Objectives To evaluate the effect of metrinidazole treatment after conventional hemorrhoidectomy pain in patients with third and fourth degree hemorrhoids. Methods We searched the Cochrane Library (Issue 1 2009), PubMed (1966 to March 2009), EMbase (1974 to March 2009), SCI (1974 to March 2009), CBM (1978 to March 2009), CNKI (1994 to March 2009), and VIP (1989 to March 2009) to identify randomized controlled trials or quasi- randomize controlled trials of metronidazole versus placebo for treating post hemorrhoidectomy pain. We evaluated the quality of the included studies by using the Handbook 4.2.6 recommend standards and analyzed data using the Cochrane Collaboration’s RevMan 4.2.10. Results We included seven randomized controlled trials or quais-randomized controlled trials (n=553). Meta-analyses showed that there were statistical differences between metronidazole and placebo in pain after hemorrhoidectomy and the use of an additional dose of analgesia. Conclusions The current evidence shows that metronidazole relieves the pain after conventional hemorrhoidectomy and reduces the additional used of analgesics. Further high quality, large sample randomized controlled trials should be carried out.
Objective
To investigate the status quo of knowledge and attitude towards pain among medical staff in West China Hospital of Sichuan University.
Methods
The medical staff in Emergency Department of West China Hospital of Sichuan University were investigated by the Chinese version of Knowledge and Attitudes Survey Regarding Pain (2008) questionnaire, the contents of which related to pain assessment, pain related knowledge, analgesic related knowledge, and comprehensive application, etc. And the questionnaire scores were compared among medical workers with different background.
Results
A total of 156 questionnaires were sent out and 130 valid ones were taken back, with an effective recovery rate of 83.3%. There was no statistically significant difference in questionnaire scores among the medical workers with different education background or different professional titles (P>0.05). The questionnaire scores were significantly different among nurses with different seniority (F=3.785, P=0.035), and the mean score of the nurses with more than 10 years of seniority was the highest (22.78±7.11). The questionnaire scores were significantly different among nurses working in different areas (F=3.043, P=0.033), and the mean score of the nurses working in rescue room was the highest (24.53±7.84).The erroneous items were concentrated on item 5, 17, 19. In the answers to the open questions, 97.7% (127/130) thought that the existing pain knowledge could not satisfy the needs of clinical work; 100.0% (130/130) believed that it was necessary to study pain related knowledge; 80.0% (104/130) acquired pain related knowledge from clinical experience, 40.0% (52/130) from books, 15.4% (20/130) from the network; 90% ( 117/130) commonly used numeric rating scale to evaluate the patients’ pain degree, 20.0% (26/130) evaluated the patients’ pain degree through facial expressions.
Conclusions
The overall level of pain management knowledge and attitude in medical staff in Emergency Department is low. The continuing education on pain knowledge should be strengthened, the attitude towards pain treatment and the importance of pain management should be paid more attention, and the standardized training and supervision should be enhanced.
ObjectiveTo compare degree and characteristics of early postoperative pain for patients with inguinal hernia underwent laparoscopic versus open tension-free hernioplasty.
MethodsThe clinical data of 120 patients who underwent tension-free hernioplasty from July 2013 to June 2015 were analyzed. All of the patients were divided into open tension-free hernioplasty group (open group, n=60) and laparoscopic tension-free hernioplasty group (laparoscope group, n=60). Visual analogue scale (VAS) score was evaluated at different time point.
Results① Within 12 h after operation, the comparison of total VAS score between the laparoscope group and the open group had no significant difference (F=1.674, P=0.198), the difference of VAS score in these two groups was significantly different at each time point (F=21.186, P=0.000), and the variation tendency was influenced by grouping factors (F=87.038, P=0.000). ② Within 7 d after opera-tion, the differences of comparison of total VAS score between the laparoscope group and the open group and at each time point were statistically significant (F=46.358, P=0.000; F=576.387, P=0.000) and had a downtrend, further more the variation tendency was influenced by grouping factors (F=19.454, P=0.000). ③ The composition ratios of pain site and characteristics had significant differences between these two groups within 7d after operation (χ2=10.108, P=0.001; χ2=7.144, P=0.028), the dosage of analgesic drugs between two groups had no significant difference (t=0.872, P=0.386).
ConclusionAs a representative of minimally invasive surgery, laparoscopic technology has certain advantages in reducing postoperative pain for patients with inguinal hernia, but minimally invasive technique does not mean to painless. Further improvement is needed by hernia surgery.
Objective To understand the incidence and severity of postoperative acute pain in patients undergoing day surgery, and to explore the influencing factors of moderate to severe pain after surgery, so as to provide a reference for pain management in day surgery. Methods Convenience sampling method was used to select patients undergoing day surgery under multi-modal pain management in West China Hospital of Sichuan University between April and August 2020, and the general conditions, surgical conditions, and postoperative pain of the patients were investigated. According to the degree of postoperative pain, patients were divided into mild pain group and moderate to severe pain group. Logistic regression analysis was used to explore the influencing factors of postoperative pain in the two groups. Results A total of 509 patients were finally included, of which 69 patients presented with moderate to severe pain. Logistic regression analysis showed that patient age [odds ratio (OR)=0.970, 95% confidence interval (CI) (0.946, 0.993), P=0.012], pain threshold [OR=1.348, 95%CI (1.048, 1.734), P=0.020] and postoperative drainage tube [OR=2.752, 95%CI (1.090, 6.938), P=0.017] were the influencing factors of moderate to severe pain after surgery. Conclusion Under multimodal pain management, the incidence of moderate to severe pain in day surgery patients is low, and medical staff should further strengthen pain management from the factors affecting pain to reduce the incidence of moderate to severe pain after surgery.
ObjectiveTo explore the feasibility to use pain scale and arterial oxygen partial pressure(PaO2)as screening internal fixation indications for patients with multiple rib fractures.
MethodsClinical data of 48 patients with multiple rib fractures who were admitted to Shanghai Pudong Hospital from September 2010 to February 2013 were retrospectively analyzed. Visual analogue scale (VAS) was used for pain assessment. Twenty-four patients whose VAS was greater than or equal to 6 and PaO2 was less than 60 mm Hg 3 days after injury were chosen as the experimental group, including 16 males and 8 females with their age of 49.29±15.73 years. Another 24 patients whose VAS was less than or equal to 5 and PaO2 was greater than 60 mm Hg 3 days after injury were chosen as the control group, including 19 males and 5 females with their age of 48.63±13.49 years. Patients in both groups received rib internal fixation with steel plates. Three days and 1 week after surgery respectively, VAS and PaO2 were compared between the 2 groups.
ResultsIn the experimental group, VAS 3 days after surgery was significantly lower than preoperative VAS (4.09±0.93 vs. 8.21±1.18, P < 0.05), and VAS 1 week after surgery was significantly lower than preoperative VAS (3.20±0.98 vs. 8.21±1.18, P < 0.05). In the control group, there was no statistical difference between VAS 3 days after surgery and preoperative VAS (P > 0.05), and there was no statistical difference between VAS 1 week after surgery and preoperative VAS (P > 0.05). Three days after surgery, PaO2 of the experimental group was significantly higher than preoperative PaO2 (61.00±3.47 mm Hg vs. 53.00±3.97 mm Hg, P < 0.05). There was no statistical difference between PaO2 3 days after surgery and preoperative PaO2 in the control group (66.71±5.15 mm Hg vs. 66.00±5.00 mm Hg, P > 0.05). Three days after surgery, pneumonia occurred in 4 patients in the experimental group and 2 patients in the control group (χ2=0.762, P > 0.05). Three days after surgery, pain scale reduction of the experimental group was significantly higher than that of the control group (4.13±1.45 vs. 0.00±0.42, P < 0.05). One week after surgery, pain scale reduction of the experimental group was significantly higher than that of the control group (5.04±1.23 vs. 0.08±0.28, P < 0.05). Three days after surgery, PaO2 increase of the experimental group was significantly higher than that of the control group (7.42±3.59 mm Hg vs. 0.21±0.98 mmHg, P < 0.05).
ConclusionIt's reasonable and feasible to use pain scale greater than or equal to 6 and PaO2 less than 60 mm Hg as internal fixation indications for patients with multiple rib fractures.
Sleep deprivation can cause hyperalgesia, and the mechanisms involve glutamic acid, dopamine, serotonin, metabotropic glutamate receptor subtype 5, adenosine A2A receptor, nicotinic acetylcholine receptor, opioid receptor, brain-derived neurotrophic factor, melatonin, etc. The mechanisms of hyperalgesia caused by sleep deprivation are complex. The current treatment methods are mainly to improve sleep and relieve pain. This paper reviews the mechanism and treatment progress of hyperalgesia induced by sleep deprivation, and aims to provide scientific evidence for the treatment of hyperalgesia caused by sleep deprivation.
Mirror therapy is a rehabilitation therapy in which a mirror is placed between the arms or legs so that the image of a moving non-affected limb gives the illusion of normal movement in the affected limb. As a simple, safe, and low-cost treatment, mirror therapy has been widely used. By summarizing and analyzing the literature about mirror therapy at home and abroad, this article summarizes its mechanism and clinical application in pain, stroke, cerebral palsy and so on, so as to provide reference for research and application on mirror therapy.
ObjectiveTo determine postoperative pain of the robotic technique for the patients with lobectomy.
MethodsWe retrospectively analyzed the clinical data of 120 patients with lobectomy between October 2014 and May 2015 in our hospital. The patients are divided into two groups:a robotic group, including 40 patients with 16 males and 24 females at age of 59.7±7.2 years, undergoing robotic lobectomy, and a video-assisted thoraciscopic surgery (VATS) lobectomy group (a VATS group) including 80 patients with 29 males and 51 females at age of 61.2±8.9 years, undergoing VATS lobectomy. We used the numerical rating scale (NRS) and verbal rating scale (VRS) to assess the pain level on the first day, the 7th day and the 30th day after the surgery. The pain level of the two groups was compared.
ResultsThe patients in the two groups both felt pain. There were no statistical differences in the scores of VRS and NRS on the first day, the 7th day and the 30th day after the surgery between the two group (P>0.05). The pain score of the patients in the two groups decreased with no statistical difference from the first day to the 30th day after the surgery (P>0.05).
ConclusionThe patients with robotic lobectomy have similar pain level after surgery compared with the patients with VATS lobectomy.
The concept of "enhanced recovery after surgery (ERAS)" has been well known by care providers. Implementation of the ERAS principles requires minimally invasive surgical technology in conjunction with multidisciplinary teamwork. Only if these two aspects of peri-operative care regime optimization and "all-in-one model in medical" care were linked up associatelly, ERAS could be realized. Thoracoscopic surgery was a milestone in thoracic surgery. The successful application of such a recovery program requires the foundation of pain and risk free ward in perioperative period and improving quality of life post discharge. This review summarizes the peri-operative regimen care optimization regarding the utility of ERAS in the VATS lobectomy of patients with lung cancer. The first one is preoperative evaluation issues. It involves conditioning the patient and implementing a pre-operative exercise and a physical therapy regimen. The second one is operative and individual anesthetic maneuvers and the selective use of tube in the post-operative period. The third one is the foundation of pain and risk free ward:what are methods optimum of post operative management? The fourth one is medical management of patient's outcomes and the ERAS regimen continuing optimum. The fifth one is the importance of function of multi-departmental coordination in ERAS.
ObjectiveTo observe the clinical efficacy of non-nutritional sucking and 10% glucose water plus non-nutritional sucking in relieving the venipuncture pain for premature infants.
MethodA total of 167 premature infants between April and December 2014 were selected as our study subjects, and they were randomly divided into three groups:intervention group Ⅰ (n=53), intervention group Ⅱ (n=58), and the control group (without any intervention, n=56). Two minutes before venous indwelling needle puncture, blood oxygen saturation and heart rate of the infants were recorded during their quiet state. In the process of venipuncture, the intervention group Ⅰ was given non-nutritional sucking, intervention group Ⅱ was given 10% glucose water plus non-nutritional sucking, and the control group did not accept any intervention. Premature pain rating scale (PIPP) was used to compare the three groups of infants in terms of pain score, heart rate and blood oxygen saturation 1 minute and 5 minutes after intravenous indwelling needle puncture. SPSS 17.0 software was applied for statistical analysis.
ResultsOf the 167 premature infants, one-time puncture was successful in 152 infants, with 46 in intervention group Ⅰ, 54 in intervention group Ⅱ, and 52 in control group. One minute after intravenous indwelling needle puncture, PIPP score of intervention group Ⅰ and Ⅱ was significantly lower than that of the control group (P<0.05). The PIPP score of intervention group Ⅱ was significantly lower than that of intervention group Ⅰ (P<0.05). One minute and 5 minutes after intravenous indwelling needle puncture, heart rate in the intervention groups was significantly lower than that in the control group (P<0.05), blood oxygen saturation in the intervention groups was signficantly higher than that in the control group (P<0.05), and they were significantly lower in intervention group Ⅱ than in intervention group Ⅰ (P<0.05).
ConclusionsNon-nutritional sucking is effective in alleviating venipuncture pain for premature infants, especially when it is used together with 10% glucose water. The method is worthy of clinical promotion.
