Medicine and Health Sciences Commons^™

Effect Of Intraoperative Dexmedetomidine Infusion On Perioperative Opioid Use, Lindsey Holter

Nursing Capstones

No abstract provided.

Intraoperative Lidocaine Infusions For Postoperative Pain Management, Sarah Solberg

Nursing Capstones

No abstract provided.

Restoration Of Penile Sensation After Dorsal Nerve Trauma In Cismen, Kevin M. Klifto, A. Lee Dellon

Research Day

Purpose: Loss of penis sensation or development of a painful penis can occur after injury to the dorsal branch of the pudendal nerve. Attempted relief of this problem through neurolysis of the dorsal nerve in the inferior pubic ramus canal has been reported rarely. While recovery of genital sensibility has been discussed frequently in transmen, this subject has been reported rarely in cismen. The purpose of this report is to review our experience with recovery of sensation after decompression of the dorsal branch of the pudendal nerve.

Methods: A retrospective chart review was carried out from 2014 to …

Children And Their Parents’ Assessment Of Postoperative Surgical Pain: Agree Or Disagree?, Olivia Kaminsky, Michelle Fortier, Brooke N. Jenkins, Robert S. Stevenson, Jeffrey I. Gold, Jeannie Zuk, Brenda Golianu, Sherrie H. Kaplan, Zeev N. Kain

Psychology Faculty Articles and Research

Objective

The purpose of this study is to compare postoperative pain scores between children undergoing tonsillectomy and adenoidectomy (T&A) surgery and their parents, identify potential predictors for this disagreement, and determine possible impact on analgesic administration.

Methods

This is a prospective longitudinal study conducted with children undergoing outpatient T&A in 4 major tertiary hospitals and their parents. Children and their parents were enrolled prior to surgery and completed baseline psychological instruments assessing parental anxiety (STAI), parental coping style (MBSS), child temperament (EAS) and parental medication administration attitude questionnaire (MAQ). Postoperatively, parents and children completed at-home pain severity ratings (Faces Pain …

Correlation Of Chronic Conditions And Pain Scale With Varying Levels Of Obesity In The Geriatric Population, Shabbir Hossain, Adarsh Gupta D.O.

Rowan-Virtua Research Day

The overall objective of this study was to establish whether obesity’s contribution to pain is stronger than vice versa – the medical debilities in elderly patients that contribute to obesity. In the process, this study will allow us to achieve whether different age samples with similar BMIs demonstrate the same level of medical complexities in geriatric patients. In summary, the purpose of this research study was to correlate a relationship between obesity and aging. We hypothesized that obesity will contribute to greater pain in the aging population, and that patients – regardless of their age groups in the aging population …

Increasing Doses Of Intraoperative Hydromorphone Do Not Reduce Postoperative Pain, Craig S. Curry, Michael B. Henry, Wendy Craig, Janelle M. Richard, Denham S. Ward

MaineHealth Maine Medical Center

Introduction:

• Intermediate and long acting opioids are given intraoperatively to reduce pain during emergence from anesthesia.

• Recent evidence suggests that intraoperative opioids have inconsistent effects on nociception and pain in the immediate postoperative period.

• Multiple potent, short-acting opioids such as remifentanil, sufentanil and fentanyl have been shown to produce dose-related increases in pain scores and opioid consumption in the immediate postoperative recovery period.

• Intraoperative doses of longer acting opioids such as morphine and methadone6 have been shown to reduce pain scores and narcotic requirements in the immediate postoperative period.

• Hydromorphone is an intermediate duration narcotic …

Welfare Challenges Influence The Complexity Of Movement: Fractal Analysis Of Behaviour In Zebrafish, Anthony G. Deakin, Joseph W. Spencer, Andrew R. Cossins, Iain S. Young, Lynne U. Sneddon

Experimental Research and Animal Welfare Collection

The ability to assess welfare is an important refinement that will ensure the good condition of animals used in experimentation. The present study investigated the impact of invasive procedures on the patterns of movement of zebrafish (Danio rerio). Recordings were made before and after fin clipping, PIT tagging and a standard pain test and these were compared with control and sham handled zebrafish. The fractal dimension (FD) from the 3D trajectories was calculated to determine the effect of these treatments on the complexity of movement patterns. While the FD of zebrafish trajectories did not differ over time in either the …

Caring For Children With Severe Cerebral Palsy: The Lived Experience Of Parents, Jason Eric Cook

Department of Physical Therapy Student Theses, Dissertations and Capstones

The purpose of this study is to explore the lived experience of parents who care for their child withcerebral palsy who function at Gross Motor Function Classification System (GMFCS) Level V. Additionally, the study also explores the parent’s understandings and beliefs about pain and non-pain related emotional distress, and the meaning of caring, providing care, and providing comfort for their child with GMFCS Level V cerebral palsy. The study was conducted using a qualitative, hermeneutic phenomenology approach with semi-structured interviews and participant-initiated journaling. The study included 11 participants who are caregiving parents of their child with GMFCS Level V cerebral …

Is Cannabis Effective In Reducing Muscle Spasticity And Body Pain Amongst Patients With Multiple Sclerosis?, William E. Johnson

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not cannabis is effective in reducing muscle spasticity and body pain amongst patients with Multiple Sclerosis (MS).

STUDY DESIGN: A systematic review of three peer-reviewed studies published between the years of 2003 and 2012.

DATA SOURCES: Three randomized control trials (RCTs) evaluating if cannabis can reduce muscle spasticity and body pain for patients diagnosed with Multiple Sclerosis. All three sources were selected from PubMed and examined for outcomes that were patient oriented.

OUTCOMES MEASURED: The two primary outcomes measured include: muscle spasticity measured by the Ashworth scale, …

Does Grounding To The Earth Reduce Subjective Experience Of Pain?, Adam Umbro

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not grounding to the earth reduces subjective experience of pain.

STUDY DESIGN: This paper evaluates one double-blind, randomized placebo-controlled trial, one randomized placebo-controlled trial, and one prospective cohort trial investigating the efficacy of grounding in reducing subjects’ experience of pain.

DATA SOURCES: All articles were published in English language peer-reviewed journals and accessed through PubMed.

OUTCOMES MEASURED: The outcome measured in this review is the subjective experience of pain by study participants. Pain levels are measured using a visual-analog pain scale or pain survey.

RESULTS: Two studies …

Use Of Emoji In Pain Level Assessment In Pediatric Dental Patients, Manpreet K. Dhillon

Theses and Dissertations

USE OF EMOJI IN PAIN LEVEL ASSESSMENT IN PEDIATRIC DENTAL PATIENTS

Purpose: The purpose of this study is to determine the efficacy of a pain scale with Emoji images in comparison to the commonly used Wong-Baker FACES® pain scale. Methods: Healthy, English-speaking patients aged 4-17 presenting to the VCU Pediatric Dental clinic and the operating room and presenting to the MCV Pediatric Emergency Room were asked to rate their pain using the Wong-Baker FACES® and Emoji scales. These patients were then asked to select which pain scale they preferred. Results: A total of 151 children were enrolled in the study. …

The Relationship Between Generalized Anxiety Disorder And Self-Reported Pain Scores Among Emergency Department Patients, Nicholas Seitz

Scholarship in Medicine - All Papers

Anxiety is common among Emergency Department (ED) patients. Self-reported pain scores have been associated with a variety of physical and psychological factors. However, the relationship between pain and anxiety in ED patients has not been previously reported. This study aims to identify a relationship between self-reported pain scores and the diagnosis of generalized anxiety disorder among ED patients.

This prospective patient survey study was conducted at Miami Valley Hospital, an urban ED in Dayton, Ohio. Eligible participants included ED patients age 18 or over, with a self-reported pain score ranging from 1-10 on the verbal numeric rating pain scale (VNRS). …

Multimodal Analgesia In Orthopaedic Surgery And Presentation Of A Comprehensive Postoperative Pain Protocol: A Review, Christopher L. Shultz, Benjamin D. Packard, Kathryn C. Helmig, Christopher Kurnik, Benjamin S. Albertson, Nathan E. Huff, Gehron P. Treme

UNM Orthopaedic Research Journal

Rising opioid use in the United States has now been termed an epidemic. Opioid use is associated with considerable morbidity, mortality, and cost to the healthcare system. Orthopaedic surgeons play a key role in the opioid epidemic by prescribing postoperative narcotics. Although our understanding of the quantity of narcotics to prescribe postoperatively for analgesia is progressing, there is still a paucity of data focused on routine postoperative pain protocols. The purpose of this article is to review the current options for both opioid and non-opioid analgesia and put forth a multisubspecialty orthopaedic protocol of postoperative pain. On the basis of …

Enhancing Comfort Care Techniques In The Pediatric Inpatient Setting, Nicole Rae Mansky

Walden Dissertations and Doctoral Studies

The benefits of pharmacological and nonpharmacological interventions for children undergoing painful medical procedures are well documented in extant nursing literature; however, such techniques continue to be underused in practice. Improving comfort during medical procedures is necessary to enhance the patient and family experience. The purpose of this project was to provide education to nursing staff about pediatric pain theories and evidence-based practice recommendations that support the use comfort interventions for pediatric patients of all ages. The practice-focused question addressed the development of an educational program designed to enhance staff knowledge of comfort intervention options and the benefits provided to patients. …

Using Music Therapy As An Adjunct To Pharmacologic Therapies For Chronic Pain, Andrea L. Rosenberg

Theses and Graduate Projects

Chronic pain affects more than 1 in 4 individuals in the United States. Many patients are being prescribed opioids to manage this pain, leading to an immense problem involving addiction, overdoses, and preventable deaths. Music therapy has been shown to provide “music analgesia,” improving anxiety, depression, and mobility problems associated with chronic pain conditions. The most benefit was seen when the music was known to the patient, the patient had a role in choosing the music, and when the music had a beat of less than 120 beats per minute. These promising results include a wide variety of chronic pain …

Low Back Pain In Family Practice, Marc R. Kostrubiak

Family Medicine Clerkship Student Projects

Low Back Pain (LBP) is the worlds leading cause of disability and the second most common reason for visiting a physician in the US. LBP is the second only to heart disease in healthcare costs. In most cases a definitive cause is never found, however most cases are also self-limited. Patient education in this area is currently insufficient and many people expect to receive advanced imaging and treatments. Most of the time these are not indicated and may be harmful to patients. To address the gap in patient knowledge and improve health literacy a patient focused educational trifold pamphlet was …

Caregiver Burnout, Elizabeth Anne Lynch

Family Medicine Clerkship Student Projects

Caring for someone with advanced health care needs, dementia, or a difficult diagnosis can take a mental, physical and financial toll on the caregiver. It is important for providers to recognize, address and assist caregivers in as many ways as possible. Providing physicians with a readily available patient-education template in Epic may improve outreach and communication with increasingly isolated patients and caregivers and improve care for all without burdening physicians more.

Lived Experience After Surgery Among Hispanic Adults, Kimberly Sanchez

Dissertations

Background: In 2010, more than 51.4 million procedures were performed in hospitals in the United States. Almost half of all patients had a surgical procedure prior to their hospital discharge and over 80% of patients experienced acute pain after surgery. When acute pain persists for two or more months after surgery, chronic pain develops, costing the United States up to $635 billion annually. Hispanics, in particular, disproportionately experience disparities in pain treatment as they are less likely to receive analgesics. Routine pain assessments conducted using instruments may be inaccurately capturing the pain experience of Hispanic adults. No research has …

Efficiency Of Pulsed Electromagnetic Fields On Pain, Disability, Anxiety, Depression, And Quality Of Life In Patients With Cervical Disc Herniation: A Randomized Controlled Study, Erkam Hattapoğlu, İbrahi̇m Batmaz, Banu Di̇lek, Mehmet Karakoç, Serda Em, Remzi̇ Çevi̇k

Turkish Journal of Medical Sciences

Background/aim: In this study, it was aimed to investigate the effects ofpulsed electromagnetic field(PEMF) therapy on pain, disability, psychological state, and quality of life in cervical disc herniation.Materials and methods: Patients were randomly divided into two groups, including Group 1, which received a therapy consisting of transcutaneous electrical nerve stimulation (TENS), hot pack (HP), and PEMF, and Group 2, which received a magnetic field (sham magnetic field) without current flow in addition to TENS and HP therapy. Pain was assessed by a visual analog scale (VAS, 0?10 cm). The other outcome measures were function (Neck Pain and Disability Scale), anxiety-depressive …

Pharmacological Assessment Of Adjuncts To Enhance Mu-Opioid Receptor Agonist Antinociception In Male Rhesus Monkeys: Does One + One = Three?, Jeremy Cornelissen

Theses and Dissertations

Mu-opioid receptor (MOR) agonists are effective agents for pain management, but are also limited by a number of undesirable effects. One approach to enhance the therapeutic effects and minimize the undesirable effects of MOR agonists may be to combine MOR agonists with an adjunct targeting a different receptor system. This targeted medical approach, known as “combination therapy”, aims to augment the desired effects of the MOR agonist (i.e. antinociception) and/or diminish the undesirable deleterious side effects of the MOR agonist. This dissertation investigated the utility of this approach in an assay of thermal nociception and schedule-controlled responding in male rhesus …

Fatigue And Sleep In Children And Adolescents With Juvenile Idiopathic Arthritis:A Cross-Sectional Study, Ela Tarakci, Sai̇me Ni̇lay Arman, Kenan Barut, Sezgi̇n Şahi̇n, Amra Adrovi̇ç, Özgür Kasapçopur

Turkish Journal of Medical Sciences

The aims of this study were to primarily investigate fatigue and sleep and to secondarily examine possible relationships between disease activity, pain, and functional ability in children and adolescents with juvenile idiopathic arthritis (JIA). Materials and methods: Ninety-six patients were enrolled in the study. Disease activity, functional ability, fatigue symptoms, fatigue severity, and sleep quality were assessed with the Juvenile Arthritis Disease Activity Score (JADAS), Childhood Health Assessment Questionnaire (CHAQ), Pediatric Quality of Life Inventory-Multidimensional Fatigue Scale (PedsQL-F), visual analog scale (VAS), and Pittsburgh Sleep Quality Index (PSQI), respectively. Results: Fatigue severity was moderate to high in 75% of patients …

Local Radiation Therapy For Palliation In Patients With Multiple Myeloma Of The Spine, D. Mark, P. Gilbo, R. Meshrekey, M. Ghaly

Journal Articles

No abstract provided.

Primary Open Abductor Reconstruction - A 5-10 Year Study, Olivia J.K Fox, Graeme Wertheimer, Michael Walsh

Medical Papers and Journal Articles

Background: Gluteal tears are recognised as the source of pain over the greater trochanter. We investigated the outcome of primary open abductor tendon reconstruction with a 5 year follow-up.

Methods: 165 consecutive hips underwent an open abductor tendon reconstruction, with all tears confirmed pre-operatively by MRI. Oxford hip scores (OHS) were assessed at the initial visit, and at 5 to 10 years.

Results: The average pre-operative OHS was 22 (r: 7y – 34y) and average post-operative OHS was 40 a difference of 18 (p<0.0001).

Conclusion: Surgical reconstruction of degenerate abductor tendons should be considered in the presence of an MRI …