Objective:To explore the clinical effect of multimodal nursing intervention on postoperative pain management in patients undergoing gastrointestinal surgery.Methods:A total of 120 patients who underwent gastrointestin...Objective:To explore the clinical effect of multimodal nursing intervention on postoperative pain management in patients undergoing gastrointestinal surgery.Methods:A total of 120 patients who underwent gastrointestinal surgery in our hospital from January 2023 to January 2024 were selected as the research subjects.They were randomly divided into the intervention group and the control group,with 60 cases in each group.The control group received routine postoperative care,while the intervention group received multimodal pain care intervention.The postoperative pain scores,the rate of using analgesic drugs,postoperative recovery indicators,and nursing satisfaction were compared between the two groups.Results:At 24 hours,48 hours,and 72 hours after surgery,the VAS pain scores of the intervention group were significantly lower than those of the control group(p<0.05);the rate of using analgesic drugs in the intervention group(25.0%)was significantly lower than that in the control group(48.3%)(p<0.05);the first defecation time,first ambulation time,and hospital stay of the intervention group were shorter than those of the control group(p<0.05);the nursing satisfaction of the intervention group(96.7%)was significantly higher than that of the control group(80.0%)(p<0.05).Conclusion:Multimodal pain care intervention can effectively relieve postoperative pain in patients undergoing gastrointestinal surgery,reduce the use of analgesic drugs,promote postoperative recovery,and improve nursing satisfaction.展开更多
Objective:This study was designed to determine the nurse assessment of postoperative pain and its management in selected hospitals,Benin City,Edo State,Nigeria.Materials and Methods:A descriptive cross-sectional surve...Objective:This study was designed to determine the nurse assessment of postoperative pain and its management in selected hospitals,Benin City,Edo State,Nigeria.Materials and Methods:A descriptive cross-sectional survey was adopted.The target population consist of 222 purposely nurses who are in the cadre of nursing officer II to chief nursing officer who works in the various surgical wards/units of the selected health facilities.The data were collected from the participants using the pretested structured questionnaire developed by the researcher.Results:Results showed that 66.2%of nurses had a poor level of knowledge on postoperative pain assessment.The McGill Pain Questionnaire was the most used pain assessment tool with a mean score of 2.84 whereas the Dallas Pain Questionnaire was the least used with a mean score of 1.90.“Providing clean,calm,and well-ventilated ward environment”(3.69±0.61)was the most used nonpharmacological method for postoperative pain management,followed by“distraction,relaxation,and guided imagery”(3.52±0.50),“dressing,bandage,splint,and reinforce wound sites postoperatively”(3.39±0.54),and“early ambulation/exercise”(3.20±0.62).The most used pharmacological interventions were“acetaminophen”(3.63±0.55),“topical anesthetic”(2.92±0.62),“nonselective nonsteroidal anti-inflammatory drugs”(2.87±0.43),and“mixed opioid agonist-antagonist”(2.56±0.56).Conclusion:There is a poor level of knowledge on postoperative pain assessment among nurses in this study setting.It is,therefore,pertinent for hospitals to organize continuous in-service training for postoperative pain assessment and management,especially on nonpharmacological approaches among nurses.展开更多
Objective To evaluate the changes in postoperative plasmaβ-endorphin(β-EP)levels in patients who had received perioperative electroacupuncture(EA)treatment in 10 randomized controlled trials(RCTs)and examine the imp...Objective To evaluate the changes in postoperative plasmaβ-endorphin(β-EP)levels in patients who had received perioperative electroacupuncture(EA)treatment in 10 randomized controlled trials(RCTs)and examine the impact of EA on postoperative pain.Methods This meta-analysis evaluated the changes in plasmaβ-EP levels and visual analog scale(VAS)12,24 and 48 hours after surgery in patients receiving perioperative EA.It also assessed the changes in plasma serotonin(5-hydroxytryptamine,5-HT)and prostaglandin E2(PGE2)levels at 24 hours postsurgery.A comprehensive search was conducted in the China National Knowledge Infrastructure(CNKI),Wanfang,Chongqing VIP database,Chinese Biomedical Database(CBM),Web of Science,and PubMed databases.RCTs on perioperative EA andβ-EP published from the inception of the websites up to July 25,2023,were retrieved.Effect size aggregation,literature quality assessment,and bias analysis were performed using RevMan 5.3 software,and sensitivity analysis was conducted via R 4.3.1.Results A total of 10 RCTs involving 706 patients were included.EA in conjunction with conventional anesthesia significantly increased plasmaβ-EP levels at 12 hours postsurgery[standard mean difference(SMD)=2.79,95%CI(1.85,3.72),Z=5.81,P<0.00001],24 hours postsurgery[SMD=1.87,95%CI(0.9,2.83),Z=3.79,P=0.0001],and 48 hours postsurgery[SMD=2.02,95%CI(1.49,2.54),Z=7.50,P<0.00001].EA reduced plasma PGE2 levels at 24 hours postsurgery and plasma 5-HT levels at 24 hours postsurgery,and the VAS at 12,24 and 48 hours after surgery also decreased.Conclusion These findings suggest that perioperative EA markedly elevates plasmaβ-EP levels,reduces pain-inducing factors in plasma,and effectively alleviates acute postoperative pain.展开更多
BACKGROUND Abdominal aortic aneurysm(AAA)repair often involves significant postoperative pain,traditionally managed with systemic opioids,which can cause undesirable side effects.This case report explores the novel us...BACKGROUND Abdominal aortic aneurysm(AAA)repair often involves significant postoperative pain,traditionally managed with systemic opioids,which can cause undesirable side effects.This case report explores the novel use of a surgically-initiated rectus sheath block with a catheter-over-needle assembly for pain management in AAA repair.CASE SUMMARY A 67-year-old female with hypertension and previous aortic dissection underwent elective open repair of an infrarenal AAA,which had grown from 3.4 cm to 4.3 cm over 14 months.A rectus sheath block was initiated surgically for postoperative pain control.The patient reported low pain scores and did not require systemic intravenous opioids,enabling early ambulation and discharge on postoperative day seven without complications.By preventing complications of systemic opi-oids,the method indicating a promising direction for postoperative pain management in major vascular surgeries.CONCLUSION Surgically-initiated rectus sheath block as a valuable tool for managing postoperative pain in AAA repair.展开更多
Postoperative pain is an acute pain that appears due to the surgical act, reaching its maximum intensity in the first 24 - 48 hours after surgery. Postoperative pain control reduces possible postoperative complication...Postoperative pain is an acute pain that appears due to the surgical act, reaching its maximum intensity in the first 24 - 48 hours after surgery. Postoperative pain control reduces possible postoperative complications, as well as the patient’s stay in the medical institution. Objective: This study compared the effectiveness and side effects of oral transmucosal fentanyl citrate (OTFC) with IV morphine in the control of postoperative pain. Methods: Seventy-three patients (Fentanyl group: 27, morphine group: 46) were included. Changes in pain were evaluated with Visual Analog Scale (VAS) and Pain Relief Scale, Pain Intensity Differences (PID), Sum of Pain Intensity Differences (SPID), and Total Pain Relief (TOTPAR). At time zero, 15, 30, 45 min and 1, 2, 3, 4, 5 and 6 h. Results: The decrease in pain intensity measured by VAS was similar in both groups with no significant differences at any of the measurement points. Both products produced a significant increase in the Pain Relief scale, with no differences between groups at any of the measurement times. There were no differences between groups when comparing PID. Comparing SPID between groups, there were no differences at 15, 30 minutes, then there were significant differences in favor of the Fentanyl group up to 6 hours. Both products produced a significant increase in the TOPAR scale, with no differences between groups at any of the measurement times. The appearance of adverse effects was similar in both groups. Conclusions: Both products produced a significant reduction in the measures of pain intensity (VAS), increase of SPID, as well as a significant increase in the Pain Relief scale, a significant increase in the TOPAR scale, with no differences between the groups. The number of adverse effects was similar. The convenience of OTFC administration allows its administration without the special conditions needed for the administration of IV morphine.展开更多
OBJECTIVE:To explore the clinical efficacy of the Chinese medicine,Neibu Huangqi Youhua formula(内补黄芪汤优化方)combined with Kangfuxin solution(康复新液)for the nursing of patients after anal fistula surgery.METHODS...OBJECTIVE:To explore the clinical efficacy of the Chinese medicine,Neibu Huangqi Youhua formula(内补黄芪汤优化方)combined with Kangfuxin solution(康复新液)for the nursing of patients after anal fistula surgery.METHODS:A total of 160 cases with anal fistula who underwent surgical treatment were recruited,and divided into control group(treated with external application of Kangfuxin liquid gauze)and experimental group(receiving the Neibu Huangqi Youhua formula combined with Kangfuxin liquid gauze)based on a random numbering table.The wound recovery,postoperative pain and inflammation were evaluated and compared between the two groups.RESULTS:At 3,7,and 14 d after the operation,the wound healing rate of the experimental group was significantly higher than that of the control group at any time point.The visual analogue scale scores of the two groups gradually decreased in a time-dependent manner after surgery,while the experimental group showed a more significant downward trend in comparison with the control group.At 14 d after the operation,the experimental group had high levels of epidermal growth factor,fibroblast growth factor-1,secretory Ig A,tissue inhibitor of matrix metalloproteinase-1,5-hydroxytryptamine,prostaglandin E-2,substances P and neuropeptide Y compared with control group,but low levels of C-reactive protein,procalcitonin,and serum amyloid A protein.CONCLUSIONS:The Neibu Huangqi Youhua formula can reduce the levels of inflammatory factors and pain mediators in patients after anal fistula surgery,thereby accelerating the process of wound healing and alleviating the pain of patients.展开更多
Background:To comprehensively analyze the clinical characteristics of patients who underwent gastric endoscopic submucosal dissection(ESD)and explore the incidence and influencing factors of postoperative pain.Methods...Background:To comprehensively analyze the clinical characteristics of patients who underwent gastric endoscopic submucosal dissection(ESD)and explore the incidence and influencing factors of postoperative pain.Methods:The clinical data of patients who underwent gastric ESD at our center from 2009 to 2024 were retrospectively analyzed.Pain severity was assessed using a visual analogue scale,with a score≥4 defined as postoperative pain.Based on the presence or absence of postoperative pain,patients were divided into a pain group and a control group.Independent factors influencing postoperative pain were identified using multivariate logistic regression analysis.To control for confounding bias,patients in the case and control groups were matched by sex and lesion size,and the matched participants were further analyzed using a conditional logistic regression model.Results:In total,993 patients were analyzed.The incidence of postoperative pain was 9.1%(95%confidence interval[CI],7.3-11.1).In the univariate analysis,sex,operation duration,anesthesia method,intraoperative electrocoagulation,nasogastric tube placement,and postoperative vomiting were significantly associated with postoperative pain.Multivariate analysis identified eight independent factors:male sex(odds ratio[OR],0.61;95%CI,0.37-0.97;p=0.04),operation duration(OR,1.29;95%CI,1.03-1.63;p=0.02),protuberant lesions(OR,0.43;95%CI,0.26-0.71;p<0.01),antral lesions(OR,1.84;95%CI,1.10-3.05;p=0.01),intubation general anesthesia(OR,0.40;95%CI,0.22-0.72;p=0.002),intraoperative electrocoagulation(OR,0.32;95%CI,0.19-0.55;p<0.01),nasogastric tube placement(OR,2.005;95%CI,1.12-3.57;p=0.01),and postoperative vomiting(OR,3.24;95%CI,1.40-7.47;p=0.005).Conditional logistic regression analysis further identified diabetes mellitus(OR,2.50;95%CI,1.03-6.06;p=0.04).Conclusion:Female sex,diabetes mellitus,concave-type lesions,lesions in the gastric antrum,non-intubation general anesthesia,absence of intraoperative electrocoagulation,prolonged operation duration,nasogastric tube placement,and postoperative vomiting were independent factors associated with moderate to severe pain after gastric ESD.For patients at increased risk of postoperative pain,appropriate prophylactic and therapeutic measures during the perioperative period may effectively alleviate pain following gastric ESD.展开更多
This editorial highlights the randomized controlled trial by Qian et al evaluating the efficacy of nalbuphine in managing postoperative pain and associated inflammatory factors in patients undergoing radical gastrecto...This editorial highlights the randomized controlled trial by Qian et al evaluating the efficacy of nalbuphine in managing postoperative pain and associated inflammatory factors in patients undergoing radical gastrectomy for gastric cancer.Utilizing a multimodal analgesic approach with a controlled analgesia pump and a transverse abdominis muscle plane block,the study compared nalbuphine against sufentanil.Results indicate that nalbuphine significantly reduces pain scores at various postoperative intervals,decreases consumption and patientcontrolled analgesia presses,and lowers levels of pain markers such as prostaglandin E2,serotonin,and substance P.While both agents demonstrated effective pain control,nalbuphine was associated with a lower incidence of adverse effects,suggesting its potential as a valuable alternative in appropriate clinical scenarios.This study offers valuable insights into nalbuphine’s clinical applicability,underscoring its benefits for pain management and enhancing patient recovery in the postoperative setting.展开更多
BACKGROUND Anxiety,depression,and postoperative pain are common in patients with hip joint disorders and are associated with compromised functional outcomes and delayed recovery.AIM To investigate the prevalence of an...BACKGROUND Anxiety,depression,and postoperative pain are common in patients with hip joint disorders and are associated with compromised functional outcomes and delayed recovery.AIM To investigate the prevalence of anxiety and depression among geriatric patients who underwent total hip arthroplasty(THA),explored their association with postoperative pain,and identified contributing risk factors.METHODS A total of 111 geriatric patients who underwent THA between January 2021 and January 2024 were included.Standardized psychological assessment tools-including the Zung Self-Rating Anxiety Scale(SAS)and the Zung Self-Rating Depression Scale(SDS)-and the Numeric Rating Scale(NRS)for pain quantification were systematically administered.Pearson correlation analysis was utilized to explore the relationships among SAS,SDS,and NRS scores.Univariate and multivariate binary logistic regression analyses were conducted to identify risk factors for anxiety and depression in these patients.RESULTS The cohort exhibited moderate anxiety(SAS:44.23±9.03),mild depression(SDS:46.98±9.15),and moderate postoperative pain(NRS:4.93±2.37).Patients with anxiety or depression reported significantly higher NRS scores than those without these conditions.Significant positive correlations were observed between SAS and SDS scores,as well as between each of these and NRS scores.Univariate analysis revealed that gender,age,disease duration,alcohol use,diabetes history,and NRS scores were significantly associated with anxiety and depression.Multivariate analysis further identified female gender,disease duration≥2 years,alcohol use,and NRS scores≥5 as independent predictors of postoperative psychological distress.CONCLUSION Anxiety and depression are closely linked with postoperative pain in geriatric patients post-THA recovery.Early psychological screening and multimodal pain management strategies are recommended-particularly for individuals with a disease duration of≥2 years,a history of alcohol consumption,or an NRS score of≥5,as well as female patients-to effectively mitigate their negative emotional states and improve postoperative recovery.展开更多
BACKGROUND Limited evidence exists regarding the role of enhanced recovery after surgery(ERAS)protocols in optimizing pain management and functional recovery after colorectal cancer(CRC)surgery.AIM To evaluate the imp...BACKGROUND Limited evidence exists regarding the role of enhanced recovery after surgery(ERAS)protocols in optimizing pain management and functional recovery after colorectal cancer(CRC)surgery.AIM To evaluate the impact of ERAS protocols on postoperative pain management and functional recovery in patients undergoing CRC surgery.METHODS A total of 109 patients with CRC admitted to The Third Affiliated Hospital of Jinzhou Medical University between June 2021 and June 2024 were enrolled in this study.They were divided into two groups:A control group(n=50)receiving standard perioperative care and an observation group(n=59)managed under an ERAS protocol.Clinical outcomes,including postoperative pain intensity[assessed using the Visual Analogue Scale(VAS)],functional recovery indicators(time to first ambulation,bowel sound recovery,first anal gas discharge,and first defecation),average sleep duration on postoperative day 3,sleep quality(measured using the Pittsburgh Sleep Quality Index),length of hospitalization,quality of life(evaluated using the Short Form 36 Health Survey),and incidence of postoperative complications(e.g.,surgical site infection,pulmonary infection,abdominal distension/pain,and intestinal obstruction),were systematically compared between the two groups.RESULTS The observation group exhibited significantly lower VAS scores at 72 hours postoperatively,shorter durations of maximum VAS scores,earlier recovery of functional indicators(time to first ambulation,bowel sound recovery,first anal gas discharge,and first defecation),and shorter hospitalization compared with the control group.Additionally,average sleep duration on postoperative day 3 was significantly longer in the observation group.Furthermore,the observation group demonstrated significantly improved sleep quality(lower Pittsburgh Sleep Quality Index scores)and higher quality of life(higher Short Form 36 Health Survey scores across all domains)than both the baseline and control groups.The incidence of total postoperative complications was also significantly lower in the observation group than in the control group.CONCLUSION ERAS protocols are highly effective in relieving postoperative pain,accelerating functional recovery,and improving overall clinical outcomes in patients with CRC undergoing surgery,supporting their broader clinical application.展开更多
Objective:To conduct a scoping review on the application status of the Functional Activity Score(FAS)in postoperative active pain management in China,providing a reference for its standardized and normative promotion....Objective:To conduct a scoping review on the application status of the Functional Activity Score(FAS)in postoperative active pain management in China,providing a reference for its standardized and normative promotion.Methods:Computerized searches of Chinese and English databases were performed to collect studies published by Chinese scholars from 2005 to July 2025 on the application of FAS in postoperative active pain management.After strict screening,the basic characteristics,application fields,assessment models,evaluation timing,types of functional activities,and clinical outcomes of the included literature were systematically analyzed.Results:A total of 18 studies were included,involving surgical types such as thoracic surgery,general surgery,and orthopedics.All studies adopted FAS combined with the Numeric Rating Scale(NRS)for assessment,with evaluation timing mostly concentrated within 72 hours postoperatively.The selected functional activities primarily included respiration-related and limb movements.Evaluation indicators covered pain control,functional recovery,complications,adverse events,patient experience,and tool assessment,with most studies reporting positive outcomes.Conclusion:FAS can effectively enhance pain control and promote functional recovery in postoperative active pain management in China,demonstrating high clinical value.However,existing studies exhibit inconsistencies in assessment criteria,selection of activity types,and research quality.展开更多
Objective To explore the effectiveness of treating postoperative pain of mixed hemorrhoid by embedding needles in Erbai （二白EX-UE 2） and find possible ways for relieving postoperative pain of mixed hemorrhoids. Met...Objective To explore the effectiveness of treating postoperative pain of mixed hemorrhoid by embedding needles in Erbai （二白EX-UE 2） and find possible ways for relieving postoperative pain of mixed hemorrhoids. Methods press needle （SEIRIN pyonexes） were embedded in EX-UE 2 of patients with postoperative pain of mixed hemorrhoid, once a day and totally 7 treatments. Visual analogue scale （VAS） values were adopted for evaluation. Results Complete remission of clinical pain was observed in 34 cases, accounting for 50.00%; significantly effective in 19 cases, accounting for 27.94%; effective in 13 cases, accounting for 19.12%; and ineffective in 2 cases, accounting for 2.94%; the total effective rate was 97.06%. Conclusion The therapy of treating postoperative pain of mixed hemorrhoid by embedding press needle in EX-UE2 is effectively satisfactory.展开更多
Objective:To explore the impact of psychological care on preoperative anxiety and postoperative pain in patients undergoing liver biopsy.Methods:A total of 100 patients undergoing liver biopsy in our hospital from Jan...Objective:To explore the impact of psychological care on preoperative anxiety and postoperative pain in patients undergoing liver biopsy.Methods:A total of 100 patients undergoing liver biopsy in our hospital from January 2024 to October 2024 were selected as the study subjects.They were divided into a control group and a study group using a random number table method,with 50 patients in each group.The control group received routine care,while the study group received psychological care on the basis of the control group’s treatment.The nursing satisfaction,fear scores,anxiety scores,postoperative pain levels,and incidence of complications(local pain at the puncture site,bleeding at the puncture site,skin irritation,tension blisters,infection,severe abdominal pain,pneumothorax)were compared between the two groups.Results:The nursing satisfaction in the study group was higher than that in the control group(P<0.05).After nursing,the fear scores and anxiety scores in both groups were lower than before nursing,and the fear scores and anxiety scores in the study group were lower than those in the control group(P<0.05).The postoperative pain scores in the study group were lower than those in the control group(P<0.05),and the incidence of complications in the study group was lower than that in the control group(P<0.05).Conclusion:The application of psychological care in patients undergoing liver biopsy has a definite effect,which can improve patient satisfaction,reduce preoperative anxiety and fear,alleviate postoperative pain,and reduce the incidence of postoperative complications.It is worthy of clinical promotion and application.展开更多
Objective: This prospective cohort study explored factors related to postoperative pain in gastric cancer patients.Methods: A total of 236 patients who underwent gastrectomy were enrolled. All patients enrolled in the...Objective: This prospective cohort study explored factors related to postoperative pain in gastric cancer patients.Methods: A total of 236 patients who underwent gastrectomy were enrolled. All patients enrolled in the study completed the Hospital Anxiety and Depression Scale(HADS) questionnaire and Life Orientation Test-Revised(LOT-R) questionnaire on the day before surgery. Heat pain threshold(HPT), cold pain threshold(CPT) and pressure pain threshold(PPT) were measured for all patients one day prior to surgery and demographic details were collected. All patients were connected to a patient-controlled intravenous analgesia(PCIA) pump at the end of the surgery. The occurrence of postoperative pain was used as a dependent variable, and multivariate logistic regression analyses were conducted to screen for factors affecting postoperative pain.Results: In total, 83 patients(35.2%) had postoperative pain. Body mass index(BMI) ≥28 kg/m^(2) [odds ratio(OR): 2.67;95% confidence interval(95% CI): 1.07-6.67], total gastrectomy(OR: 2.64;95% CI: 1.42-4.91),preoperative anxiety score ≥8(OR: 2.37;95% CI: 1.12-5.02), heat pain threshold ≤4.9 s(OR: 2.14;95% CI:1.06-4.32), pressure pain threshold ≤4 g(OR: 2.05;95% CI: 1.05-4.03), and female gender(OR: 1.99;95% CI:1.04-3.83) were risk factors for postoperative pain.Conclusions: Obesity, wide range of gastrectomy, high preoperative anxiety, low HPT and PPT, and female gender are associated with increased risk for postoperative pain.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
<strong>Background: </strong>Pre-clinical and clinical studies have shown that inflammatory pain intensity is increased under diabetes condition. Open cholecystectomy (OC) is a surgical procedure with pred...<strong>Background: </strong>Pre-clinical and clinical studies have shown that inflammatory pain intensity is increased under diabetes condition. Open cholecystectomy (OC) is a surgical procedure with predictable postoperative pain. However, the comparison of postoperative pain due to open cholecystectomy in diabetic and non-diabetic patients remains unknown. The research question to answer was whether diabetic patients undergoing OC development greater intensity of postoperative pain than non-diabetic patients. <strong>Methods: </strong>The study was conducted between June 2016 and February 2018 at the Regional Hospital of High Specialty “Dr. Juan Graham Casasús” of Villahermosa, Tabasco, Mexico. Seventy patients in two groups of 35 patients each scheduled for OC under general anesthesia were studied. Pain was assessed using the 11-point numerical rating scale (NRS). The primary endpoint was to know NRS pain scores after awaking of general anesthesia. Secondary outcomes included the time of onset of pain and comparing NRS scores between diabetic and non-diabetic patients undergoing OC. <strong>Results:</strong> Diabetic patients reported significantly greater intensity pain than non-diabetic patients. The mean overall pain score in the diabetic and non-diabetic patients was 7.2 ± 0.3 and 5.3 ± 0.3 (P = 0.0002), respectively. Furthermore, 60% of diabetic patients had severe pain (NRS ≥ 8) compared to 20% of non-diabetics (P = 0.006). The time to onset postoperative pain was about 35 minutes in both groups (P = 0.876). <strong>Conclusions:</strong> Diabetic patients undergoing OC have greater intensity postoperative pain and also more frequency of patients with severe pain scores compared with non-diabetic patients. Therefore, analgesic treatment in those patients should consider this point in order to provide a satisfactory postoperative analgesia.展开更多
Postoperative pain is the most common complaint after laparoscopic cholecystectomy. This study was carried out to evaluate whether preoperative administration of intramuscular dezocine can provide postoperative analge...Postoperative pain is the most common complaint after laparoscopic cholecystectomy. This study was carried out to evaluate whether preoperative administration of intramuscular dezocine can provide postoperative analgesia and reduce postoperative opioid consumption in patients undergoing laparoscopic cholecystectomy. Patients （ASA Ⅰ or Ⅱ ） scheduled for laparoscopic cholecystectomy were randomly assigned into intramuscular dezocine group （group 1） or intramuscular normal saline group （group 2）. Dezocine and equal volume normal saline were administered intramuscularly 10 rain before the induction of anesthesia. After operation, the severity of postoperative pain, postoperative fentanyl requirement, incidence and severity of side-effects were assessed. Postoperative pain and postoperative patient-controlled fentanyl consumption were reduced significantly in group l compared with group 2. The incidence and severity of side effects were similar between the two groups. Preoperative single-dose administration of intramuscular dezocine 0.1 mg/kg was effective in reducing postoperative pain and postoperative patient-controlled fentanyl requirement in patients undergoing laparoscopic cholecystectomy.展开更多
AIM To prospectively evaluate the effect of local wound infiltration with ropivacaine on postoperative pain relief and stress response reduction after open hepatectomy.METHODS A total of 56 patients undergoing open he...AIM To prospectively evaluate the effect of local wound infiltration with ropivacaine on postoperative pain relief and stress response reduction after open hepatectomy.METHODS A total of 56 patients undergoing open hepatectomy were randomly divided into two groups:a ropivacaine group(wound infiltration with ropivacaine solution)and a control group(infiltration with isotonic saline solution).A visual analog scale(VAS)at rest and on movement was used to measure postoperative pain for the first 48 h after surgery.Mean arterial pressure(MAP),heart rate(HR),time to bowel recovery,length of hospitalization after surgery,cumulative sufentanil consumption,and incidence of nausea and vomiting were compared between the two groups.Surgical stress hormones(epinephrine,norepinephrine,and cortisol)were detected using enzyme-linked immunosorbent assay,and the results were compared. RESULTS VAS scores both at rest and on movement at 24 h and48 h were similar between the two groups.Significantly lower VAS scores were detected at 0,6,and 12 h in the ropivacaine group compared with the control group(P<0.05 for all).MAP was significantly lower at 6,12,and 24 h(P<0.05 for all);HR was significantly lower at 0,6,12,and 24 h(P<0.05 for all);time to bowel recovery and length of hospitalization after surgery(P<0.05 for both)were significantly shortened;and cumulative sufentanil consumption was significantly lower at 6,12,24,and 36 h(P<0.05 for all)in the ropivacaine group than in the control group,although the incidence of nausea and vomiting showed no significant difference between the two groups.The levels of epinephrine,norepinephrine,and cortisol were significantly lower in the ropivacaine group than in the control group at 24 and 48 h(P<0.01 for all). CONCLUSION Local wound infiltration with ropivacaine after open hepatectomy can improve postoperative pain relief,reduce surgical stress response,and accelerate postoperative recovery.展开更多
AIM: To prospectively evaluate the effectiveness and safety of continuous wound infiltration(CWI) for pain management after open gastrectomy. METHODS: Seventy-five adult patients with American Society of Anesthesiolog...AIM: To prospectively evaluate the effectiveness and safety of continuous wound infiltration(CWI) for pain management after open gastrectomy. METHODS: Seventy-five adult patients with American Society of Anesthesiologists(ASA) Physical Status Classification System(ASA) grade 1-3 undergoing open gastrectomy were randomized to three groups. Group 1 patients received CWI with 0.3% ropivacaine(group CWI). Group 2 patients received 0.5 mg/m L morphine intravenously by a patient-controlled analgesia pump(PCIA)(group PCIA). Group 3 patients received epidural analgesia(EA) with 0.12% ropivacaine and 20 μg/m L morphine with an infusion at 6-8 m L/h for 48 h(group EA). A standard general anesthetic technique was used for all three groups. Rescue analgesia(2 mg bolus of morphine, intravenous) was given when the visual analogue scale(VAS) score was ≥ 4. The outcomes measured over 48 h after the operation were VAS scores both at rest and during mobilization, total morphine consumption, relative side effects, and basic vital signs. Further results including time to extubation, recovery of bowel function, surgical wound healing,mean length of hospitalization after surgery, and the patient's satisfaction were also recorded.RESULTS: All three groups had similar VAS scores during the first 48 h after surgery. Group CWI and group EA, compared with group PCIA, had lower morphine consumption(P < 0.001), less postoperative nausea and vomiting(1.20 ± 0.41 vs 1.96 ± 0.67, 1.32 ± 0.56 vs 1.96 ± 0.67, respectively, P < 0.001), earlier extubation(16.56 ± 5.24 min vs 19.76 ± 5.75 min, P < 0.05, 15.48 ± 4.59 min vs 19.76 ± 5.75 min, P < 0.01), and earlier recovery of bowel function(2.96 ± 1.17 d vs 3.60 ± 1.04 d, 2.80 ± 1.38 d vs 3.60 ± 1.04 d, respectively, P < 0.05). The mean length of hospitalization after surgery was reduced in groups CWI(8.20 ± 2.58 d vs 10.08 ± 3.15 d, P < 0.05) and EA(7.96 ± 2.30 d vs 10.08 ± 3.15 d, P < 0.01) compared with group PCIA. All three groups had similar patient satisfaction and wound healing, but group PCIA was prone to higher sedation scores when compared with groups CWI and EA, especially during the first 12 h after surgery. Group EA had a lower mean arterial pressure within the first postoperative 12 h compared with the other two groups.CONCLUSION : CWI with ropivacaine yields a satisfactory analgesic effect within the first 48 h after open gastrectomy, with lower morphine consumption and accelerated recovery.展开更多
Objective:Electroacupuncture(EA)is good at post-surgical pain.But point selection method in treating incision-induced pain remains a major clinical challenge.We reasoned that different acupoints may work though adjust...Objective:Electroacupuncture(EA)is good at post-surgical pain.But point selection method in treating incision-induced pain remains a major clinical challenge.We reasoned that different acupoints may work though adjusting prostaglandin E2 in spinal cord.We wish to explore the analgesic mechanism of electroacupuncture on plantar incision pain rats and provide more therapeutic ideas for acupuncture analgesia.Methods:A total of 50 male rats were randomly divided into a sham operation group,a model group,an EA 1,EA 2 and a drug group(n=10,each).A rat model of left plantar incision pain was established.The rats in EA1 group was needled at ipsilateral Yanglingquan(GB34)and Taixi(KI3).The rats in EA2 group was needled at ipsilateral Quchi(LI11)and Hegu(LI4).EA stimulation(2/100 Hz,1-2-3 mA)was administered 30 minutes immediately after operation.The rats in drug group were fed with Fenbid by gavage 20 minutes before incision(30 mg/kg,p.o.).The hot plate pain detector was used to measure the thermal pain threshold(TPT)before and 24 hours after operation Prostaglandin E2 content of spinal cord was detected by enzyme-linked immunosorbent assay(ELISA)at 1 and 24 hours after operation.Results:Compared with sham operation group,the TPT in model group decreased 41%.Compared with the model group,the TPT increased 56%in EA1,29%in EA2,190%in drug group(P>0.05).At 1 h after operation,compared with the sham operation group,PGE_2 in model group increased 15%.Compared with the model group,PGE_2 in drug group decreased 5%.At 24 hours after operation,compared with sham operation group,PGE_2 in model group increased 9%.Compared with model group,it decreased 4%in EA 1 group,8%in drug group and increased 3%in EA2 group.Conclusion:Both the drug and the electroacupuncture can adjust the 24-hour pain threshold and PGE_2 in spinal cord.The curative effects of the drug are better than that of electroacupuncture.The proximal point is better than that of the distal point.Electroacupuncture can treat postoperative pain by regulating PGE_2 in spinal cord.展开更多
文摘Objective:To explore the clinical effect of multimodal nursing intervention on postoperative pain management in patients undergoing gastrointestinal surgery.Methods:A total of 120 patients who underwent gastrointestinal surgery in our hospital from January 2023 to January 2024 were selected as the research subjects.They were randomly divided into the intervention group and the control group,with 60 cases in each group.The control group received routine postoperative care,while the intervention group received multimodal pain care intervention.The postoperative pain scores,the rate of using analgesic drugs,postoperative recovery indicators,and nursing satisfaction were compared between the two groups.Results:At 24 hours,48 hours,and 72 hours after surgery,the VAS pain scores of the intervention group were significantly lower than those of the control group(p<0.05);the rate of using analgesic drugs in the intervention group(25.0%)was significantly lower than that in the control group(48.3%)(p<0.05);the first defecation time,first ambulation time,and hospital stay of the intervention group were shorter than those of the control group(p<0.05);the nursing satisfaction of the intervention group(96.7%)was significantly higher than that of the control group(80.0%)(p<0.05).Conclusion:Multimodal pain care intervention can effectively relieve postoperative pain in patients undergoing gastrointestinal surgery,reduce the use of analgesic drugs,promote postoperative recovery,and improve nursing satisfaction.
文摘Objective:This study was designed to determine the nurse assessment of postoperative pain and its management in selected hospitals,Benin City,Edo State,Nigeria.Materials and Methods:A descriptive cross-sectional survey was adopted.The target population consist of 222 purposely nurses who are in the cadre of nursing officer II to chief nursing officer who works in the various surgical wards/units of the selected health facilities.The data were collected from the participants using the pretested structured questionnaire developed by the researcher.Results:Results showed that 66.2%of nurses had a poor level of knowledge on postoperative pain assessment.The McGill Pain Questionnaire was the most used pain assessment tool with a mean score of 2.84 whereas the Dallas Pain Questionnaire was the least used with a mean score of 1.90.“Providing clean,calm,and well-ventilated ward environment”(3.69±0.61)was the most used nonpharmacological method for postoperative pain management,followed by“distraction,relaxation,and guided imagery”(3.52±0.50),“dressing,bandage,splint,and reinforce wound sites postoperatively”(3.39±0.54),and“early ambulation/exercise”(3.20±0.62).The most used pharmacological interventions were“acetaminophen”(3.63±0.55),“topical anesthetic”(2.92±0.62),“nonselective nonsteroidal anti-inflammatory drugs”(2.87±0.43),and“mixed opioid agonist-antagonist”(2.56±0.56).Conclusion:There is a poor level of knowledge on postoperative pain assessment among nurses in this study setting.It is,therefore,pertinent for hospitals to organize continuous in-service training for postoperative pain assessment and management,especially on nonpharmacological approaches among nurses.
基金Supported by Beijing Natural Science Foundation(7232130)Fundamental Research Funds for the Central Universities(2024-JYB-JBZD-024)CZ015-High Level Traditional Chinese Medicine Hospital SM Project(DZMG-LJRC0006)。
文摘Objective To evaluate the changes in postoperative plasmaβ-endorphin(β-EP)levels in patients who had received perioperative electroacupuncture(EA)treatment in 10 randomized controlled trials(RCTs)and examine the impact of EA on postoperative pain.Methods This meta-analysis evaluated the changes in plasmaβ-EP levels and visual analog scale(VAS)12,24 and 48 hours after surgery in patients receiving perioperative EA.It also assessed the changes in plasma serotonin(5-hydroxytryptamine,5-HT)and prostaglandin E2(PGE2)levels at 24 hours postsurgery.A comprehensive search was conducted in the China National Knowledge Infrastructure(CNKI),Wanfang,Chongqing VIP database,Chinese Biomedical Database(CBM),Web of Science,and PubMed databases.RCTs on perioperative EA andβ-EP published from the inception of the websites up to July 25,2023,were retrieved.Effect size aggregation,literature quality assessment,and bias analysis were performed using RevMan 5.3 software,and sensitivity analysis was conducted via R 4.3.1.Results A total of 10 RCTs involving 706 patients were included.EA in conjunction with conventional anesthesia significantly increased plasmaβ-EP levels at 12 hours postsurgery[standard mean difference(SMD)=2.79,95%CI(1.85,3.72),Z=5.81,P<0.00001],24 hours postsurgery[SMD=1.87,95%CI(0.9,2.83),Z=3.79,P=0.0001],and 48 hours postsurgery[SMD=2.02,95%CI(1.49,2.54),Z=7.50,P<0.00001].EA reduced plasma PGE2 levels at 24 hours postsurgery and plasma 5-HT levels at 24 hours postsurgery,and the VAS at 12,24 and 48 hours after surgery also decreased.Conclusion These findings suggest that perioperative EA markedly elevates plasmaβ-EP levels,reduces pain-inducing factors in plasma,and effectively alleviates acute postoperative pain.
基金Supported by the Taichung Veterans General Hospital,No.TCVGH-1125401B.
文摘BACKGROUND Abdominal aortic aneurysm(AAA)repair often involves significant postoperative pain,traditionally managed with systemic opioids,which can cause undesirable side effects.This case report explores the novel use of a surgically-initiated rectus sheath block with a catheter-over-needle assembly for pain management in AAA repair.CASE SUMMARY A 67-year-old female with hypertension and previous aortic dissection underwent elective open repair of an infrarenal AAA,which had grown from 3.4 cm to 4.3 cm over 14 months.A rectus sheath block was initiated surgically for postoperative pain control.The patient reported low pain scores and did not require systemic intravenous opioids,enabling early ambulation and discharge on postoperative day seven without complications.By preventing complications of systemic opi-oids,the method indicating a promising direction for postoperative pain management in major vascular surgeries.CONCLUSION Surgically-initiated rectus sheath block as a valuable tool for managing postoperative pain in AAA repair.
文摘Postoperative pain is an acute pain that appears due to the surgical act, reaching its maximum intensity in the first 24 - 48 hours after surgery. Postoperative pain control reduces possible postoperative complications, as well as the patient’s stay in the medical institution. Objective: This study compared the effectiveness and side effects of oral transmucosal fentanyl citrate (OTFC) with IV morphine in the control of postoperative pain. Methods: Seventy-three patients (Fentanyl group: 27, morphine group: 46) were included. Changes in pain were evaluated with Visual Analog Scale (VAS) and Pain Relief Scale, Pain Intensity Differences (PID), Sum of Pain Intensity Differences (SPID), and Total Pain Relief (TOTPAR). At time zero, 15, 30, 45 min and 1, 2, 3, 4, 5 and 6 h. Results: The decrease in pain intensity measured by VAS was similar in both groups with no significant differences at any of the measurement points. Both products produced a significant increase in the Pain Relief scale, with no differences between groups at any of the measurement times. There were no differences between groups when comparing PID. Comparing SPID between groups, there were no differences at 15, 30 minutes, then there were significant differences in favor of the Fentanyl group up to 6 hours. Both products produced a significant increase in the TOPAR scale, with no differences between groups at any of the measurement times. The appearance of adverse effects was similar in both groups. Conclusions: Both products produced a significant reduction in the measures of pain intensity (VAS), increase of SPID, as well as a significant increase in the Pain Relief scale, a significant increase in the TOPAR scale, with no differences between the groups. The number of adverse effects was similar. The convenience of OTFC administration allows its administration without the special conditions needed for the administration of IV morphine.
基金a Grant from the National Natural Science Foundation of China:CRL4DCAF4 E3 Ubiquitin Ligase Regulates the Pathogenesis of Colorectal Cancer(No.82172909)。
文摘OBJECTIVE:To explore the clinical efficacy of the Chinese medicine,Neibu Huangqi Youhua formula(内补黄芪汤优化方)combined with Kangfuxin solution(康复新液)for the nursing of patients after anal fistula surgery.METHODS:A total of 160 cases with anal fistula who underwent surgical treatment were recruited,and divided into control group(treated with external application of Kangfuxin liquid gauze)and experimental group(receiving the Neibu Huangqi Youhua formula combined with Kangfuxin liquid gauze)based on a random numbering table.The wound recovery,postoperative pain and inflammation were evaluated and compared between the two groups.RESULTS:At 3,7,and 14 d after the operation,the wound healing rate of the experimental group was significantly higher than that of the control group at any time point.The visual analogue scale scores of the two groups gradually decreased in a time-dependent manner after surgery,while the experimental group showed a more significant downward trend in comparison with the control group.At 14 d after the operation,the experimental group had high levels of epidermal growth factor,fibroblast growth factor-1,secretory Ig A,tissue inhibitor of matrix metalloproteinase-1,5-hydroxytryptamine,prostaglandin E-2,substances P and neuropeptide Y compared with control group,but low levels of C-reactive protein,procalcitonin,and serum amyloid A protein.CONCLUSIONS:The Neibu Huangqi Youhua formula can reduce the levels of inflammatory factors and pain mediators in patients after anal fistula surgery,thereby accelerating the process of wound healing and alleviating the pain of patients.
基金supported by Beijing Natural Science Foundation(L232101).
文摘Background:To comprehensively analyze the clinical characteristics of patients who underwent gastric endoscopic submucosal dissection(ESD)and explore the incidence and influencing factors of postoperative pain.Methods:The clinical data of patients who underwent gastric ESD at our center from 2009 to 2024 were retrospectively analyzed.Pain severity was assessed using a visual analogue scale,with a score≥4 defined as postoperative pain.Based on the presence or absence of postoperative pain,patients were divided into a pain group and a control group.Independent factors influencing postoperative pain were identified using multivariate logistic regression analysis.To control for confounding bias,patients in the case and control groups were matched by sex and lesion size,and the matched participants were further analyzed using a conditional logistic regression model.Results:In total,993 patients were analyzed.The incidence of postoperative pain was 9.1%(95%confidence interval[CI],7.3-11.1).In the univariate analysis,sex,operation duration,anesthesia method,intraoperative electrocoagulation,nasogastric tube placement,and postoperative vomiting were significantly associated with postoperative pain.Multivariate analysis identified eight independent factors:male sex(odds ratio[OR],0.61;95%CI,0.37-0.97;p=0.04),operation duration(OR,1.29;95%CI,1.03-1.63;p=0.02),protuberant lesions(OR,0.43;95%CI,0.26-0.71;p<0.01),antral lesions(OR,1.84;95%CI,1.10-3.05;p=0.01),intubation general anesthesia(OR,0.40;95%CI,0.22-0.72;p=0.002),intraoperative electrocoagulation(OR,0.32;95%CI,0.19-0.55;p<0.01),nasogastric tube placement(OR,2.005;95%CI,1.12-3.57;p=0.01),and postoperative vomiting(OR,3.24;95%CI,1.40-7.47;p=0.005).Conditional logistic regression analysis further identified diabetes mellitus(OR,2.50;95%CI,1.03-6.06;p=0.04).Conclusion:Female sex,diabetes mellitus,concave-type lesions,lesions in the gastric antrum,non-intubation general anesthesia,absence of intraoperative electrocoagulation,prolonged operation duration,nasogastric tube placement,and postoperative vomiting were independent factors associated with moderate to severe pain after gastric ESD.For patients at increased risk of postoperative pain,appropriate prophylactic and therapeutic measures during the perioperative period may effectively alleviate pain following gastric ESD.
基金Supported by National Natural Science Foundation of China,No.82404612.
文摘This editorial highlights the randomized controlled trial by Qian et al evaluating the efficacy of nalbuphine in managing postoperative pain and associated inflammatory factors in patients undergoing radical gastrectomy for gastric cancer.Utilizing a multimodal analgesic approach with a controlled analgesia pump and a transverse abdominis muscle plane block,the study compared nalbuphine against sufentanil.Results indicate that nalbuphine significantly reduces pain scores at various postoperative intervals,decreases consumption and patientcontrolled analgesia presses,and lowers levels of pain markers such as prostaglandin E2,serotonin,and substance P.While both agents demonstrated effective pain control,nalbuphine was associated with a lower incidence of adverse effects,suggesting its potential as a valuable alternative in appropriate clinical scenarios.This study offers valuable insights into nalbuphine’s clinical applicability,underscoring its benefits for pain management and enhancing patient recovery in the postoperative setting.
文摘BACKGROUND Anxiety,depression,and postoperative pain are common in patients with hip joint disorders and are associated with compromised functional outcomes and delayed recovery.AIM To investigate the prevalence of anxiety and depression among geriatric patients who underwent total hip arthroplasty(THA),explored their association with postoperative pain,and identified contributing risk factors.METHODS A total of 111 geriatric patients who underwent THA between January 2021 and January 2024 were included.Standardized psychological assessment tools-including the Zung Self-Rating Anxiety Scale(SAS)and the Zung Self-Rating Depression Scale(SDS)-and the Numeric Rating Scale(NRS)for pain quantification were systematically administered.Pearson correlation analysis was utilized to explore the relationships among SAS,SDS,and NRS scores.Univariate and multivariate binary logistic regression analyses were conducted to identify risk factors for anxiety and depression in these patients.RESULTS The cohort exhibited moderate anxiety(SAS:44.23±9.03),mild depression(SDS:46.98±9.15),and moderate postoperative pain(NRS:4.93±2.37).Patients with anxiety or depression reported significantly higher NRS scores than those without these conditions.Significant positive correlations were observed between SAS and SDS scores,as well as between each of these and NRS scores.Univariate analysis revealed that gender,age,disease duration,alcohol use,diabetes history,and NRS scores were significantly associated with anxiety and depression.Multivariate analysis further identified female gender,disease duration≥2 years,alcohol use,and NRS scores≥5 as independent predictors of postoperative psychological distress.CONCLUSION Anxiety and depression are closely linked with postoperative pain in geriatric patients post-THA recovery.Early psychological screening and multimodal pain management strategies are recommended-particularly for individuals with a disease duration of≥2 years,a history of alcohol consumption,or an NRS score of≥5,as well as female patients-to effectively mitigate their negative emotional states and improve postoperative recovery.
文摘BACKGROUND Limited evidence exists regarding the role of enhanced recovery after surgery(ERAS)protocols in optimizing pain management and functional recovery after colorectal cancer(CRC)surgery.AIM To evaluate the impact of ERAS protocols on postoperative pain management and functional recovery in patients undergoing CRC surgery.METHODS A total of 109 patients with CRC admitted to The Third Affiliated Hospital of Jinzhou Medical University between June 2021 and June 2024 were enrolled in this study.They were divided into two groups:A control group(n=50)receiving standard perioperative care and an observation group(n=59)managed under an ERAS protocol.Clinical outcomes,including postoperative pain intensity[assessed using the Visual Analogue Scale(VAS)],functional recovery indicators(time to first ambulation,bowel sound recovery,first anal gas discharge,and first defecation),average sleep duration on postoperative day 3,sleep quality(measured using the Pittsburgh Sleep Quality Index),length of hospitalization,quality of life(evaluated using the Short Form 36 Health Survey),and incidence of postoperative complications(e.g.,surgical site infection,pulmonary infection,abdominal distension/pain,and intestinal obstruction),were systematically compared between the two groups.RESULTS The observation group exhibited significantly lower VAS scores at 72 hours postoperatively,shorter durations of maximum VAS scores,earlier recovery of functional indicators(time to first ambulation,bowel sound recovery,first anal gas discharge,and first defecation),and shorter hospitalization compared with the control group.Additionally,average sleep duration on postoperative day 3 was significantly longer in the observation group.Furthermore,the observation group demonstrated significantly improved sleep quality(lower Pittsburgh Sleep Quality Index scores)and higher quality of life(higher Short Form 36 Health Survey scores across all domains)than both the baseline and control groups.The incidence of total postoperative complications was also significantly lower in the observation group than in the control group.CONCLUSION ERAS protocols are highly effective in relieving postoperative pain,accelerating functional recovery,and improving overall clinical outcomes in patients with CRC undergoing surgery,supporting their broader clinical application.
基金School-level Educational Reform Project of Hangzhou Normal University(Project No.:HLXYJG202304)。
文摘Objective:To conduct a scoping review on the application status of the Functional Activity Score(FAS)in postoperative active pain management in China,providing a reference for its standardized and normative promotion.Methods:Computerized searches of Chinese and English databases were performed to collect studies published by Chinese scholars from 2005 to July 2025 on the application of FAS in postoperative active pain management.After strict screening,the basic characteristics,application fields,assessment models,evaluation timing,types of functional activities,and clinical outcomes of the included literature were systematically analyzed.Results:A total of 18 studies were included,involving surgical types such as thoracic surgery,general surgery,and orthopedics.All studies adopted FAS combined with the Numeric Rating Scale(NRS)for assessment,with evaluation timing mostly concentrated within 72 hours postoperatively.The selected functional activities primarily included respiration-related and limb movements.Evaluation indicators covered pain control,functional recovery,complications,adverse events,patient experience,and tool assessment,with most studies reporting positive outcomes.Conclusion:FAS can effectively enhance pain control and promote functional recovery in postoperative active pain management in China,demonstrating high clinical value.However,existing studies exhibit inconsistencies in assessment criteria,selection of activity types,and research quality.
基金supported by General scientific project for institutions of higher learning in Liaoning Province:L 2014370
文摘Objective To explore the effectiveness of treating postoperative pain of mixed hemorrhoid by embedding needles in Erbai （二白EX-UE 2） and find possible ways for relieving postoperative pain of mixed hemorrhoids. Methods press needle （SEIRIN pyonexes） were embedded in EX-UE 2 of patients with postoperative pain of mixed hemorrhoid, once a day and totally 7 treatments. Visual analogue scale （VAS） values were adopted for evaluation. Results Complete remission of clinical pain was observed in 34 cases, accounting for 50.00%; significantly effective in 19 cases, accounting for 27.94%; effective in 13 cases, accounting for 19.12%; and ineffective in 2 cases, accounting for 2.94%; the total effective rate was 97.06%. Conclusion The therapy of treating postoperative pain of mixed hemorrhoid by embedding press needle in EX-UE2 is effectively satisfactory.
文摘Objective:To explore the impact of psychological care on preoperative anxiety and postoperative pain in patients undergoing liver biopsy.Methods:A total of 100 patients undergoing liver biopsy in our hospital from January 2024 to October 2024 were selected as the study subjects.They were divided into a control group and a study group using a random number table method,with 50 patients in each group.The control group received routine care,while the study group received psychological care on the basis of the control group’s treatment.The nursing satisfaction,fear scores,anxiety scores,postoperative pain levels,and incidence of complications(local pain at the puncture site,bleeding at the puncture site,skin irritation,tension blisters,infection,severe abdominal pain,pneumothorax)were compared between the two groups.Results:The nursing satisfaction in the study group was higher than that in the control group(P<0.05).After nursing,the fear scores and anxiety scores in both groups were lower than before nursing,and the fear scores and anxiety scores in the study group were lower than those in the control group(P<0.05).The postoperative pain scores in the study group were lower than those in the control group(P<0.05),and the incidence of complications in the study group was lower than that in the control group(P<0.05).Conclusion:The application of psychological care in patients undergoing liver biopsy has a definite effect,which can improve patient satisfaction,reduce preoperative anxiety and fear,alleviate postoperative pain,and reduce the incidence of postoperative complications.It is worthy of clinical promotion and application.
基金supported by Peking University Medicine Seed Fund for Interdisciplinary Research (No. BMU 2020MX028)Braun Anesthesia science research fund (No. BBFD-2011-006)。
文摘Objective: This prospective cohort study explored factors related to postoperative pain in gastric cancer patients.Methods: A total of 236 patients who underwent gastrectomy were enrolled. All patients enrolled in the study completed the Hospital Anxiety and Depression Scale(HADS) questionnaire and Life Orientation Test-Revised(LOT-R) questionnaire on the day before surgery. Heat pain threshold(HPT), cold pain threshold(CPT) and pressure pain threshold(PPT) were measured for all patients one day prior to surgery and demographic details were collected. All patients were connected to a patient-controlled intravenous analgesia(PCIA) pump at the end of the surgery. The occurrence of postoperative pain was used as a dependent variable, and multivariate logistic regression analyses were conducted to screen for factors affecting postoperative pain.Results: In total, 83 patients(35.2%) had postoperative pain. Body mass index(BMI) ≥28 kg/m^(2) [odds ratio(OR): 2.67;95% confidence interval(95% CI): 1.07-6.67], total gastrectomy(OR: 2.64;95% CI: 1.42-4.91),preoperative anxiety score ≥8(OR: 2.37;95% CI: 1.12-5.02), heat pain threshold ≤4.9 s(OR: 2.14;95% CI:1.06-4.32), pressure pain threshold ≤4 g(OR: 2.05;95% CI: 1.05-4.03), and female gender(OR: 1.99;95% CI:1.04-3.83) were risk factors for postoperative pain.Conclusions: Obesity, wide range of gastrectomy, high preoperative anxiety, low HPT and PPT, and female gender are associated with increased risk for postoperative pain.
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<strong>Background: </strong>Pre-clinical and clinical studies have shown that inflammatory pain intensity is increased under diabetes condition. Open cholecystectomy (OC) is a surgical procedure with predictable postoperative pain. However, the comparison of postoperative pain due to open cholecystectomy in diabetic and non-diabetic patients remains unknown. The research question to answer was whether diabetic patients undergoing OC development greater intensity of postoperative pain than non-diabetic patients. <strong>Methods: </strong>The study was conducted between June 2016 and February 2018 at the Regional Hospital of High Specialty “Dr. Juan Graham Casasús” of Villahermosa, Tabasco, Mexico. Seventy patients in two groups of 35 patients each scheduled for OC under general anesthesia were studied. Pain was assessed using the 11-point numerical rating scale (NRS). The primary endpoint was to know NRS pain scores after awaking of general anesthesia. Secondary outcomes included the time of onset of pain and comparing NRS scores between diabetic and non-diabetic patients undergoing OC. <strong>Results:</strong> Diabetic patients reported significantly greater intensity pain than non-diabetic patients. The mean overall pain score in the diabetic and non-diabetic patients was 7.2 ± 0.3 and 5.3 ± 0.3 (P = 0.0002), respectively. Furthermore, 60% of diabetic patients had severe pain (NRS ≥ 8) compared to 20% of non-diabetics (P = 0.006). The time to onset postoperative pain was about 35 minutes in both groups (P = 0.876). <strong>Conclusions:</strong> Diabetic patients undergoing OC have greater intensity postoperative pain and also more frequency of patients with severe pain scores compared with non-diabetic patients. Therefore, analgesic treatment in those patients should consider this point in order to provide a satisfactory postoperative analgesia.
文摘Postoperative pain is the most common complaint after laparoscopic cholecystectomy. This study was carried out to evaluate whether preoperative administration of intramuscular dezocine can provide postoperative analgesia and reduce postoperative opioid consumption in patients undergoing laparoscopic cholecystectomy. Patients （ASA Ⅰ or Ⅱ ） scheduled for laparoscopic cholecystectomy were randomly assigned into intramuscular dezocine group （group 1） or intramuscular normal saline group （group 2）. Dezocine and equal volume normal saline were administered intramuscularly 10 rain before the induction of anesthesia. After operation, the severity of postoperative pain, postoperative fentanyl requirement, incidence and severity of side-effects were assessed. Postoperative pain and postoperative patient-controlled fentanyl consumption were reduced significantly in group l compared with group 2. The incidence and severity of side effects were similar between the two groups. Preoperative single-dose administration of intramuscular dezocine 0.1 mg/kg was effective in reducing postoperative pain and postoperative patient-controlled fentanyl requirement in patients undergoing laparoscopic cholecystectomy.
基金Supported by National Natural Science foundation of China,No.81571367 and No.81502050Scientific and Technological Project of Shandong Province,No.2016GSf201082
文摘AIM To prospectively evaluate the effect of local wound infiltration with ropivacaine on postoperative pain relief and stress response reduction after open hepatectomy.METHODS A total of 56 patients undergoing open hepatectomy were randomly divided into two groups:a ropivacaine group(wound infiltration with ropivacaine solution)and a control group(infiltration with isotonic saline solution).A visual analog scale(VAS)at rest and on movement was used to measure postoperative pain for the first 48 h after surgery.Mean arterial pressure(MAP),heart rate(HR),time to bowel recovery,length of hospitalization after surgery,cumulative sufentanil consumption,and incidence of nausea and vomiting were compared between the two groups.Surgical stress hormones(epinephrine,norepinephrine,and cortisol)were detected using enzyme-linked immunosorbent assay,and the results were compared. RESULTS VAS scores both at rest and on movement at 24 h and48 h were similar between the two groups.Significantly lower VAS scores were detected at 0,6,and 12 h in the ropivacaine group compared with the control group(P<0.05 for all).MAP was significantly lower at 6,12,and 24 h(P<0.05 for all);HR was significantly lower at 0,6,12,and 24 h(P<0.05 for all);time to bowel recovery and length of hospitalization after surgery(P<0.05 for both)were significantly shortened;and cumulative sufentanil consumption was significantly lower at 6,12,24,and 36 h(P<0.05 for all)in the ropivacaine group than in the control group,although the incidence of nausea and vomiting showed no significant difference between the two groups.The levels of epinephrine,norepinephrine,and cortisol were significantly lower in the ropivacaine group than in the control group at 24 and 48 h(P<0.01 for all). CONCLUSION Local wound infiltration with ropivacaine after open hepatectomy can improve postoperative pain relief,reduce surgical stress response,and accelerate postoperative recovery.
基金Supported by Foundation of Health Department of Zhejiang ProvinceChina+3 种基金No.2011RCA207Foundation of Education Department of Zhejiang ProvinceChinaNo.Y201431914
文摘AIM: To prospectively evaluate the effectiveness and safety of continuous wound infiltration(CWI) for pain management after open gastrectomy. METHODS: Seventy-five adult patients with American Society of Anesthesiologists(ASA) Physical Status Classification System(ASA) grade 1-3 undergoing open gastrectomy were randomized to three groups. Group 1 patients received CWI with 0.3% ropivacaine(group CWI). Group 2 patients received 0.5 mg/m L morphine intravenously by a patient-controlled analgesia pump(PCIA)(group PCIA). Group 3 patients received epidural analgesia(EA) with 0.12% ropivacaine and 20 μg/m L morphine with an infusion at 6-8 m L/h for 48 h(group EA). A standard general anesthetic technique was used for all three groups. Rescue analgesia(2 mg bolus of morphine, intravenous) was given when the visual analogue scale(VAS) score was ≥ 4. The outcomes measured over 48 h after the operation were VAS scores both at rest and during mobilization, total morphine consumption, relative side effects, and basic vital signs. Further results including time to extubation, recovery of bowel function, surgical wound healing,mean length of hospitalization after surgery, and the patient's satisfaction were also recorded.RESULTS: All three groups had similar VAS scores during the first 48 h after surgery. Group CWI and group EA, compared with group PCIA, had lower morphine consumption(P < 0.001), less postoperative nausea and vomiting(1.20 ± 0.41 vs 1.96 ± 0.67, 1.32 ± 0.56 vs 1.96 ± 0.67, respectively, P < 0.001), earlier extubation(16.56 ± 5.24 min vs 19.76 ± 5.75 min, P < 0.05, 15.48 ± 4.59 min vs 19.76 ± 5.75 min, P < 0.01), and earlier recovery of bowel function(2.96 ± 1.17 d vs 3.60 ± 1.04 d, 2.80 ± 1.38 d vs 3.60 ± 1.04 d, respectively, P < 0.05). The mean length of hospitalization after surgery was reduced in groups CWI(8.20 ± 2.58 d vs 10.08 ± 3.15 d, P < 0.05) and EA(7.96 ± 2.30 d vs 10.08 ± 3.15 d, P < 0.01) compared with group PCIA. All three groups had similar patient satisfaction and wound healing, but group PCIA was prone to higher sedation scores when compared with groups CWI and EA, especially during the first 12 h after surgery. Group EA had a lower mean arterial pressure within the first postoperative 12 h compared with the other two groups.CONCLUSION : CWI with ropivacaine yields a satisfactory analgesic effect within the first 48 h after open gastrectomy, with lower morphine consumption and accelerated recovery.
基金supported by a grant from National University Students'Innovation and Entrepreneurship Training project(No.201810026036)a grant from the National Key Basic Research and Development Program"973"Project(No.2007CB512503)。
文摘Objective:Electroacupuncture(EA)is good at post-surgical pain.But point selection method in treating incision-induced pain remains a major clinical challenge.We reasoned that different acupoints may work though adjusting prostaglandin E2 in spinal cord.We wish to explore the analgesic mechanism of electroacupuncture on plantar incision pain rats and provide more therapeutic ideas for acupuncture analgesia.Methods:A total of 50 male rats were randomly divided into a sham operation group,a model group,an EA 1,EA 2 and a drug group(n=10,each).A rat model of left plantar incision pain was established.The rats in EA1 group was needled at ipsilateral Yanglingquan(GB34)and Taixi(KI3).The rats in EA2 group was needled at ipsilateral Quchi(LI11)and Hegu(LI4).EA stimulation(2/100 Hz,1-2-3 mA)was administered 30 minutes immediately after operation.The rats in drug group were fed with Fenbid by gavage 20 minutes before incision(30 mg/kg,p.o.).The hot plate pain detector was used to measure the thermal pain threshold(TPT)before and 24 hours after operation Prostaglandin E2 content of spinal cord was detected by enzyme-linked immunosorbent assay(ELISA)at 1 and 24 hours after operation.Results:Compared with sham operation group,the TPT in model group decreased 41%.Compared with the model group,the TPT increased 56%in EA1,29%in EA2,190%in drug group(P>0.05).At 1 h after operation,compared with the sham operation group,PGE_2 in model group increased 15%.Compared with the model group,PGE_2 in drug group decreased 5%.At 24 hours after operation,compared with sham operation group,PGE_2 in model group increased 9%.Compared with model group,it decreased 4%in EA 1 group,8%in drug group and increased 3%in EA2 group.Conclusion:Both the drug and the electroacupuncture can adjust the 24-hour pain threshold and PGE_2 in spinal cord.The curative effects of the drug are better than that of electroacupuncture.The proximal point is better than that of the distal point.Electroacupuncture can treat postoperative pain by regulating PGE_2 in spinal cord.
