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1.
JAMA ; 324(13): 1351, 2020 10 06.
Artigo em Inglês | MEDLINE | ID: mdl-33021662
2.
JAMA ; 324(13): 1351-1352, 2020 10 06.
Artigo em Inglês | MEDLINE | ID: mdl-33021665
3.
J Cardiothorac Surg ; 15(1): 292, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33008484

RESUMO

BACKGROUND: Aortoesophageal fistula (AEF) caused by an esophageal foreign body is a life-threatening crisis, with rapid progress and high mortality. The first case of AEF was reported in 1818, but the first successfully managed case was not until 1980. Although there have been some reports on this condition, in most cases, the aorta was invaded and corroded due to its adjacent relationship with the esophagus and subsequent mediastinitis. To date, few reports have described an aortic wall directly penetrated by a sharp foreign body, likely because this type of injury is extremely rare and most patients cannot receive timely treatment. Here, we present a rare case of a fish bone that directly pierced the aorta via the esophagus. CASE PRESENTATION: A 31-year-old female experienced poststernum swallowing pain after eating a meal of fish. Gastroscope showed a fishbone-like foreign body had penetrated the esophagus wall. Computed tomography revealed that the foreign body had directly pierced the aorta to form an AEF. Surgery was successfully performed to repair the aorta and esophagus. The postoperation and follow-up was uneventful. CONCLUSIONS: For the treatment of foreign bodies in the esophagus, we should be alert of the possibility of AEFs. The effective management of AEFs requires early diagnosis and intervention, as well as long-term treatment and follow-up, which still has a long way to go.


Assuntos
Aorta/lesões , Doenças da Aorta/cirurgia , Osso e Ossos , Fístula Esofágica/cirurgia , Corpos Estranhos/cirurgia , Adulto , Animais , Aorta/diagnóstico por imagem , Transtornos de Deglutição/etiologia , Fístula Esofágica/diagnóstico por imagem , Feminino , Corpos Estranhos/diagnóstico por imagem , Humanos , Dor/etiologia , Tomografia Computadorizada por Raios X
4.
Yakugaku Zasshi ; 140(10): 1207-1212, 2020.
Artigo em Japonês | MEDLINE | ID: mdl-32999199

RESUMO

T-type calcium channels are low-threshold voltage-gated calcium channel and characterized by unique electrophysiological properties such as fast inactivation and slow deactivation kinetics. All subtypes of T-type calcium channel (Cav3.1, 3.2 and 3.3) are widely expressed in the central nerve system, and they have an important role in homeostasis of sleep, pain response, and development of epilepsy. Recently, several reports suggest that T-type calcium channels may mediate neuronal plasticity in the mouse brain. We succeeded to develop T-type calcium channel enhancer ethyl 8'-methyl-2',4-dioxo-2-(piperidin-1-yl)-2'H-spiro[cyclopentane-1,3'-imidazo[1,2-a]pyridine]-2-ene-3-carboxylate (SAK3) which enhances Cav3.1 and 3.3 currents in each-channel expressed neuro2A cells. SAK3 can promote acetylcholine (ACh) release in the mouse hippocampus via enhancing T-type calcium channel. In this review, we have introduced the role of T-type calcium channel, especially Cav3.1 channel in the mouse hippocampus based on our previous data using SAK3 and Cav3.1 knockout mice.


Assuntos
Canais de Cálcio Tipo T/efeitos dos fármacos , Canais de Cálcio Tipo T/fisiologia , Imidazóis/farmacologia , Neurônios/fisiologia , Compostos de Espiro/farmacologia , Acetilcolina/metabolismo , Animais , Encéfalo/fisiologia , Canais de Cálcio Tipo T/genética , Canais de Cálcio Tipo T/metabolismo , Células Cultivadas , Sistema Nervoso Central/metabolismo , Fenômenos Eletrofisiológicos , Epilepsia/etiologia , Expressão Gênica/efeitos dos fármacos , Hipocampo/metabolismo , Homeostase , Camundongos , Plasticidade Neuronal , Dor/etiologia , Ratos , Sono/fisiologia
6.
Pancreas ; 49(9): e82-e83, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33003092
7.
Medicine (Baltimore) ; 99(40): e22538, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33019462

RESUMO

The current studies revealed inconsistent relationship between reproductive factors and osteoarthritis. Community-based research has not been conducted in China. The study was to examine the association of reproductive factors with the prevalence of knee osteoarthritis (OA).Through a multistage stratified random sampling method, 10 streets or villages from 5 cities in Hunan province were randomly selected, a total 2746 eligible women aged 50 to 83 were recruited in this cross-sectional study. A structured questionnaire including demographic factors, socio-economic status, reproductive factors, and knee OA was used. According to the criteria of American College of Rheumatology, clinical knee OA was assessed by doctors in community or village health clinics for knee pain, age, morning stiffness, crepitus on active motion or for knee pain, morning stiffness, crepitus on active motion, and tenderness of the bony navigation of the joint. Self-reported age of menarche, parity, abortion history, and menopausal status were collected.The prevalence of knee OA was 13.44%. Abortion is associated with knee OA (odds ratio [OR] = 1.271, 95% confidence interval [CI] = 1.007, 1.606), but age at menarche, parity, and menopausal status were not the factors. Furthermore, age (OR = 1.040, 95% CI = 1.020, 1.060), weight (OR = 1.019, 95% CI = 1.004, 1.035), higher education level (OR = 1.530, 95% CI = 1.121, 2.088), higher monthly household income (OR = .583, 95% CI = 0.441, 0.770 for 3000-4999 ¥ and OR = 0.599, 95% CI = 0.431, 0.833 for 5000 ¥ or more), and chronic gastritis (OR = 3.364, 95% CI = 2.548, 4.442) were associated with knee OA.Abortion may increase the risk of knee OA. Special attention should be paid to women with a history of abortion, and women who are planning to abort should be informed of the risk of knee OA later in life. The relationship between abortion and knee OA should be interpreted with caution and further confirmed.


Assuntos
Aborto Espontâneo/epidemiologia , Osteoartrite do Joelho/epidemiologia , Osteoartrite do Joelho/etiologia , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Osteoartrite do Joelho/diagnóstico por imagem , Osteoartrite do Joelho/patologia , Dor/diagnóstico , Dor/epidemiologia , Prevalência , Radiografia/métodos , Medição de Risco , Autorrelato , Classe Social , Inquéritos e Questionários
8.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 1507-1511, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018277

RESUMO

Pain is a subjective experience and clinicians need to treat patients with accurate pain levels. EEG has emerged as a useful tool for objective pain assessment, but due to the low signal-to-noise ratio of pain-related EEG signals, the prediction accuracy of EEG-based pain prediction models is still unsatisfactory. In this paper, we proposed an autoencoder model based on convolutional neural networks for feature extraction of pain-related EEG signals. More precisely, we used EEGNet to build an autoencoder model to extract a small set of features from high-density pain-evoked EEG potentials and then establish a machine learning models to predict pain levels (high pain vs. low pain) from extracted features. Experimental results show that the new autoencoder-based approach can effectively identify pain-related features and can achieve better classification results than conventional methods.


Assuntos
Algoritmos , Eletroencefalografia , Percepção da Dor , Humanos , Redes Neurais de Computação , Dor
9.
Ther Umsch ; 77(6): 270-273, 2020 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-32930075

RESUMO

Diagnostic and therapeutic nerve blocks in pain therapy Abstract. Nerve blocks are not only performed in anaesthesiology to enable surgery, but also in pain therapy to diagnose and treat localised pain. For diagnostic purposes a minimal dose of local anaesthetic is applied directly to the nerve. Ultrasound has recently become the most precise and practicable tool to localise the nerve. When the effect of the block lasts as long as the predicted duration of the local anaesthetic, this confirms that the blocked nerve conducts the pain. In such cases, repetitive therapeutic blocks with local anaesthetics can be used to desensitise the nerve. A structural lesion of the nerve caused by heat (radiofrequency ablation), cold (cryoneurolysis) or even surgical nerve dissection can lead to long-term pain reduction. However, there is only weak evidence supporting these therapies and a relevant risk of pain due to deafferentation, and depending on the nerve, there could be persistent motor or sensitivity disturbances. Any intervention in humans includes placebo and nocebo effects. Those effects should be taken into consideration by asking the patient about previous experiences and their expectations for the intervention. The knowledge of placebo and nocebo effects can then be used to make the patient more comfortable during the procedure, to improve therapeutic effects and to reduce side effects. Problematic psychosocial factors and signs of centralised sensitivity should be evaluated in advance in order to consider withholding the use of interventional procedures in sensitised patients.


Assuntos
Bloqueio Nervoso , Anestesia Local , Anestésicos Locais , Humanos , Dor , Manejo da Dor
10.
Ther Umsch ; 77(6): 258-262, 2020 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-32930077

RESUMO

Pathophysiology and Diagnosis of Chronic Regional Pain Syndrome: What is important for the General Practitioner and the Surgeon? Abstract. Complex regional pain syndrome (CRPS) describes a variety of painful conditions following an initiating event and appears distally on the affected limb. Characteristically CRPS exceeds the expected clinical course in both magnitude and duration. CRPS affects mainly women between 61 and 70 years and the upper extremity is mainly involved. Clinical manifestations include sensory, vasomotor, sudomotor, motor and trophic changes. The clinical spectrum develops individually and changes over time. The diagnosis is based on the modified Budapest Criteria. Essential differential diagnosis includes infections, neurological compression and inflammatory conditions. Early signs encompass a disproportional painful swelling of the affected limb. Although benign courses are reported, many patients develop a chronic condition with persistent complaints after one year. Because there is no underlying or causal cure the therapy remains a challenge. The therapy is based on the presenting clinical signs or symptoms and includes a variety of pharmacological, interventional, physiotherapeutic, occupational and psychiatric measures.


Assuntos
Síndromes da Dor Regional Complexa/diagnóstico , Clínicos Gerais , Cirurgiões , Doença Crônica , Feminino , Humanos , Dor
11.
Ther Umsch ; 77(6): 263-269, 2020 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-32930079

RESUMO

Pain assessment of CRPS in Hand Therapy Abstract. Pain massively controls everyday life of affected persons. In case of a nerve being damaged, pain becomes more complex, as the trophism of the affected skin area may significantly be altered in addition to loss of sensibility and / or motor function. Quantifying pain is, therefore, difficult. Nevertheless, there exists a broad variety of pain assessments in hand therapy. A comprehensive documentation of pain and its effects on the patients' life are therefore pivotal for the individual design of therapy. Guidelines recommend an early start of therapy, a multimodal approach and a mixture of drug and non-drug interventions. However, specific recommendations are difficult to make, as the course of therapy is often complex and varies from person to person. Therefore, open and transparent communication, a stable therapeutic relationship, professional knowledge and active involvement of those affected are a prerequisite for successful therapy. In this article, the most frequently used assessments for pain in hand therapy are presented, as they are applied, for example, in complex regional pain syndromes. The clinical examination of allodynia is described in more detail by means of a patient example. Potential therapy goals and contents are illustrated. Despite all launched therapy interventions, treatment of pain remains a challenge that is best approached in an interdisciplinary setting and with the support of those affected.


Assuntos
Síndromes da Dor Regional Complexa/diagnóstico , Mãos , Humanos , Hiperalgesia , Dor/diagnóstico , Medição da Dor , Modalidades de Fisioterapia
12.
Ther Umsch ; 77(6): 239-245, 2020 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-32930083

RESUMO

Neuroanatomy and Pathophysiology of Pain Perception Abstract. Nociception, the possibility of our sensory nervous system to detect painful and therefore potentially harmful stimuli, is crucial for survival. In essence it serves as a "detect and protect" mechanism. For this reason, many features of this complex network, for example the nociceptors, are evolutionary highly preserved. To guarantee an adequate and fast response to prevent tissue damage, the information has to be processed in a fast and stable manner. To this account, the network is designed to be able to potentiate the information at any level. However, sometimes triggered by pathophysiological factors like inflammation, this functional and structural plasticity can become maladaptive, leading to chronification of pain and in this way become a disease itself. Nociception starts in the periphery by activation of a nociceptor which is a highly specialized neuron of the somatosensory nervous system. Some of them are thinly myelinated Aδ fibers, others unmyelinated C fibers. The free nerve endings in the skin or other tissues are equipped with different receptors and ion channels to translate noxious stimuli (like temperature or pressure) into electrochemical signals. These are transmitted to the dorsal horn of the spinal cord, where the second neuron is activated via excitatory amino acids (like glutamate) and other substances, a process which is modulated by inhibitory interneurons. This second neuron projects to cerebral locations, mostly to the thalamus but also to hypothalamus and amygdala, where the usually fast emotional and vegetative reaction is generated. The third order neuron then terminates in the somatosensory cortex and is embedded in a complex network, the so called "pain matrix". Areas involved are for example the prefrontal cortex, where decision making happens, and the limbic structures, where pain memory and learning processes take place. Descending projections from the locus coeruleus, raphe nuclei and the rostroventral medulla oblongata to the spinal cord can either facilitate or inhibit the nociceptive information. Sensitization leading to enhanced activation of the nociceptive pathways can take place at any level, which can become a "circulus vitiosus", finally underlying a chronic pain disorder.


Assuntos
Neuroanatomia , Nociceptores , Humanos , Dor , Percepção da Dor , Medula Espinal
13.
Niger J Clin Pract ; 23(9): 1183-1187, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32913154

RESUMO

Aims: This study compared the analgesic effect of apical peri-prostatic block with that of intra-rectal xylocaine gel for trans-rectal ultrasound guided prostate biopsy (TRUS-PBx) in Nigeria. Methods: This is a prospective randomized comparative study carried out over one year in University of Benin Teaching Hospital, Edo State, Nigeria. The participants were randomized into two groups; Group A had 10 mls of intra-rectal xylocaine gel instillation while Group B had apical infiltration of 10 mls of 1% xylocaine all before TRUS-PBx. Result: There was a statistically significant difference in the mean pain score during and one hour after TRUS-PBx between Group A and Group B of the study population respectively (p < 0.0001). Those that had intra-rectal xylocaine gel (Group A) had more pain during and after biopsy. There was no difference in the mean pain score during probe insertion between the two groups (p = 0.952). Conclusion: This study demonstrated the superiority of apical peri-prostatic nerve block over intra rectal xylocaine gel instillation during TRUS-PBx with respect to its anesthetic efficacy. Therefore, centers providing TRUS-PBx in Nigeria should consider apical peri-prostatic nerve block as their mode of anesthesia for the procedure due to its efficacy and high safety profile.


Assuntos
Biópsia por Agulha/métodos , Biópsia Guiada por Imagem/métodos , Lidocaína/administração & dosagem , Bloqueio Nervoso/métodos , Dor/prevenção & controle , Próstata/patologia , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/patologia , Administração Retal , Idoso , Anestésicos Locais/administração & dosagem , Biópsia por Agulha/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria , Dor/etiologia , Medição da Dor , Estudos Prospectivos , Próstata/diagnóstico por imagem , Próstata/inervação , Reto/patologia , Ultrassonografia de Intervenção
14.
Niger J Clin Pract ; 23(9): 1207-1214, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32913158

RESUMO

Aims: Our study aimed to assess the oral health-related quality of life (OHRQoL) changes during the initial stage of fixed orthodontic appliance therapy and determined the impact of various orthodontic therapy needs on the OHRQoL of Saudi patients seeking orthodontic treatment. Materials and Methods: Forty-two patients aged 14-24 years (69% females) were recruited from the orthodontic clinics. OHRQoL was quantified by a self-administered short version of oral health impact profile (OHIP-14) questionnaire used before treatment (T0) and following bonding of fixed appliance on days 1 (T1), 7 (T2), 14 (T3), and 30 (T4). The higher the OHIP-14 score, the poorer the OHRQoL. The dental health component (DHC) of the index of orthodontic treatment needs (IOTN) was used to assess malocclusion severity. The missing, overjet, crossbite, displacement, overbite (MOCDO) hierarchical scale was used to categorize the most severe feature in each patient and determine the grade of orthodontic treatment need. Changes of OHRQoL over time were compared using the Friedman test. Result: Overall OHIP-14 score significantly increased following orthodontic appliance bonding at T1 and T2 compared to T0 (P < 0.001). The functional limitation domains in OHIP-14 pain and discomfort, physical disability, psychological disability, and psychological discomfort were affected at T1 compared to T0 (P < 0.05). Grade 4 IOTN-DHC (definite treatment needs) significantly influenced most OHIP-14 domains compared to other grades. Conclusion: With the growing therapeutic and cosmetic demands of orthodontic treatment and the focus on OHRQoL, the study findings can be used to enhance patients' cooperation, expectation, and adherence to orthodontic treatment.


Assuntos
Má Oclusão/terapia , Saúde Bucal/estatística & dados numéricos , Aparelhos Ortodônticos Fixos , Qualidade de Vida/psicologia , Adolescente , Adulto , Feminino , Humanos , Índice de Necessidade de Tratamento Ortodôntico , Masculino , Dor , Arábia Saudita , Índice de Gravidade de Doença , Inquéritos e Questionários , Resultado do Tratamento , Adulto Jovem
15.
Rev Med Suisse ; 16(707): 1757-1762, 2020 Sep 23.
Artigo em Francês | MEDLINE | ID: mdl-32969613

RESUMO

The effectiveness of hypnosis in the management of pain and anxiety has been widely demonstrated today. While this technique is commonly used in anesthesia and psychiatry, its use in emergencies is still poorly developed. The fields of application in hospital and extra-hospital emergency are however multiple and, contrary to popular belief, emergencies are the ideal place for the practice of hypnosis. Hypnosis is a reliable, safe, effective and inexpensive technique that any caregiver can learn. It strengthens the caregiver-patient relationship and helps us to treat differently, more humanly and more serenely.


Assuntos
Medicina de Emergência/métodos , Hipnose , Ansiedade/psicologia , Ansiedade/terapia , Hábitos , Humanos , Dor/prevenção & controle , Manejo da Dor
16.
Psychiatr Danub ; 32(Suppl 2): 290-297, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32970649

RESUMO

INTRODUCTION: Sensitive skin has been described as a syndrome defined by the occurrence of unpleasant sensations (stinging, burning, pain, pruritus, and tingling sensations) in response to stimuli that normally should not provoke such sensations. Although often transient, and in many cases unaccompanied by visual dermatological responses, sensitive skin affects the quality of life. The aim of this survey was to assess the prevalence of sensitive skin and collect clinical data on sensitive skin in the population of Herzegovina-Neretva County. SUBJECTS AND METHODS: The survey included a total of 73 participants, 45 female and 28 male, aged 20 years and above, with a diagnosis of sensitive skin syndrome (SSS) confirmed by physicians. A dermatological exam assessing skin type, phototype and skin sensitivity was performed. The survey collected an assortment of information including demographics and included customized standardized questionnaires that closely examine skin sensitivity and the burden of sensitive skin. RESULTS: Findings concurred with existing evidence that individuals with sensitive skin represent almost half the examined population. The prevalence of perceived sensitive skin was significantly higher in females than in males. The main skin symptom was itching, followed by prickling, warmth and numbness. Our results clearly show that there is a burden of sensitive skin. CONCLUSION: This study investigated the prevalence of sensitive skin and the burden of sensitive skin in the population of Herzegovina-Neretva County. It is the first to focus on sensitive skin among Herzegovina-Neretva County population. Further studies are needed to bolster epidemiological data and physiological pathways of sensitive skin syndrome.


Assuntos
Dermatopatias/epidemiologia , Adulto , Bósnia e Herzegóvina/epidemiologia , Feminino , Humanos , Masculino , Dor/epidemiologia , Prevalência , Prurido/epidemiologia , Qualidade de Vida , Síndrome , Adulto Jovem
17.
Sr Care Pharm ; 35(10): 404-405, 2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-32972488

RESUMO

Through the use of opiate analgesia, it is possible to alter perceptions of pain, but equally, these same drugs have the potential to cause other profound consequences. Long before the COVID-19 pandemic began to impact societies worldwide, many developed nations (and particularly the United States) were caught up in a struggle to contain the consequences of opioid use, which has directly contributed to numerous deaths and ongoing disability for many others.


Assuntos
Analgésicos Opioides , Epidemia de Opioides , Dor/tratamento farmacológico , Ácido gama-Aminobutírico/análogos & derivados , Infecções por Coronavirus , Humanos , Pandemias , Pneumonia Viral , Estados Unidos
18.
J Oral Facial Pain Headache ; 34(3): 217-221, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32870950

RESUMO

AIMS: To assess the effect of geographic tongue (GT) on taste, salivary flow, and pain characteristics in burning mouth syndrome (BMS) to determine whether GT is a contributing factor to BMS and whether BMS and GT represent similar patient populations. METHODS: A retrospective chart study was conducted. Patients with a diagnosis of BMS or BMS/GT were included. Data regarding smell testing, spatial taste-testing, salivary flow, oral pH, and subjective pain rating on a generalized labeled magnitude scale (gLMS) were collected. RESULTS: No significant differences in age, gender, oral pH, smell, or pain were found between groups. Stimulated and unstimulated salivary flow were significantly lower in BMS/GT. Taste responses to all taste stimuli and to ethanol were significantly lower in BMS, with the exception of sour at the fungiform papillae. CONCLUSION: BMS and BMS/GT present with similar clinical pain phenotype and demographics; however, taste was more intact in BMS/GT, suggesting that GT may be a contributing factor in the development of BMS through a mechanism that does not involve taste.


Assuntos
Síndrome da Ardência Bucal , Glossite Migratória Benigna , Humanos , Dor , Estudos Retrospectivos , Paladar
19.
J Oral Facial Pain Headache ; 34(3): 240-254, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32870953

RESUMO

AIMS: To assess the effectiveness of a variety of physical treatments in the management of tension-type headache (TTH) in children. METHODS: This review is reported in accordance with the PRISMA guidelines and was registered in the PROSPERO database (CRD42014015290). Randomized and nonrandomized controlled trials that examined the effects of all treatments with a physical component in the management of TTH in children and compared these treatments to a placebo intervention, no intervention, or a controlled comparison intervention were included. The Physiotherapy Evidence Database (PEDro) criteria for bias assessment and the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) Working Group criteria were used to assess the quality of the body of evidence. The outcome measures were pain, functioning, and quality of life. Only RCTs were included in the meta-analyses. RESULTS: An initial search produced 10,464 published articles. Of these, 17 were relevant trials, including 1,815 participants. The overall GRADE rating of the included studies was moderate, and 11 of the 17 studies could be used in the meta-analyses. The effectiveness of physical treatments in terms of a reduction of pain of 50% or more showed a risk ratio (RR) of 2.37 (95% CI: 1.69 to 3.33). Relaxation training was the most evaluated intervention and proved to be significantly effective (RR: 3.00 [95% CI: 1.94 to 4.63]). In children having TTH combined with temporomandibular disorders, occlusal appliances were effective (RR: 2.58 [95% CI: 1.37 to 4.85]). CONCLUSION: This review supports the use of physical treatments to reduce pain in children with TTH.


Assuntos
Cefaleia do Tipo Tensional , Criança , Humanos , Dor , Modalidades de Fisioterapia , Qualidade de Vida
20.
Urologiia ; (4): 50-54, 2020 Sep.
Artigo em Russo | MEDLINE | ID: mdl-32897014

RESUMO

INTRODUCTION: Cystoscopy is one of the most common procedures in urology. There is no single approach to pain relief. In the literature, there are conflicting data on the efficiency of intra-urethral gels. The use of non-steroidal anti-inflammatory drugs, intravenous sedation, and nitric oxide analgesia has been described. Phenazopyridine has been known for a long time. Acting on the bladder mucosa, it has a local analgesic effect. AN evaluation of phenazopyridine intake prior to cystoscopy in order to decrease pain during procedure and facilitate subsequent urination was performed. MATERIALS AND METHODS: A total of 97 patients were included in the study. Indications for cystoscopy were as following: hematuria, lower urinary tract symptoms/pain, a need to remove ureteral stent. The patients were randomized into two groups. In the main group (n=50), phenazopyridine 200 mg was administered 20 minutes before cystoscopy and then at a dose of 200 mg every 8 hours (in total three doses) in combination with lidocaine gel. In the control group (n=47), only lidocaine gel was used. Heart rate was measured before and after the procedure. All patients were asked to complete a visual analogue scale (VAS) 3, 8 and 24 hours after cystoscopy with the assessment of the first urination. RESULTS: After cystoscopy, the difference between groups in VAS score was 27.7% in favor of the main group (p<0.001). After 3 hours, the average score in the main group was two times less than in the Control (p=0.012), while 3 and 8 hours after cystoscopy, the proportion of "zero" results was 10% and 0%, 28% and 4%, respectively, p<0.005. The heart rate after the procedure in the main group was 75.1 beats/min, compared to 77.9 beats/min in the control group (p=0.016). CONCLUSION: The intake of phenazopyridine allows to reduce pain intensity during and after cystoscopy and alleviate pain during first urination.


Assuntos
Cistoscopia/efeitos adversos , Fenazopiridina , Ureter , Humanos , Dor , Fenazopiridina/uso terapêutico
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