Clinical attitudes towards pain treatment post-orthopedic surgery： a multicenter study in Beijing

Background Pain is a common post-operative complication. Incidence of pain directly affects patients＇ quality of life in terms of patient physiology, psychology, and social characteristics. This study was to understand clinical attitudes with regards to Beijing surgeons, and patients＇ attitude towards pain treatment after orthopedic surgery. Methods A hospital-based cross-sectional and cluster sample survey of 40 hospitals in Beijing was conducted, including 20 level III （tier three） and 20 level II （tier two） general hospitals. Enrolled subjects completed a specifically designed interview-questionnaire. Results The prevalence of pain 2 weeks post-orthopedic surgery was high in Beijing （96.1%）. Meanwhile, collected data indicated most subjects in Beijing suffered moderate to severe pain, 45.1% and 41.4%, respectively, post-surgery. And for the concern of patients before surgery, most subjects chose full recovery from surgery （78.6%）, as well as, the pain after operation was 39.2% ranked the third. According to the data from the study, Tramadol use was more common in Level III hospitals, where Somiton was preferred in Level II hospitals. When it came to the education of pain before and after operation, more patients get educated before operation than after it. In our study, case physicians or attending physicians enacted education before and after surgery. Related to the sense of patients, among the surgeons preferring post-operative analgesia, 67.6% considered administration when receiving complaints of moderate level pain, 50.0% indicated they will terminate analgesic treatment once pain degree scale wise decreases to benign pain. Conclusions The majority of orthopedic patients experience post-operative pain. Identification of post-operative pain will facilitate future awareness on pain treatment and nursing care in Beijing hospitals, with pain relief through regulated improvements in strategic pain management.

A Clinical Observation of Functional Abdominal Pain Syndrome in Patients Treated by Traditional Chinese Spinal Orthopedic Manipulation

Objective： To evaluate the clinical effect of traditional Chinese spinal orthopedic manipulation（TCSOM） in treating patients with functional abdominal pain syndrome（FAPS） in comparison with Pinaverium Bromide（Dicetel, PBD）, and to assess a possible cause for FAPS. Methods： Eighty patients with FAPS were randomly and equally assigned to the TCSOM group and PBD group according to the random number table. All patients in the TCSOM group were treated with a maximum of 5 times of spinal manipulations. Patients in the PBD group were instructed to take 50 mg 3 times a day, consistently for 2 weeks. The symptoms of pre-and post-treatment were assessed on a visual analog scale（VAS） pain score. A symptom improvement rating（SIR） was implemented to evaluate the effects of the treatments. Results： The symptoms of 27 cases of the TCSOM group were relieved soon after the first TCSOM treatment and 9 cases were significantly improved. The VAS pain scores in the TCSOM group were significantly lower than those in the PBD group after 2 weeks treatment. According to the SIR based on VAS, the TCSOM group included 30 cases with excellent results, 7 cases with good, and 3 cases with poor. Adverse events to the treatment were not reported. Based on VAS, the PBD group reported 8 cases with excellent results, 10 cases with good and 22 cases with poor. There was a significant difference between the two groups（P〈0.01）. Conclusions： The displacement of intervertebral discs and/or vertebra in the thoracic or lumbar region seems to be a contributing factor in the symptoms of FAPS. TCSOM is an effective treatment for FAPS.