BACKGROUND Ultrasound-guided peripherally inserted central catheter(PICC)placement is vital for cancer therapy,but lidocaine infiltration faces limitations like puncture pain and vasospasm.AIM To assess the clinical e...BACKGROUND Ultrasound-guided peripherally inserted central catheter(PICC)placement is vital for cancer therapy,but lidocaine infiltration faces limitations like puncture pain and vasospasm.AIM To assess the clinical efficacy of a no-pain intervention-combining compound lidocaine cream with warm compress-in reducing pain during ultrasound-guided PICC placement in cancer patients.METHODS A retrospective cohort study analyzed 88 cancer patients undergoing PICC placement(Shanghai Fourth People’s Hospital,2024).Patients were divided into control(lidocaine infiltration,n=44)and intervention(cream+warm compress,n=44)groups.Primary outcomes:Pain scores(numerical rating scale),procedural time,complications;secondary outcome:Satisfaction.RESULTS The intervention group showed significantly lower pain scores(1.2±0.4 vs 3.8±1.2,P=0.012)with comparable first-attempt success(95.5%vs 90.9%)and safety(P=0.672).Thermal activation of transient receptor potential vanilloid 1 channel enhanced drug penetration,achieving anesthesia within 8-10 minutes.Patient satisfaction reached 97.7%.CONCLUSION The combination of compound lidocaine cream with warm compress significantly alleviates procedural pain and enhances patient satisfaction during ultrasound-guided PICC placement in cancer patients,supporting its clinical application.展开更多
This literature review examines the mechanisms of how exercise, specifically in the form of resistance training, may lead to pain relief in the cancer population. Primary data from three different cancer populations: ...This literature review examines the mechanisms of how exercise, specifically in the form of resistance training, may lead to pain relief in the cancer population. Primary data from three different cancer populations: breast, prostate, and lung, will be examined. A number of experimental studies have been conducted to confirm the effectiveness of resistance training on pain relief as well as the biochemical pathways that relate to this process. In this review, we will examine 5 randomized controlled trials. For the purposes of this review, pain is defined as physical suffering or discomfort associated with illness. Pain is the body’s natural signal, bringing attention to damage that has been sustained by tissues. However, chronic pain is common in the cancer population, and often serves no good purpose but instead will negatively impact both physical and mental health. The three types of pain: nociceptive, neuropathic, and inflammatory pathways have been investigated, and the knowledge of pain mechanisms allows for the understanding of how it is associated with pain. The purpose of this exploratory literature review is to give insight on how to maximize pain-relieving effects of resistance training. Research has indicated that resistance training modulates pain pathways by upregulating the release of pain-relieving substances including beta-endorphins, anti-inflammatory cytokines, and endocannabinoids. Understanding of the benefits of resistance training may be useful in relieving cancer pain, and reproducing effects of pain-relieving strategies while minimizing the symptoms related to cancer and its treatment.展开更多
The symptom of cancer most feared by many patients is pain. The physical and psychological distress of constant pain without relief should not be underestimated, and all complaints of pain should be actively treated. ...The symptom of cancer most feared by many patients is pain. The physical and psychological distress of constant pain without relief should not be underestimated, and all complaints of pain should be actively treated. The clinician should not forget however that drugs used in the treatment of展开更多
Bone metastases(BM)are a common complication in advanced cancer patients,significantly contributing to morbidity and mortality due to their ability to cause pain,fractures,and spinal cord compression.Radiation therapy...Bone metastases(BM)are a common complication in advanced cancer patients,significantly contributing to morbidity and mortality due to their ability to cause pain,fractures,and spinal cord compression.Radiation therapy(RT)is vital in managing these complications by targeting metastatic lesions to ease pain,improve mobility,and reduce the risk of skeletal-related events such as fractures.Evidence supports the effectiveness of RT in pain relief,showing its ability to provide significant palliation and lessen the need for opioid painkillers,thereby enhancing the overall quality of life(QoL)for patients with BM.However,optimizing RT outcomes involves considerations such as the choice of radiation technique,dose fractionation schedules,and the integration of supportive care measures to mitigate treatment-related side effects like fatigue and skin reactions.These factors highlight the importance of personalized treatment planning tailored to individual patient needs and tumor characteristics.This mini-review aims to provide comprehensive insights into the multifaceted impacts of RT on pain management and QoL enhancement in BM patients,with implications for refining clinical practices and advancing patient care through the synthesis of findings from various studies.展开更多
Objectives:This study sought to examine midwives’utilization of nonpharmacological pain relief measures in labor pain management and to test the relationship between midwives’knowledge and utilization of nonpharmaco...Objectives:This study sought to examine midwives’utilization of nonpharmacological pain relief measures in labor pain management and to test the relationship between midwives’knowledge and utilization of nonpharmacological pain relief measures for labor pain management in secondary health facility in Calabar,Cross River State,Nigeria.Materials and Methods:A descriptive cross-sectional design was used for the study.The study was rooted in Katherine Kolcaba’s Comfort theory.Totally,67 participants were recruited for the study using the purposive sampling technique.A self-made structured questionnaire was used to obtain participants’information on knowledge,utilization,and predictors of nonpharmacological pain relief measures.Results:Although 41(61.2%)of the participants had knowledge about nonpharmacological pain relief measures,few did not know some of the cognitive-behavioral and environmental measures in labor pain management.There was 35.8%(24/67)for utilization of cognitive-behavioral measures and 55.2%(37/67)for psychological/emotional measures for labor pain management by respondents,respectively.Fifty(74.6%)of respondents agreed that predictors such as lack of knowledge,lack of updates and training,work experience,best practice guidelines,and equipment were hindrances to utilization.There was statistically significance in relationship between the level of knowledge and utilization of nonpharmacological pain relief measures(r=0.6,P<0.05).Conclusion:The utilization of nonpharmacological measures for labor pain management is low,thus it is recommended that frequent education,training updates on effective labor pain management,provision of clinical guidelines on labor pain management,and enrichment of midwifery training curriculum are imperative to ensure quality labor pain management and positive health outcome.展开更多
Objective: To compare 3 local field radiation therapies for bone metastases to determine the strategy producing the best results. Methods: Among 104 patients with bone metastases, 30 patients were given 8 Gy in single...Objective: To compare 3 local field radiation therapies for bone metastases to determine the strategy producing the best results. Methods: Among 104 patients with bone metastases, 30 patients were given 8 Gy in single fraction, 31 given 20 Gy in 5 fractions, 43 given 40 Gy in 20 fractions. Results and Conclusion: The method of 40 Gy in 20 fractions had a higher pain relief rate and a lower pain relapse rate, suggesting that large-dose fractioned treatment regimen is more appropriate for patients with bone metastasis.展开更多
Background: Pain in labour is perceived differently for every individual. We can improve the outcomes and patient satisfaction with intrapartum care by ensuring adequate education and appropriate use of requested pain...Background: Pain in labour is perceived differently for every individual. We can improve the outcomes and patient satisfaction with intrapartum care by ensuring adequate education and appropriate use of requested pain relief options. Encouraging informed personal control contributes to a women’s overall satisfaction. Aims: To assess current practice and identify improvement areas in the perception, planning and use of pain relief options, and how this impacts satisfaction of pain relief in labour. Methods: 114 retrospective anonymous patient questionnaires were returned by women delivering by spontaneous vaginal delivery, instrumental delivery or emergency caesarean section at Nambour General Hospital between April and July 2011. Data were collated and analysed using STATA. Results: 83% and 65% of women had their pain relief options explained antenatally and on admission respectively. 92% reported their pain relief was adequately provided. There was a significant difference (p Conclusions: Education of pain relief options for labour antenatally and on birth suite admission, with adequate discussion and documentation of their wishes encourages informed planning and use of pain relief. This promotes personal choice and control, resulting in improved overall satisfaction of pain relief in labour.展开更多
Background:In today’s society the ongoing discussion about euthanasia triggers emotionally charged debates surrounding the delicate balance between valuing life and respecting an individual’s autonomy.With the persi...Background:In today’s society the ongoing discussion about euthanasia triggers emotionally charged debates surrounding the delicate balance between valuing life and respecting an individual’s autonomy.With the persistence of this debate,there has been the emergence of the concept of the so-called alternative:palliative care.Positioned as a substitute for euthanasia,palliative care aims to alleviate suffering in terminally ill patients without engaging in the ethical dilemmas associated with euthanasia.Methods:This paper explores the facets of palliative care highlighting its core objectives such as providing adequate pain relief as a compassionate alternative to euthanasia.Results:By examining palliative care as a comprehensive approach to end of life support,this study challenges the perceived necessity of euthanasia and advocates,for compassionate and dignified end of life experiences.Conclusion:In conclusion,palliative care emerges as a viable and ethically sound alternative to euthanasia,emphasizing the importance of compassionate end-of-life care and pain management.展开更多
Over the years,electroconductive hydrogels(ECHs)have been extensively applied for stimulating nerve regeneration and restoring locomotor function after peripheral nerve injury(PNI)with diabetes,given their favorable m...Over the years,electroconductive hydrogels(ECHs)have been extensively applied for stimulating nerve regeneration and restoring locomotor function after peripheral nerve injury(PNI)with diabetes,given their favorable mechanical and electrical properties identical to endogenous nerve tissue.Nevertheless,PNI causes the loss of locomotor function and inflammatory pain,especially in diabetic patients.It has been established that bone marrow stem cells-derived exosomes(BMSCs-Exos)have analgesic,anti-inflammatory and tissue regeneration properties.Herein,we designed an ECH loaded with BMSCs-Exos(ECH-Exos)electroconductive nerve dressing to treat diabetic PNI to achieve functional recovery and pain relief.Given its potent adhesive and self-healing properties,this laminar dressing is convenient for the treatment of damaged nerve fibers by automatically wrapping around them to form a size-matched tube-like structure,avoiding the cumbersome implantation process.Our in vitro studies showed that ECH-Exos could facilitate the attachment and migration of Schwann cells.Meanwhile,Exos in this system could modulate M2 macrophage polarization via the NF-κB pathway,thereby attenuating inflammatory pain in diabetic PNI.Additionally,ECH-Exos enhanced myelinated axonal regeneration via the MEK/ERK pathway in vitro and in vivo,consequently ameliorating muscle denervation atrophy and further promoting functional restoration.Our findings suggest that the ECH-Exos system has huge prospects for nerve regeneration,functional restoration and pain relief in patients with diabetic PNI.展开更多
Diabetic neuropathic pain is one of the most difficult to treat with high levels of reoccurrence and a substantial increase with aging. It involves expensive hospitalizations, often resulting in an amputated lower lim...Diabetic neuropathic pain is one of the most difficult to treat with high levels of reoccurrence and a substantial increase with aging. It involves expensive hospitalizations, often resulting in an amputated lower limb. We explored a variety of methods treating neuropathic pain such as low-level laser, monochromatic near-infrared treatment, TENS, acupuncture and pulsed electromagnetic fields that demonstrated inconclusive, limited or temporary pain relief with minor or short-term improvements in mobility. Research conducted by ultra-low energy technologies reports pain relief and reduction of inflammation as a result of anti-oxidant electron donation transforming free radicals into stable molecules. We report the results of a randomized double blind one-year-long longitudinal clinical study on 10 diabetic mellitus (DM) subjects with chronic neuropathy, treated with ultra-low energy nanotechnology who experienced substantial long-term neuropathic pain relief. Importantly, pain analgesia and improvement in neuropathic symptomatology were not age-contingent. This contradicts past research postulating that age-accumulated inflammation and endothelial dysfunction can further exacerbate diabetic neuropathy. Importantly, a method offering age-independent, cost-effective, long-term neuropathic pain relief and increased mobility has major implications in reducing hospitalization time and overall expenses by offering a solution that enhances quality of life.展开更多
Purpose:The aim of this study was to summarize the evidence regarding whether pain reduction in individuals with chronic non-specific low back pain(CNSLBP)following conservative interventions is related to correspondi...Purpose:The aim of this study was to summarize the evidence regarding whether pain reduction in individuals with chronic non-specific low back pain(CNSLBP)following conservative interventions is related to corresponding improvements in balance control.Methods:Randomized controlled trials were identified from 5 databases(MEDLINE,Cochrane Library,Embase,Web of Science,and PsycINFO).Two reviewers independently screened and identified relevant studies that investigated the effects of non-surgical or non-pharmacological CNSLBP treatments on both pain intensity and balance control.Meta-regression analyses were performed to establish the associations between post-treatment changes in these 2 variables.Results:Thirty one studies involving 1280 participants with CNSLBP were included.Moderate-quality evidence suggested that pain reduction was associated with and explained 34%-45%of decreases in body sway,as measured by center-of-pressure(CoP)area and CoP velocity with eyes open.However,no significant association was observed between pain reduction and CoP area or velocity in anteroposterior/mediolateral directions.Similarly,there was no significant association between pain reduction and CoP distance or radius.Low-quality evidence indicated that pain relief explained a 15%improvement in one-leg stance with eyes open but not in the eyes-closed condition.Additionally,very low-quality evidence suggested that pain relief explained a 44%decrease in the static anteroposterior stability index with eyes closed but not in the eyes-open,mediolateral,or overall conditions.Furthermore,low-quality evidence indicated that reduced pain was associated with and accounted for 25%-43%of the improved composite and posteromedial scores of the star-excursion balance test,rather than the anterior and posterolateral scores.Conclusion:Depending on the type of balance assessment,pain relief following conservative interventions may slightly to moderately enhance balance control in individuals with CNSLBP.Clinicians should pay close attention to the balance control in patients with CNSLBP,particularly among older adults.展开更多
Objective： Interventional embolization therapy is well accepted in cancer treatment, but patient may suffer from a moderate-to-severe pain after therapy and its quality of life （QoL） is influenced, this study is to...Objective： Interventional embolization therapy is well accepted in cancer treatment, but patient may suffer from a moderate-to-severe pain after therapy and its quality of life （QoL） is influenced, this study is to observe the efficacy and safety of transdermal fentanyl （TDF） in the management of pain caused by interventional embolization therapy. Methods： Morphine 10mg and TDF 25μg/h were immediately used in 52 patients who had moderate-to-severe pain complicated by interventional embolization therapy, the pain intensity was evaluated by visual analogue scale （VAS）. If VAS≥4 at t2 h after treatment, the dosage of TDF added into 50 μg/h. At 0h, 12h, 24h, 72h, 1 week, 2 weeks after TD, the vas and adverse events were observed respectively. Result： There was an obvious decrease in VAS at 12h after TDF treatment in the patients of which only 9 patients used 50ug/h dosage after partial splenic embolization （PSE） therapy. Most patients got satisfactory pain relief both the TDF 25 μg/h and TDF 50 μg/h group （VAS 0-1）. The adverse events were nausea, vomiting and dizzy, especially in the TDF 50 μg/h group. No respiratory depression was observed and only one patient got retention of urine. Conclusion： TDF was effective and safe in the treatment of moderate-to-severe pain after interventional embolizafion therapy.展开更多
<b>Background & Aims:</b> The multimodal analgesia provides superior pain relief and reduces opioid consumption and its side effects. Gabapentin has been used successfully in multi-modal analgesia in d...<b>Background & Aims:</b> The multimodal analgesia provides superior pain relief and reduces opioid consumption and its side effects. Gabapentin has been used successfully in multi-modal analgesia in different doses. We designed a double-blind randomized control trial to find the minimal effective dose of gabapentin in multimodal analgesia for postoperative pain following total abdominal hysterectomy. <b>Material & Methods:</b> After informed consent, total of 87 patients were randomly assigned to A, B & C groups to receive gabapentin orally 300 mg, 600 mg, and 900 mg respectively one to two hours before surgery. Postoperatively pain was managed by patient-controlled analgesia (PCA) using pethidine. Pain score, opioid consumption, and side effects of gabapentin were monitored. Rescue analgesia was given and monitored. <b>Results:</b> There was no statistically significant difference among the groups with respect to age, weight, height, pethidine consumption, and rescue analgesia. Mean pain scores were statistically insignificant at baseline, 8, 12, and 24 hours postoperatively. Only at 4 hours, the highest pain score (mean) was found in group A, which is statistically significant. The side effects of gabapentin like nausea, vomiting, somnolence, and dizziness were also statistically insignificant. <b>Conclusion:</b> A single preoperative oral gabapentin 300 mg was found to be minimal effective dose in multimodal analgesic regimen for reducing post-operative pain and analgesic requirement following total abdominal hysterectomy.展开更多
To establish an effective method of continuous quality control of acute pain service, a retrospective study on incident reporting during postoperative anal-gesia period was conducted. Incidents were reported and analy...To establish an effective method of continuous quality control of acute pain service, a retrospective study on incident reporting during postoperative anal-gesia period was conducted. Incidents were reported and analyzed in 1507 patients who received epidural postoperative analgesia, and the results of satisfaction of pain relief was compared with those of incident analysis. In this study, an incident was defined as any factor that might or had affected patient's safety during analgesia period. Our results showed that 1203 incidents were reported in 641 of 1507 patients, of which 122 incidents were critical. 78. 3 % of all incidents were detect-ed by acute pain service stuff. The most common incidents included complica-tions, insufficient analgesia and problems with delivery circuits. Human factors were involved in 28. 9 % of the incidents, most being associated with technical failure due to unskillfu1ness, poor communications between APS stuff and pa-tients and lack of cooperation with surgeons and nurses. The general satisfactionrate of the patients was 90. 8 %. There was a very significant difference between the satisfaction of the patients who suffered from incidents and who did not (P<t0.001). It is concluded that incidents affect the satisfaction of the patients who received postoperative pain relief. Incident reporting is a more effective method for quality control of acute pain service.展开更多
Medicine consists first of all in taking care,also in those cases when it is impossible to cure the patients and to restore their good health.In fact,healthcare workers and doctors are increasingly faced with painful ...Medicine consists first of all in taking care,also in those cases when it is impossible to cure the patients and to restore their good health.In fact,healthcare workers and doctors are increasingly faced with painful diseases and end-of-life situations.In these difficult circumstances,it becomes necessary for the doctor to recover a more global vision of the person of the patient,and to understand that the present illness can be read as a metaphor of his/her own existence-since the experience of an entire life manifests and redefines itself in the disease.Empathy and compassion constitute a guide to authentic and effective caring that manifests itself in the language used and in attitudes that become externalized as appropriate behaviours.The doctor must do all he/she can in order to alleviate the patient’s physical and psychological pain,using the tools of caregiving and palliative care.展开更多
Transvaginal oocyte retrieval (TVOR) is a common yet painful procedure in assisted reproductive technologies (ART) like in vitro fertilization (IVF). Effective pain management during and after TVOR is essential, parti...Transvaginal oocyte retrieval (TVOR) is a common yet painful procedure in assisted reproductive technologies (ART) like in vitro fertilization (IVF). Effective pain management during and after TVOR is essential, particularly since anesthesia may influence oocyte quality and treatment outcomes. This case report aims to evaluate the analgesic efficacy of 35 kDa hyaluronan fragments (HA35) to manage TVOR-associated pain. A 40-year-old patient with infertility underwent two TVOR procedures ten months apart under nearly identical preparatory conditions, including a subcutaneous injection of recombinant human chorionic gonadotropin to stimulate oocyte maturation. During the first procedure, pain management consisted of diclofenac sodium suppositories alone, while the second procedure included additional subcutaneous and topical HA35 administration alongside diclofenac sodium. The primary outcome measured was the patient’s self-reported pain level on the Numeric Pain Rating Scale (NPRS), alongside secondary indicators of postoperative recovery and discomfort. Results demonstrated that the addition of HA35 reduced the patient’s pain score by half, shortened the duration of pain, significantly improved comfort, and prevented postoperative bleeding, allowing for immediate discharge. This case suggests that HA35 may offer an effective, low-risk approach to enhance analgesia, reduce side effects, and improve patient recovery in TVOR procedures.展开更多
Objective: to explore the clinical observation of applying high-quality nursing to relieve pain after cesarean section. Methods: a retrospective analysis was made on 80 women who underwent cesarean section in our hosp...Objective: to explore the clinical observation of applying high-quality nursing to relieve pain after cesarean section. Methods: a retrospective analysis was made on 80 women who underwent cesarean section in our hospital from August 2017 to July 2018. They were divided into observation group and control group according to the principle of comparative analysis. The observation group adopted the nursing strategy, while the control group adopted the traditional nursing strategy. The pain score and compliance of the two groups were analyzed. Results: the pain situation of parturients in the observation group was lower than that in the control group, and there was a statistical difference between the two groups. The compliance score of the control group was lower than that of the observation group, and there was a significant difference between the two groups (P < 0.05). Conclusion: the application of high-quality nursing for parturients undergoing cesarean section can improve their compliance and reduce pain.展开更多
Objective: This paper mainly makes a systematic research and Analysis on the specific effect of comprehensive pain reducing delivery nursing measures. Methods: retrospective analysis was mainly adopted. In terms of re...Objective: This paper mainly makes a systematic research and Analysis on the specific effect of comprehensive pain reducing delivery nursing measures. Methods: retrospective analysis was mainly adopted. In terms of research subjects, 160 cases of puerpera collected in our hospital from February 2017 to August 2018 were selected and divided into two groups according to the principle of contrastive analysis: the control group and the observation group, among which the control group adopted traditional delivery nursing measures, and the observation group took comprehensive pain reducing delivery nursing measures in terms of delivery mode and pain control during labor. Results: the clinical nursing effect of the observation group was higher than that of the control group, and the acceptance degree of the comprehensive pain relief delivery nursing measures was higher in the observation group. Conclusion: through systematic research and analysis, it can be found that the pregnant women in the observation group have a high acceptance of comprehensive pain relief delivery nursing measures, and have obvious "pain relief" effect, which is also one of the main reasons for the high acceptance of pregnant women in the observation group, while the pain of pregnant women in the control group has not been well relieved. This shows that the traditional nursing measures can not meet the nursing requirements and needs of pregnant women, and the follow-up of comprehensive pain relief delivery nursing measures is also worthy of great promotion and adoption in clinical obstetrics.展开更多
The nucleus accumbens(NAc)is a subcortical brain structure known primarily for its roles in pleasure,reward,and addiction.Despite less focus on the NAc in pain research,it also plays a large role in the mediation of p...The nucleus accumbens(NAc)is a subcortical brain structure known primarily for its roles in pleasure,reward,and addiction.Despite less focus on the NAc in pain research,it also plays a large role in the mediation of pain and is effective as a source of analgesia.Evidence for this involvement lies in the NAc’s cortical connections,functions,pharmacology,and therapeutic targeting.The NAc projects to and receives information from notable pain structures,such as the prefrontal cortex,anterior cingulate cortex,periaqueductal gray,habenula,thalamus,etc.Additionally,the NAc and other pain-modulating structures share functions involving opioid regulation and motivational and emotional processing,which each work beyond simply the rewarding experience of pain offset.Pharmacologically speaking,the NAc responds heavily to painful stimuli,due to its high density ofμopioid receptors and the activation of several different neurotransmitter systems in the NAc,such as opioids,dopamine,calcitonin gene-related peptide,γ-aminobutyric acid,glutamate,and substance P,each of which have been shown to elicit analgesic effects.In both preclinical and clinical models,deep brain stimulation of the NAc has elicited successful analgesia.The multi-functional NAc is important in motivational behavior,and the motivation for avoiding pain is just as important to survival as the motivation for seeking pleasure.It is possible,then,that the NAc must be involved in both pleasure and pain in order to help determine the motivational salience of positive and negative events.展开更多
We hypothesised a 10 minute mindfulness based intervention performed by a novice therapist would have a beneficial effect on pain responses in naive participants. Twenty-four participants were randomly assigned to the...We hypothesised a 10 minute mindfulness based intervention performed by a novice therapist would have a beneficial effect on pain responses in naive participants. Twenty-four participants were randomly assigned to the control group or mindfulness meditation group. The control group sat quietly for 10 minutes in between two cold pressor tasks. The mindfulness meditation intervention group practiced 10 minutes of mindfulness meditation in between cold-pressor tasks following standardised mindfulness of breathing meditation technique instructions provided by a male investigator. A significant interaction effect was found between anxiety towards pain ratings (pre-intervention vs. post-intervention) and intervention (F = 6.29, p = 0.02). There was a significant decrease (t = 4.07, p = 0.002) in anxiety towards pain ratings in the mindfulness meditation group following intervention. A significant interaction effect was found between pain threshold times (pre-intervention vs. post-intervention) and intervention (F = 18.45, p 0.001) in pain threshold times in the mindfulness meditation group following intervention. A significant interaction effect was found between pain tolerance times (pre-intervention vs. post-intervention) and intervention (F = 18.34, p < 0.001). A significant increase (t = -4.20, p = 0.001) in pain tolerance times in the mindfulness meditation group following intervention was also found. The results suggest a single 10 minute mindfulness meditation intervention administered by a novice therapist can improve pain tolerance, pain threshold and decrease anxiety towards pain in na?ve healthy university aged individuals.展开更多
基金Supported by the Discipline Promotion Program of Shanghai Fourth People’s Hospital,No.SY-XKZT-2021-2006.
文摘BACKGROUND Ultrasound-guided peripherally inserted central catheter(PICC)placement is vital for cancer therapy,but lidocaine infiltration faces limitations like puncture pain and vasospasm.AIM To assess the clinical efficacy of a no-pain intervention-combining compound lidocaine cream with warm compress-in reducing pain during ultrasound-guided PICC placement in cancer patients.METHODS A retrospective cohort study analyzed 88 cancer patients undergoing PICC placement(Shanghai Fourth People’s Hospital,2024).Patients were divided into control(lidocaine infiltration,n=44)and intervention(cream+warm compress,n=44)groups.Primary outcomes:Pain scores(numerical rating scale),procedural time,complications;secondary outcome:Satisfaction.RESULTS The intervention group showed significantly lower pain scores(1.2±0.4 vs 3.8±1.2,P=0.012)with comparable first-attempt success(95.5%vs 90.9%)and safety(P=0.672).Thermal activation of transient receptor potential vanilloid 1 channel enhanced drug penetration,achieving anesthesia within 8-10 minutes.Patient satisfaction reached 97.7%.CONCLUSION The combination of compound lidocaine cream with warm compress significantly alleviates procedural pain and enhances patient satisfaction during ultrasound-guided PICC placement in cancer patients,supporting its clinical application.
文摘This literature review examines the mechanisms of how exercise, specifically in the form of resistance training, may lead to pain relief in the cancer population. Primary data from three different cancer populations: breast, prostate, and lung, will be examined. A number of experimental studies have been conducted to confirm the effectiveness of resistance training on pain relief as well as the biochemical pathways that relate to this process. In this review, we will examine 5 randomized controlled trials. For the purposes of this review, pain is defined as physical suffering or discomfort associated with illness. Pain is the body’s natural signal, bringing attention to damage that has been sustained by tissues. However, chronic pain is common in the cancer population, and often serves no good purpose but instead will negatively impact both physical and mental health. The three types of pain: nociceptive, neuropathic, and inflammatory pathways have been investigated, and the knowledge of pain mechanisms allows for the understanding of how it is associated with pain. The purpose of this exploratory literature review is to give insight on how to maximize pain-relieving effects of resistance training. Research has indicated that resistance training modulates pain pathways by upregulating the release of pain-relieving substances including beta-endorphins, anti-inflammatory cytokines, and endocannabinoids. Understanding of the benefits of resistance training may be useful in relieving cancer pain, and reproducing effects of pain-relieving strategies while minimizing the symptoms related to cancer and its treatment.
文摘The symptom of cancer most feared by many patients is pain. The physical and psychological distress of constant pain without relief should not be underestimated, and all complaints of pain should be actively treated. The clinician should not forget however that drugs used in the treatment of
文摘Bone metastases(BM)are a common complication in advanced cancer patients,significantly contributing to morbidity and mortality due to their ability to cause pain,fractures,and spinal cord compression.Radiation therapy(RT)is vital in managing these complications by targeting metastatic lesions to ease pain,improve mobility,and reduce the risk of skeletal-related events such as fractures.Evidence supports the effectiveness of RT in pain relief,showing its ability to provide significant palliation and lessen the need for opioid painkillers,thereby enhancing the overall quality of life(QoL)for patients with BM.However,optimizing RT outcomes involves considerations such as the choice of radiation technique,dose fractionation schedules,and the integration of supportive care measures to mitigate treatment-related side effects like fatigue and skin reactions.These factors highlight the importance of personalized treatment planning tailored to individual patient needs and tumor characteristics.This mini-review aims to provide comprehensive insights into the multifaceted impacts of RT on pain management and QoL enhancement in BM patients,with implications for refining clinical practices and advancing patient care through the synthesis of findings from various studies.
文摘Objectives:This study sought to examine midwives’utilization of nonpharmacological pain relief measures in labor pain management and to test the relationship between midwives’knowledge and utilization of nonpharmacological pain relief measures for labor pain management in secondary health facility in Calabar,Cross River State,Nigeria.Materials and Methods:A descriptive cross-sectional design was used for the study.The study was rooted in Katherine Kolcaba’s Comfort theory.Totally,67 participants were recruited for the study using the purposive sampling technique.A self-made structured questionnaire was used to obtain participants’information on knowledge,utilization,and predictors of nonpharmacological pain relief measures.Results:Although 41(61.2%)of the participants had knowledge about nonpharmacological pain relief measures,few did not know some of the cognitive-behavioral and environmental measures in labor pain management.There was 35.8%(24/67)for utilization of cognitive-behavioral measures and 55.2%(37/67)for psychological/emotional measures for labor pain management by respondents,respectively.Fifty(74.6%)of respondents agreed that predictors such as lack of knowledge,lack of updates and training,work experience,best practice guidelines,and equipment were hindrances to utilization.There was statistically significance in relationship between the level of knowledge and utilization of nonpharmacological pain relief measures(r=0.6,P<0.05).Conclusion:The utilization of nonpharmacological measures for labor pain management is low,thus it is recommended that frequent education,training updates on effective labor pain management,provision of clinical guidelines on labor pain management,and enrichment of midwifery training curriculum are imperative to ensure quality labor pain management and positive health outcome.
文摘Objective: To compare 3 local field radiation therapies for bone metastases to determine the strategy producing the best results. Methods: Among 104 patients with bone metastases, 30 patients were given 8 Gy in single fraction, 31 given 20 Gy in 5 fractions, 43 given 40 Gy in 20 fractions. Results and Conclusion: The method of 40 Gy in 20 fractions had a higher pain relief rate and a lower pain relapse rate, suggesting that large-dose fractioned treatment regimen is more appropriate for patients with bone metastasis.
文摘Background: Pain in labour is perceived differently for every individual. We can improve the outcomes and patient satisfaction with intrapartum care by ensuring adequate education and appropriate use of requested pain relief options. Encouraging informed personal control contributes to a women’s overall satisfaction. Aims: To assess current practice and identify improvement areas in the perception, planning and use of pain relief options, and how this impacts satisfaction of pain relief in labour. Methods: 114 retrospective anonymous patient questionnaires were returned by women delivering by spontaneous vaginal delivery, instrumental delivery or emergency caesarean section at Nambour General Hospital between April and July 2011. Data were collated and analysed using STATA. Results: 83% and 65% of women had their pain relief options explained antenatally and on admission respectively. 92% reported their pain relief was adequately provided. There was a significant difference (p Conclusions: Education of pain relief options for labour antenatally and on birth suite admission, with adequate discussion and documentation of their wishes encourages informed planning and use of pain relief. This promotes personal choice and control, resulting in improved overall satisfaction of pain relief in labour.
文摘Background:In today’s society the ongoing discussion about euthanasia triggers emotionally charged debates surrounding the delicate balance between valuing life and respecting an individual’s autonomy.With the persistence of this debate,there has been the emergence of the concept of the so-called alternative:palliative care.Positioned as a substitute for euthanasia,palliative care aims to alleviate suffering in terminally ill patients without engaging in the ethical dilemmas associated with euthanasia.Methods:This paper explores the facets of palliative care highlighting its core objectives such as providing adequate pain relief as a compassionate alternative to euthanasia.Results:By examining palliative care as a comprehensive approach to end of life support,this study challenges the perceived necessity of euthanasia and advocates,for compassionate and dignified end of life experiences.Conclusion:In conclusion,palliative care emerges as a viable and ethically sound alternative to euthanasia,emphasizing the importance of compassionate end-of-life care and pain management.
基金supported by the President Foundation of Nanfang Hospital,Southern Medical University(2020C024)the Natural Science Foundation of Fujian Province(2021J011156).
文摘Over the years,electroconductive hydrogels(ECHs)have been extensively applied for stimulating nerve regeneration and restoring locomotor function after peripheral nerve injury(PNI)with diabetes,given their favorable mechanical and electrical properties identical to endogenous nerve tissue.Nevertheless,PNI causes the loss of locomotor function and inflammatory pain,especially in diabetic patients.It has been established that bone marrow stem cells-derived exosomes(BMSCs-Exos)have analgesic,anti-inflammatory and tissue regeneration properties.Herein,we designed an ECH loaded with BMSCs-Exos(ECH-Exos)electroconductive nerve dressing to treat diabetic PNI to achieve functional recovery and pain relief.Given its potent adhesive and self-healing properties,this laminar dressing is convenient for the treatment of damaged nerve fibers by automatically wrapping around them to form a size-matched tube-like structure,avoiding the cumbersome implantation process.Our in vitro studies showed that ECH-Exos could facilitate the attachment and migration of Schwann cells.Meanwhile,Exos in this system could modulate M2 macrophage polarization via the NF-κB pathway,thereby attenuating inflammatory pain in diabetic PNI.Additionally,ECH-Exos enhanced myelinated axonal regeneration via the MEK/ERK pathway in vitro and in vivo,consequently ameliorating muscle denervation atrophy and further promoting functional restoration.Our findings suggest that the ECH-Exos system has huge prospects for nerve regeneration,functional restoration and pain relief in patients with diabetic PNI.
文摘Diabetic neuropathic pain is one of the most difficult to treat with high levels of reoccurrence and a substantial increase with aging. It involves expensive hospitalizations, often resulting in an amputated lower limb. We explored a variety of methods treating neuropathic pain such as low-level laser, monochromatic near-infrared treatment, TENS, acupuncture and pulsed electromagnetic fields that demonstrated inconclusive, limited or temporary pain relief with minor or short-term improvements in mobility. Research conducted by ultra-low energy technologies reports pain relief and reduction of inflammation as a result of anti-oxidant electron donation transforming free radicals into stable molecules. We report the results of a randomized double blind one-year-long longitudinal clinical study on 10 diabetic mellitus (DM) subjects with chronic neuropathy, treated with ultra-low energy nanotechnology who experienced substantial long-term neuropathic pain relief. Importantly, pain analgesia and improvement in neuropathic symptomatology were not age-contingent. This contradicts past research postulating that age-accumulated inflammation and endothelial dysfunction can further exacerbate diabetic neuropathy. Importantly, a method offering age-independent, cost-effective, long-term neuropathic pain relief and increased mobility has major implications in reducing hospitalization time and overall expenses by offering a solution that enhances quality of life.
基金supported by GP Batteries Industrial Safety Trust Fund(Funding number:R-ZDDR).
文摘Purpose:The aim of this study was to summarize the evidence regarding whether pain reduction in individuals with chronic non-specific low back pain(CNSLBP)following conservative interventions is related to corresponding improvements in balance control.Methods:Randomized controlled trials were identified from 5 databases(MEDLINE,Cochrane Library,Embase,Web of Science,and PsycINFO).Two reviewers independently screened and identified relevant studies that investigated the effects of non-surgical or non-pharmacological CNSLBP treatments on both pain intensity and balance control.Meta-regression analyses were performed to establish the associations between post-treatment changes in these 2 variables.Results:Thirty one studies involving 1280 participants with CNSLBP were included.Moderate-quality evidence suggested that pain reduction was associated with and explained 34%-45%of decreases in body sway,as measured by center-of-pressure(CoP)area and CoP velocity with eyes open.However,no significant association was observed between pain reduction and CoP area or velocity in anteroposterior/mediolateral directions.Similarly,there was no significant association between pain reduction and CoP distance or radius.Low-quality evidence indicated that pain relief explained a 15%improvement in one-leg stance with eyes open but not in the eyes-closed condition.Additionally,very low-quality evidence suggested that pain relief explained a 44%decrease in the static anteroposterior stability index with eyes closed but not in the eyes-open,mediolateral,or overall conditions.Furthermore,low-quality evidence indicated that reduced pain was associated with and accounted for 25%-43%of the improved composite and posteromedial scores of the star-excursion balance test,rather than the anterior and posterolateral scores.Conclusion:Depending on the type of balance assessment,pain relief following conservative interventions may slightly to moderately enhance balance control in individuals with CNSLBP.Clinicians should pay close attention to the balance control in patients with CNSLBP,particularly among older adults.
文摘Objective： Interventional embolization therapy is well accepted in cancer treatment, but patient may suffer from a moderate-to-severe pain after therapy and its quality of life （QoL） is influenced, this study is to observe the efficacy and safety of transdermal fentanyl （TDF） in the management of pain caused by interventional embolization therapy. Methods： Morphine 10mg and TDF 25μg/h were immediately used in 52 patients who had moderate-to-severe pain complicated by interventional embolization therapy, the pain intensity was evaluated by visual analogue scale （VAS）. If VAS≥4 at t2 h after treatment, the dosage of TDF added into 50 μg/h. At 0h, 12h, 24h, 72h, 1 week, 2 weeks after TD, the vas and adverse events were observed respectively. Result： There was an obvious decrease in VAS at 12h after TDF treatment in the patients of which only 9 patients used 50ug/h dosage after partial splenic embolization （PSE） therapy. Most patients got satisfactory pain relief both the TDF 25 μg/h and TDF 50 μg/h group （VAS 0-1）. The adverse events were nausea, vomiting and dizzy, especially in the TDF 50 μg/h group. No respiratory depression was observed and only one patient got retention of urine. Conclusion： TDF was effective and safe in the treatment of moderate-to-severe pain after interventional embolizafion therapy.
文摘<b>Background & Aims:</b> The multimodal analgesia provides superior pain relief and reduces opioid consumption and its side effects. Gabapentin has been used successfully in multi-modal analgesia in different doses. We designed a double-blind randomized control trial to find the minimal effective dose of gabapentin in multimodal analgesia for postoperative pain following total abdominal hysterectomy. <b>Material & Methods:</b> After informed consent, total of 87 patients were randomly assigned to A, B & C groups to receive gabapentin orally 300 mg, 600 mg, and 900 mg respectively one to two hours before surgery. Postoperatively pain was managed by patient-controlled analgesia (PCA) using pethidine. Pain score, opioid consumption, and side effects of gabapentin were monitored. Rescue analgesia was given and monitored. <b>Results:</b> There was no statistically significant difference among the groups with respect to age, weight, height, pethidine consumption, and rescue analgesia. Mean pain scores were statistically insignificant at baseline, 8, 12, and 24 hours postoperatively. Only at 4 hours, the highest pain score (mean) was found in group A, which is statistically significant. The side effects of gabapentin like nausea, vomiting, somnolence, and dizziness were also statistically insignificant. <b>Conclusion:</b> A single preoperative oral gabapentin 300 mg was found to be minimal effective dose in multimodal analgesic regimen for reducing post-operative pain and analgesic requirement following total abdominal hysterectomy.
文摘To establish an effective method of continuous quality control of acute pain service, a retrospective study on incident reporting during postoperative anal-gesia period was conducted. Incidents were reported and analyzed in 1507 patients who received epidural postoperative analgesia, and the results of satisfaction of pain relief was compared with those of incident analysis. In this study, an incident was defined as any factor that might or had affected patient's safety during analgesia period. Our results showed that 1203 incidents were reported in 641 of 1507 patients, of which 122 incidents were critical. 78. 3 % of all incidents were detect-ed by acute pain service stuff. The most common incidents included complica-tions, insufficient analgesia and problems with delivery circuits. Human factors were involved in 28. 9 % of the incidents, most being associated with technical failure due to unskillfu1ness, poor communications between APS stuff and pa-tients and lack of cooperation with surgeons and nurses. The general satisfactionrate of the patients was 90. 8 %. There was a very significant difference between the satisfaction of the patients who suffered from incidents and who did not (P<t0.001). It is concluded that incidents affect the satisfaction of the patients who received postoperative pain relief. Incident reporting is a more effective method for quality control of acute pain service.
文摘Medicine consists first of all in taking care,also in those cases when it is impossible to cure the patients and to restore their good health.In fact,healthcare workers and doctors are increasingly faced with painful diseases and end-of-life situations.In these difficult circumstances,it becomes necessary for the doctor to recover a more global vision of the person of the patient,and to understand that the present illness can be read as a metaphor of his/her own existence-since the experience of an entire life manifests and redefines itself in the disease.Empathy and compassion constitute a guide to authentic and effective caring that manifests itself in the language used and in attitudes that become externalized as appropriate behaviours.The doctor must do all he/she can in order to alleviate the patient’s physical and psychological pain,using the tools of caregiving and palliative care.
文摘Transvaginal oocyte retrieval (TVOR) is a common yet painful procedure in assisted reproductive technologies (ART) like in vitro fertilization (IVF). Effective pain management during and after TVOR is essential, particularly since anesthesia may influence oocyte quality and treatment outcomes. This case report aims to evaluate the analgesic efficacy of 35 kDa hyaluronan fragments (HA35) to manage TVOR-associated pain. A 40-year-old patient with infertility underwent two TVOR procedures ten months apart under nearly identical preparatory conditions, including a subcutaneous injection of recombinant human chorionic gonadotropin to stimulate oocyte maturation. During the first procedure, pain management consisted of diclofenac sodium suppositories alone, while the second procedure included additional subcutaneous and topical HA35 administration alongside diclofenac sodium. The primary outcome measured was the patient’s self-reported pain level on the Numeric Pain Rating Scale (NPRS), alongside secondary indicators of postoperative recovery and discomfort. Results demonstrated that the addition of HA35 reduced the patient’s pain score by half, shortened the duration of pain, significantly improved comfort, and prevented postoperative bleeding, allowing for immediate discharge. This case suggests that HA35 may offer an effective, low-risk approach to enhance analgesia, reduce side effects, and improve patient recovery in TVOR procedures.
文摘Objective: to explore the clinical observation of applying high-quality nursing to relieve pain after cesarean section. Methods: a retrospective analysis was made on 80 women who underwent cesarean section in our hospital from August 2017 to July 2018. They were divided into observation group and control group according to the principle of comparative analysis. The observation group adopted the nursing strategy, while the control group adopted the traditional nursing strategy. The pain score and compliance of the two groups were analyzed. Results: the pain situation of parturients in the observation group was lower than that in the control group, and there was a statistical difference between the two groups. The compliance score of the control group was lower than that of the observation group, and there was a significant difference between the two groups (P < 0.05). Conclusion: the application of high-quality nursing for parturients undergoing cesarean section can improve their compliance and reduce pain.
文摘Objective: This paper mainly makes a systematic research and Analysis on the specific effect of comprehensive pain reducing delivery nursing measures. Methods: retrospective analysis was mainly adopted. In terms of research subjects, 160 cases of puerpera collected in our hospital from February 2017 to August 2018 were selected and divided into two groups according to the principle of contrastive analysis: the control group and the observation group, among which the control group adopted traditional delivery nursing measures, and the observation group took comprehensive pain reducing delivery nursing measures in terms of delivery mode and pain control during labor. Results: the clinical nursing effect of the observation group was higher than that of the control group, and the acceptance degree of the comprehensive pain relief delivery nursing measures was higher in the observation group. Conclusion: through systematic research and analysis, it can be found that the pregnant women in the observation group have a high acceptance of comprehensive pain relief delivery nursing measures, and have obvious "pain relief" effect, which is also one of the main reasons for the high acceptance of pregnant women in the observation group, while the pain of pregnant women in the control group has not been well relieved. This shows that the traditional nursing measures can not meet the nursing requirements and needs of pregnant women, and the follow-up of comprehensive pain relief delivery nursing measures is also worthy of great promotion and adoption in clinical obstetrics.
文摘The nucleus accumbens(NAc)is a subcortical brain structure known primarily for its roles in pleasure,reward,and addiction.Despite less focus on the NAc in pain research,it also plays a large role in the mediation of pain and is effective as a source of analgesia.Evidence for this involvement lies in the NAc’s cortical connections,functions,pharmacology,and therapeutic targeting.The NAc projects to and receives information from notable pain structures,such as the prefrontal cortex,anterior cingulate cortex,periaqueductal gray,habenula,thalamus,etc.Additionally,the NAc and other pain-modulating structures share functions involving opioid regulation and motivational and emotional processing,which each work beyond simply the rewarding experience of pain offset.Pharmacologically speaking,the NAc responds heavily to painful stimuli,due to its high density ofμopioid receptors and the activation of several different neurotransmitter systems in the NAc,such as opioids,dopamine,calcitonin gene-related peptide,γ-aminobutyric acid,glutamate,and substance P,each of which have been shown to elicit analgesic effects.In both preclinical and clinical models,deep brain stimulation of the NAc has elicited successful analgesia.The multi-functional NAc is important in motivational behavior,and the motivation for avoiding pain is just as important to survival as the motivation for seeking pleasure.It is possible,then,that the NAc must be involved in both pleasure and pain in order to help determine the motivational salience of positive and negative events.
文摘We hypothesised a 10 minute mindfulness based intervention performed by a novice therapist would have a beneficial effect on pain responses in naive participants. Twenty-four participants were randomly assigned to the control group or mindfulness meditation group. The control group sat quietly for 10 minutes in between two cold pressor tasks. The mindfulness meditation intervention group practiced 10 minutes of mindfulness meditation in between cold-pressor tasks following standardised mindfulness of breathing meditation technique instructions provided by a male investigator. A significant interaction effect was found between anxiety towards pain ratings (pre-intervention vs. post-intervention) and intervention (F = 6.29, p = 0.02). There was a significant decrease (t = 4.07, p = 0.002) in anxiety towards pain ratings in the mindfulness meditation group following intervention. A significant interaction effect was found between pain threshold times (pre-intervention vs. post-intervention) and intervention (F = 18.45, p 0.001) in pain threshold times in the mindfulness meditation group following intervention. A significant interaction effect was found between pain tolerance times (pre-intervention vs. post-intervention) and intervention (F = 18.34, p < 0.001). A significant increase (t = -4.20, p = 0.001) in pain tolerance times in the mindfulness meditation group following intervention was also found. The results suggest a single 10 minute mindfulness meditation intervention administered by a novice therapist can improve pain tolerance, pain threshold and decrease anxiety towards pain in na?ve healthy university aged individuals.
