forms, pain characteristics questionnaires, Visual Analogue Scales and pain beliefs questionnaires. One-way variance analysis and Pearson's correlation and t tests were used for data analysis. RESULTS The mean age of the participants was 48.63 ± 14.27 years. A total of 37.3% of the participants experienced moderate pain and 35.7% experienced severe pain at the 8th postoperative hour. Pain intensity significantly decreased at 16, 24 and 32 h postoperatively. In the predischarge interviews, 92.1% of the patients expressed limitations in physical activities due to pain. There was a relationship between 8-16 h postoperatively and sex and pain expectancy. Mean scores obtained from the organic and psychological beliefs subscales of the Pain Belief Questionnaire were 3.12 ± 0.79, and 2.37 ± 1.11, respectively. The psychological beliefs score was negatively associated with the level of education, and the organic beliefs score was higher for those participants who had undergone gynaecological surgery. There was a weak and positive correlation between the organic beliefs and psychological beliefs subscales of the Pain Beliefs Questionnaire. CONCLUSION Patients had moderate to severe postoperative pain, and sex and pain expectations affected the experienced level of pain. Most participants believed that the pain was organic in origin. The level of education exerted a significant impact on pain beliefs. RELEVANCE TO CLINICAL PRACTICE Characteristics and perception of pain and pain beliefs are important factors that should be determined to personalise pain relief care and maintain effective pain management.
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Affiliation(s)
| | - Gulsah Kose
- Department of Nursing, Faculty of Health Sciences, Mugla Sıtkı Kocman University, Mugla, Turkey
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Lin LY, Hung TC, Lai YH. Pain control and related factors in hospitalized patients. Medicine (Baltimore) 2021; 100:e26768. [PMID: 34397723 PMCID: PMC8322552 DOI: 10.1097/md.0000000000026768] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 07/06/2021] [Indexed: 01/04/2023] Open
Abstract
Pain is a common health problem for hospitalized patients. It is necessary to understand the factors that affect patients' pain to provide individual and complete pain management. This study explored the severity and incidence of pain in hospitalized patients on the admission day, during the hospitalization, and the discharge day, and explored the predictive factors that affect the patient's pain on the discharge day.This was a retrospective study that reviewed the medical records of 73,814 hospitalized patients from January 2016 to April 2018. The number of pain assessments was 471,339.The incidence of pain on the discharge day of patients was significantly higher than that on the admission day. The factors that affect and predict the pain of patients on discharge day include the degree of pain on the day of admission, emotional distress on the day of discharge, disease category, gender, age, and length of stay in hospital. It shows that the higher the degree of pain on the day of admission, the higher the degree of emotional distress on the day of discharge, female patients, younger patients, longer hospitalization days, and surgical and gynecological patients have significantly higher pain levels on the day of discharge (P < .05).This study found that the incidence of pain on the discharge day of patients was 46.5%. Previous pain level, disease category, emotional distress, gender, age, and length of hospital stay were important factors affecting patient pain on the discharge day. The influencing factors of patient pain should be fully assessed to provide individual and complete pain management, and improve patient quality of life after discharge.
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Affiliation(s)
- Li-Ying Lin
- Department of Nursing, Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan
- Department of Nursing, Meiho University, Pingtung County, Taiwan
| | - Tzu-Ching Hung
- Department of Nursing, Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan
| | - Yen-Ho Lai
- Department of Nursing, Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan
- National Kaohsiung University of Science and Technology, Kaohsiung City, Taiwan
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Park SK, Yoon S, Kim BR, Choe SH, Bahk JH, Seo JH. Pre-emptive epidural analgesia for acute and chronic post-thoracotomy pain in adults: a systematic review and meta-analysis. Reg Anesth Pain Med 2020; 45:1006-1016. [DOI: 10.1136/rapm-2020-101708] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 09/14/2020] [Accepted: 09/16/2020] [Indexed: 01/03/2023]
Abstract
Background and objectivesEpidural analgesia is the gold standard for post-thoracotomy pain management and can be started before or after surgical incision. This systematic review and meta-analysis investigated whether pre-emptive epidural analgesia before thoracotomy incision reduces acute and chronic post-thoracotomy pain in adults compared with epidural analgesia after incision.MethodsWe searched databases including MEDLINE, Embase, and CENTRAL for randomized controlled trials comparing epidural analgesia initiated before (pre-emptive group) and after (control group) thoracotomy incision in adults. The primary outcomes were the pain intensity during rest and coughing within 72 hours after surgery and the incidence of pain 1 to 6 months after surgery. Data were combined with random-effects meta-analyses. We rated the quality of evidence as high, moderate, low, and very low using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) method.ResultsWe included 19 trials with 1062 participants involving 529 in the pre-emptive group and 533 in the control group. The pain intensity was significantly lower at rest within 72 hours after surgery (19 studies, n=1062) and during coughing within 48 hours after surgery (11 studies, n=638), and the incidence of pain was significantly lower 1 to 6 months after surgery (6 studies, n=276) in the pre-emptive group than in the control group. The quality of evidence was moderate or low in the primary outcomes.ConclusionsOur review provides low-quality evidence that pre-emptive epidural analgesia reduces the intensity of acute pain and the incidence of chronic pain after thoracotomy in adults.Protocol registration numberCRD42019131620.
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Ding L, Hua H, Zhu H, Zhu S, Lu J, Zhao K, Xu Q. Effects of virtual reality on relieving postoperative pain in surgical patients: A systematic review and meta-analysis. Int J Surg 2020; 82:87-94. [PMID: 32882400 DOI: 10.1016/j.ijsu.2020.08.033] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 08/12/2020] [Accepted: 08/19/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Postoperative pain is a prevalent problem leading to many adverse outcomes in surgical patients. Virtual reality (VR) is an emerging non-pharmacological method of postoperative pain relief, but the effects of it are not clear. This review aimed to explore the effects of VR on relieving postoperative pain. METHODS Studies published up to November 2019 were identified by searching the PubMed (Medline), Embase, Web of Science, and other databases. Meta-analyses were conducted to compare VR and usual care for relieving postoperative pain. Subgroup analyses and sensitivity analyses were performed to explain the heterogeneity. RESULTS Overall, 8 randomized control trials (RCTs) enrolling 723 participants were included. Our results demonstrated that the patients receiving the VR intervention had lower postoperative pain scores than those receiving the usual care (mean difference [MD] -0.64; 95% CI -1.05 to -0.22; P = 0.002). One subgroup analysis revealed that VR could relieve postoperative pain both in minor surgery (MD -1.48; 95% CI -2.02 to -0.95; P < 0.0001) and major surgery (MD -0.32; 95% CI -0.53 to -0.11; P < 0.03). Another subgroup analysis demonstrated a significant reduction in postoperative pain among patients receiving VR during the intraoperative (MD -1.51; 95% CI -2.04 to -0.97; P < 0.00001) and the postoperative periods (MD -0.50; 95% CI -0.76 to -0.24; P = 0.002). However, there was no significant postoperative pain relief when receiving VR during the preoperative period. Additionally, significant improvements in postoperative satisfaction were reported in two studies. However, another two studies included found that VR could not affect physiological parameters related to pain. CONCLUSIONS Applying VR can relieve postoperative pain effectively. The type of surgery and timing of using VR are the main sources of heterogeneity. More rigorous studies about the relationship between VR and postoperative pain relief will be needed.
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Affiliation(s)
- Lingyu Ding
- School of Nursing, Nanjing Medical University, Nanjing, 211166, China
| | - Hongxia Hua
- School of Nursing, Nanjing Medical University, Nanjing, 211166, China
| | - Hanfei Zhu
- School of Nursing, Nanjing Medical University, Nanjing, 211166, China
| | - Shuqin Zhu
- School of Nursing, Nanjing Medical University, Nanjing, 211166, China
| | - Jinling Lu
- School of Nursing, Nanjing Medical University, Nanjing, 211166, China
| | - Kang Zhao
- School of Nursing, Nanjing Medical University, Nanjing, 211166, China
| | - Qin Xu
- School of Nursing, Nanjing Medical University, Nanjing, 211166, China.
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Sharma SK, Thakur K, Mudgal SK, Payal YS. Acute postoperative pain experiences and satisfaction with its management among patients with elective surgery: An observational study. Indian J Anaesth 2020; 64:403-408. [PMID: 32724249 PMCID: PMC7286399 DOI: 10.4103/ija.ija_33_20] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Revised: 03/07/2020] [Accepted: 04/02/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND AND AIM There is a paucity of regional data on acute postoperative pain. The present study was conducted with an aim to assess the acute postoperative pain experiences, its interference with ADLs, emotions, sleep, IPR and satisfaction with pain management among patients who had undergone elective surgeries. METHODS In this observational study, 200 postoperative adult patients; who had undergone elective surgery were interviewed using American Pain Society's Patient Outcome and Satisfaction Survey Questionnaire. Pain perception and interference of pain with ADLs, emotions, sleep, and IPR was measured on 0-10 numerical scale and satisfaction on 6 point Likert scale, i.e., very satisfied to very dissatisfied. RESULTS There was high incidence (82.5%) of acute postoperative pain experience and mean score for worst episodes of pain was significantly high, i.e., 7.6 ± 1.5, which had significant interference with ADLs (5.6 ± 2.1), sleep (3.6 ± 1.7), and emotions (3.6 ± 1.6). Majority of patients reported that pain was assessed only once (17%) or twice (48.5%) in each shift. Despite of poor pain control, a large number of patients were satisfied with overall pain treatment (69%), and response of physicians (81%) and nurses (62%) for their pain complaints. Acute pain score was directly associated with the duration of postoperative hospital stay (P = 0.001). CONCLUSION Acute postoperative pain was inadequately assessed and undertreated but still a large number of participants were satisfied with acute postoperative pain management probably because patients expects that pain is inevitable after surgery. Postoperative pain had significant interference with ADLs, emotions and sleep of patients, which may affect postoperative comfort and recovery.
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Affiliation(s)
- Suresh K Sharma
- College of Nursing, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Kalpana Thakur
- College of Nursing, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Shiv K Mudgal
- College of Nursing, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Yashwant S Payal
- Department of Anaesthesiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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Factors that influence the quality of pain management in patients with skin traction. Int J Orthop Trauma Nurs 2020; 36:100713. [DOI: 10.1016/j.ijotn.2019.100713] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 05/30/2019] [Accepted: 08/18/2019] [Indexed: 11/20/2022]
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Stoker KC. Use of Abdominal Binders for Postoperative Pain After Gastrointestinal Surgery: An Integrative Review. J Perianesth Nurs 2019; 34:829-833. [DOI: 10.1016/j.jopan.2018.10.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 10/16/2018] [Accepted: 10/26/2018] [Indexed: 10/27/2022]
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Eshete MT, Baeumler PI, Siebeck M, Tesfaye M, Haileamlak A, Michael GG, Ayele Y, Irnich D. Quality of postoperative pain management in Ethiopia: A prospective longitudinal study. PLoS One 2019; 14:e0215563. [PMID: 31042777 PMCID: PMC6494043 DOI: 10.1371/journal.pone.0215563] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 04/04/2019] [Indexed: 02/06/2023] Open
Abstract
Background The annual number of surgical operations performed is increasing throughout the world. With this rise in the number of surgeries performed, so too, the challenge of effectively managing postoperative pain. In Africa, there are scanty data available that make use of multi-center data to characterize the quality of postoperative pain management. In this study using a longitudinal data, we have attempted to characterize the quality of postoperative pain management; among patients scheduled for major elective orthopedic, gynecologic and general surgery. Methods This prospective longitudinal study evaluated the quality of postoperative pain management in patients undergoing elective general, gynecologic, and orthopedic surgery. We quantified the prevalence of moderate to severe postoperative pain with the International Pain Outcome Questionnaire and the corresponding adequacy of treatment with the pain management index. At four time points after surgery, we estimated pain severity, its physical and emotional interference, and patient satisfaction. Results Moderate to severe postoperative pain was present in 88.2% of patients, and pain was inadequately treated in 58.4% of these patients. Chronic pain (β = 0.346, 95% CI: 0.212, 0.480) predicted patients’ worst pain intensity. Gender was not associated with the worst pain intensity or percentage of time spent in severe pain. Patient’s pain intensity did not predicted the level of satisfaction. Conclusions The prevalence of moderate to severe postoperative pain and its functional interference is high in Ethiopian patients. The treatment provided to patients is inadequate and not in line with international recommendations and standards.
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Affiliation(s)
- Million Tesfaye Eshete
- Department of Anesthesiology, Institute of Health, Faculty of Medicine, Jimma University, Jimma, Ethiopia
- CIHLMU Center for International Health, Medical Center of the University of Munich (LMU), Munich, Germany
- * E-mail:
| | - Petra I. Baeumler
- Multidisciplinary Pain Center, Department of Anesthesiology, University Hospital, Ludwig Maximilians University (LMU), Munich, Germany
| | - Matthias Siebeck
- CIHLMU Center for International Health, Medical Center of the University of Munich (LMU), Munich, Germany
- Department of General, Visceral und Transplantation Surgery, Medical Center of the University of Munich (LMU), Munich, Germany
| | - Markos Tesfaye
- Department of Psychiatry, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Abraham Haileamlak
- Department of Pediatrics and Child Health, Institute Of Health, Faculty of Medicine, Jimma University, Jimma, Ethiopia
| | - Girma G. Michael
- Department of Anesthesiology, Institute of Health, Faculty of Medicine, Jimma University, Jimma, Ethiopia
| | - Yemane Ayele
- Department of Anesthesiology, Institute of Health, Faculty of Medicine, Jimma University, Jimma, Ethiopia
| | - Dominik Irnich
- Multidisciplinary Pain Center, Department of Anesthesiology, University Hospital, Ludwig Maximilians University (LMU), Munich, Germany
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Schultz H, Skræp U, Schultz Larsen T, Rekvad LE, Littau-Larsen J, Schmidt SF, Möller S, Qvist N. Psychometric evaluation of the Danish version of a modified Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R-D) for patients hospitalized with acute abdominal pain. Scand J Pain 2019; 19:117-130. [PMID: 30352045 DOI: 10.1515/sjpain-2018-0106] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 09/27/2018] [Indexed: 01/10/2023]
Abstract
Background and aims This paper forms part of a study evaluating the effect of patient-controlled oral analgesia for patients admitted to hospital with acute abdominal pain. Pain is a subjective experience, and a multifaceted evaluation tool concerning patient-reported outcome measures is needed to monitor, evaluate, and guide health care professionals in the quality of pain management. The Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R) is a validated multifaceted evaluation tool for measuring patient-reported pain experiences to evaluate different pain management interventions. The aim of this study was to evaluate the psychometric properties of a modified Danish version of the Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R-D) used during and after hospitalization for patients with acute abdominal pain. Methods The APS-POQ-R was translated into Danish and two slightly different questionnaires were formed. Questionnaire one had 39 items and the six subscales pain severity (pain), perception of care (satisfaction), pain interference with function (activity) and emotions (emotion), side effects of treatment (safety), and patient-related barriers to pain management. The questionnaire focused on time during hospital stay and was to be completed at discharge. Questionnaire two included 25 items and the five subscales pain, satisfaction, activity, emotion, and safety and focused on time at home and was to be completed daily 1 week after discharge. The questionnaires were tested on 156 patients with acute abdominal pain. Internal consistency reliability and construct validity was examined. Results In both questionnaires, the results of correlations and tests for internal consistency reliability showed a Cronbach's alpha of >0.7 for the pain, activity, and emotion subscales, but the value was ≥0.69 for the satisfaction subscale. In questionnaire one, Cronbach's alpha was ≤0.64 for the safety subscale, but this was 0.73 when the item "itching" was deleted. In questionnaire two, Cronbach's alpha was ≤0.51 for the safety subscale. For the patient-barrier subscale in questionnaire one, Cronbach's alpha was ≤0.62 for any combination of the items in the subscale. The results of the construct validity and factor analysis showed a five-factor structure in questionnaire one and a three-factor structure in questionnaire two. In questionnaire one, items from the pain, activity, emotion, and safety subscales, except for the items "least pain" and "itching," loaded on factor one. In questionnaire two, all items from the pain, activity, and emotion subscales loaded on factor one. Conclusions The modified APS-POQ-R-D demonstrated adequate psychometric properties for the five subscales pain severity (pain), perception of care (satisfaction), pain interference with function (activity) and emotions (emotion), side effects of treatment (safety), but not for the patient-barrier subscale for patients hospitalized with acute abdominal pain. Consequently, the APS-POQ-R-D may be used without the patient-barrier subscale. Implications The clinical implications of this study may help clinicians with investigating how acute patients manage pain during and after hospital admission.
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Affiliation(s)
- Helen Schultz
- Surgical Department, Odense University Hospital, J.B. Winsløws Vej 4, 5000 Odense C, Denmark.,Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.,OPEN - Odense Patient Data Explorative Network, Odense University Hospital, Odense, Denmark, Phone: (+45) 2240 1513
| | - Ulla Skræp
- Surgical Department, Odense University Hospital, Svendborg, Denmark
| | | | | | | | | | - Sören Möller
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.,OPEN - Odense Patient Data Explorative Network, Odense University Hospital, Odense, Denmark
| | - Niels Qvist
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.,Surgical Department, Odense University Hospital, Odense, Denmark
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Bellury LM, Mullinax K, Mozingo J, Dantzler B, McGee N. Transforming Care to Evidence-Based Practice With Scripted Messages: An Improvement Project for Pain Management in Outpatient Surgical Patients. Worldviews Evid Based Nurs 2018; 15:257-263. [DOI: 10.1111/wvn.12296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2018] [Indexed: 01/17/2023]
Affiliation(s)
- Lanell M. Bellury
- Associate Professor, Georgia Baptist College of Nursing of Mercer University; Mercer University; Atlanta GA USA
| | - Karen Mullinax
- Nurse Scholar Orthopedic and Spine Operating Room, Emory Healthcare at Saint Joseph's Hospital; Atlanta GA USA
| | - Judi Mozingo
- Staff Nurse Operating Room; Children's Healthcare of Atlanta-Scottish Rite; Atlanta GA USA
| | - Berta Dantzler
- Staff Nurse ICU; Emory Healthcare at Saint Joseph's Hospital; Atlanta GA USA
| | - Nancy McGee
- Nurse Recruiter; Virginia Mason Medical Center; Seattle WA USA
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Alaloul F, Williams K, Myers J, Jones KD, Sullivan K, Logsdon MC. Contextual Factors Impacting a Pain Management Intervention. J Nurs Scholarsh 2017; 49:504-512. [DOI: 10.1111/jnu.12319] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Fawwaz Alaloul
- Iota Zeta, Assistant Professor, School of Nursing; Health Sciences Campus; K-Wing Louisville KY USA
| | - Kimberly Williams
- Acute Pain Service Charge Nurse; University of Louisville Hospital; Louisville KY USA
| | - John Myers
- Associate Professor, Department of Pediatrics; School of Medicine, Health Sciences Campus; Louisville KY USA
| | | | - Katelyn Sullivan
- Student, School of Nursing; Health Sciences Campus; Louisville KY USA
| | - M. Cynthia Logsdon
- Alpha and Iota Gamma, Professor, School of Nursing, University of Louisville; Associate Chief of Nursing for Research, University of Louisville Hospital; James Graham Brown Cancer Center; Louisville KY USA
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Babazade R, Turan A. Sufentanil sublingual tablet system for the management of postoperative pain. Expert Opin Pharmacother 2017; 17:2351-2357. [PMID: 27796147 DOI: 10.1080/14656566.2016.1254190] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Intravenous patient-controlled opioid analgesia has been an important improvement in addressing insufficient management of acute postoperative pain for over 40 years. However, there are number of weaknesses for intravenous patient-controlled analgesia, including operator and device error, intravenous line patency issues, and risk of catheter-related infection, all of which contribute to the complications and increase in cost of care. The sublingual sufentanil tablet system is a major evolution in both drug and technological management of postoperative pain. Areas covered: We reviewed the use of the sublingual sufentanil tablet system in management of moderate to severe postoperative pain in hospitalized patients, with a particular focus on the pharmacological properties of sufentanil and clinical use in different surgical patients. Expert opinion: The sublingual sufentanil tablet system can decrease intravenous opioid based patient-controlled analgesia related complications and safety issues. Current clinical studies have demonstrated this noninvasive-novel system to be safe and effective in management of acute pain in the postsurgical setting. Researchers should focus on comparing it with other available patient controlled analgesia modalities and evaluating the efficiency and cost effectiveness of the sublingual sufentanil tablet system.
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Affiliation(s)
- Rovnat Babazade
- a Department of Anesthesiology , The University of Texas Medical Branch , Galveston , TX , USA
| | - Alparslan Turan
- b Department of Outcomes Research , Anesthesiology Institute , Cleveland Clinic, Cleveland , OH , USA
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Liu Y, Wang L, Wei Y, Wang X, Xu T, Sun J. Validation of a Chinese version of the Chronic Pain Acceptance Questionnaire (CAPQ) and CPAQ-8 in chronic pain patients. Medicine (Baltimore) 2016; 95:e4339. [PMID: 27537558 PMCID: PMC5370785 DOI: 10.1097/md.0000000000004339] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Acceptance of chronic pain has increasingly become a significant issue in the field of pain management. Many researchers have suggested that patients with better acceptance of pain are more likely to have better functioning both in physical and psychological status. In many countries, the Chronic Pain Acceptance Questionnaire (CPAQ) and CPAQ-8 have been validated and utilized frequently to measure the pain acceptance of patients with chronic pain. However, the CPAQ and CPAQ-8 yet have not been introduced and validated in Mainland China.In this study, we aimed to translate the English version of the CPAQ into simplified Chinese, make proper cross-cultural adaptations, and validate the psychometric properties of the Chinese version of the CPAQ and the CPAQ-8.The English version of the CPAQ was first linguistically translated and cross-culturally adapted to formulate a Chinese version. Then, we recruited 224 patients from a pain clinic and every participant was asked to finish a series of questionnaires. Finally, statistical analysis was performed to test the psychometric properties of the CPAQ and the CPAQ-8.Both confirmatory factor analysis (CFA) and principal component analysis (PCA) confirmed a 2-factor structure for the CPAQ and the CPAQ-8. Nine out of 10 of the hypotheses were validated for construct validity. The overall intraclass correlation coefficient (ICC) value for the CPAQ and CPAQ-8 were 0.92 and 0.89, respectively. In addition, the Cronbach α values for both the CPAQ and the CPAQ-8 showed excellent test-retest reliability.In conclusion, the original CPAQ was successfully developed into the Chinese version of the CPAQ and CPAQ-8 with excellent validity and reliability. The scores of the CPAQ or CPAQ-8 might be a strong predictor for the physical and psychological function of chronic pain patients. In addition, to improve the satisfaction of surgery patients, we recommend measuring patients' pain acceptance using the CPAQ or CPAQ-8 before and after the surgery. For patients with lower acceptance, psychological interventions may be more effective than treatment that simply reduces symptoms. Finally, we suggest that the Chinese version of the CPAQ and CPAQ-8 are appropriate for use in clinical settings or fundamental research in Mainland China.
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Affiliation(s)
- Yaqun Liu
- Department of Rheumatology and Immunology, Changzheng Hospital, Second Military Medical University
| | - Lei Wang
- Faculty of Health Service
- Central Hospital of Shanghai Zhabei District
| | | | - Xiaolin Wang
- Department of Anesthesiology, Changhai Hospital, Second Military Medical University, f Department of Orthopedics, No. 455 Hospital of PLA, Shanghai, China
| | - Tianming Xu
- Department of Anesthesiology, Changhai Hospital, Second Military Medical University, f Department of Orthopedics, No. 455 Hospital of PLA, Shanghai, China
- Department of Orthopedics, No.455 Hospital of PLA, Shanghai, China
- Correspondence: Tianming Xu, Department of Orthopedics, No. 455 Hospital of PLA, 338 West Huaihai Road, Shanghai, 200052 P.R. China; Jinhai Sun, Faculty of Health Service, Second Military Medical University, No. 800 Xiangyin Road, Shanghai 200433, P.R. China (emails: ; )
| | - Jinhai Sun
- Faculty of Health Service
- Correspondence: Tianming Xu, Department of Orthopedics, No. 455 Hospital of PLA, 338 West Huaihai Road, Shanghai, 200052 P.R. China; Jinhai Sun, Faculty of Health Service, Second Military Medical University, No. 800 Xiangyin Road, Shanghai 200433, P.R. China (emails: ; )
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Babazade R, Turan A. Pharmacokinetic and pharmacodynamic evaluation of sublingual sufentanil in the treatment of post-operative pain. Expert Opin Drug Metab Toxicol 2016; 12:217-24. [DOI: 10.1517/17425255.2016.1134487] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Rovnat Babazade
- Department of Outcomes Research, Cleveland Clinic, Cleveland, OH, USA
| | - Alparslan Turan
- Department of Outcomes Research, Cleveland Clinic, Cleveland, OH, USA
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