Analgesic effect of music during wound care among patients with diaphyseal tibial fractures: Randomized controlled trial.

BACKGROUND: Evidence is scarce regarding the analgesic effect of music for the relief of acute pain during the care of surgical tibial fracture wounds. OBJECTIVE: To evaluate the analgesic effect of music on acute procedural pain during the care of surgical tibial fracture wounds. METHOD: This was a randomized, controlled, blinded clinical trial with 70 patients in the immediate postoperative period for diaphyseal tibial fracture surgery. Participants were randomly allocated to two groups: a control group (CG), in which patients received only the institution's standard analgesia, and an intervention group (IG) composed of patients receiving a 30-min session of music of their own choice, as a complementary method to the institution's standard analgesia. Pain was evaluated during the first postoperative dressing change, using the Numerical Rating Scale (NRS). RESULTS: The sample was homogeneously composed of men (91.4%), young adults (61.4%), without previous diseases (88.6%) and whose traumas were related to a motorcycle crash (84.3%). The main musical genres chosen by participants were the most popular in their region (61.4%). Those who listened to music presented lower pain scores when compared with those in the CG (IG:2.4 ± 2.4 versus CG:5.8 ± 2.7; p < 0.001; η2  = 0.171; p < 0.001). CONCLUSION: Listening to music is effective for relieving acute procedural pain during the first post-operative tibial fracture dressing change. Music should be incorporated into the multimodal analgesia protocols for management of orthopedic postoperative wound care-related pain. SIGNIFICANCE: Patients with diaphyseal tibial fractures that listened to music before and during the wound dressing change showed less pain when compared to those who received the standardized pharmacologic analgesia alone.

Lidocaine for pain relief during nasogastric intubation: systematic review and meta-analysis / Lidocaína para o alívio da dor durante a intubação nasogástrica: revisão sistemática e meta-análise

ABSTRACT BACKGROUND AND OBJECTIVES: Procedural acute pain is a common experience associated with nasogastric tube insertion. Nevertheless, there is an important gap in the knowledge on its management. Lidocaine seems an effective option for relieving procedural pain. The objective of this study was a systematic review with metanalysis to evaluate the analgesic efficacy of jelly, spray, atomized and nebulized lidocaine during nasogastric intubation in adult patients. CONTENTS: The Pubmed, LILACS, Scopus, CINAHL and Cochrane databases were searched using the keywords: pain, acute pain, pain management, lidocaine and gastrointestinal intubation. The identified articles were then screened according to the population, intervention, comparison, outcome and type of study. A total of 192 people were included, 30 of whom were healthy, while 162 had gastrointestinal disorders. The data revealed heterogeneity between the studies regarding the presentation and administration route of lidocaine, as well as the comparison groups. The group pain scores that received atomized lidocaine were significantly different from those of the control group (37.4 vs 64.5), the lidocaine spray group (23.6±16.6 vs 43.1±31.4) and the lidocaine gel group (33±29 vs 48±27). In the study evaluating lidocaine gel, atomized lidocaine and cocaine, the results were 19.3±24.9, 23.9±26.4, 30.5±29.6, respectively. CONCLUSION: Thus, the metanalytic estimate showed that lidocaine led to a significant reduction in pain compared to the control group in all studies.

RESUMO JUSTIFICATIVA E OBJETIVOS: A dor aguda procedural é uma experiência comum associada à inserção da sonda nasogástrica. No entanto, existe uma lacuna importante no conhecimento sobre sua gestão. A lidocaína parece uma opção eficaz para aliviar a dor procedural. O objetivo deste estudo foi realizar uma revisão sistemática com meta-análise para avaliar a eficácia analgésica da lidocaína durante a intubação nasogástrica em pacientes adultos. CONTEÚDO: As bases de dados Pubmed, LILACS, Scopus, CINAHL e Cochrane foram pesquisadas utilizando as palavras-chave: dor, dor aguda, manejo da dor, lidocaína e intubação gastrointestinal. Os artigos identificados foram selecionados de acordo com a população, intervenção, comparação, resultado e tipo de estudo. Foram incluídas 192 pessoas, 30 das quais saudáveis, enquanto 162 apresentavam distúrbios gastrointestinais. Os dados revelaram heterogeneidade entre os estudos sobre a apresentação e via de administração da lidocaína, bem como os grupos de comparação. Os escores de dor do grupo que recebeu lidocaína atomizada foram significativamente diferentes daqueles do grupo controle (37,4 vs 64,5), do grupo spray de lidocaína (23,6±16,6 vs 43,1±31,4) e do grupo gel de lidocaína (33±29 vs 48±27). No estudo que avaliou gel de lidocaína, lidocaína atomizada e cocaína, os resultados foram 19,3±24,9, 23,9±26,4, 30,5±29,6, respectivamente. CONCLUSÃO: Assim, a estimativa meta-analítica mostrou que a lidocaína levou a uma redução significativa da dor em comparação com o grupo controle em todos os estudos.

Analgesic efficacy of 10% lidocaine spray during nasoenteral catheterization: Randomized triple-blind trial.

BACKGROUND: Pain is a common experience during nasoenteral catheterization. Although the procedure causes discomfort and distress to patients, procedural pain remains neglected and undertreated. OBJECTIVE: To evaluate the analgesic efficacy of the use of 10% lidocaine spray during nasoenteral catheterization. METHOD: A randomized, triple-blind trial of 50 patients was performed. The patients were randomly assigned to two groups: an intervention group (IG), in which 10% lidocaine spray combined with 2% lidocaine gel was used, and a control group (CG), in which a saline solution spray combined with 2% lidocaine gel was used. Pain and discomfort were assessed during and after nasoenteral catheterization using numerical rating scale (NRS) and the visual analogue scale (VAS), respectively. RESULTS: Intervention group participants reported lower pain scores during (0.20 ± 0.71 vs. 5.00 ± 2.84, p < .001; |d| = -0.677) and after (0.00 ± 0.00 vs. 2.80 ± 2.83, p < .001; |d| = -0.718) nasoenteral catheterization compared to the CG. CONCLUSION: Spraying 10% lidocaine spray before nasoenteral catheterization was most effective for relieving discomfort and pain, with lower pain and discomfort recorded in NRS and VAS. Topical administration of 10% lidocaine spray is therefore a suggested measure for procedural pain relief related to nasoenteral catheterization. SIGNIFICANCE: The use of 10% lidocaine spray was more effective in relieving procedural pain and discomfort during nasoenteral catheterization. Patients who received 10% lidocaine spray registered lower discomfort and pain scores than those from 2% lidocaine gel group; there were less complications among patients in the IG.