As a new technology of drug-free treatment, virtual reality technique has been used in various medical fields, and is being increasingly applied in the field of wound repair. Virtual reality technology can alleviate the pain caused by acute and chronic wounds, relieve the psychological anxiety of patients with wounds, and then facilitate the recovery of patients. This paper reviews the research progress of virtual reality technique's application as a clinical adjuvant therapy in wound repair in three aspects: pain treatment, psychological treatment, and functional rehabilitation, analyzes the advantages and disadvantages of this technique, and discusses the prospects of its further application in the field of wound repair.
Anxiety ; Humans ; Pain ; Pain Management/methods* ; Technology ; Virtual Reality

Transcuataneous electrical nerve stimulation (TENS) analgesia as a non-drug method has received people's more and more attention recently. Considering problems of existing products, such as unstable performance and unsatisfied effectiveness, we developed a new analgesia therapy system for delivery based on bio-feedback TENS in our laboratory. We proposed a new idea for stimulation signal design, that is, we modulated a middle frequency signal by a traditional low frequency TENS wave in the new system. We designed different prescription waves for pain relief during a uterine contraction or massage between contractions. In the end, a bio-feedback TENS method was proposed, in which the waveforms of stimulation signals were selected and their parameters were modified automatically based on feedback from uterine pressure, etc. It was proved through quality tests and clinical trials that the system had good performance and satisfied analgesia effectiveness.
Analgesia ; methods ; Biofeedback, Psychology ; methods ; Female ; Humans ; Pain Management ; Transcutaneous Electric Nerve Stimulation ; methods ; Uterine Contraction

Epidural steroid injection (ESI), which is commonly used for treatment of low back pain with lumbosacral radicular pain, can be performed via transforaminal, interlaminar, or caudal routes. The transforaminal route is generally regarded as more effective than the interlaminar route due to its high level of drug delivery to the ventral epidural space. However, in some postoperative patients, use of the transforaminal route may be difficult. Thus, there is an urgent need for technology that can offer more effective drug delivery to the ventral epidural space with fewer complications. In this context, we describe a case about our new method where patient has undergone oblique interlaminar lumbar epidural steroid injection (OIL-ESI) instead of transforaminal ESI. We treated a patient with OIL-ESI instead of transforaminal ESI. Patient was symptomatic improved at postoperative visits. Based on our findings, OIL-ESI may be a suitable alternative to transforaminal ESI.
Epidural Space ; Fluoroscopy ; Humans ; Injections, Epidural ; Low Back Pain* ; Methods ; Pain Management

Epidural steroid injection (ESI), which is commonly used for treatment of low back pain with lumbosacral radicular pain, can be performed via transforaminal, interlaminar, or caudal routes. The transforaminal route is generally regarded as more effective than the interlaminar route due to its high level of drug delivery to the ventral epidural space. However, in some postoperative patients, use of the transforaminal route may be difficult. Thus, there is an urgent need for technology that can offer more effective drug delivery to the ventral epidural space with fewer complications. In this context, we describe a case about our new method where patient has undergone oblique interlaminar lumbar epidural steroid injection (OIL-ESI) instead of transforaminal ESI. We treated a patient with OIL-ESI instead of transforaminal ESI. Patient was symptomatic improved at postoperative visits. Based on our findings, OIL-ESI may be a suitable alternative to transforaminal ESI.
Epidural Space ; Fluoroscopy ; Humans ; Injections, Epidural ; Low Back Pain* ; Methods ; Pain Management

Pain is the most common symptom in clinics. Therefore, the quality, time course and location of pain are important for the diagnosis and treatment. However, pain is very difficult to define, and it is one of the conditions poorly understood by the medical sciences. In Western medicine pain is often described in terms of a penetrating or tissue-destructive process and/or emotional reactions, but in Chinese medicine the pathogenesis and description of pain are different. It is described based on the theories and pathogenesis of Chinese medicine, and the patients' feeling according to their languages and cultures. Thus, when taking the history and conducting physical examination in patients in China and treating them according to Chinese medicine, we have to know how these patients express and describe their pain when they go to clinics. This article will explain some terms and words in the Chinese language and their corresponding terms in the English language.
Blood Circulation ; physiology ; Humans ; Medicine, Chinese Traditional ; methods ; Pain ; etiology ; Pain Management ; Pressure ; Temperature ; Time Factors

Transcutaneous electrical nerve stimulation (TENS), as a non-pharmacological and non-invasive analgesic therapy with low-cost, has been widely used to relieve pain in various clinical applications, by delivering current pulses to the skin area to activate the peripheral nerve fibers. Nevertheless, analgesia induced by TENS varied in the clinical practice, which could be caused by the fact that TENS with different stimulus parameters has different biological mechanisms in relieving pain. Therefore, to advance our understanding of TENS in various basic and clinical studies, we discussed (1) neurophysiological and biochemical mechanisms of TENS-induced analgesia; (2) relevant factors that may influence analgesic effects of TENS from the perspectives of stimulus parameters, including stimulated position, pulse parameters (current intensity, frequency, and pulse width), stimulus duration and used times in each day; and (3) applications of TENS in relieving clinical pain, including post-operative pain, chronic low back pain and labor pain. Finally, we propose that TENS may involve multiple and complex psychological neurophysiological mechanisms, and suggest that different analgesic effects of TENS with different stimulus parameters should be taken into consideration in clinical applications. In addition, to optimize analgesic effect, we recommend that individual-based TENS stimulation parameters should be designed by considering individual differences among patients, e.g., adaptively adjusting the stimulation parameters based on the dynamic ratings of patients' pain.
Analgesia ; methods ; Humans ; Pain Management ; Pain Measurement ; Skin ; Transcutaneous Electric Nerve Stimulation

BACKGROUND: Surgical-site, multimodal drug injection has recently evolved to be a safe and useful method for multimodal pain management even in patients with musculoskeletal trauma. METHODS: Fifty consecutive patients who underwent plating for mid-shaft and distal clavicular fractures were included in the study. To evaluate whether surgical-site injections (SIs) have pain management benefits, the patients were divided into two groups (SI and no-SI groups). The injection was administered between the deep and superficial tissues prior to wound closure. The mixture of anesthetics consisted of epinephrine hydrochloride (HCL), morphine sulfate, ropivacaine HCL, and normal saline. The visual analogue scale (VAS) pain scores were measured at 6-hour intervals until postoperative hour (POH) 72; stress biomarkers (dehydroepiandrosterone sulfate [DHEA-S], insulin, and fibrinogen) were measured preoperatively and at POH 24, 48, and 72. In patients who wanted further pain control or had a VAS pain score of 7 points until POH 72, 75 mg of intravenous tramadol was administered, and the intravenous tramadol requirements were also recorded. Other medications were not used for pain management. RESULTS: The SI group showed significantly lower VAS pain scores until POH 24, except for POH 18. Tramadol requirement was significantly lower in the SI group until POH 24, except for POH 12 and 18. The mean DHEA-S level significantly decreased in the no-SI group (74.2 ± 47.0 µg/dL) at POH 72 compared to that in the SI group (110.1 ± 87.1 µg/dL; p = 0.046). There was no significant difference in the insulin and fibrinogen levels between the groups. The correlation values between all the biomarkers and VAS pain scores were not significantly different between the two groups (p > 0.05). CONCLUSIONS: After internal fixation of the clavicular fracture, the surgical-site, multimodal drug injection effectively relieved pain on the day of the surgery without any complications. Therefore, we believe that SI is a safe and effective method for pain management after internal fixation of a clavicular fracture.
Anesthetics ; Biomarkers* ; Clavicle ; Epinephrine ; Fibrinogen ; Humans ; Insulin ; Methods ; Morphine ; Pain Management ; Pain, Postoperative ; Tramadol ; Wounds and Injuries

Moderate and deep sedation can effectively relieve or eliminate the pain and body discomfort during wound dressing change in pediatric burn patients, relieve anxiety, agitation, and even delirium of the children, reduce the metabolic rate of the children, make them in a quiet, comfortable, and cooperative state, which is conducive to the smooth completion of dressing change. This paper summarized the three aspects of moderate and deep sedation in pediatric burn patients, including the overview, main points of implementation, and effects, and further introduced the moderate and deep sedation medication regimens for different routes of administration, as well as the content of evaluation and monitoring. Suggestions on the prevention and management of related complications and the management of moderate and deep sedation implementation procedures were put forward, in order to provide references for the development of moderate and deep sedation for wound dressing change in pediatric burn patients in China.
Child ; Humans ; Bandages/adverse effects* ; Burns/therapy* ; Deep Sedation ; Pain/complications* ; Pain Management/methods*

BACKGROUND: The effects of acupuncture have varied in different randomized controlled trials (RCTs), and there are many factors that influence treatment effect of acupuncture in different outcomes, with conflicting results. OBJECTIVE: To identify factors and their impact on the treatment effect of acupuncture in different outcomes. METHODS: Acupuncture RCTs were searched from 7 databases including Medline (PubMed), Embase, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Wanfang Database, VIP Database, and China Biology Medicine disc between January 1st, 2015 and December 31st, 2019. Eligible studies must compare acupuncture to no acupuncture, sham acupuncture, or waiting lists, and report at least 1 patient-important outcome. A multi-level meta-regression was conducted using a 3-level robust mixed model and univariate analyses were performed for all independent variables, even those excluded from the multivariable model due to collinearities. We used thresholds of 0.2 and 0.4 for the difference of standardized mean differences (SMDs), categorising them as small (<0.2), moderate (0.2-0.4), or large (>0.4) effects. RESULTS: The pain construct analysis involved 211 effect estimates from 153 studies and 14 independent variables. High-frequency acupuncture treatment sessions produced larger effects compared to low-frequency sessions [large magnitude, the difference of adjusted SMDs 0.46, 95% confidence interval (CI) 0.07 to 0.84; P=0.02]. The non-pain symptoms construct analysis comprised 323 effect estimates from 231 studies and 15 independent variables. Penetrating acupuncture showed moderately larger effects when compared to non-penetrating acupuncture (0.30, 95% CI 0.06 to 0.53; P=0.01). The function construct analysis included 495 effect estimates from 274 studies and 14 independent variables. Penetrating acupuncture and the flexible acupuncture regimen showed moderately larger effects, compared to non-penetrating acupuncture and fixed regimen, respectively (0.40, 95% CI 0 to 0.80; P=0.05; 0.29, 95% CI 0.06 to 0.53; P=0.01). CONCLUSIONS High-frequency acupuncture sessions appear to be a more effective approach to managing painful symptoms. Penetrating acupuncture demonstrated greater effect in relieving non-painful symptoms. Both penetrating acupuncture type and flexible acupuncture regimen were linked to significant treatment effects in function outcomes. Future studies should consider the factors that are significantly associated with the effects of acupuncture in patient-important outcomes.
Humans ; Randomized Controlled Trials as Topic ; Acupuncture Therapy/methods* ; Pain ; Pain Management ; China

Fu's subcutaneous needling (FSN) is a modern approach developed from traditional Chinese acupuncture. It could give some stimulation in the subcutaneous region that has a quick and long-lasting effect on soft tissue injuries and some of the internal medicine diseases. It is a safe approach without adverse reaction. Through analysis of the features and possible mechanism of FSN, it is believed that research on mechanism of FSN is beneficial to the development of modern medicine, especially to pain management.
Acupuncture Analgesia ; instrumentation ; methods ; Acupuncture Points ; Humans ; Pain Management ; instrumentation ; methods