To compare the effect of cold or room temperature of tumescence anesthesia solution on pain perception during and after endovenous laser ablation (EVLA) for varicose veins of lower limb.
 Methods: A total of 51 patients with lower extremity varicose vein were treated by EVLA with tumescence anesthesia solution. All patients were used for local anesthesia and randomly divided into 2 groups according to the temperature of tumescence anesthesia solution: Group A (n=26) with room temperature (24 ℃) of tumescence anesthesia solution and Group B (n=25) with cold (4 ℃) tumescence anesthesia solution. Number rating scale (NRS) was recorded immediately after the procedure and postoperative 1, 2, 3 day. Patients were asked to register pain scores during the week.
 Results: The mean linear endovenous energy density (LEED) in the 2 groups was not significantly different (P>0.05). The ratio of patients without pain during the operation in the Group A was lower than that in the Group B (30.8% vs 64%, P<0.05). On the day of operation and postoperative day 1, 2, 3, the average number rating scale (NRS) scores in the Group A were greater than those in the Group B (P<0.05). Postoperative day 1, only 30.8% of the patients in the Group A resumed daily activities, which was lower than that (68% of the patients) in the Group B.
 Conclusion: In the process of EVLA for varicose veins of lower limb, there is less pain during operation and post-operation using cold tumescence anesthesia solution comparing room temperature tumescence anesthesia solution.
Anesthesia ; methods ; Cold Temperature ; Humans ; Intraoperative Complications ; physiopathology ; Laser Therapy ; Lower Extremity ; Pain Measurement ; Pain Perception ; physiology ; Pain, Postoperative ; physiopathology ; Treatment Outcome ; Varicose Veins ; physiopathology ; surgery

OBJECTIVE: To determine the effect of preamputation pain on the behavioral response and astrocytic activation in the spinal cord of amputated rats, and to assess the association between preamputation pain and chronic amputation-related pain. METHODS: A total of 84 adult male SD rats were randomly distributed into an NA group (n=42) and a PA group (n=42). The NA group was intraplantarly injected with saline 100 μL, while the PA group was intraplantarly injected with complete Freund's adjuvant (CFA) 100 μL in both cases at 7 d before the amputation. Thermal withdrawal latency (TWL) was measured before the injection and at 1, 3, 5, and 7 d after the injection. All rats were amputated on the 7th day. The TWL, diet and water intake were measured on 1, 3, 5, 7, 10, 14, 17, 21, and 28 d after the amputation. Expression of glial fibrillary acidic protein (GFAP) in the L4-6 of spinal cord was measured by immunohistochemistry before the saline/ CFA injection, 7 d after the injection and 1, 3, 5, 7, 10 d after the amputation.. RESULTS: The TWL significantly decreased on 1, 3, 5, and 7 d after the intraplantar administration of CFA compared with the basic value in the PA group (P<0.05), while there was no difference between 1, 3, 5, and 7 d after the intraplantar administration of saline and the basic value in the NA group (P>0.05). In addtions to the basic value, the TWL of the PA group was shorter than that of the NA group at the above-mentioned time-points (P<0.05). Compared with the preoperative level, the diet and water intake decreased significantly after the amputation in both groups, but recovered to the preoperative levels, by 3 d after the amputation in the NA group, and by 5 d after the amputation in the PA group. Compared with the TWL of the residual limb on the day of amputation, the TWL of the residual limb increased significantly 3 d after the amputation and remained elevated until 28 d after the amputation in the NA group (P<0.05), while there was no difference between each time point after the amputation and the day of the amputation in the PA group. Compared with the basic value, there was an obviously high expression of GFAP in the NA group beginning on the day of amputation and in the PA group 7 d after the CFA injection (P<0.05). After the amputation, the expression of GFAP was significantly higher in the PA group (P<0.05). CONCLUSION Preamputation pain delays the recovery and activates the spinal astrocytes which may turn the acute postoperative pain into a chronic one.
Amputation ; Animals ; Astrocytes ; physiology ; Behavior, Animal ; Male ; Pain ; physiopathology ; Pain, Postoperative ; physiopathology ; Preoperative Period ; Rats ; Rats, Sprague-Dawley ; Spinal Cord ; physiopathology

PURPOSE: To compare early postoperative pain and visual outcomes after epipolis-laser in situ keratomileusis (epi-LASIK) and photorefractive keratectomy (PRK) in the treatment of myopia. METHODS: A retrospective chart review was designed and included 49 eyes in 30 patients who underwent epi-LASIK and 54 eyes in 29 patients who underwent PRK. During the early postoperative period (days 1 to 5), pain, uncorrected visual acuity (UCVA), and time to epithelial healing were recorded. Visual outcomes were followed for up to six months. RESULTS: Mean preoperative spherical equivalent refraction for the epi-LASIK group was -3.99+/-1.39 diopters (D) and that of the PRK group was -3.54+/-1.27 D. The pain scores on the fourth postoperative day were significantly higher in the epi-LASIK group than in the PRK group (p=0.017). Duration of pain in the epi-LASIK group was longer than in the PRK group (p=0.010). Mean healing time was significantly longer in the epi-LASIK group than in the PRK group (p<0.000). In addition, UCVA in the epi-LASIK group at postoperative days 1 and 3 were significantly lower than those in the PRK group (p=0.021 and p<0.000, respectively). Uncorrected visual acuity at one week and one month after epi-LASIK were lower than those after PRK (p=0.023 and p=0.004, respectively). CONCLUSIONS: In the epi-LASIK patients, pain relief, corneal healing, and visual recovery seemed to be slower during the early postoperative period compared to those of the PRK patients. With longer duration of follow-up, however, there were no significant differences in visual outcome between the two groups.
Adult ; Humans ; *Keratomileusis, Laser In Situ ; Pain, Postoperative/*physiopathology ; *Photorefractive Keratectomy ; Postoperative Period ; Retrospective Studies ; Treatment Outcome ; *Visual Acuity ; Young Adult

OBJECTIVETo evaluate the outcome of total knee arthroplasty with or without resurfacing of the patella with particular attention to knee score, knee function score and incidence of postoperative anterior knee pain, providing the basis for the choice of surgical procedure.

METHODSCNKI, PubMed, ScienceDirect, Highwire and other databases were searched for the randomized controlled trials relevant to the patellar with or without replacement in total knee replacement arthroplasty between 1998 and 2010, evaluating of the methodological quality of included studies and extracting valid data.

RESULTSThe 80 citations were identified as related to patellar resurfacing during total knee arthroplasty, 13 articles meet all inclusion criteria for this study. The incidence of postoperative anterior knee pain is greater in knees without replaced patellas (RR = 0.78, 95%CI: 0.61 - 0.99, P = 0.04). No differences are observed between the 2 groups for knee score and knee function score. Knee score (WMD = -0.49, 95%CI: -1.79 - 0.81, P = 0.46), knee function score (WMD = 1.10, 95%CI: -1.77 - 3.98, P = 0.45).

CONCLUSIONSThe patella replacement can significantly reduce the incidence of postoperative anterior knee pain. There is no difference in the knee score and knee function score between two groups.

Arthroplasty, Replacement, Knee ; adverse effects ; methods ; Humans ; Knee Joint ; physiopathology ; Pain, Postoperative ; etiology ; Patella ; surgery ; Randomized Controlled Trials as Topic

OBJECTIVETo prove analgesia and sedative effect of adjuvant anesthesia with magnetic auricular point-sticking on abdominal gynecological operation and its effect on postoperative recovery of body function.

METHODSNinety-two patients with abdominal gynecological operation were randomly divided into 3 groups. The auricular point-sticking group (APS group, n=31) was pasted and pressed by plasters with magnetic beads at bilateral Shenmen, Pizhixia (subcortex), Zigong (uterus) and Penqiang (pelvic cavity), etc. the night before operation. The placebo group (n=31) was pasted by plasters without magnetic beads. The blank group (n=30) was given no intervention. The mental and gastrointestinal functional changes before and 3 days after the operation were observed.

RESULTSAs compared with those in the control group and the blank group, the postoperative score of Self rating Anxiety Scale (SAS) was less (25.5 +/- 0.81 vs. 28.9 +/- 3.19, 28.3 +/- 2.36, both P < 0.01), with lower-dose of Innovar [(2.5 + 1.1) mL vs. (3.4 + 1.8) mL, (3.2 + 1.6) mL, both P < 0.05], earlier exsufflation after the operation [(34.2 + 12.1) h vs. (46.3 + 10.9) h, (43.2 + 14.8) h, both P < 0.01] and higher level serum of beta-endorphin before and after the operation in the APS group (all P < 0.05).

CONCLUSIONThe magnetic auricular point-sticking has sedative, analgesic and function-regulating effects on the abdominal gynecological operation.

Acupuncture Analgesia ; Acupuncture, Ear ; Adjuvants, Anesthesia ; administration & dosage ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Pain, Postoperative ; drug therapy ; physiopathology ; therapy ; Postoperative Period ; Recovery of Function ; Young Adult

Scrotal pain is a common complaint in a urological practice. Its diagnosis can prove challenging in both acute and chronic forms and requires a thorough and complete history and physical examination. This article discusses the evaluation and management of several entities of scrotal pain, including testicular torsion, epididymitis, postvasectomy pain, varicocele, and chronic orchialgia.
Diagnosis, Differential ; Epididymitis/*diagnosis/drug therapy ; Humans ; Male ; Pain/*diagnosis ; *Pain Management ; Pain, Postoperative ; Physical Examination ; *Scrotum ; Spermatic Cord Torsion/*diagnosis/surgery ; Testis/physiopathology ; Varicocele/*diagnosis/physiopathology/therapy ; Vasectomy

BACKGROUNDAnalgesic and wound-healing effects of cinnamon, a widely used spice, have been shown in laboratory rats. However, we found no human studies in this area.

OBJECTIVEThe aim of this study was to assess the effect of cinnamon on perineal pain and healing of episiotomy incision.

DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONSIn this double-blind, randomized, placebo-controlled trial, 144 postpartum women were allocated into two groups, using stratified block randomization, 1 h after completion of episiotomy repair. They received cinnamon or placebo ointment, 2 mL every 12 h for 10 d.

MAIN OUTCOME MEASURESPerineal pain and wound healing were assessed using visual analogue scale (0-10) and Redness, Edema, Ecchymosis, Discharge, Approximation scale (0-15), respectively. General linear model was used to compare the groups on the outcomes adjusted for baseline values and stratified factors.

RESULTSFollow-up rate was 100% up to the 8 h time point in both groups, and 86% (62 of 72) in the cinnamon group and 85% (61 of 72) in the placebo group at day 10-11 after delivery. Pain score in the cinnamon group was significantly lower than that in the placebo group at (4±1) h (adjusted difference: -0.6, 95% confidence interval: -1.0 to -0.2) and (8±1) h (-0.9, -1.4 to -0.3) after intervention, and on the 10-11th day after delivery (-1.4, -2.0 to -0.7). Also the cinnamon group showed significantly more improvement than the control group in healing score at (8±1) h (-0.2, -0.4 to -0.04) and the 10-11th day after delivery (-1.6, -2.0 to -1.1).

CONCLUSIONCinnamon can be used for reducing perineal pain and improving healing of episiotomy incision.

Adult ; Analgesics ; administration & dosage ; Cinnamomum zeylanicum ; chemistry ; Delivery, Obstetric ; Female ; Humans ; Pain Measurement ; Pain, Postoperative ; drug therapy ; physiopathology ; Pelvic Pain ; drug therapy ; physiopathology ; Perineum ; surgery ; Plant Extracts ; administration & dosage ; Wound Healing ; drug effects ; Young Adult

OBJECTIVETo evaluate the role that post-operative difference value of pelvic incidence and lumbar lordosis (PI-LL) played on loss of correction, implant failure and health-related quality of life during follow-up in degenerative scoliosis patients.

METHODSRetrospective review of 62 patients (average age (57 ± 10) years, 11 male and 51 female patients) with degenerative scoliosis who underwent one stage posterior surgical instrumentation in the affiliated Drum Tower Hospital of Nanjing University Medical School from January 2005 to December 2011. The mean follow-up duration was 4.2 years. Long-cassette standing upright sagittal radiographs were obtained before and after operation and at the last follow-up. At the last follow-up, visual analogue scale and Oswestry disability index were collected. Based on post-operative PI-LL, patients were divided into two groups: group A (-9° < post-operative PI-LL<9°) and group B (post-operative PI-LL < -9°or post-operative PI-LL>9°). Independent t test and χ(2) test were performed for statistical analysis. For all statistical analysis, the level of significance was set at P < 0.05.

RESULTSNo difference was observed in terms of loss of correction between two groups during follow-up. More implant failure were observed in group B (15.63% vs. 6.7%, χ(2) = 21.85, P = 0.012). In addition, patients with better PI-LL matching came with better visual analogue scale (3.9 ± 2.4 vs. 5.2 ± 3.3, F = 0.089, P = 0.024).

CONCLUSIONWorse quality of life and increased risk for implant failure during follow-up may be related to mismatched PI-LL.

Aged ; Female ; Humans ; Incidence ; Lordosis ; complications ; physiopathology ; Male ; Middle Aged ; Pain Measurement ; Pelvis ; Postoperative Period ; Posture ; Quality of Life ; Retrospective Studies ; Scoliosis ; complications ; physiopathology ; Spine ; Treatment Outcome

OBJECTIVETo evaluate the benefit and safety of continuous femoral nerve block in patients undergoing total knee arthroplasty.

METHODSFrom December 2008 to August 2009, 80 patients with total knee arthroplasty were randomly divided into two groups, 40 patients in each group. In group A the pain-control was dominanted by continuous femoral nerve block, there were 5 males adn 35 females with an average age of (65.0 +/- 4.2) years old; In group B the pump of vein odynolysis was used, there were 5 males and 35 females with an average age of (64.7 +/- 8.5) years old. The treatment of relieve pain continued for 3 days. The pain of visual analog scale (VAS), sleep condition, early-stage rehabilitation and adverse effects were recorded.

RESULTSThe VAS scores of group A was lower than that of group B at 2, 6, 24, 36, 48, 56, 72 h after operation (P < 0.05 or P < 0.01); The sleep condition and early-stage rehabilitation of group A were better than that of group B. The complications of group B occurrenced more than group A; The analgetica of group B were used more than that of group A.

CONCLUSIONThe continuous femoral nerve block is an effective pain relieve method and is benefical to rehabilitation from total knee arthroplasty early.

Aged ; Analgesia ; Arthroplasty, Replacement, Knee ; rehabilitation ; Female ; Femoral Nerve ; Humans ; Knee Joint ; physiopathology ; Male ; Middle Aged ; Nerve Block ; methods ; Pain Measurement ; Pain, Postoperative ; therapy

OBJECTIVETo establishment and verify pelvic nerve denervation (PND) model in mice.

METHODS(1) Establishment of models. Seventy-two healthy male SPE class C57 mice with age of 7 weeks and body weight of (25±1) g were chosen. These 72 mice were randomly divided into PND group containing 36 mice and sham operation group containing 36 mice. Referring to the establishment method of PND rats, after anesthesia, a laparotomy was performed on the mouse with an abdominal median incision. Under the dissection microscope, the pelvic nerves behind and after each sides of the prostate gland were bluntly separated with cotton swabs and cut with a dissecting scissor. After the operation, the urination of mice was assisted twice every day. For the mice of sham operation group, the pelvic nerves were only exposed without cutting. (2) Detection of models. Colonic transit test was performed in 18 mice chosen randomly from each group to detect the colonic transit ratio (colored colon by methylene blue/ whole colon) and visceral sensitivity tests was performed in the rest mice to observe and record the changes of electromyogram.

RESULTSThree mice died of colonic transit test in each group. Uroschesis occurred in all the mice of PND group and needed bladder massage to assist the urination. Colonic transit test showed that the colonic transit ratios of sham operation group at postoperative day (POD) 1, 3 and 7 were (0.4950±0.3858)%, (0.6386±0.1293)% and (0.6470±0.1088)% without significant difference (F=0.3647, P=0.058), while in PND group, the colonic transit ratio at POD 7 [(0.6044±0.1768) %] was obviously higher than that both at POD 3[(0.3876±0.1364)%, P=0.022] and POD 1[(0.2542±0.0371)%, P=0.001], indicating a recovery trend of colonic transit function (F=9.143, P=0.004). Compared with the sham operation group, the colonic transit function in PND group decreased significantly at POD 1 and POD 3(both P<0.05), and at POD 7, there was no significant difference between two groups. Visceral sensitivity test showed that the visceral sensitivity of sham operation group at POD 1, 3 and 7 was 24.2808±9.5566, 33.6725±7.9548 and 43.9086±12.1875 with significant difference (F=5.722, P=0.014). The visceral sensitivity of PND group at POD 1, 3 and 7 was 11.7609±2.1049, 21.8415±8.1527 and 26.2310±4.2235 with significant difference as well (F=11.154, P=0.001). The visceral sensitivity at POD 3 and POD 7 was obviously higher than that at POD 1 (P=0.006, P<0.001), and there was no significant difference between POD 3 and POD 7 (P=0.183). Compared with sham operation group, the visceral sensitivity of PND group decreased significantly at POD 1, 3 and 7(all P<0.05).

CONCLUSIONSDenervation of pelvic nerves can obviously decrease the colonic transit function and the visceral sensitivity of mice, but these changes can recover over time, which suggests that the establishment of PND model in mice is successful.

Abdominal Pain ; physiopathology ; Animals ; Autonomic Pathways ; growth & development ; physiopathology ; surgery ; Colon ; innervation ; physiopathology ; Denervation ; methods ; Disease Models, Animal ; Gastrointestinal Transit ; physiology ; Male ; Mice ; Mice, Inbred C57BL ; Nerve Tissue ; growth & development ; physiopathology ; surgery ; Pain, Postoperative ; physiopathology ; Pelvis ; innervation ; physiopathology ; surgery ; Prostate ; innervation ; Recovery of Function ; physiology