1
|
Coviello A, Iacovazzo C, Cirillo D, Bernasconi A, Marra A, Squillacioti F, Martone M, Garone E, Coppola F, de Siena AU, Vargas M, Servillo G. Dexamethasone versus Dexmedetomidine as Adjuvants in Ultrasound Popliteal Sciatic Nerve Block for Hallux Valgus Surgery: A Mono-Centric Retrospective Comparative Study. Drug Des Devel Ther 2024; 18:1231-1245. [PMID: 38645991 PMCID: PMC11032716 DOI: 10.2147/dddt.s442808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 03/09/2024] [Indexed: 04/23/2024] Open
Abstract
Background and Aim Ultrasound popliteal sciatic nerve block (UPSNB) is commonly performed in foot and ankle surgery. This study aims to assess the use of dexmedetomidine and dexamethasone as adjuvants in UPSNB for hallux valgus (HV) surgery, comparing their efficacy in producing motor and sensory block and controlling postoperative pain. The adverse event rate was also evaluated. Methods This mono-centric retrospective study included 62 adult patients undergoing HV surgery: 30 patients received lidocaine 2% 200 mg, ropivacaine 0.5% 50 mg and dexamethasone 4 mg (Group 1), whereas 32 patients received lidocaine 2% 200 mg, ropivacaine 0.5% 50 mg, and dexmedetomidine 1 mcg/Kg (Group 2). At first, the visual analogue scale (VAS) was evaluated after 48 hours. The other outcomes were time to motor block regression, evaluation of the first analgesic drug intake, analgesic effect, adverse effects (hemodynamic disorders, postoperative nausea and vomiting (PONV)) and patient satisfaction. The continuous data were analyzed with student's t-test and the continuous one with χ2. Statistical significance was set at a p-value lower than 0.05. Results No significant difference was found in VAS after 48 hours (4.5 ± 1.6 vs 4.7 ± 1.7, p = 0.621) to motor block regression (18.9 ± 6.0 vs 18.7 ± 6, p = 0.922). The number of patients that took their first analgesic drug in the first 48 h (p = 0.947 at 6 hours; p = 0.421 at 12 hours; p = 0.122 at 24 hours and p = 0.333 at 48 hours) were not significant. A low and similar incidence of intraoperative hemodynamic disorders was recorded in both groups (hypotension p = 0.593; bradycardia p = 0.881). Neither PONV nor other complication was found. Patients in Group 1 reported a lower degree of interference with sleep (p = 0.001), less interference with daily activities (P = 0.002) and with the affective sphere (P = 0.015) along with a more satisfactory postoperative pain management (p < 0.001) as compared to Group 2. Conclusion No significant differences were observed in the duration of motor and sensory blockade between patients in both groups. Additionally, both groups showed good pain control with a low rate of adverse effects, even if there was no clinical difference between the groups. However, patients who received dexamethasone reported experiencing less interference with their sleep, daily activities and overall emotional well-being, and overall pain control.
Collapse
Affiliation(s)
- Antonio Coviello
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Naples, 80131, Italy
| | - Carmine Iacovazzo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Naples, 80131, Italy
| | - Dario Cirillo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Naples, 80131, Italy
| | - Alessio Bernasconi
- Department of Public Health, School of Medicine, University of Naples “Federico II”, Unit of Orthopedics and Traumatology, Naples, Italy
| | - Annachiara Marra
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Naples, 80131, Italy
| | - Francesco Squillacioti
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Naples, 80131, Italy
| | - Marco Martone
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Naples, 80131, Italy
| | - Eleonora Garone
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Naples, 80131, Italy
| | - Filomena Coppola
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Naples, 80131, Italy
| | - Andrea Uriel de Siena
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Naples, 80131, Italy
| | - Maria Vargas
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Naples, 80131, Italy
| | - Giuseppe Servillo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Naples, 80131, Italy
| |
Collapse
|
2
|
Hughes JA, Hazelwood S, Lyrstedt AL, Jones L, Brown NJ, Jarugula R, Douglas C, Chu K. Enhancing pain care with the American Pain Society Patient Outcome Questionnaire for use in the emergency department (APS-POQ-RED): validating a patient-reported outcome measure. BMJ Open Qual 2024; 13:e002295. [PMID: 38448040 PMCID: PMC10916172 DOI: 10.1136/bmjoq-2023-002295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 12/02/2023] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND In general, the quality of pain care in emergency departments (ED) is poor, despite up to 80% of all ED patients presenting with pain. This may be due to the lack of well-validated patient-reported outcome measures (PROMs) of pain care in the ED setting. The American Pain Society-Patient Outcome Questionnaire-Revised Edition (APS-POQ-R), with slight modification for ED patients, is a potentially useful PROM for the adult ED, however it is yet to be completely validated. METHODS Adult patients, who had presented with moderate to severe acute pain, were recruited at two large inner-city EDs in Australia. A modified version of the APS-POQ-R was administered at the completion of their ED care. Responses were randomly split into three groups and underwent multiple rounds of exploratory and confirmatory factor analysis with testing for construct, convergent, divergent validity and internal consistency. RESULTS A total of 646 ED patients (55.6% female), with a median age of 48.3 years, and moderate to severe pain on arrival, completed the ED-modified APS-POQ-R. Psychometric evaluation resulted in a reduced nine-question tool, which measures three constructs (pain relief and satisfaction (α=0.891), affective distress (α=0.823) and pain interference (α=0.908)) and demonstrated construct, convergent, divergent validity, and internal consistency. CONCLUSIONS This new tool, which we refer to as the American Pain Society-Patient Outcome Questionnaire-Revised for the ED (APS-POQ-RED), should form the basis for reporting patient-reported outcomes of ED pain care in future quality improvement and research.
Collapse
Affiliation(s)
- James A Hughes
- School of Nursing, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Sarah Hazelwood
- Emergency Department, The Prince Charles Hospital, Chermside, Queensland, Australia
| | - Anna-Lisa Lyrstedt
- Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Lee Jones
- Queensland University of Technology, Brisbane, Queensland, Australia
- QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
| | - Nathan J Brown
- Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
- Faculty of Medicine, University of Queensland Faculty of Medicine and Biomedical Sciences, Herston, Queensland, Australia
| | - Rajeev Jarugula
- Emergency Department, The Prince Charles Hospital, Chermside, Queensland, Australia
| | - Clint Douglas
- Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
- Metro North Hospital and Health Service, Herston, Queensland, Australia
| | - Kevin Chu
- Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
- Faculty of Medicine, University of Queensland Faculty of Medicine and Biomedical Sciences, Herston, Queensland, Australia
| |
Collapse
|
3
|
Sharma R, Moied S, Raikwar S, Gupta V. Functional outcomes and quality of recovery after anaesthesia and surgery - Outreaching towards protracted goals. Indian J Anaesth 2022; 66:S133-S136. [PMID: 35774242 PMCID: PMC9238233 DOI: 10.4103/ija.ija_356_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 04/29/2022] [Accepted: 04/29/2022] [Indexed: 11/05/2022] Open
Affiliation(s)
- Ridhima Sharma
- Department of Paediatric Anaesthesia, Post Graduate Institute of Child health, Sector 30, Noida, Uttar Pradesh, India
| | - Syed Moied
- Department of Anaesthesia and Critical Care, J.N. Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Surendra Raikwar
- Department of Anaesthesia, Gandhi Medical College, Bhopal, Madhya Pradesh, India
| | - Vikas Gupta
- Department of Anaesthesia, Apollo Hospital, Indore, Madhya Pradesh, India
| |
Collapse
|
4
|
Zhao J, Lu XH, Liu Y, Wang N, Chen DY, Lin IA, Li XH, Zhou FC, Wang CY. The Unique Contribution of Past Bullying Experiences to the Presence of Psychosis-Like Experiences in University Students. Front Psychiatry 2022; 13:839630. [PMID: 35573375 PMCID: PMC9096161 DOI: 10.3389/fpsyt.2022.839630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 02/23/2022] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES Both bullying and psychosis-like experiences (PLEs) have gained much attention in recent years, but their interactions are not fully unraveled. The aim of the current study was to validate the Chinese version of Bullying Scale for Adults (C-BSA), and to investigate whether past bullying experiences independently predict the presence of PLEs in university students. METHODS The validity and reliability of the C-BSA were determined in two independent samples. A battery of psychological inventories was also administered to assess the presence of PLEs, maltreatment history in the family, and current depression and anxiety, including the 15-item positive subscale of the community assessment of psychic experiences (CAPE-p15), the Chinese version of the Childhood Trauma Questionnaire (CTQ), Self-Rating Depression Scale (SDS), and Self-Rating Anxiety Scale (SAS). RESULTS In the construction sample (N = 629), a Cronbach's α of 0.921 indicated a good internal consistency of C-BSA. The exploratory factor analysis (EFA) yielded a four-factor model and a three-factor model, and both were verified by using the confirmatory factorial analysis (CFA) in the validation sample (N = 629). The total scores of C-BSA were significantly correlated with that of CTQ, CAPE-p15, SDS, and SAS. Multivariate logistic regression revealed that bullying was associated with 2.0 or 3.7 times of risk for the presence of PLEs (numbers of bullying types < = 3 or > 3, respectively) after controlling for CTQ, SDS, and SAS scores. CONCLUSIONS C-BSA has shown good psychometric properties in college students. The contribution of past bullying experiences to the present PLEs seems to be independent of other childhood trauma, current depression, and anxiety.
Collapse
Affiliation(s)
- Jie Zhao
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital and the Advanced Innovation Center for Human Brain Protection, School of Mental Health, Capital Medical University, Beijing, China
| | - Xiao-Hua Lu
- Psychological Consulting Center, Beijing Jiaotong University, Beijing, China
| | - Yuan Liu
- Nursing Department, National University Polyclinic, Singapore, Singapore
| | - Nan Wang
- Department of General Psychiatry, Central Region, Institute of Mental Health, Singapore, Singapore
| | - Dong-Yang Chen
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital and the Advanced Innovation Center for Human Brain Protection, School of Mental Health, Capital Medical University, Beijing, China
| | - Iun-An Lin
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital and the Advanced Innovation Center for Human Brain Protection, School of Mental Health, Capital Medical University, Beijing, China
| | - Xiao-Hong Li
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital and the Advanced Innovation Center for Human Brain Protection, School of Mental Health, Capital Medical University, Beijing, China
| | - Fu-Chun Zhou
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital and the Advanced Innovation Center for Human Brain Protection, School of Mental Health, Capital Medical University, Beijing, China
| | - Chuan-Yue Wang
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital and the Advanced Innovation Center for Human Brain Protection, School of Mental Health, Capital Medical University, Beijing, China
| |
Collapse
|