BACKGROUND Patients who undergo orthopedic procedures are often given excess opioid medication.Understanding the relationship between pain and opioid consumption following total hip arthroplasty(THA)is key to creating...BACKGROUND Patients who undergo orthopedic procedures are often given excess opioid medication.Understanding the relationship between pain and opioid consumption following total hip arthroplasty(THA)is key to creating safe and effective opioid prescribing guidelines.AIM To evaluate the association between the quantity of opioid consumption in relation to pain scores both pre-and postoperatively in patients undergoing primary THA.METHODS We retrospectively reviewed patients who underwent primary THA from November 2018-May 2019 and answered both the visual analog scale(VAS)pain and opioid medication questionnaires pre-and postoperatively.Both surveys were delivered daily for 7-days before surgery through the first 30 postoperative days.Survey results were divided into preoperative,postoperative days 1-7,postoperative days 8-14,and postoperative days 15-30 for analysis.Mean opioid pill consumption and VAS pain scores in each time period were determined and compared to patients’preoperative status using hierarchical Poisson and linear regressions,respectively.RESULTS There were 105 patients included.Mean VAS pain scores were the highest preoperatively 7.41±1.72.However,VAS pain scores significantly declined in each successive postoperative category compared to preoperative scores:postoperative day 1-7(5.07±1.79;P<0.001),postoperative day 8-14(3.60±1.64;P<0.001),and postoperative day 15-30(3.15±1.63;P<0.001).Mean opioid pill consumption preoperatively was 0.68±1.29 pills.Compared to preoperative opioid consumption,opioid use was significantly greater between postoperative days 1-7(1.51±1.58;P=0.001)and postoperative days 8-14(1.00±1.27;P=0.043).Opioid consumption declined below preoperative levels between postoperative days 15-30(0.35±0.72;P=0.160)which correlates with a VAS pain score of 3.15.CONCLUSION All patients experienced significant benefit and pain relief from having undergone THA.Average postoperative opioid consumption decreased below preoperative consumption between postoperative days 15-30,which was associated with a VAS pain score of 3.15.These results can be used to appropriately guide opioid prescribing practices and set patient expectations regarding pain management following THA.展开更多
目的观察激痛点火针疗法对腰背肌筋膜炎患者疼痛的影响。方法选取2021年3月—2023年3月在福建中医药大学附属三明市中西医结合医院康复科就诊的腰背肌筋膜炎患者65例,按随机数字表法分为对照组(n=32)与观察组(n=33)。对照组采用常规针...目的观察激痛点火针疗法对腰背肌筋膜炎患者疼痛的影响。方法选取2021年3月—2023年3月在福建中医药大学附属三明市中西医结合医院康复科就诊的腰背肌筋膜炎患者65例,按随机数字表法分为对照组(n=32)与观察组(n=33)。对照组采用常规针刺治疗,观察组采用针刺联合激痛点火针疗法。6周后评估2组患者疼痛评分、腰椎功能评分,观察腰背部红外成像结果。结果观察组患者视觉模拟评分法(visual analog scale,VAS)评分[(3.76±1.08)分vs.(5.28±1.55)分],Oswestry功能障碍指数问卷(Oswestry disability index,ODI)评分[(13.76±3.42)分vs.(11.50±4.58)分]及腰背部红外成像的平均温度[(30.21±3.03)℃vs.(33.31±3.16)℃]均显著低于对照组,差异有统计学意义(P<0.05)。结论针刺联合激痛点火针疗法可以有效缓解腰背肌筋膜炎患者疼痛,改善腰椎功能障碍。展开更多
文摘BACKGROUND Patients who undergo orthopedic procedures are often given excess opioid medication.Understanding the relationship between pain and opioid consumption following total hip arthroplasty(THA)is key to creating safe and effective opioid prescribing guidelines.AIM To evaluate the association between the quantity of opioid consumption in relation to pain scores both pre-and postoperatively in patients undergoing primary THA.METHODS We retrospectively reviewed patients who underwent primary THA from November 2018-May 2019 and answered both the visual analog scale(VAS)pain and opioid medication questionnaires pre-and postoperatively.Both surveys were delivered daily for 7-days before surgery through the first 30 postoperative days.Survey results were divided into preoperative,postoperative days 1-7,postoperative days 8-14,and postoperative days 15-30 for analysis.Mean opioid pill consumption and VAS pain scores in each time period were determined and compared to patients’preoperative status using hierarchical Poisson and linear regressions,respectively.RESULTS There were 105 patients included.Mean VAS pain scores were the highest preoperatively 7.41±1.72.However,VAS pain scores significantly declined in each successive postoperative category compared to preoperative scores:postoperative day 1-7(5.07±1.79;P<0.001),postoperative day 8-14(3.60±1.64;P<0.001),and postoperative day 15-30(3.15±1.63;P<0.001).Mean opioid pill consumption preoperatively was 0.68±1.29 pills.Compared to preoperative opioid consumption,opioid use was significantly greater between postoperative days 1-7(1.51±1.58;P=0.001)and postoperative days 8-14(1.00±1.27;P=0.043).Opioid consumption declined below preoperative levels between postoperative days 15-30(0.35±0.72;P=0.160)which correlates with a VAS pain score of 3.15.CONCLUSION All patients experienced significant benefit and pain relief from having undergone THA.Average postoperative opioid consumption decreased below preoperative consumption between postoperative days 15-30,which was associated with a VAS pain score of 3.15.These results can be used to appropriately guide opioid prescribing practices and set patient expectations regarding pain management following THA.
文摘目的 观察头穴丛刺长留针法治疗偏头痛的临床疗效。方法 将88例偏头痛患者随机分为观察组(44例,脱落2例)和对照组(44例,脱落3例)。观察组采用常规针刺联合头穴丛刺长留针法治疗,对照组采用常规针刺方法治疗。比较两组临床疗效,观察两组治疗前后的视觉模拟量表(visual analog scale, VAS)评分、偏头痛特异性生活质量问卷(migraine-specific quality of life questionnaire, MSQ)、血清5-羟色胺(5-hydroxytryptamine, 5-HT)浓度。结果 观察组总有效率为92.9%,高于对照组的78.0%,差异有统计学意义(P>0.05)。两组治疗后VAS评分较治疗前降低(P<0.05),两组随访时VAS评分较治疗前和治疗后降低(P<0.05);观察组治疗后及随访时,VAS评分均低于对照组(P<0.05)。两组治疗后MSQ评分较治疗前升高(P<0.05),两组随访时MSQ评分较治疗前和治疗后升高(P<0.05);观察组治疗后及随访时,MSQ评分均高于对照组(P<0.05)。两组治疗后血清5-HT浓度均升高,且观察组高于对照组,差异有统计学意义(P<0.05)。结论 在常规针刺基础上,头穴丛刺长留针法治疗偏头痛临床疗效优于常规针刺方法,且在减轻偏头痛患者疼痛程度,改善其生活质量及提高5-HT浓度方面优于常规针刺方法。
文摘目的观察激痛点火针疗法对腰背肌筋膜炎患者疼痛的影响。方法选取2021年3月—2023年3月在福建中医药大学附属三明市中西医结合医院康复科就诊的腰背肌筋膜炎患者65例,按随机数字表法分为对照组(n=32)与观察组(n=33)。对照组采用常规针刺治疗,观察组采用针刺联合激痛点火针疗法。6周后评估2组患者疼痛评分、腰椎功能评分,观察腰背部红外成像结果。结果观察组患者视觉模拟评分法(visual analog scale,VAS)评分[(3.76±1.08)分vs.(5.28±1.55)分],Oswestry功能障碍指数问卷(Oswestry disability index,ODI)评分[(13.76±3.42)分vs.(11.50±4.58)分]及腰背部红外成像的平均温度[(30.21±3.03)℃vs.(33.31±3.16)℃]均显著低于对照组,差异有统计学意义(P<0.05)。结论针刺联合激痛点火针疗法可以有效缓解腰背肌筋膜炎患者疼痛,改善腰椎功能障碍。