Validation of a New “Objective Pain Score” Vs. “Numeric Rating Scale” For the Evaluation of Acute Pain: A Comparative Study

Tandon, Manish; Singh, Anshuman; Saluja, Vandana; Dhankhar, Mandeep; Pandey, Chandra Kant; Jain, Priyanka

doi:10.5812/aapm.32101

Cited by 37 publications

(52 citation statements)

References 7 publications

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“…Recovery time (defined as the time from the end of operation to spontaneous eye opening or response to verbal command) and extubation time (defined as the time from the completion of operation to extubation) was evaluated and recorded. Objective pain score (OPS) (as shown in Table 1) [22,23] was used for the evaluation of pain degree, and the PAED scale (as shown in Table 2) [24–27] and CPS (as shown in Table 3) [28–30] was employed to assess POED at the time points of 0, 5, 15, 30, 45, and 60 minutes after transfer into the PACU. One parent or guardian met the child on arrival in the recovery area and the child was allowed to regain consciousness undisturbed.…”

Section: Methodsmentioning

confidence: 99%

Effects of intraoperative dexmedetomidine with intravenous anesthesia on postoperative emergence agitation/delirium in pediatric patients undergoing tonsillectomy with or without adenoidectomy

et al. 2016

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Postoperative emergence agitation/delirium (POED) is a common complication in pediatric surgery patients, which increases the risk of developing postoperative airway obstruction and respiratory depression. This study aims to investigate the safety and efficacy of intraoperative infusion of dexmedetomidine (DEX) and its effects on POED in pediatric patients undergoing tonsillectomy with or without adenoidectomy.Sixty patients scheduled for tonsillectomy with or without adenoidectomy, aged 2 to 8 years, were randomly allocated into 2 groups (n = 30). Pediatric patients in the group DEX received intravenous (IV) DEX 1 μg/kg over 10 minutes, followed by 0.5 μg/kg/h continuous infusion, and the same volume of 0.9% saline was administrated in the group control. Anesthesia was maintained with target-controlled infusion (TCI) of propofol and remifentanyl. Intraoperative heart rate (HR), noninvasive blood pressure (NIBP), blood oxygen saturation (SPO2), recovery time, and extubation time were recorded. Pain level was evaluated using the objective pain score (OPS), pediatric anesthesia emergence delirium (PAED) scale and Cole 5-point scale (CPS) was used to evaluate POED when patients at 0, 5, 15 minutes, and then at intervals of 15 minutes for 60 minutes after parents arrival at postanesthesia care unit (PACU).The results showed that intraoperative HR was significantly lower in group DEX (P <0.05), mean diastolic and systolic NIBP was not statistically different between groups. Time to wake and time to extubation were lengthened in group DEX as compared with group control (P <0.05). OPS and CPS were lower in group DEX at 15, 30, and 45 minutes time points (P <0.05); however, there were no significantly differences in the PAED score at different time points in the PACU.The present data suggested that intraoperative infusion of dexmedetomidine combined with intravenous anesthetics can provide satisfactory intraoperative conditions for pediatric patients undergoing tonsillectomy with or without adenoidectomy, without adverse hemodynamic effects, though the lower incidence of POED was not observed.

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Section: Methodsmentioning

confidence: 99%

Effects of intraoperative dexmedetomidine with intravenous anesthesia on postoperative emergence agitation/delirium in pediatric patients undergoing tonsillectomy with or without adenoidectomy

et al. 2016

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“…Objective pain score is a good tool for assessment of postoperative pain and need for analgesia. 9 Clonidine and dexmedetomidine belong to α-2 agonist group. But dexmedetomidine is a highly selective α-2a agonist, having 1600 times more affinity for α-2a receptors.…”

Section: Discussionmentioning

confidence: 99%

A Randomized Controlled Double-Blind Comparative Study between Bupivacaine 0.25% Plus Fentanyl and Bupivacaine 0.25% Plus Dexmedetomidine for Caudal Epidural Postoperative Analgesia in Pediatric Lower Abdominal and Urogenital Surgeries in Indian Genotype

Godbole

Gill

Bhattacharya

et al. 2020

International Journal of Recent Surgical and Medical Sciences

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Objectives This study aimed to clinically evaluate and compare the efficacy of caudal epidural bupivacaine in prolonging the postoperative analgesia, with adjuvants like fentanyl or dexmedetomidine among children of Indian genotype. Materials and Methods A prospective double-blind randomized comparative study. The study population of 68 patients of Indian phenotype were randomly taken from a random number table and divided into two groups with 34 patients in each group. They received single shot caudal epidural blocks, with group A receiving 0.75 mL/kg of 0.25% bupivacaine + 1 mcg/kg fentanyl, group B receiving 0.75 mL/kg of 0.25% bupivacaine + 1 mcg/kg dexmedetomidine. Global Assessment of anesthesia, defined as the time from caudal injection to the first administration of rescue analgesia, will be recorded for both the groups. Results The addition of either fentanyl or dexmedetomidine as adjuvants in caudal block provided excellent postoperative analgesia, and sedation was significantly longer duration with dexmedetomidine (18.0 hours) than fentanyl (13.1 hours). We observed good hemodynamic stability in both the groups. Conclusion Addition of dexmedetomidine over fentanyl to bupivacaine for caudal epidural analgesia in pediatric age group has multiple advantages like better control of intraoperative and postoperative hemodynamics, significantly longer duration of postoperative analgesia, lesser bleeding during surgery, and achieving good surgical satisfaction. As the children are pain-free, calm, quiet, and sedated but arousable, the parents’ satisfaction is rewarding. The caudal epidural dose of 0.25% bupivacaine 0.75 mL/kg with adjuvants like dexmedetomidine or fentanyl is effective for postoperative analgesia in lower abdominal surgeries and is without side effects among the Indian population.

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“…We read with interest the article by Tandon and colleagues (1), entitled “Validation of a New ‘Objective Pain Score’ Vs. ‘Numeric Rating Scale’ For the Evaluation of Acute Pain: A Comparative Study”, published in Anesthesiology and Pain Medicine. Tandon et al reason that although a numeric rating scale (NRS) is widely used, it requires abstract thinking by each patient, and the interpretation of reflected pain severity can, therefore, be biased.…”

mentioning

confidence: 99%

“…Tandon et al conclude that OPS is a good stand-alone pain score and is better than the NRS for defining mild and moderate pain. They further suggest that OPS may even be used to supplement NRS when it is indicative of mild or moderate pain (1). …”

mentioning

confidence: 99%