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Actual. osteol ; 19(2): 119-127, sept. 2023. tab
Article in Spanish | LILACS, UNISALUD, BINACIS | ID: biblio-1523051


Introducción: la pandemia por COVID-19 afectó negativamente los sistemas de salud. Las fracturas vertebrales osteoporóticas y el aislamiento social se relacionan con mayor morbimortalidad. Objetivos: caracterizar la morbilidad de las fracturas vertebrales osteoporóticas y evaluar una posible relación entre morbilidad y nivel de aislamiento social se-cundario al estado de pandemia. Material y métodos: estudio observacional, analítico y transversal. Resultados: se incluyeron en el estudio 45 adultos. La fractura fue mayorita-riamente lumbar con una evolución superior de 3 meses. El 35% presentaba seguimiento, el 48% había recibido tratamiento para osteoporosis y el 48% presentaba fracturas previas documentadas. El 46% refirió falta de accesibilidad al sistema. Se evaluó el aisla-miento social con la escala sociofamiliar de Gijón, que evidenció una situación buena en el 75% y un deterioro social intermedio/severo en el 24%. El Índice de Oswestry mostró una discapacidad mínima/moderada en el 66% y severa o mayor en el 33%. Se evaluó el dolor por la Escala análoga visual (VAS) y se obtuvo un VAS mayor de 5 en el 57%. Al comparar el grupo de situación sociofamiliar buena con el de deterioro social intermedio/severo se observó una diferencia en multipli-cidad de fracturas (p 0,030), hipovitaminosis D (p 0,045) y falta de accesibilidad (p 0,029). En discapacidad y dolor no hubo diferencias. Conclusión: el grupo con mayor aislamiento presentó una enfermedad más severa en términos de multiplicidad de fracturas e hipovitaminosis D; esto podría indicar una asociación entre aislamiento social secundario al estado de pandemia y morbilidad por las fracturas vertebrales. (AU)

Introduction: the COVID-19 pandemic had a negative impact on healthcare systems. Osteoporotic vertebral fractures and social isolation have a significant morbidity in our setting. Objectives: to characterize the morbidity of osteoporotic vertebral fractures and evaluate a potential relationship between morbidity and the level of social isolation secondary to the pandemic. Material and methods: observational, analytical and cross-sectional study. Results: forty-five adults were included. Fractures were mostly lumbar with a history of over 3 months. Thirty-five percent (35%) had been followed-up, 48% had been treated for osteoporosis and 48% had previous documented fractures. Forty-six percent (46%) reported lack of accessibility to healthcare. Social isolation was measured using Gijón ́s social-familial evaluation scale, which showed a good situation in 75% of cases and an intermediate/severe social deterioration in 24%. According to the Oswestry index, disability was minimal/moderate in 66% of cases and severe or worse in 33%. Pain was assessed using the Visual Analogue Scale (VAS), with a score greater than 5 recorded in 57% of patients. When comparing the group with a good social-familial situation vs. the group with intermediate/severe social deterioration, differences were found in multiplicity of fractures (p 0.030), hypovitaminosis D (p 0.045) and lack of accessibility (p 0.029). No differences were found in disability and pain. Conclusion: the group with higher levels of isolation exhibited more severe disease in terms of multiplicity of fractures and hypovitaminosis D, which might suggest an association between social isolation secondary to the pandemic and morbidity due to vertebral fractures. (AU)

Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Social Isolation , Spinal Fractures/epidemiology , Osteoporotic Fractures/epidemiology , COVID-19/complications , Social Conditions , Vitamin D Deficiency/epidemiology , Pain Measurement/methods , Indicators of Morbidity and Mortality , Cross-Sectional Studies , Morbidity , Social Determinants of Health , Sociodemographic Factors
International Journal of Oral Science ; (4): 58-58, 2023.
Article in English | WPRIM | ID: wpr-1010713


Chronic Painful Temporomandibular Disorders (TMD) are challenging to diagnose and manage due to their complexity and lack of understanding of brain mechanism. In the past few decades' neural mechanisms of pain regulation and perception have been clarified by neuroimaging research. Advances in the neuroimaging have bridged the gap between brain activity and the subjective experience of pain. Neuroimaging has also made strides toward separating the neural mechanisms underlying the chronic painful TMD. Recently, Artificial Intelligence (AI) is transforming various sectors by automating tasks that previously required humans' intelligence to complete. AI has started to contribute to the recognition, assessment, and understanding of painful TMD. The application of AI and neuroimaging in understanding the pathophysiology and diagnosis of chronic painful TMD are still in its early stages. The objective of the present review is to identify the contemporary neuroimaging approaches such as structural, functional, and molecular techniques that have been used to investigate the brain of chronic painful TMD individuals. Furthermore, this review guides practitioners on relevant aspects of AI and how AI and neuroimaging methods can revolutionize our understanding on the mechanisms of painful TMD and aid in both diagnosis and management to enhance patient outcomes.

Humans , Facial Pain/diagnostic imaging , Artificial Intelligence , Temporomandibular Joint Disorders/diagnostic imaging , Neuroimaging/methods , Pain Measurement/methods
Audiol., Commun. res ; 27: e2583, 2022. tab, graf
Article in Portuguese | LILACS | ID: biblio-1374476


RESUMO Objetivo investigar o impacto da dor orofacial na qualidade de vida de portadores de câncer de boca e orofaringe. Métodos trata-se de um estudo de corte transversal, observacional, descritivo, com amostra de conveniência. Participaram da pesquisa 30 pacientes de ambos os sexos, na faixa etária de 35 a 75 anos. Para a coleta de dados, foi utilizado questionário sociodemográfico elaborado pelos pesquisadores e o Questionário de Dor McGill. Resultados Os achados experimentais apresentaram resultados relevantes em diversos níveis classificatórios para dor orofacial. As maiores repercussões foram encontradas nos aspectos sociais, como em relação ao sono (40%), apetite/alimentação (78%), higiene pessoal (55%) e lazer (40%), que foram os subitens que tiveram maior impacto da dor na qualidade de vida dos portadores de câncer de boca e orofaringe. Conclusão Portadores de câncer de boca e orofaringe apresentam variados níveis de dor orofacial e sofrem impactos em suas vidas, principalmente nos quesitos relacionados a atividades simples do cotidiano.

ABSTRACT Purpose To investigate the impact of orofacial pain on the quality of life of patients with oral and oropharyngeal cancer. Methods This is a cross-sectional, observational, descriptive study with a convenience sample. Thirty patients of both sexes participated in the research, aged between 35 and 75 years. For data collection, a sociodemographic questionnaire prepared by the researchers, the McGuill pain protocol, was used. Results The experimental findings show us relevant results at different classification levels for orofacial pain. The greatest repercussions were found in social aspects, such as sleep (40%), appetite/food (78%), personal hygiene (55%) and leisure (40%), which were the sub-items that had the greatest impact on pain (or which were the sub-items mostly affected by pain), affecting the the quality of life of patients with oral and oropharyngeal cancer. Conclusion Under these experimental conditions, it is concluded that patients with oral and oropharyngeal cancer present different levels of orofacial pain, and suffer impacts on their lives, especially in matters related to simple daily activities.

Humans , Male , Female , Adult , Middle Aged , Aged , Pain Measurement/methods , Facial Pain/etiology , Mouth Neoplasms , Oropharyngeal Neoplasms , Sickness Impact Profile , Cross-Sectional Studies
Rev. chil. anest ; 50(5): 646-652, 2021.
Article in Spanish | LILACS | ID: biblio-1532449


Pain is a complex subjective organic function which is influenced by sensorial, emotional, cognitive and behavioral elements. Despite the wide offer of pain measurement devices in the perioperative period, none of them is completely validated for their transverse use in the anesthetic practice. The aim of this review is to present the existing devices for objective pain evaluation during the perioperative period along with the scientific evidence supporting each of them. Articles from the PubMed/MEDLINE literature search engine were reviewed. As result, 37 articles were selected due to its relevance, from which 13 pain assessment devices were described, regarding its clinical relevance as well as the amount of scientific evidence found. Among them are ANI, NOL, pupillometry, qNOX, and others. The nociceptive measurement performed by most of these is based mainly on the evaluation of the autonomic nervous system activity and variations of the electroencephalographic signal. However, it is not possible to recommend any particular device. This review aims to offer a broad overview of the available options in order to estimate the role that each of them could play in clinical anesthesiology practice.

El dolor es una experiencia subjetiva compleja en la que inciden elementos sensoriales, emocionales, cognitivos y conductua- les. A pesar de una amplia oferta de dispositivos para medir dolor en el perioperatorio, hoy no existe un instrumento de medición de analgesia validado y utilizado transversalmente en la práctica anestésica. El objetivo de esta revisión es presentar las actuales opciones disponibles para la medición del dolor agudo utilizadas en el período perioperatorio junto con la evidencia científica que respalda cada una de ellas. Se realizó una revisión de la literatura utilizando como fuente de búsqueda bibliográfica la base de datos MEDLINE/pubMed utilizando términos MESH. Como resultado, se seleccionaron 37 artículos de acuerdo a su importancia, a partir de los cuales se describen 13 dispositivos de valoración nociceptiva, a propósito de su relevancia clínica como también por la cantidad de evidencia científica encontrada. Entre ellos destacan ANI, NOL, pupilometría, qNOX, entre otros. La medición nociceptiva realizada por la mayoría de estos se basa principalmente en la evaluación de la actividad del sistema nervioso autónomo y variaciones de la señal electroencefalográfica. Sin embargo, no es posible recomendar algún dispositivo en particular. Esta revisión pretende ofrecer una visión amplia de las opciones disponibles con el fin de estimar el rol que cada uno de ellos podría desempeñar en la práctica clínica anestesiológica.

Humans , Pain/diagnosis , Pain Measurement/methods , Perioperative Care , Pain, Postoperative/diagnosis , Nociceptive Pain/diagnosis , Monitoring, Physiologic
Rev. bras. anestesiol ; 70(4): 325-332, July-Aug. 2020. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1137203


Abstract Background: Skin conductance response reflects the activity of the sympathetic nervous system and is used to measure acute pain. This pilot study examines correlations of skin conductance response with emotional stressors postoperatively. Methods: The correlation of skin conductance response with pain, anxiety, nausea and intellectual task performance was analyzed in postoperative patients. Results: Significant correlations were observed between anxiety and pain during physical activity on both postoperative day 1 and 2. No significant correlations were found between skin conductance response versus mild pain, nausea, anxiety or intellectual task performance. Conclusion: This pilot study suggests that when the pain is well-controlled in the early postoperative period, skin conductance response monitoring may not be influenced by other emotional stressors.

Resumo Justificativa: A variação da condutância da pele reflete a atividade do sistema nervoso simpático e é usada para avaliar dor aguda. Este estudo piloto examinou as correlações entre a variação da condutância da pele e estressores emocionais no pós-operatório. Método: A correlação entre a variação da condutância da pele e dor, ansiedade, náusea e desempenho de tarefa intelectual foi analisada em pacientes no pós-operatório. Resultados: Correlações significantes foram observadas entre ansiedade e dor durante atividade física nos dias 1 e 2 pós-operatórios. Não foram encontradas correlações significantes entre a variação da condutância da pele e dor leve, náusea, ansiedade ou desempenho de tarefa intelectual. Conclusão: Este estudo piloto sugere que, quando a dor é bem controlada no pós-operatório inicial, o monitoramento empregando a variação da condutância da pele pode não ser influenciado por outros estressores emocionais.

Humans , Male , Female , Aged , Pain, Postoperative/diagnosis , Stress, Psychological/psychology , Pain Measurement/methods , Galvanic Skin Response/physiology , Anxiety/psychology , Pain, Postoperative/psychology , Postoperative Period , Time Factors , Exercise , Pilot Projects , Prospective Studies , Cohort Studies , Emotions , Middle Aged
Rev. cuba. hematol. inmunol. hemoter ; 36(2): e1042, abr.-jun. 2020.
Article in Spanish | LILACS, CUMED | ID: biblio-1149893


Introducción: El dolor como experiencia subjetiva desagradable es un síntoma frecuente en los pacientes atendidos en el servicio de Hematología. Este afecta al individuo a nivel psicológico y provoca la aparición de dificultades en las áreas laboral, educacional, familiar y en las relaciones interpersonales. La percepción del dolor puede verse distorsionada como resultado de esta alteración provocada en el paciente. Objetivo: Analizar los factores psicológicos que median la percepción del dolor de los pacientes. Métodos: Se realizó una revisión de la literatura, a través del sitio web PubMed y el motor de búsqueda Google Académico. Se emplearon las palabras clave: dolor, manejo del dolor, evaluación del dolor, psicología del dolor, dolor en hematología, dolor en drepanocitosis, dolor en hemofilia, dolor en leucemia. Análisis y síntesis de la información: Se evidencia el carácter multifacético de esta experiencia subjetiva. Los determinantes y mecanismos del dolor son diversos, lo cual implica que su enfrentamiento requiera un enfoque integral que ayude a los pacientes a desarrollar conciencia acerca de los efectos de la enfermedad que padece y los síntomas del dolor. También es necesario guiarlos en la comprensión de los factores que contribuyen a su magnificación, crear estrategias que les ayuden a minimizar la exposición a estos, y orientarlos para que desarrollen métodos personales que les permitan lidiar con el dolor con un mínimo estrés psicológico. Conclusiones: El dolor es un fenómeno complejo que involucra diversas variables y factores en su funcionamiento. Su manejo requiere un enfoque integral para la atención de los pacientes en su enfrentamiento al dolor(AU)

Introduction: Pain as an unpleasant subjective experience is a frequent symptom in patients treated by the Hematology service. This affects the individual on a psychological level and causes the onset of difficulties in the work, educational, family and interpersonal relationships. The perception of pain can be distorted as a result of this alteration caused in the patient. Objective: To analyze the psychological factors that mediate patients' perception of pain. Methods: A literature review was carried out through the PubMed website and the search engine of Google Scholar. The following keywords were used: dolor [pain], manejo del dolor [pain management], evaluación del dolor [pain assessment], psicología del dolor [pain psychology], dolor en hematología [pain in hematology], dolor en drepanocitosis [pain in sickle cell disease], dolor en hemofilia [pain in hemophilia], dolor en leucemia [pain in leukemia]. Information analysis and synthesis: The multifaceted nature of this subjective experience is evidenced. Pain determinants and mechanisms are diverse, which implies that their coping requires a comprehensive approach that helps patients develop awareness about the disease effects and the pain symptoms. It is also necessary to guide them in understanding the factors that contribute to pain magnification, create strategies that help them minimize pain exposure, and guide them to develop personal methods that allow them to deal with pain with minimal psychological stress. Conclusions: Pain is a complex phenomenon involving several variables and factors in its operation. Its management requires a comprehensive approach to patient care regarding coping with pain(AU)

Humans , Male , Female , Pain Measurement/methods , Pain Measurement/psychology , Pain Perception/physiology , Pain Management/psychology , Hematologic Diseases/psychology , Hematology
Int. arch. otorhinolaryngol. (Impr.) ; 24(1): 62-67, Jan.-Mar. 2020. tab, graf
Article in English | LILACS | ID: biblio-1090549


Abstract Introduction Posttonsillectomy pain results in significant morbidity to the patients. There is a disagreement in the literature regarding the use of local anesthetics during tonsillectomy. The aim of this placebo-controlled, double-blind study is to evaluate the effect of peritonsillar administration of local anesthetics. Objective To evaluate the role of intraoperative use of analgesics in tonsillar fossa and postoperative evaluation with visual analogue scale (VAS) scores in achieving pain relief after tonsillectomy procedure Methods In this study, 180 patients were randomized to 1 of the 6 groups: bupivacaine infiltration, lidocaine infiltration, normal saline infiltration, bupivacaine packing, lidocaine packing, and normal saline packing. Pain caused by speaking, swallowing, and on rest was assessed using VAS at 4, 8, 12, 16 hours, and at discharge. Results Significant analgesia was obtained in patients who received bupivacaine infiltration and packing compared with placebo (p < 0.05). The majority of the study subjects had no postoperative complications, and patients receiving bupivacaine infiltration required less additional analgesics in the first 24 hours after surgery. Conclusion We advocate the use of bupivacaine infiltration or packing immediately following the procedure to achieve adequate postoperative analgesia.

Humans , Male , Female , Child , Adolescent , Pain, Postoperative/drug therapy , Tonsillectomy , Analgesia , Analgesics/administration & dosage , Analgesics/therapeutic use , Intraoperative Care , Pain, Postoperative/diagnosis , Pain, Postoperative/prevention & control , Pakistan , Placebos/administration & dosage , Postoperative Complications , Pain Measurement/methods , Bupivacaine/administration & dosage , Bupivacaine/therapeutic use , Double-Blind Method , Prospective Studies , Injections, Intravenous , Lidocaine/administration & dosage , Lidocaine/therapeutic use
Rev. bras. ter. intensiva ; 32(1): 66-71, jan.-mar. 2020. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1138453


RESUMO Objetivo: Avaliar temporalmente o estímulo doloroso em prematuros com o uso de três escalas de mensuração de dor neonatal. Métodos: Foram observados 83 prematuros durante a aspiração de vias aéreas por três avaliadores (E1, E2 e E3) utilizando três escalas de avaliação da dor (Neonatal Facial Coding System - NFCS; Neonatal Infant Pain Scale - NIPS; e Premature Infant Pain Profile - PIPP) em cinco momentos: T1 (antes da aspiração de vias aéreas), T2 (durante a aspiração de vias aéreas), T3 (1 minuto após a aspiração de vias aéreas), T4 (3 minutos após a aspiração de vias aéreas) e T5 (5 minutos após a aspiração de vias aéreas). Utilizaram-se o Light's Kappa (concordância entre examinadores e entre as escalas em cada tempo) e teste de McNemar (comparação entre os tempos), considerando-se p < 0,05. Resultados: Houve diferença significativa entre T1 e T2 para os três examinadores nas três escalas. Em T3, observou-se dor em 22,9%/E1, 28,9%/E2 e 24,1%/E3 de acordo com a NFCS; 22,9%/E1, 21,7%/E2 e 16,9%/E3, conforme a NIPS e 49,4%/E1, 53,9%/E2 e 47%/E3 considerando a PIPP dos prematuros. Houve diferença entre T1 e T3 nas três escalas, exceto para dois examinadores na PIPP (E2: p = 0,15/ E3: p = 0,17). Ao comparar T4 e T5 ao T1, não houve diferença em nenhuma das três escalas. Conclusão: Os prematuros necessitaram de pelo menos 3 minutos para retornarem ao seu estado inicial de repouso (sem dor).

ABSTRACT Objective: To temporally assess a painful stimulus in premature infants using 3 neonatal pain scales. Methods: A total of 83 premature infants were observed during airway aspiration by 3 evaluators (E1, E2 and E3) using 3 pain assessment scales (Neonatal Facial Coding System - NFCS; Neonatal Infant Pain Scale - NIPS; and Premature Infant Pain Profile - PIPP) at 5 time points: T1 (before airway aspiration), T2 (during airway aspiration), T3 (1 minute after airway aspiration), T4 (3 minutes after airway aspiration), and T5 (5 minutes after airway aspiration). Light's Kappa (agreement among examiners and among scales at each time point) and the McNemar test (comparison among time points) were used considering p < 0.05. Results: There was a significant difference between the 3 examiners for T1 and T2 using the 3 scales. In T3, pain was observed in 22.9%/E1, 28.9%/E2, and 24.1%/E3 according to the NFCS; 22.9%/E1, 21.7%/E2, and 16.9%/E3 according to the NIPS; and 49.4%/E1, 53.9%/E2, and 47%/E3 according to the PIPP. There was a difference between T1 and T3 using the 3 scales, except for 2 examiners for the PIPP (E2: p = 0.15/E3: p = 0.17). Comparing T4 and T5 to T1, there was no difference in the 3 scales. Conclusion: Premature infants required at least 3 minutes to return to their initial state of rest (no pain).

Humans , Infant, Newborn , Pain/etiology , Suction/adverse effects , Pain Measurement/methods , Time Factors , Infant, Premature , Airway Obstruction/therapy
J. appl. oral sci ; 28: e20190025, 2020. tab, graf
Article in English | LILACS, BBO | ID: biblio-1056588


Abstract Periodontal therapy usually requires local anesthesia. If effective, a non-invasive, liposomal anesthetic gel could increase the levels of acceptance of patients in relation to periodontal therapy. Objective: This study investigated the efficacy of liposomal anesthetic gel for pain control during periodontal therapy. Methodology: Forty volunteers with moderate to severe chronic periodontitis were recruited, of which at least three sextants required periodontal therapy. At least one of the selected teeth had one site with a probing depth of ≥4 mm. The volunteers received the following three gels: a placebo, lidocaine/prilocaine (Oraqix®), or a liposomal lidocaine/prilocaine, which were applied to different sextants. Pain frequency was registered during treatment and the volunteers received a digital counter to register any painful or uncomfortable experiences. At the end of each session, the volunteers indicated their pain intensity using rating scales (NRS-101 and VRS-4). The volunteers had their hemodynamic parameters measured by a non-invasive digital monitor. Results: Pain frequency/intensity did not show statistical difference between intervention groups. The tested gels did not interfere with the hemodynamic indices. Dental anxiety, suppuration and probing depth could influence pain during periodontal therapy. Conclusion: Our results suggest limited indications for the use of non-invasive anesthesia when used for scaling and root planing. Intra-pocket anesthetic gel could be a good option for anxious patients, or those who have a fear of needles.

Humans , Male , Female , Adult , Middle Aged , Aged , Pain/prevention & control , Dental Scaling/adverse effects , Root Planing/adverse effects , Gels/administration & dosage , Anesthesia, Dental/methods , Anesthetics, Local/administration & dosage , Periodontal Pocket , Placebos , Prilocaine/administration & dosage , Pain Measurement/methods , Double-Blind Method , Chronic Periodontitis/complications , Chronic Periodontitis/therapy , Lidocaine, Prilocaine Drug Combination , Lidocaine/administration & dosage
Rev. Paul. Pediatr. (Ed. Port., Online) ; 38: e2018178, 2020. tab, graf
Article in English | LILACS | ID: biblio-1057220


ABSTRACT Objective: To describe the perception of physiotherapists in neonatal units regarding pain, the use of measurement scales and strategies that minimize pain. Methods: Interviews were conducted with physiotherapists in hospitals with neonatal units between 2013 and 2015 in Rio de Janeiro. The questions concerned the knowledge of the feeling of pain, from its recognition to its care or treatment. The description of the results was done by comparing public and private hospitals (Fisher''s Exact exact Testtest), considering p<0.05 as significant. Results: 27 hospitals were visited. All the professionals interviewed (n=27) stated that the newborns feel pain, with facial expression being the most cited and known sign for pain. 26% of physiotherapists believe that newborns experience pain at the same magnitude as adults. Among the scales, the Neonatal Infant Pain Scale (NIPS) was the most well known, but only 37% of the units had routine pain assessment protocols. IV cannulation and blood collection were the most mentioned procedures as a cause of pain and there was no difference between public and private hospitals. Conclusions: There is a gap in the knowledge about neonatal pain and how to evaluate it among the participating physiotherapists, with no systematization of care routines involving this assessment.

RESUMO Objetivo: Descrever a percepção dos fisioterapeutas de unidades neonatais sobre a dor, a utilização de escalas de mensuração e estratégias que a minimizem. Métodos: Entrevistas foram realizadas com chefes ou rotinas de fisioterapia em hospitais com unidades neonatais entre 2013 e 2015, no Rio de Janeiro. As perguntas versaram sobre o conhecimento da sensação dolorosa, desde seu reconhecimento até seu cuidado ou tratamento. Foi realizada a descrição dos resultados, comparando-se os dados dos hospitais públicos com os privados (teste exato de Fisher), considerando-se p<0,05 como significante. Resultados: Vinte e sete hospitais foram visitados. Todos os profissionais entrevistados (n=27) afirmaram que os recém-nascidos sentem dor, sendo a expressão facial o sinal de dor mais conhecido. Do total de fisioterapeutas entrevistados, 26% acreditam que os neonatos sentem dor na mesma magnitude que o adulto. Entre as escalas, a Neonatal Infant Pain Scale (NIPS) era a mais conhecida, e apenas 37% das unidades possuíam protocolos de avaliação da dor na rotina. As coletas e as punções foram os procedimentos mais mencionados como causa de dor, e não houve diferença entre os hospitais públicos e privados. Conclusões: Constatou-se uma lacuna no conhecimento sobre dor neonatal e como avaliá-la entre os fisioterapeutas participantes, com ausência de sistematização de rotinas assistenciais que envolvam essa aferição.

Humans , Infant, Newborn , Pain/diagnosis , Perception/physiology , Pain Measurement/methods , Physical Therapists/psychology , Pain/etiology , Pain/epidemiology , Brazil/epidemiology , Infant, Premature/psychology , Intensive Care Units, Neonatal/organization & administration , Intensive Care Units, Neonatal/statistics & numerical data , Interviews as Topic/methods , Hospitals, Private/statistics & numerical data , Knowledge , Facial Expression , Hospitals, Public/statistics & numerical data
Ribeirão Preto; s.n; 2020. 173 p. ilus, tab, fig.
Thesis in Portuguese | LILACS, BDENF | ID: biblio-1418547


Introdução: A dor repetida e não tratada no período neonatal pode ocasionar efeitos deletérios no crescimento e desenvolvimento infantil. Assim, o uso de estratégias de avaliação e controle da dor são fundamentais. Especificamente com relação a avaliação da dor, o treinamento online pode ser contribuir para a capacitação técnica e atualização dos profissionais de saúde. Objetivo: Avaliar o Programa de Avaliação da Dor Neonatal (PAD-Neo) aplicado a enfermeiros envolvidos na assistência neonatal de um hospital de ensino. Método: Trata-se de estudo quantitativo, longitudinal, quase-experimental realizado com 30 enfermeiros e respectivas chefias nas unidades de Alojamento Conjunto, Terapia Intensiva Neonatal e Pediátrica e Cuidados Intermediários do Hospital Universitário da Universidade de São Paulo. Os dados foram coletados entre abril e outubro de 2018. Antes do treinamento, os enfermeiros responderam questionários sobre perfil e motivação para aprender, além de pré-teste. O treinamento online foi oferecido ao longo de nove semanas e ao seu término, os enfermeiros responderam ao pós-teste e aos questionários de avaliação de reação e motivação para transferir. Após 45 dias do término do treinamento, os enfermeiros e suas chefias responderam a questionários de impacto em profundidade e amplitude, assim como suporte para transferência de treinamento. Todos os questionários foram respondidos eletronicamente. Os dados foram analisados no programa R versão 3.6.2. Foi realizada análise estatística descritiva, assim como modelo de análise de variância, Kruskal-Wallis, teste de correlação de Pearson, correlação de Kendall, correlação intraclasse e modelo de efeitos mistos. Foi adotado nível de significância de 5%. Resultados: A maioria dos enfermeiros eram do gênero feminino (93,33%), com idade média de 42,8 anos e tempo médio de formação de 18,6 anos. A média de motivação em transferir (4,09, DP=0,53) foi maior que a média da motivação em aprender (3,44, DP=0,33), independente da unidade de trabalho. Houve aumento significativo no conhecimento dos enfermeiros de todas as unidades, comparando-se as médias de pré e pós-teste (p<0.0001), independente da unidade de trabalho (p=0,9368). A reação dos enfermeiros em relação à tutoria, ambiente virtual, avaliação do aluno, conteúdo e atividades e comunicação visual foi positiva. O treinamento influenciou diretamente (impacto em profundidade) a prática assistencial dos enfermeiros, tanto na autoavaliação quanto heteroavaliação (média=4,28 e média=3,93, respectivamente). Contudo, o treinamento não apresentou efeitos indiretos (impacto em amplitude) na prática, na avaliação dos enfermeiros (média=2,37) e chefias (média=2,97). O suporte à transferência de treinamento demonstrou que às vezes (média=2,82 DP=0,48) o enfermeiro é encorajado a usar o que aprendeu no ambiente do trabalho, tanto pela chefia quanto por colegas. Conclusões: Avaliar o impacto da oferta de treinamentos na prática profissional é necessário. No presente estudo, o PAD-Neo contribuiu para o aumento do conhecimento dos participantes. O ambiente foi considerado adequado, de fácil manuseio, interativo e dinâmico, o que permite a construção ativa do conhecimento. O treinamento influenciou diretamente a prática assistencial dos enfermeiros, mas não apresentou efeitos indiretos em relação à conhecimentos, habilidades, atitudes e comportamentos, com apoio insuficiente do ambiente de trabalho.

Introduction: Repeated and untreated neonatal pain can lead to deleterious effects on child growth and development. Therefore, pain assessment and management are vital on pain prevention. Concerning pain assessment, online training can contribute to technical training and updating of health care professionals. Aim: To evaluate the Programa de Avaliação da Dor Neonatal (PAD-Neo) targeted at nurses involved in neonatal care at a teaching hospital. Methodology: This quantitative, longitudinal, quasi-experimental study enrolled 30 nurses and their managers from the Rooming- Inn, Neonatal and Pediatric Intensive Care and Intermediate Neonatal Care units at the Hospital Universitário of the Universidade de São Paulo. Data were collected between April and October 2018. Before training, nurses answered questionnaires about their profile and motivation to learn, in addition to a pre-test. The online training was offered over nine weeks and at completion, the nurses answered a post-test, and assessment questionnaires about reaction and motivation to transfer. After 45 days the end of the training, the nurses and their managers answered questionnaires about impact in depth and breadth, as well as support for transfer. All questionnaires were completed electronically. Data were analyzed using the R version 3.6.2 program. Descriptive statistical analyses were performed, as well as the variance analysis model, Kruskal-Wallis, Pearson's correlation test, Kendall's correlation, intraclass correlation and mixed effects model. A significance level of 5% was adopted. Results: Most nurses were female (93.33%), with mean age of 42.8 years and mean length of academic education of 18.6 years. Mean of motivation to transfer (4.09, SD=0.53) was higher than mean motivation to learn (3.44, SD=0.33), regardless of the workplace. There was a significant increase in nurses knowledge in all units, comparing the mean scores from pre and post-test (p <0.0001), regardless of the workplace (p=0.9368). The nurses' reaction about tutoring, virtual environment, student evaluation, content and activities, and visual communication were positive. The training directly influenced (in-depth impact) nurses' care practice, both in self-assessment and hetero- assessment (mean=4.28 and mean=3.93, respectively). However, the training had no indirect effects (impact on breadth) in practice, in the nurses assessment (mean = 2.37) and managers (mean = 2.97). Support for transfer training demonstrated that sometimes (mean = 2.82 SD = 0.48) nurses are encouraged to use what they have learned in the workplace environment, both by their managers and colleagues. Conclusions: It is relevant to assess the impact of training on professional practice. In this current study, the PAD-Neo contributed to increase the participants' knowledge. The learning environment was considered adequate, easy to handle, interactive and dynamic, which allows the active construction of knowledge. The training directly influenced the nurses' care practice, but did not resulted in indirect effects in relation to knowledge, skills, attitudes and behaviors, with insufficient support from the work environment.

Humans , Male , Female , Infant, Newborn , Pain Measurement/methods , Educational Technology , Education, Distance , Education, Nursing , Nurses
Rev. bras. enferm ; 73(5): e20190125, 2020. tab, graf
Article in English | LILACS, BDENF | ID: biblio-1115387


ABSTRACT Objectives: to verify the effects of hierarchization and in vivo exposure for fear of pain, avoidance of movement, and anxiety in chronic low back pain. Methods: quasi-experimental study. The 27 patients who participated graded the damage associated with the movements in each of the 40 activities of daily living depicted in pictures using a scale from 0 to 100. The patients chose five out of all the activities that received a score higher than 50 to carry out the exposure. The intensities of fear and anxiety were measured before and after each exposure session. Results: the frequencies of the gender were equal, and the mean age was 44.9 years. The activities chosen more frequently for the exposure were shoveling (33.3%) and running (33.3%). There was reduction of fear and anxiety before and after exposure (p<0.001). Conclusions: hierarchization and in vivo exposure were effective in reducing fear and anxiety.

RESUMEN Objetivos: verificar los efectos de la jerarquización y exposición viva al supuesto miedo al dolor y evitar el movimiento y la ansiedad en pacientes con dolor lumbar crónico. Métodos: estudio cuasiexperimental. Los 27 pacientes que participaron clasificaron el dolor de cada uno de los 40 movimientos de la actividad cotidiana representados en fotos, utilizando una escala de 0-100. Entre las actividades clasificadas con más de 50, eligieron 5 para realizar la exposición. La intensidad del miedo y la ansiedad fueron medidas antes y después de cada sesión de exposición. Resultados: la muestra expresó equivalencia entre sexos, media etaria de 44,9 años. Las actividades más elegidas para la exposición fueron: trabajar con la pala (33,3%) y correr (33,3%). Hubo reducción del miedo y de la ansiedad antes y después de las exposiciones (p<0,001). Conclusiones: la jerarquización y exposición vivas fueron efectivas para reducir el miedo y la ansiedad.

RESUMO Objetivos: verificar os efeitos do uso da hierarquização e exposição ao vivo para a crença de medo da dor e evitação do movimento e ansiedade em pacientes com dor lombar crônica. Métodos: estudo quase-experimental. Os 27 pacientes que participaram graduaram o dano de cada um dos 40 movimentos de atividades da vida diária representados em fotos, utilizando uma escala de 0 a 100. Dentre as atividades graduadas acima de 50, escolheram 5 para realizar a exposição. As intensidades do medo e da ansiedade foram mensuradas antes e depois de cada sessão de exposição. Resultados: a frequência entre os sexos foi equitativa, a média da idade foi de 44,9 anos. As atividades mais escolhidas para a exposição foram trabalhar com a pá (33,3%) e correr (33,3%). Houve redução do medo e ansiedade antes e após as exposições (p<0,001). Conclusões: a hierarquização e exposição ao vivo foram efetivas na redução do medo e da ansiedade.

Adult , Female , Humans , Male , Middle Aged , Avoidance Learning , Low Back Pain/psychology , Fear/psychology , Pain Measurement/statistics & numerical data , Pain Measurement/methods , Surveys and Questionnaires , Low Back Pain/complications , Low Back Pain/nursing , Movement/physiology
Braz. oral res. (Online) ; 34: e043, 2020. tab, graf
Article in English | LILACS, BBO | ID: biblio-1132658


Abstract The aim of the present study was to compare the sensitivity and specificity of pain scales used to assess dentin hypersensitivity (DH). The preferred scale, and toothbrushing habits of participants were also investigated. This cross-sectional study was conducted with students and employees of a Brazilian Federal University who presented DH. The participants answered a questionnaire about their toothbrushing and drinking habits. Hypersensitive and non-sensitive teeth were submitted to tactile and ice stick stimuli. Then, the subjects marked their pain level in the visual analogue (VAS), numeric scale (NS), faces pain scale (FPS) and verbal evaluation scale (VES). DH was also assessed by Schiff scale (SS). The data were analyzed by Wilcoxon and Chi-Square tests, as well as by ROC curve. The mean age of the sample (56 women, 16 men) was 27.8 years. The most prevalent acidic beverage was coffee (36.0%) and the most preferred scale was the NS (47.2%). The pain level was statistically higher in teeth with DH compared to teeth without DH (p < 0.05). The accuracy ranged from 0.729 (SS) to 0.750 (NS). The highest sensitivity value was 81.9% for NS. The SS presented the highest specificity (91%). The visual analog, numerical, verbal evaluation, faces pain, and Schiff scales were accurate for DH diagnosis. The Schiff scale was the preferred scale for DH assessment.

Humans , Male , Female , Adolescent , Adult , Young Adult , Pain Measurement/methods , Dentin Sensitivity/diagnosis , Toothbrushing/adverse effects , Beverages/adverse effects , Severity of Illness Index , Cross-Sectional Studies , Surveys and Questionnaires , Reproducibility of Results , Sensitivity and Specificity , Statistics, Nonparametric , Facial Expression
Rev. bras. ter. intensiva ; 31(4): 571-581, out.-dez. 2019. tab, graf
Article in Portuguese | LILACS | ID: biblio-1058057


RESUMO Objetivo: Descrever a adequação de duas escalas comportamentais, a Behavioral Pain Scale e a Critical Care Pain Observation Tool, para a avaliação da dor em pacientes intubados orotraquealmente, internados em unidades de terapia intensiva. Método: Utilizando a metodologia recomendada pelo Centro Cochrane, foi realizada revisão sistemática da literatura, na base de dados eletrônica EBSCO host (CINAHL Complete, MEDLINE®Complete, Nursing & Allied Health Collection: Comprehensive, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Library, Information Science & Technology Abstracts, MedicLatina). Foram realizadas duas pesquisas com os seguintes termos em inglês no campo de pesquisa: "behavioral pain scale" AND "critical care pain observation tool" AND "behavioral pain scale" OR "critical care pain observation tool". Dois revisores independentes realizaram a avaliação crítica, a extração e a síntese dos dados. Resultados: Foram incluídos 15 estudos que evidenciaram que a Behavioral Pain Scale e a Critical Care Pain Observation Tool eram duas escalas válidas e confiáveis para a avaliação da dor em pacientes intubados orotraquealmente e internados em unidade de terapia intensiva. As escalas apresentaram propriedades psicométricas semelhantes, bem como boa confiabilidade. Conclusão: Ambas as escalas são adequadas para a avaliação da dor em pacientes intubados orotraquealmente, internados em unidade de terapia intensiva, contudo, apresentam limitações em populações específicas como doentes vítimas de trauma, queimados e do foro neurocirurgico. É sugerida a realização de mais estudos sobre o tema e em populações específicas.

ABSTRACT Objective: Descrever a adequação de duas escalas comportamentais, a Behavioral Pain Scale e a Critical Care Pain Observation Tool, para a avaliação da dor em pacientes intubados orotraquealmente, internados em unidades de terapia intensiva. Method: Utilizando a metodologia recomendada pelo Centro Cochrane, foi realizada revisão sistemática da literatura, na base de dados eletrônica EBSCO host (CINAHL Complete, MEDLINE®Complete, Nursing & Allied Health Collection: Comprehensive, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Library, Information Science & Technology Abstracts, MedicLatina). Foram realizadas duas pesquisas com os seguintes termos em inglês no campo de pesquisa: "behavioral pain scale" AND "critical care pain observation tool" AND "behavioral pain scale" OR "critical care pain observation tool". Dois revisores independentes realizaram a avaliação crítica, a extração e a síntese dos dados. Results: Foram incluídos 15 estudos que evidenciaram que a Behavioral Pain Scale e a Critical Care Pain Observation Tool eram duas escalas válidas e confiáveis para a avaliação da dor em pacientes intubados orotraquealmente e internados em unidade de terapia intensiva. As escalas apresentaram propriedades psicométricas semelhantes, bem como boa confiabilidade. Conclusion: Ambas as escalas são adequadas para a avaliação da dor em pacientes intubados orotraquealmente, internados em unidade de terapia intensiva, contudo, apresentam limitações em populações específicas como doentes vítimas de trauma, queimados e do foro neurocirurgico. É sugerida a realização de mais estudos sobre o tema e em populações específicas.

Humans , Pain/diagnosis , Pain Measurement/methods , Critical Care/methods , Intensive Care Units , Intubation, Intratracheal
Rev. bras. anestesiol ; 69(6): 587-593, nov.-Dec. 2019. tab
Article in English | LILACS | ID: biblio-1057466


Abstract Background and objectives: To investigate, describe, and assess the phenomenon of "rebound pain" as a clinically relevant problem in anesthetic practice. Content: The phenomenon of "rebound pain" has been demonstrated and described as a very severe pain, which occurs after a peripheral nerve block resolution with the recovery of sensitivity. The incidence of rebound pain is unknown. Usually, it occurs between 12 and 24 hours after surgery and, adversely affecting sleep quality. It is not yet possible to establish a mechanism as a definitive cause or trigger factor of rebound pain. Studies suggest that rebound pain is a side effect of peripheral nerve blocks, despite their effectiveness in pain control. Currently, the extent and clinical significance of rebound pain cannot be well determined due to the lack of large prospective studies. Conclusion: Rebound pain assessment should always be considered in clinical practice, as it is not a rare side effect of peripheral nerve blocks. There are still many challenging questions to be answered about rebound pain, so large prospective studies are needed to address the issue. For prevention, the use of peripheral nerve block techniques that avoid nerve damage and adequate perioperative analgesia associated with patient education on the early administration of analgesics, even during the period of analgesia provided by peripheral nerve block, is recommended. A better understanding of the "rebound pain" phenomenon, its pathophysiology, associated risk factors, and long-term consequences may help in developing more effective preventive strategies.

Resumo Justificativa e objetivos: Investigar, descrever e avaliar o fenômeno da "dor rebote" como um problema clinicamente relevante na prática anestésica. Conteúdo: O fenômeno da "dor rebote" foi demonstrado e descrito como uma dor muito intensa que ocorre após a resolução do bloqueio de nervo periférico com o retorno da sensibilidade. A incidência de dor rebote é desconhecida. Normalmente ela ocorre entre 12 a 24 horas após a cirurgia e afeta negativamente a qualidade do sono. Ainda não é possível estabelecer um mecanismo como causa definitiva ou fator desencadeante da dor rebote. Estudos sugerem que a dor rebote seja um efeito colateral dos bloqueios de nervos periféricos, apesar destes terem eficácia no controle álgico. Atualmente, a extensão e a significância clínica da dor rebote não podem ser bem determinadas, devido à falta de grandes estudos prospectivos. Conclusão: A avaliação da dor rebote deve ser sempre considerada na prática clínica, pois não é um efeito colateral raro dos bloqueios de nervo periféricos. Ainda existem muitas questões desafiadoras a serem respondidas sobre a dor rebote, portanto fazem-se necessários amplos estudos prospectivos sobre a temática. Para a sua prevenção recomenda-se o uso de técnicas de bloqueio de nervo periférico que evitem a lesão do nervo e uma adequada analgesia perioperatória associada à orientação do paciente sobre a administração precoce de analgésicos mesmo na vigência da analgesia proporcionada pelo bloqueio de nervo periférico. A melhor compreensão do fenômeno "dor rebote", sua fisiopatologia, seus fatores de risco associados e suas consequências em longo prazo poderá ajudar na elaboração de estratégias preventivas mais eficazes.

Humans , Pain/etiology , Nerve Block/adverse effects , Pain/physiopathology , Pain/epidemiology , Pain, Postoperative/prevention & control , Pain Measurement/methods , Patient Education as Topic , Risk Factors , Nerve Block/methods
Rev. méd. Maule ; 34(2): 8-13, dic. 2019. tab
Article in English | LILACS | ID: biblio-1371186


INTRODUCTION: Increasing evidence suggests that changes in the balance of excitatory/inhibitory neurotransmission are involved in the development of the majority of chronic pain forms. In this context, impairment in glycine mediated inhibitory neurotransmission is thought to play a critical role in the disinhibition that accounts for the development and maintenance of central pain hypersensitivity. AIMS: The goal of this study was to evaluate the Glycine Receptor α3 subunit (α3GlyR) expression in neuropathic (Chronic Constriction Injury, CCI) and inflammatory (Zymosan A injected) animal models of chronic pain. RESULTS AND CONCLUSION: RT-qPCR analysis of spinal cord samples showed that glra3 gene expression does not change after 3 days of CCI and 4 hours of Zymosan A injection. However, we found that protein levels evaluated by Western blot increased after inflammatory pain. These data suggest that central sensitization is differentially regulated depending on the type of pain. α3GlyR protein expression plays an important role in the first step of inflammatory pain establishment.

Animals , Receptors, Glycine/metabolism , Receptors, Glycine/agonists , Central Nervous System Sensitization/physiology , Pain/diagnosis , Pain/physiopathology , Zymosan/administration & dosage , Pain Measurement/methods , Analysis of Variance , Receptors, Glycine/chemistry , Real-Time Polymerase Chain Reaction/methods
Rev. Paul. Pediatr. (Ed. Port., Online) ; 37(4): 450-457, Oct.-Dec. 2019. tab, graf
Article in English | LILACS | ID: biblio-1041368


ABSTRACT Objective: To propose and analyze the test-retest reliability of an instrument to verify the presence and intensity of pain in the cervical, thoracic and lumbar spine in Brazilian young people. Methods: This reliability study enrolled a sample of 458 participants (13 to 20 years). Two groups were formed for each sex according to the range of days for the test-retest (10±3 and 28±2 days). For analysis of spinal pain, a drawing of the human body with cervical, thoracic and lumbar spine areas delimited was presented. The following question was presented: during a normal day, do you feel pain in any of these regions of your spine? If so, what is the intensity from 0 to 10 (mark on the line)? The starting point, with the number 0, corresponded to no pain, and the number 10 to severe pain. The agreement of frequency and of intensity of pain was verified by Kappa test and Bland-Altman plot, respectively. Results: Intraclass correlation coefficients ranged from 0.71 (confidence interval of 95% - 95%CI - 0.59-0.79) to 0.94 (95%CI 0.90-0.96). The results concerning the agreement of pain scores showed the mean differences to be close to 0, and the largest mean difference was -0.40 (95%CI -5.14-4.34). The agreement in reported pain ranged from 72.2 (Kappa 0.43; 95%CI 0.28-0.58) to 90.1% (Kappa 0.76; 95%CI 0.60-0.92). Conclusions: This instrument was shown to be a reliable manner to verify the pain in different regions of the spine in Brazilian young people.

RESUMO Objetivo: Propor e analisar a reprodutibilidade de um instrumento para verificar a presença e a intensidade da dor na coluna cervical, torácica e lombar em jovens brasileiros. Métodos: Estudo de reprodutibilidade com uma amostra de 458 participantes (13 a 20 anos). Dois grupos foram formados para cada sexo de acordo com o intervalo de dias entre teste e reteste (10±3 e 28±2 dias). Para a análise da dor na coluna, foi apresentada a figura de um corpo humano com as áreas da coluna cervical, torácica e lombar delimitadas. A seguinte pergunta foi realizada: durante um dia comum, você sente dor em alguma dessas regiões da coluna? Se sim, qual é a intensidade de 0 a 10 (marque um traço)? A extremidade com o número 0 correspondia à ausência de dor e o número 10, à dor muito intensa. A concordância na frequência e intensidade da dor foi verificada por meio do teste Kappa e da plotagem de Bland-Altman, respectivamente. Resultados: Os coeficientes de correlação intraclasse variaram de 0,71 (intervalo de confiança de 95% - IC95% - 0,59-0,79) a 0,94 (IC95% 0,90-0,96). Os resultados relativos à concordância no escore de dor mostraram que as diferenças médias foram próximas de 0 e a maior diferença média foi de -0,40 (IC95% -5,14-4,34). A concordância no relato de dor variou de 72,2 (Kappa 0,43; IC95% 0,28-0,58) a 90,1% (Kappa 0,76; IC95% 0,60-0,92). Conclusões: O instrumento demonstrou ser uma forma reprodutível de verificar a dor em diferentes regiões da coluna vertebral em jovens brasileiros.

Humans , Male , Female , Adolescent , Young Adult , Pain Measurement/methods , Back Pain/diagnosis , Neck Pain/diagnosis , Spine , Brazil , Reproducibility of Results
Rev. gastroenterol. Perú ; 39(4): 323-328, oct.-dic 2019. ilus
Article in English | LILACS | ID: biblio-1144616


Introduction and aim: Functional abdominal pain (FAP) is one of the major gastrointestinal complaints in childhood. Studies have reported occult constipation (OC) as one of the leading causes of abdominal pain. Recent researches have proposed laxatives as potent therapeutic targets for abdominal pain in patients with OC. However, no study has compared effect of poly ethylene glycol (PEG) and lactulose on occult constipation. Materials and methods: 51 patients aged 4 to 18 years with abdominal pain who had OC (defined as fecal impaction in abdominal X ray) were studied. Demographic and clinical data including age, sex, body weight, height, abdominal pain duration, abdominal pain rate and fecal odor were registered. They were randomly assigned to receive PEG (1gr/kg) or Lactulose (1cc/kg) for at least two weeks. All patients were reevaluated by pain measurement scale after at least two weeks of treatment. Results: It is indicated that the efficacy of PEG for reducing abdominal pain in OC was 48% while it was 37% for Lactulose. This study indicated that this efficacy is not affected significantly by sex and fecal odor, however this efficacy is influenced by age, body weight, abdominal pain duration and abdominal pain rate for both PEG and Lactulose. Conclusion: It could be concluded that PEG is a more efficient drug for treating abdominal pain in occult constipation than Lactulose and its optimum effect can be achieved in elder patients with more severe abdominal pain.

Introducción y objetivo: El dolor abdominal funcional (FAP) es una de las principales molestias gastrointestinales en la infancia. Los estudios han informado que el estreñimiento oculto (OC) es una de las principales causas de dolor abdominal. Investigaciones recientes han propuesto laxantes como objetivos terapéuticos potentes para el dolor abdominal en pacientes con OC. Sin embargo, ningún estudio ha comparado el efecto del polietilenglicol (PEG) y la lactulosa sobre el estreñimiento oculto. Materiales y métodos: Se estudiaron 51 pacientes de 4 a 18 años con dolor abdominal que tenían OC (definida como impactación fecal en rayos X abdominales). Se registraron datos demográficos y clínicos que incluyen edad, sexo, peso corporal, altura, duración del dolor abdominal, tasa de dolor abdominal y olor fecal. Fueron asignados aleatoriamente para recibir PEG (1 gr/kg) o lactulosa (1 cc/kg) durante al menos dos semanas. Todos los pacientes fueron reevaluados por la escala de medición del dolor después de al menos dos semanas de tratamiento. Resultados: Se indica que la eficacia de PEG para reducir el dolor abdominal en OC fue del 48% mientras que fue del 37% para la lactulosa. Este estudio indicó que esta eficacia no se ve afectada significativamente por el sexo y el olor fecal, sin embargo, esta eficacia está influenciada por la edad, el peso corporal, la duración del dolor abdominal y la tasa de dolor abdominal tanto para PEG como para lactulosa. Conclusión: Se podría concluir que el PEG es un fármaco más eficaz para tratar el dolor abdominal en el estreñimiento oculto que la lactulosa y que su efecto óptimo se puede lograr en pacientes mayores con dolor abdominal más severo.Palabras clave: dolor abdominal, estreñimiento oculto, polietilenglicol, lactulosa.

Adolescent , Child , Child, Preschool , Female , Humans , Male , Polyethylene Glycols/therapeutic use , Abdominal Pain/drug therapy , Constipation/drug therapy , Laxatives/therapeutic use , Fecal Impaction/drug therapy , Lactulose/therapeutic use , Time Factors , Body Weight , Pain Measurement/methods , Abdominal Pain/etiology , Sex Factors , Age Factors , Constipation/complications , Fecal Impaction/complications , Fecal Impaction/diagnostic imaging