ABSTRACT
Pain is a common problem all over the world. A previous report estimated that the prevalence of pain is 40% in Japan. One of the roles of pharmacist is to build evidence with more patient-centered care, but less in region of pain. Our objective was to identify pharmacists’ contributions to patient care through pain-management using PainVision (PV) in an outpatient pain clinic and interventions with polypharmacy. We investigated 28 patients who underwent nerve blocks. Pain were assessed relatively and subjectively using PV and numerical analogue scale (NRS), respectively. The pharmacist intervened pre- and post-nerve block. Interventions focused on evaluations of pain, drug efficacy, complications, blood pressure, pulse rate, and oxygen saturation. Wilcoxon signed-rank test, Spearman rank correlation coefficient and Friedman test were used to analyze the data. The mean age of the patients was 77 (interquartile range 69-84) years, and 12 patients were diagnosed with zoster-associated pain. The pharmacists consulted with patients 213 times and evaluated pain 426 times. We found that the analgesic effect of nerve block were evaluated PV (70; 23-162→20; 5.0-49) and NRS (4; 2-6→1; 0-2) by pharmacist, significantly. It was significant correlation between PV and NRS (r=0.799: P<0.001). Our study showed similar results to previous studies in which doctors and nurses used PV. It is clinically valuable for pharmacists to using PV in outpatient clinics to evaluate pain. Greater roles for pharmacists in hospital outpatient department should be considered, especially pharmacist-led clinical research.
ABSTRACT
Objective To explore the relationship between the expression of inflammatory factors and the degree of pain in patients with Kashin-Beck disease after total knee arthroplasty. Methods Forty-nine patients with Kashin-Beck disease and 55 patients with knee osteoarthritis who underwent total knee arthroplasty in the Department of Orthopaedics, Gansu Provincial People's Hospital from January 2016 to December 2018, were selected, as the Kashin -Beck disease group and osteoarthritis group, respectively, and 50 healthy subjects who underwent healthy physical examination at the same time were selected as the control group. At the 7th day after operation, 3 ml of fasting venous blood was collected from all subjects. The expression levels of interleukin (IL)-6, tumor necrosis factor (TNF)-α, and C-reactive protein (CRP) were measured by enzyme-linked immunosorbent assay (ELISA); the visual analogue score (VAS) and knee society score (KSS) were used to compare the pain degree and knee function of each group; correlation analysis between postoperative inflammatory factor levels and VAS, KSS scores in patients with Kashin-Beck disease were studied. Results The expressions of IL-6 [(78.17 ± 13.28), (60.28 ± 9.92), (9.65 ± 3.12) ng/L], TNF-α [(126.67 ± 15.83), (105.29 ± 12.76), (21.09 ± 5.82) ng/L] and CRP [(11.23 ± 3.41), (8.31 ± 2.54), (2.14 ± 1.01) mg/L] in Kashin-Beck disease group, osteoarthritis group and control group were significantly different (F =12.397, 19.982, 9.167, P < 0.05); and the VAS scores [(5.21 ± 1.44), (2.98 ± 1.03), (0.61 ± 0.22) points], and KSS scores [(60.15 ± 8.91), (72.91 ± 9.19), (93.92 ± 5.73) points] between the three groups were statistically different (F = 21.092, 16.743, P < 0.05). The correlation analysis showed that IL-6, TNF-α, and CRP levels were positively correlated with VAS scores in patients with Kashin-Beck disease (r = 0.517, 0.498, 0.522, P < 0.05), and negatively correlated with KSS scores (r = - 0.509, - 0.514, - 0.487, P < 0.05). Conclusion After total knee arthroplasty for patients with Kashin-Beck disease, the expression levels of inflammatory factors IL-6, TNF-α and CRP are higher, and they are associated with postoperative pain and knee function recovery.
ABSTRACT
Objective@#To explore the relationship between the expression of inflammatory factors and the degree of pain in patients with Kashin-Beck disease after total knee arthroplasty.@*Methods@#Forty-nine patients with Kashin-Beck disease and 55 patients with knee osteoarthritis who underwent total knee arthroplasty in the Department of Orthopaedics, Gansu Provincial People's Hospital from January 2016 to December 2018, were selected, as the Kashin-Beck disease group and osteoarthritis group, respectively, and 50 healthy subjects who underwent healthy physical examination at the same time were selected as the control group. At the 7th day after operation, 3 ml of fasting venous blood was collected from all subjects. The expression levels of interleukin (IL)-6, tumor necrosis factor (TNF)-α, and C-reactive protein (CRP) were measured by enzyme-linked immunosorbent assay (ELISA); the visual analogue score (VAS) and knee society score (KSS) were used to compare the pain degree and knee function of each group; correlation analysis between postoperative inflammatory factor levels and VAS, KSS scores in patients with Kashin-Beck disease were studied.@*Results@#The expressions of IL-6 [(78.17 ± 13.28), (60.28 ± 9.92), (9.65 ± 3.12) ng/L], TNF-α [(126.67 ± 15.83), (105.29 ± 12.76), (21.09 ± 5.82) ng/L] and CRP [(11.23 ± 3.41), (8.31 ± 2.54), (2.14 ± 1.01) mg/L] in Kashin-Beck disease group, osteoarthritis group and control group were significantly different (F=12.397, 19.982, 9.167, P < 0.05); and the VAS scores [(5.21 ± 1.44), (2.98 ± 1.03), (0.61 ± 0.22) points], and KSS scores [(60.15 ± 8.91), (72.91 ± 9.19), (93.92 ± 5.73) points] between the three groups were statistically different (F=21.092, 16.743, P < 0.05). The correlation analysis showed that IL-6, TNF-α, and CRP levels were positively correlated with VAS scores in patients with Kashin-Beck disease (r=0.517, 0.498, 0.522, P < 0.05), and negatively correlated with KSS scores (r=-0.509,-0.514, -0.487, P < 0.05).@*Conclusion@#After total knee arthroplasty for patients with Kashin-Beck disease, the expression levels of inflammatory factors IL-6, TNF-α and CRP are higher, and they are associated with postoperative pain and knee function recovery.
ABSTRACT
Objective @# To investigate the clinical effects of micro implant anchorage nail and Ni-Ti coilspring to lower the elongation molar. @*Methods@#60 patients with the first maxillary molar elongation were divided into 2 groups. 30 of them were treated with micro implant anchorage nail and Ni-Ticoil spring to lower the molar (observation group), and the other 30 patients were treated with segmental arch to lower the molar (control group). The average lowering time, depth and pain degree of the 2 groups were compared. @*Results@#The average lowering time was faster and the overage lowering depth was greater in the observation group than that in the control group; the slight pain rate in the observation group was significantly higher than that in the control group (P<0.05), while the ratio of moderate pain and severe pain was significantly lower than that in the control group (P<0.05).@*Conclusion@# To lower the elongation molar with micro implant anchorage nail and Ni-Ti coilspring might have shorter course and less pain.
ABSTRACT
Objective To explore a layered nursing intervention based on risk assessment strategies application effect in elderly patients with hip replacement. Methods Chosen during January 2013 to December 2014 rows of orthopaedic trauma treated 224 patients of senile hip replacement as the research objectto divide into observation group and control group 112 caseseach according to admission time.Observation group applied based on risk assessment strategy stratification nursing intervention, the control group used conventional care. Compared two groups of patients with postoperative pain degree, hip function, complications, and patient satisfaction. Results For 24 h, 48 h, 72 h after the operation, Visual Analog Scale (VAS) scores of observation groupwere 2.25 ± 0.35, 2.01 ± 0.31, 1.92 ± 0.23, which were significantly lower than 3.53 ± 0.51, 2.84±0.45, 2.70±0.35 of the control group (t=21.900, 16.075, 21.900, P<0.01);3 months and 12 months after the surgery, the index of the Harris hip score observation group was 71.32 ± 7.45, 93.44 ± 9.65, which were obviously higher than 60.47 ± 6.65, 83.75 ± 9.21 of control group (t=11.498, 7.688, P<0.01);8.04%(9/112) incidence of complications such as infection of incision, increase of observation group was obviously lower than 20.54%(23/112) of the control group(χ2=7.146, P<0.05);97.32%(109/112) satisfaction was significantly higher than 78.57% (88/112) of the control group (χ2= 18.572, P < 0.05). Conclusions Stratified nursing intervention based on risk assessment strategy can help to alleviate the degreeof pain, improve hip function, reduce postoperative complications and improve patient satisfaction.
ABSTRACT
Objective To investigate the clinical effect of Zhanjinhuoxue Formula combined with the tower-type pad natural traction for the treatment of pure thoracolumbar compression fracture.Methods Fifty patients with thoracolumbar compression fractures treated in our hospital from January to December 2014 were selected and divided into the observation group(n=25) and control group(n=25).The control group was given the tower-type natural traction method,while the observation group was given Zhanjinhuoxue Formula combined with the tower-type pad natural traction method.The curative effect,pain score,activity ability score,analgesic drugs score,bone mineral density (BMD) and the Japanese Orthopedic Association(JOA) score were compared between the two groups.Results The effective rate was 92.00％ in the observation group and 68.00％ in the control group,the difference between the two groups was statistically significant (x2 =4.50,P＜0.05).The pain score,activity ability score and analgesic drugs score after 6-month treatment in the observation group were significantly lower than those in the control group (P＜0.05);the BMD and JOA scores in the observation group were significantly higher than those in the control group (P＜0.05).Condusion Zhanjinhuoxue Formula coordinated by the tower-type pad natural traction method can conduce to alleviate the pain symptom in the patients with pure thoracolumbar compression fracture,increases the movement function and improves the treatment effect.
ABSTRACT
Objective To investigate the effect of combination therapy of Gabapentin and Cobamamide in treatment of painful diabetic neuropathy (PDN).Methods A total of 96 patients with type 2 diabetes (T2DM) and PDN were enrolled in this study and randomly divided into control group (Con,n=32),Cobamamide group,(n=32),and Gabapentin+Cobamamide group,(n=32).FPG and HbA1c were actively controlled in each group.Con group was treated with vitamin B1.Clinical and biochemical data of all the subjects were collected.The degree of pain was assessed by visual analogue scale (VAS).The changes of median nerve,peroneal nerve motor nerve conduction velocity (MNCV),and sensory nerve conduction velocity (SNCV) were evaluated by EMG assessment.The assessment of sleep quality was done by Pittsburgh sleep quality index scale (PSQI).Results There was no significant differences of baseline MNCV,SNCV and the degree of pain among the three groups (P>0.05).After treatment,all the above index were improved in both Cobamamide group and Gabapentin+Cobamamide group.MNCV and SNCV were higher in Gabapentin+Cobamamide group than in Cobamamide group (P0.05).Conclusion The combination therapy of Gabapentin and adenosine cobalt amine could reduce pain,improve nerve conduction velocity,and improve the quality of sleep.
ABSTRACT
Objective To explore the effect of psychological intervention combined with drug multimodal therapy on orthopedic analgesia and its effect on stress response, and to provide reference for clinical application.Methods 88 cases treated with open reduction and internal fixation for lower limb fracture as the object of study were collected from March 2015 to March 2017 in Baoji traditional Chinese medicine hospital, which were received multi-mode drug treatment.According to whether to receive psychological intervention, 88cases were divided into the intervention group(45 cases) and the control group(43 cases).Postoperative pain was assessed by visual analogue scale(VAS) and simplified McGill questionnaire(SF-MPQ), the changes of plasma CRP and IL-6 levels were compared before and after operation.Results There was no significant difference in VAS score, SF-MPQ score, preoperative plasma CRP and IL-6 levels between the two groups.One and 24 hour after operation, VAS score and SF-MPQ score were higher than those at admission(P<0.05).The VAS score and SF-MPQ score in the intervention group were lower than those in the control group at different time points(P<0.05).One and 24 hour after operation, plasma CRP and IL-6 levels in the two groups were significantly higher than those before operation(P<0.05), the levels of plasma CRP and IL-6 in the intervention group were significantly lower than those in the control group(P<0.05).Conclusion Psychological intervention combined with multimodal drug therapy can effectively reduce the degree of postoperative pain and stress reaction, and is conducive to postoperative rehabilitation.
ABSTRACT
Objective To evaluate the postoperative pain induced by various therapeutic catheters after abdominal surgery.Methods A prospective study was conducted in patients selected based on the inclusion criteria.The general condition of the patients was recorded,and nutritional risk screening was performed.The indwelling of therapeutic catheters after abdominal surgery were recorded,including urinary catheter,nasogastric tube,peritoneal drainage tube,common bile duct drainage tube,wound drainage tube,central venous catheter and peripherally inserted central catheter.The pain caused by each type of catheters was evaluated using visual analog scale at 24,48 and 72 hours after tube/catheter insertion.Results A total of 157 patients were selected,including 70 males and 87 females,aged (60.5 ± 12.5) years,with a body mass index of (23.8 ± 3.2) kg/m2,and a total nutritional risk rate of 42％.According to visual analog scale scores,the degrees of pain due to the therapeutic catheters,in descending order,were as follows:4.9 ± 1.7 for nasogastric tube,3.6 ± 0.9 for wound drainage tube,3.0 ±0.9 for urinary catheter,2.6 ±0.9 for central venous catheter,2.4 ± 1.0 for peritoneal drainage tube,1.9 ± 0.7 for common bile duct drainage tube,and 1.8 ± 0.8 for peripherally inserted central catheter.The catheter-induced pain accounted for (44.9 ± 14.1)％ of the total pain during the hospital stay.Conclusions Nasogastric tube,wound drainage tube and urinary catheter can increase the pain of patients.It is therefore recommended to remove the indwelling tubes as early as possible if only the removal does not harm the outcome of the patient.