BACKGROUND Tourniquets are commonly used in elective extremity orthopaedic surgery to reduce blood loss,improve visualization in the surgical field,and to potentially reduce surgical time.There is a lack of consensus ...BACKGROUND Tourniquets are commonly used in elective extremity orthopaedic surgery to reduce blood loss,improve visualization in the surgical field,and to potentially reduce surgical time.There is a lack of consensus in existing guidelines regarding the optimal tourniquet pressure,placement site,and duration of use.There is a paucity of data on the relationship between the site of a tourniquet and postoperative pain in foot and ankle surgery.AIM To explore the relationship between tourniquet site and intensity of post-operative pain scores in patients undergoing elective foot and ankle surgery.METHODS Retrospective analysis of prospectively collected data on 201 patients who underwent foot and ankle surgery in a single institution was undertaken.Intraoperative tourniquet duration,tourniquet pressure and site,and postoperative pain scores using Visual Analogue Score were collected in immediate recovery,at six hours and at 24 h post-op.Scatter plots were used to analyse the data and to assess for the statistical correlation between tourniquet pressure,duration,site,and pain scores using Pearson correlation coefficient.RESULTS All patients who underwent foot and ankle surgery had tourniquet pressure of 250 mmHg for ankle tourniquet and 300 mmHg for thigh.There was no correlation between the site of the tourniquet and pain scores in recovery,at six hours and after 24 h.There was a weak correlation between tourniquet time and Visual Analogue Score immediately post-op(r=0.14,P=0.04)but not at six or 24 h post-operatively.CONCLUSION This study shows that there was no statistically significant correlation between tourniquet pressure,site and postop pain in patients undergoing foot and ankle surgery.The choice of using a tourniquet is based on the surgeon's preference,with the goal of minimizing the duration of its application at the operative site.展开更多
Children often experience pain in different stage of life. After birth, newborns are exposed to many painful attempts and their anxiety levels increase with it. These painful attempts lead to metabolic or physiologica...Children often experience pain in different stage of life. After birth, newborns are exposed to many painful attempts and their anxiety levels increase with it. These painful attempts lead to metabolic or physiological problems in newborns. Excessive protein expenditure when exposed to pain for a long time, electrolyte inhalation, weakening of the immune system. Even repetitive painful procedures increase mortality and morbidity. Children experience pain due to acute onset diseases such as otitis media or pharyngitis and also in different medical interventions such vaccination, blood transfusion, vascular access, dressing change, lumber punching, or sickle cell anemia. Appropriate assessment scales should be used to treat pain effectively and adequately. Pharmacological treatment as well as non-pharmacological treatment methods has been found to be effective in the treatment of pain. Non-pharmacological methods allow your body to release natural endorphins and help to lift the pain to a minimum level or completely. In this study, current approaches and studies about pain in children will be presented. Non-pharmacological methods will be examined in more detail. Every child has right to live a painless life. It is one of the main purposes of nursing care to relieve children’s pain and improve their life quality.展开更多
目的评估标准化急诊预检分诊模式在急诊胸痛患者中的应用效果。方法选择2023年2—5月福建省泉州市第一医院城东院区急诊科接诊的50例急性胸痛患者为对照组,2023年6—9月福建省泉州市第一医院城东院区急诊科接诊的50例急性胸痛患者为研...目的评估标准化急诊预检分诊模式在急诊胸痛患者中的应用效果。方法选择2023年2—5月福建省泉州市第一医院城东院区急诊科接诊的50例急性胸痛患者为对照组,2023年6—9月福建省泉州市第一医院城东院区急诊科接诊的50例急性胸痛患者为研究组。对照组采用传统急诊预检分诊方法,研究组采用基于改良早期预警评分系统(modified early warning score,MEWS)的标准化急诊预检分诊模式。比较2组患者急诊处理时间、急性冠脉综合征患者首次医疗接触到球囊开通时间(first medical contact to balloon,FMC-to-B)、进入医院大门至球囊开通时间(door to ballon,D-to-B)、不良事件发生情况。结果研究组预检分诊时间[(2.2±0.5)min vs.(3.6±1.4)min]、首份心电图时间[(6.1±1.9)min vs.(8.9±2.6)min]、床旁即时检测完成时间[(21.4±3.2)min vs.(30.6±6.8)min]、急诊科停留时间[(40.2±7.6)min vs.(54.6±11.8)min]均短于对照组(P<0.05)。研究组急性冠脉综合征患者FMC-to-B[(50.4±9.3)min vs.(71.3±14.7)min]与D-to-B[(78.6±11.7)min vs.(106.9±15.4)min]短于对照组(P<0.05)。研究组心力衰竭、休克、心律失常累计发生率低于对照组(10.0%vs.28.0%,P<0.05)。结论基于MEWS的标准化急诊预检分诊模式可提升急性胸痛救治效率,改善患者预后。展开更多
AIM: To evaluate safety, efficacy, and patient adherence of intracameral lidocaine as supplement of classic topical anesthetic drops in cataract surgery.METHODS: A prospective and controlled trial including a large co...AIM: To evaluate safety, efficacy, and patient adherence of intracameral lidocaine as supplement of classic topical anesthetic drops in cataract surgery.METHODS: A prospective and controlled trial including a large cohort of 1650 individuals suffering with bilateral cataract not complicated, in program by phacoemulsification surgery, were randomly assigned to 2 different groups for the type of anesthesia received, 0.4% oxybuprocaine hydrochloride(INN) drops, and INN drops associated to intracameral 1% lidocaine hydrochloride monohydrate. At the end of surgery, tables were assigned to each patient indicating the degree of pain(0-3) felt during the operation.RESULTS: Thirty-two percent of patients in group 1 declared to have not felt any pain against the 77% of patients in group 2. Fifty-nine percent of patients in group 1 complained about only a slight discomfort against 20% of group 2 patients. Only a small percentage of patients in group 1(5%) admitted severe pain, while no patient in group 2 admitted severe pain. Four patients of group 2 reported an episode of transient amaurosis, lasting several hours after surgery.CONCLUSION: Intracameral administration of lidocaine is a simple and secure method able to increase the analgesia during the cataract surgery, eliminating the discomfort and increasing also the cooperation of the patients during the steps of manipulation.展开更多
文摘BACKGROUND Tourniquets are commonly used in elective extremity orthopaedic surgery to reduce blood loss,improve visualization in the surgical field,and to potentially reduce surgical time.There is a lack of consensus in existing guidelines regarding the optimal tourniquet pressure,placement site,and duration of use.There is a paucity of data on the relationship between the site of a tourniquet and postoperative pain in foot and ankle surgery.AIM To explore the relationship between tourniquet site and intensity of post-operative pain scores in patients undergoing elective foot and ankle surgery.METHODS Retrospective analysis of prospectively collected data on 201 patients who underwent foot and ankle surgery in a single institution was undertaken.Intraoperative tourniquet duration,tourniquet pressure and site,and postoperative pain scores using Visual Analogue Score were collected in immediate recovery,at six hours and at 24 h post-op.Scatter plots were used to analyse the data and to assess for the statistical correlation between tourniquet pressure,duration,site,and pain scores using Pearson correlation coefficient.RESULTS All patients who underwent foot and ankle surgery had tourniquet pressure of 250 mmHg for ankle tourniquet and 300 mmHg for thigh.There was no correlation between the site of the tourniquet and pain scores in recovery,at six hours and after 24 h.There was a weak correlation between tourniquet time and Visual Analogue Score immediately post-op(r=0.14,P=0.04)but not at six or 24 h post-operatively.CONCLUSION This study shows that there was no statistically significant correlation between tourniquet pressure,site and postop pain in patients undergoing foot and ankle surgery.The choice of using a tourniquet is based on the surgeon's preference,with the goal of minimizing the duration of its application at the operative site.
文摘Children often experience pain in different stage of life. After birth, newborns are exposed to many painful attempts and their anxiety levels increase with it. These painful attempts lead to metabolic or physiological problems in newborns. Excessive protein expenditure when exposed to pain for a long time, electrolyte inhalation, weakening of the immune system. Even repetitive painful procedures increase mortality and morbidity. Children experience pain due to acute onset diseases such as otitis media or pharyngitis and also in different medical interventions such vaccination, blood transfusion, vascular access, dressing change, lumber punching, or sickle cell anemia. Appropriate assessment scales should be used to treat pain effectively and adequately. Pharmacological treatment as well as non-pharmacological treatment methods has been found to be effective in the treatment of pain. Non-pharmacological methods allow your body to release natural endorphins and help to lift the pain to a minimum level or completely. In this study, current approaches and studies about pain in children will be presented. Non-pharmacological methods will be examined in more detail. Every child has right to live a painless life. It is one of the main purposes of nursing care to relieve children’s pain and improve their life quality.
文摘目的评估标准化急诊预检分诊模式在急诊胸痛患者中的应用效果。方法选择2023年2—5月福建省泉州市第一医院城东院区急诊科接诊的50例急性胸痛患者为对照组,2023年6—9月福建省泉州市第一医院城东院区急诊科接诊的50例急性胸痛患者为研究组。对照组采用传统急诊预检分诊方法,研究组采用基于改良早期预警评分系统(modified early warning score,MEWS)的标准化急诊预检分诊模式。比较2组患者急诊处理时间、急性冠脉综合征患者首次医疗接触到球囊开通时间(first medical contact to balloon,FMC-to-B)、进入医院大门至球囊开通时间(door to ballon,D-to-B)、不良事件发生情况。结果研究组预检分诊时间[(2.2±0.5)min vs.(3.6±1.4)min]、首份心电图时间[(6.1±1.9)min vs.(8.9±2.6)min]、床旁即时检测完成时间[(21.4±3.2)min vs.(30.6±6.8)min]、急诊科停留时间[(40.2±7.6)min vs.(54.6±11.8)min]均短于对照组(P<0.05)。研究组急性冠脉综合征患者FMC-to-B[(50.4±9.3)min vs.(71.3±14.7)min]与D-to-B[(78.6±11.7)min vs.(106.9±15.4)min]短于对照组(P<0.05)。研究组心力衰竭、休克、心律失常累计发生率低于对照组(10.0%vs.28.0%,P<0.05)。结论基于MEWS的标准化急诊预检分诊模式可提升急性胸痛救治效率,改善患者预后。
文摘AIM: To evaluate safety, efficacy, and patient adherence of intracameral lidocaine as supplement of classic topical anesthetic drops in cataract surgery.METHODS: A prospective and controlled trial including a large cohort of 1650 individuals suffering with bilateral cataract not complicated, in program by phacoemulsification surgery, were randomly assigned to 2 different groups for the type of anesthesia received, 0.4% oxybuprocaine hydrochloride(INN) drops, and INN drops associated to intracameral 1% lidocaine hydrochloride monohydrate. At the end of surgery, tables were assigned to each patient indicating the degree of pain(0-3) felt during the operation.RESULTS: Thirty-two percent of patients in group 1 declared to have not felt any pain against the 77% of patients in group 2. Fifty-nine percent of patients in group 1 complained about only a slight discomfort against 20% of group 2 patients. Only a small percentage of patients in group 1(5%) admitted severe pain, while no patient in group 2 admitted severe pain. Four patients of group 2 reported an episode of transient amaurosis, lasting several hours after surgery.CONCLUSION: Intracameral administration of lidocaine is a simple and secure method able to increase the analgesia during the cataract surgery, eliminating the discomfort and increasing also the cooperation of the patients during the steps of manipulation.
