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【Objective】 To explore the efficacy of flexible ureteroscopic lithotripsy (FURL) under local anesthesia (LA) in the treatment of upper urinary tract calculi, and to analyze the risk factors of pain. 【Methods】 Clinical data of 255 patients treated during Apr.2022 and Sep.2022 were reviewed, including visual analogue score (VAS) of pain during ureteroscopy, sheath placement, holmium laser lithotripsy, 1 hour and 8 hours after operation. VAS ≥5 was defined as significant pain. Clinical and follow-up data of the significant pain group and non-significant pain group were analyzed with logistic regression to analyze the risk factors of pain in FURL under LA. 【Results】 Altogether 198 patients (77.6%) successfully completed the operation, and the stone-free rate (SFR) was 89.9% (178/198). The VAS of ureteroscopy was the highest (4.49±1.08), and 73 patients (28.6%) experienced significant pain. Univariate analysis showed that significant pain was associated with gender, previous surgical history, age, body mass index (BMI), education level, and ASA classification (P<0.05). Multivariate analysis showed that male (OR=2.896, 95%CI:1.413-5.933, P=0.040) and BMI≥28 (OR=7.776, 95%CI:2.268-26.657, P=0.001) were independent risk factors of significant pain, while age ≥65 years (OR=0.237, 95%CI:0.083-0.672, P=0.007) and previous surgical history (OR=0.156, 95%CI:0.032-0.754, P=0.021) were the protective factors. 【Conclusion】 It is feasible and effective to treat upper urinary tract calculi with FURL under LA. The presence of significant pain is associated with factors such as gender, age, BMI and previous surgical history.
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Background: In low- and middle-income countries epidural analgesia is generally not available and practically no form of labor analgesia is given to the majority of the parturient. The purpose of study was to evaluate the safety and efficacy of tramadol as a labor analgesic during first stage of labor.Methods: Pregnant women admitted in the labor room satisfying the eligibility criteria were randomized to receive intramuscular injection of either 100 mg tramadol or 2 ml distilled water. Visual analogue score (VAS) was assessed at the beginning and every hour till 4 hours. Pain satisfaction, duration of second stage of labor, fetal heart rate, mode of delivery, and any maternal side effects of the study drug were recorded. Neonatal evaluation using Apgar score at 1 and 5 minutes was done. For statistical analysis Student t-test, Chi Square test and Fisher’s exact test were used.Results: Total of 86 women were included in the study. The VAS scores were significantly lower in the tramadol group at 1, 2 and 3 hours after the administration. Pain relief satisfaction was significantly higher in the tramadol group. Rate of cervical dilatation, duration of the second and the third stage, need for instrumental delivery or lower segment caesarean section, rate of fetal distress and Apgar score at one and five minutes were comparable in both the groups. Nausea was significantly higher in tramadol group.Conclusions: Tramadol is a safe and efficacious drug which is inexpensive, easily available and easy to administer with few minor side effects. It can be used as a labour analgesic as an alternative to epidural analgesia in settings where epidural analgesia is not available. Trial registration: Clinicaltrials.gov PRS registration number: NCT02999594.
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@#Objective To analyze the effect of different drainage modes on the postoperative thoracic drainage after video-assisted thoracoscopic surgery for radical resection of lower lung carcinoma. Methods A total of 183 patients with non-small cell lung cancer who received biportal thoracoscopic anatomical lower lobectomy combined with mediastinal lymph node dissection in the First Affiliated Hospital of Xi'an Jiaotong University from August 2017 to August 2019 were enrolled, including 113 males and 70 females, aged 31-77 (56.5±6.4) years. The patients were randomly divided into three groups, including an anterior axillary line group, a mid-axillary line group and a modified anterior axillary line group. Clinical efficacy of the three groups was compared. Results No significant difference among these three groups in terms of gender, age, surgical site, pathological type, pathological staging, postoperative chest wall subcutaneous emphysema, postoperative pain score, and postoperative hospital stay was found (P>0.05). There were significant differences among the patients in terms of postoperative pleural effusion, re-insertion of chest tube or aspiration, total liquid quantity of thoracic drainage, drainage time and chest wall incision stitches time (P<0.05). The anterior axillary line group had higher risk of postoperative pleural effusion than the other groups (P<0.05). The occurrence of postoperative pleural effusion and rate of reposition of chest tube or aspiration were significantly reduced in the modified anterior axillary line group (P<0.05). Conclusion Chest drainage tube with large diameter (24F) in the 5th intercostal space of the anterior axillary line combined with another micro-tube (8.5F) in the 7th or 8th intercostal space of the inferior scapular angle line can shorten drainage time to reduce postoperative pain, reduce the occurrence of postoperative pleural effusion, and shorten the time of surgical incision stitches.
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BACKGROUND: The far-infrared ceramic microspheres developed by the State Key Laboratory of “new ceramics and fine technology” of School of Materials, Tsinghua University, are made with ceramic colloidal injection molding technology. It is a new type of physical therapy material in the field of sports rehabilitation and daily health care. With its unique small circular structure, it can completely cover the damaged parts such as feet, waist, thigh, etc. to achieve comprehensive stimulation intervention. OBJECTIVE: To investigate the effect of far-infrared ceramic microspheres on pain Intensity after muscle injury. METHODS: Thirty college students aged 18-21 years who met the diagnosis standard of posterior femoral muscle group injury were included in this study. All of them provided informed consent. They were randomly divided into three groups, with 10 students per group. Students in the massage group underwent massage therapy. Students in the far-infrared instrument group were treated with ordinary far-infrared therapeutic apparatus. Students in the far-infrared ceramic microsphere Intervention group underwent far-infrared ceramic microsphere intervention. All treatments lasted 2 successive weeks. Before and 3, 7, and 14 days after treatment, McGill pain scale score (including pain rating index, visual analogue score and present pain intensity) was measured and compared within and between groups. RESULTS AND CONCLUSION: (1) Before treatment, there were no significant differences in pain rating index (sensory, affective, and total pain rating index scores), visual analogue score and present pain intensity between three groups (P > 0.05). (2) At 3 days of treatment, pain rating index, visual analogue score and present pain intensity score in the far-infrared ceramic microsphere intervention group were significantly lower compared with the massage and far-infrared instrument groups (P < 0.05). After 7 and 14 days of treatment, each studied indicator in the far-infrared ceramic microsphere intervention group was highly significantly lower compared with the other two groups (P < 0.01). (3) At 3 days of treatment, score of each pain indicator in the far-infrared ceramic microsphere intervention group was significantly lower compared with before treatment (P < 0.05), and it was significantly decreased compared with that measured concurrently in the other two groups (P < 0.05). (4) At 7 days of treatment, score of each pain indicator in the far-infrared ceramic microsphere intervention group was significantly lower compared with before treatment (P < 0.01), and it was significantly decreased compared with that measured concurrently in the other two groups (P < 0.05). (5) After 14 days of treatment, score of each pain indicator in the massage and far-infrared instrument groups was significantly lower compared with before treatment (P < 0.05). After 14 days of treatment, score of each pain indicator in the far-infrared ceramic microsphere intervention group was highly significantly lower compared with before treatment (P < 0.01). After 14 days of treatment, score of each pain indicator in the far-infrared ceramic microsphere intervention group was significantly lower compared with the other two groups. These findings suggest that far-infrared ceramic microsphere intervention can effectively reduce the degree of posterior femoral muscle group Injury and effectively promote the recovery of muscle injury.
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Background: To evaluate the effects of preoperative Gabapentin on postoperative relief of pain in patients scheduled for surgery under general anaesthesia. Post-operative ward and OT Department of Anaesthesia, JAH, GR Medical College, Gwalior, Madhya Pradesh, India.Methods: The sixty patients subjected to ASA grade I and II posted for elective surgeries under general anaesthesia were randomized into 2 groups. One and half hour before surgery, Gabapentin 600 mg and placebo was given blindly to selected patients for the study. The postoperative pain was assessed with visual analogue score. Pain and side effects assessment were performed.Results: Total 60 patients of ASA grade I and II posted for elective surgeries under GA were randomized into 2 groups. One and half hour before surgery, the drug selected for the study was given blindly with a sip of water. The mean (±SD) of VAS score was 5.86±0.34 in Group B and 5.10±0.84 in Group A. VAS score was significantly lower in Group A. With oral Gabapentin time required for rescue analgesia is delayed as compared to control group. The mean (±SD) TRA-1 was 38.40±24.61 in Group B and 44.03±8.94 in Group A.Conclusions: Preoperative oral Gabapentin significantly decreases the severity of pain postoperatively as compared to placebo in patients posted for surgery. Time for analgesic requirement is more with oral Gabapentin. The VAS score was lower in Gabapentin group.
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INTRODUCTION@#Renal colic pain is a very severe pain usually being consulted at the emergency room.New pain relievers together with combination of other drugs is used for symptomatic relief. Thisstudy compared the efficacy and tolerability of Diclofenac versus Dexketoprofen with Hyoscine N-butyl bromide (HNBB) in the management of acute renal colic at the emergency room.@*METHODOLOGY@#This was a single blind, randomized prospective study done from June 1, 2017 toAugust 31, 2017 at the emergency department of the Jose Reyes Memorial Medical Center. Allocationand randomization were done into two treatment groups: the Diclofenac and Dexketoprofen + HNBB.Subjectivity of pain relief was based using visual analogue score (VAS), this was taken before thetreatment and 15, 30 and 60 minutes after administration of treatment.@*RESULTS@#Twenty nine (29) patients were grouped into two: Dicloenac group (n=15) and Dexketoprophen+ HNBB group (n= 14). Pain reduction in the combination group had a faster pain relief compared toDiclofenac alone with a 41% and 17% decline, respectively. The study showed that a faster pain reliefwas achieved with the Dexkoprophen + HNBB combination compared to Diclofenac alone.@*CONCLUSION@#Timing and onset of pain control in patients presenting with renal colic pain is essentialin the emergency room setting to provide adequate relief. The use of the combination therapy ofDexkotoprofen + HNNB may have a significant advantage in terms of rapid onset of relief.
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· AIM:To assess the effect of bandage contact lens on the corneal epithelium healing condition,degree of pain and corneal surface after recurrent pterygium excision.· METHODS:Retrospective case-series study.A total of 64 patients (64 eyes) with recurrent pterygium who received treatment in the First Affiliated Hospital of Huzhou University from September 2015 to September 2017 were divided into Group A (34 cases with bandage contact lens group) and Group B (30 cases without bandage contact lens group).The healing status of corneal epithelium was evaluated by fluorescent staining between the two groups at 1d and 1wk after surgery.The degree of pain was assessed between the two groups at 2h,1d and 1wk after recurrent pterygium excision by visual analogue score.Computerized corneal topography was performed on all cases with recurrent pterygium before and 1 mo after successful excision surgery.Statistical analysis of surface regularity index (SRI),surface asymmetry index (SAI) and corneal astigmatism (CA),was done before and 1mo after surgery.· RESULTS:Average scores of corneal epithelium healing condition at 1d and 1wk were better in Group A than that in Group B (P＜0.01).The mean scores of pain values at 2h,1d and 1wk after surgery in Group A were significantly lower than that in Group B respectively (P＜ 0.01).The indicators reflecting corneal surface at 1mo after surgery,including SRI,SAI,CA,were significantly lower in Group A than that in Group B (P＜0.01),while they were not significantly different before surgery between the two groups (P＞0.05).· CONCLUSION:Bandage contact lenses could significantly promote the healing status of corneal epithelium,release pain response and improve corneal refractive status after recurrent pterygium excision.
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AIM: To investigate the effect of rigid contact lens in the treatment after pterygium excision and limbal stem cell transplantation in senile patients.METHODS: Totally 90 elderly patients diagnosed as unilateral pterygium in our hospital from March 2015 to March 2016 were selected and divided into two groups, observation group and control group, 45 case with 45 eyes in each group.Observation group was treated with limbal stem cell transplantation and rigid contact lens.Control group was treated with limbal stem cell transplantation only.The following indicators were observed and compared: corneal healing time, visual analogue score(VAS) at 1, 3, 5 and 7d after surgery and the recurrence rate of pterygium.RESULTS: The score on corneal irritation of observation group was significantly lower than that of control group (P0.05).CONCLUSION: Autologous corneal stem cell transplantation combined with rigid contact lens for pterygium in elderly patients is effective with shorter healing time and less pain, and it does not increase the recurrence rate.
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AIM: To assess the effect of two different suture methods on the degree of pain and corneal epithelium healing condition after pterygium excision combined with autologous conjunctival flap graft transplantation. ·METHODS: Retrospective case-series study. According to the suture method, a total of 92 patients (92 eyes) with pterygium who received treatment in the First Affiliated Hospital of Huzhou University from June 2015 to June 2016 were divided into two group. There were 48 patients ( 48 eyes) in Group A were received intermittent suture, and 44 patients ( 44 eyes ) in Group B were received continuous interlocking suture. The degree of pain after surgery were evaluated between the two groups at 2h, 1d and 1wk after surgery by visual analogue score ( VAS). The healing status of corneal epithelium were observed between the two groups at 1d and 1wk after surgery by fluorescent staining. ·RESULTS: There was no significant difference in the average pain value 2h after surgery between Group A and Group B (P>0. 05). The average pain values 1d and 1wk after surgery in Group B was lower than that in Group A respectively (P0. 05). · CONCLUSION: Compared to intermittent suture, continuous interlocking suture can release pain response after pterygium excision combined with autologous conjunctival flap graft transplantation and promote the healing status of corneal epithelium.
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The aim of this study was to compare the pain experience among orthodontic patients treated with self-ligating brackets SmartClip® (3M Unitek, Monrovia, California, USA) and conventional brackets Victory series® (3M Unitek, Monrovia, California, USA). We used a controlled clinical trial study design to compare 69 patients treated with self-ligating to 70 patients treated by conventional brackets. The nickel-titanium archwires 0.012-in were engaged after bonding both arches on the first day; and the visual analogue scale (VAS) was used to assess the pain experience of subjects for the first seven treatment days. The pre-treatment dental study models were assessed by the Little’s irregularity index to quantify the groups’ malalignment characteristics. The self-ligating brackets reported lower pain experience than the conventional group on the first five treatment days. However, the sixth day showed 1.75 mm higher visual analogue score than conventional brackets, with almost equal pain level on the seventh day. The group differences throughout the first week were neither clinically nor statistically significant. The pain experiences in both groups decreased steadily from the third treatment day to the end of the first week of treatment. Based on the study findings, the pain experience during initial alignment is not influenced by the brackets’ ligation type. The pain experience tends to decrease steadily from the third treatment day to the end of the first week of treatment irrespective of the bracket type used.
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BACKGROUND: It is known that laparoscopic surgery is associated with less pain than open surgery in many studies. We wanted to evaluate the postoperative pain by using intravenous patient-controlled analgesia (IV-PCA) in patients undergoing laparoscopic assisted vaginal hysterectomy (LAVH) or abdominal total hysterectomy (ATH). METHODS: Ninety one women with uterine myoma were prospectively assigned to undergo either LAVH (n = 49) or ATH (n = 42). IV-PCA was used for postoperative pain control in both groups. Pain scores were assessed using a visual analogue scale (VAS) and cumulative PCA-drug consumption and incidences of nausea and vomiting were recorded in 1, 2, 4, 24, 48 hours after surgery. RESULTS: There were no differences in terms of patient's age, BMI and total operation time between the both groups. Pain scores and the demand of analgesics of the IV-PCA in 1, 2, 4, 24, and 48 hours after surgery were not significantly different in both groups. Incidences of nausea and vomiting after surgery were more common in LAVH than ATH especially within 4 hours. CONCLUSIONS: The present study demonstrates that LAVH requires adequate postoperative pain control as ATH during the first 48 hours after surgery, and the effective prevention of PONV is required in LAVH compared with ATH.