• Post-fistulotomy, patients often experience bleeding, pain, and delayed wound healing. • Sucralfate has antioxidant and antimicrobial effects. It also increases prostaglandin E2 secretion to increase mucus formation and blood flow. Additionally it increased the amount of epidermal growth factor, leading to the formation of more blood vessels (angiogenesis). • Sucralfate is an effective pain reducer and has been used in oral mucositis and post-tonsilectomy pain2-4 • When used topically, sucralfate exhibits analgesic effects post-hemorrhoidectomy5. The authors conducted a prior study and obtained similar analgesics effects 48 hours post-hemorrhoidtectomy.6 • Study not registered on clinicaltrials.gov • Study is registered in the Iranian Registry …show more content…
However the registry states that data was collected every 2 weeks. • Funded by the Mazandaran University of Medical Sciences Ethics committee • Authors declared no conflict of interest • Single-centered and parallel • Prospective randomized placebo-controlled trial • Double-blind • A nurse, unaware of the trial’s protocol and did not participate in the trial procedure, performed the randomization. • Blinded players: Health care providers, surgeon, data collectors, and the patients themselves • The blinded players did not know which treatments were being used for each patient until the end of the trial • Setting: Iman Khomeini educational hospital located in Sari, Mazandaran province in Iran. • Trial period: February 2014-March 2015 • All patients underwent elective fistulotomy • Patient ages ranged from 20-70 years • Exclusion criteria: multiple fistulas, previous fistula surgery, long-term use of corticosteroids, hx of IBD, radiation exposure, or use of chemotherapy within the last 2 …show more content…
• Primary outcomes: Postoperative pain intensity and pain upon defecation • Secondary outcomes: Anal pruritis, wound discharge, wound infection, bleeding, flatal incontinence, further curettage, and other adverse drug events • Pain was assessed using the visual analogue scale (VAS) based on the patient’s subjective perception. Scale ranged from 0-10 with 10 being the worst pain • The outcomes were examined at each weekly post-op clinic visit • Post-op clinic visits were done each week after the fistolotomy for 5 weeks. • Sucralfate ointment group: 24 patients • Placebo ointment group: 24 patients • Sample sizes were calculated by estimating a 95% confidence interval, 80% power, and 25% reduction in intensity of pain. This calculation determined that there should be at least 18 patients per group. • Utilized the SPSS software • Compared the means using independent sampled t-tests and ANOVA • The qualitative data (secondary outcomes) were compared using the chi-squared test • Ps G 95% CI Lower Limit 95% CI Upper Limit 1 -0.915 -1.371 -0.458 2 -1.459 -1.78 -1.138 3 -1.24 -1.506 -0.974 4 -1.847 -2.135 -1.559 5 -1.456 -1.706
It is essential that when using evidence-based practice guidelines to choose a treatment, that variety of research methods are applied so that the best relevant data can be produced. Such methods include qualitative/quantitative research, randomised controlled trials and systematic reviews. Both qualitative and quantative methods produce valuable data. Quantative research produces numeric evidence that is necessary for practice and can be measured and qualitative research produces descriptive data about the subject by using patients views etc. which can also be applied to clinical practice (Broeder et al, 2010)
Pain has been defined by Coates & Hindle as an unpleasant emotional and sensory experience which signals a potential or actual damage to tissues (2011, p. 213). Pain is a common human experience and can emanate from injury and illness. There are two main types of pain; acute pain is short-lived, lasting for minutes or several days and its onset often takes place rapidly. It results from the activation of pain nerve endings or nociceptors either by internal or external pain stimuli. On the other hand chronic pain is continuous and sometimes recurrent and can last for weeks, months or even years. Chronic pain is usually not located at or related to the tissue undergoing trauma (Draper & Knight, 2007, p. 104). Various theories have been proposed to explain the mechanism underlying the transmission and perception of pain.
Winfield, H., Katsikitis, M., Hart, L. and Rounsefell, B. (1989). Postoperative pain experiences: Relevant patient and staff attitudes. [online] 34(5): pp.543-552. Available at: http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T8V-45WYV7R-7G&_user=10&_coverDate=12%2F31%2F1990&_rdoc=1&_fmt=high&_orig=gateway&_origin=gateway&_sort=d&_docanchor=&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=35e6b5e8c8f803b487b35d4ae3b06cef&searchtype=a[ [accessed 8/5/2013]
Pain Management Nursing, 10(2), 76-84.
Assessing and managing pain is an inevitable part of nursing and the care of patients. Incomplete relief of pain remains prevalent despite years of research due to barriers such as lack of kn...
Potter, J. E., White, K., Hopkins, K., Amastae, J., & Grossman, D. (2010). Clinic Versus Over-
on Pain Care will evaluate the adequacy of pain assessment, treatment, and management; identify and
To provide the best care for their elderly patients, nurses must incorporate pain assessment into their daily care of patients. Pain assessment is a key aspect of the nurse’s role. There are many factors to consider when assessing patients’ pain such as if they are verbal or non-verbal, what language they speak, their age and their cultural background. There are many tools that a nurse can use to assess a patient’s pain but one of the most common tools is the 0-10 scale. This tool can be asked verbally by asking what their pain level is on a scale of 0 to 10 with 0 being no pain and 10 being the worst pain they have ever had. You may also use this tool in a visual manner with faces that correlate to the numbers. 0 being a happy face and 10 being a very sad face. Elderly patients from diverse cultural backgrounds are increasing in long term care facilities so it is important to have a 0 – 10 pain scale written in their native language. Some patients are stoic and do not express their pain as much as other people so it is important to understand that a 0 – 10 pain scale might not always be sufficient and could be combined with observing any physical signs that the patient might be in pain such as facial expressions and guarding. Nurses must have a good base of knowledge and attitude towards pain and always take what the patient reports their pain scale to be as truth. If the patient does report pain it would be important to treat the pain or if it is a new occurrence to follow this assessment up with another val...
Within this set, the investigators randomized how many trials the participants would complete: 7, 10, or 13. Then, they were giving the chance to do 3 or 6 more trials and were ask to record their results.
Conclusions. An adequate and clear understanding of the concept of pain and implementing interventions of pain treatment and management is essential in the clinical settings. Understanding the concept of pain is necessary for its relationships with other concepts that are related and similar to the pain experience for theory building. The in the end, understanding the concept of pain will ultimately benefit the patient and lead to better and approp...
Pain, which is defined in its widest sense as an emotion which is the opposite of pleasure (White, 2004, p.455), is one of the major symptoms of cancer, affecting a majority of sufferers at some point during their condition (De Conno & Caraceni, 1996, p.8). The World Health Organization (WHO, 2009, online) suggests that relief from pain may be achieved in more than 90 percent of patients; however, Fitzgibbon and Loeser (2010, p.190) stress that pain may often be undertreated, even in the UK. Foley and Abernathy (2008, p.2759) identify numerous barriers to effective pain management, among which are professional barriers such as inadequate knowledge of pain mechanisms, assessment and management strategies.
Lindley, P., Pestano, C. R., & Gargiulo, K. (2009). Comparison of postoperative pain management using two patient-controlled analgesia methods: Nursing perspective. Journal of Advanced Nursing, 65(7), 1370-1380. doi: 10.1111/j.1365-2648.2009.04991.x
O'Brien, D. (2009). Randomized controlled trials (RCTs). In R. Mullner (Ed.), Encyclopedia of health services research. (pp. 1017-1021). Thousand Oaks, CA: SAGE Publications, Inc. doi: http://dx.doi.org.proxy1.ncu.edu/10.4135/9781412971942
...amount of pain) is a great teaching tool for the patient who is able to self-report (Nevius & D’Arcy, 2008). This will put the patient and nurse on the same level of understanding regarding the patient’s pain. The patient should also be aware of the added information included with the pain scale: quality, duration, and location of the pain. During patient teaching, it should be noted that obtaining a zero out of ten on the pain scale is not always attainable after a painful procedure. A realistic pain management goal can be set by the patient for his pain level each day.
The nurse should educate the patient of the importance of pain control and how controlling pain is essential to a patient’s wellbeing and recovery. It needs to be a balance of what the patient says and what the nurse observes and interprets while always respecting the wishes of the patient. Nurses have a variety of assessment tools available to assess pain in their patients. One dimensional pain scales such as visual analog scale, verbal descriptor scale, numeric pain intensity scale and the combined thermometer scale all measure the intensity of the pain (Jensen, 2011). Other pain scales such as McGill pain questionnaire, brief pain inventory, and brief pain impact questionnaire take into account aspects beyond intensity (Jensen 2011). There are additional pain assessments specialized for children, older adults, patients who are unable to respond, and patients with opioid tolerance (Jensen, 2011). The nurse should be familiar with these methods of pain assessment and know the appropriate use of each. Incorrect medication and treatment choices due to inaccurate or poor pain assessment cause patient suffering (Jensen,