1.
Pre-emptive ketorolac for prevention of intraoperative shoulder pain in patients undergoing cesarean section: A double blind randomized clinical trial.
Abbas, MS, Askar, OA, Abdel Aleem, AA
Asian journal of anesthesiology. 2017;(3):68-72
Abstract
BACKGROUND Shoulder pain is a commonly observed but mostly neglected consequence of cesarean section and little is known as well as explored about intraoperative shoulder pain. We conducted this randomized prospective double-blinded study to evaluate the efficacy of ketorolac in reducing the incidence and severity of intraoperative shoulder pain in patients undergoing cesarean section. METHODS Two hundred ASA I and II patients scheduled to undergo elective cesarean section under spinal anesthesia were randomized to receive either intravenous ketorolac 30 mg (ketorolac group) or normal saline (control group). The primary outcome was the incidence of intraoperative shoulder pain. Secondary outcomes were severity of intraoperative shoulder pain, amount of intraoperative blood loss, incidence of hypotension, bradycardia and request for intraoperative rescue analgesia. RESULTS The incidence of intraoperative shoulder pain in the control group was significantly higher than the ketorolac group (P = 0.003). Severity of shoulder pain and requests for intraoperative analgesia was significantly higher in the control group (P = 0.012, P = 0.006 respectively). Patients in the Ketorolac group experienced significantly higher incidences of bradycardia (P = 0.037). CONCLUSION 30 mg ketorolac administered intravenously just before the operation could decrease incidence and severity of intraoperative shoulder pain in patients undergoing cesarean section. CLINICAL TRIAL REGISTRATION ClinicalTrial.gov (Registration number: NCT02380898, first registered in 01/03/2015).
2.
[Case control study on ultrasound guided microtraumatic treatment of acute subacromial bursitis].
Duan, H, Pu, D, Chen, SY
Zhongguo gu shang = China journal of orthopaedics and traumatology. 2016;(9):800-803
Abstract
OBJECTIVE To evaluate the efficacy of ultrasound guided microtraumatic treatment of acute subacromial bursitis. METHODS The patients with shoulder pain from June 2012 to March 2014 were treated with musculoskeletal bone ultrasound examination. A total of 120 patients were diagnosed with acute subacromial bursitis, who were randomized divided into two groups:US guided injection group(ultrasound group) and palpation guided injection group(closed group). The patients in each group were injected with a mixture of 3.5 ml Betamethasone compound lidocaine mixture and 2.5 ml Sodium hyaluronate into the subacromial bursa. The outcome measures were the visual analog scale(VAS) for analyzing pain degree, the night rest pain and Constant-Murley score for detecting shoulder function, rate of secondary injection, and comprehensive effect. The VAS, the night rest pain and CMS were evaluated before, 1 day, 1 week, and 1 month after the injection. RESULTS After treatment, the shoulder pain and function were improved. One day and 1 week after the injection, the VAS between the two groups were compared. The pain improvement in ultrasonic group was better than in the traditional group, and the difference was statistically significant(P<0.05). In the two groups, the night rest pain was relieved after treatment, and 1 day after the injection, the night rest pain in the ultrasonic group was significantly lower than that in the traditional group(P<0.05). One day, 1 week and 1 mouth after the injection, the CMS between the two groups were compared, and the improvement of CMS in the ultrasonic group was significantly better than that in the traditional group(P<0.05). The patient number with secondary injection in the ultrasonic group was 13 cases, which was significantly less than that in the closed group 45 cases(P<0.05). The recovery number of ultrasonic group was significantly better than that of the traditional group(P<0.05). CONCLUSIONS The ultrasound guided microtraumatic treatment of acute subacromial bursitis worked faster than traditional closed therapy. The short term curative effect and the comprehensive curative effect is better than the traditional closed treatment. The US guided subacromial injection technique is effective in guiding the needle into the subacromial bursa in patients with acute subacromial bursitis.
3.
Extracorporeal shock-wave therapy for supraspinatus calcifying tendinitis: a randomized clinical trial comparing two different energy levels.
Ioppolo, F, Tattoli, M, Di Sante, L, Attanasi, C, Venditto, T, Servidio, M, Cacchio, A, Santilli, V
Physical therapy. 2012;(11):1376-85
Abstract
BACKGROUND Extracorporeal shock-wave therapy (ESWT) represents a valid intervention in the treatment of people with supraspinatus calcifying tendinitis (SCT), but there is limited evidence for the useful range of ESWT doses. OBJECTIVE The aim of this study was to compare 2 different ranges of energy flux density in treatment of SCT with ESWT. DESIGN This study was designed as a single-blind randomized clinical trial. SETTING This study was performed in a university hospital. PATIENTS Forty-six patients with SCT were randomly assigned to 2 groups that received different therapeutic energy doses of ESWT (1) group A received ESWT at an energy level of 0.20 mJ/mm², and (2) group B received ESWT at an energy level of 0.10 mJ/mm². INTERVENTION The treatment protocol consisted of 4 sessions performed once a week. MEASUREMENTS The change in mean Constant Murley Scale (CMS) scores at 3 and 6 months was the primary endpoint. The change in the mean visual analog scale (VAS) scores from baseline to 3 and 6 months after the intervention and radiographic change in size of calcium deposits were evaluated as secondary endpoints. At 12 months, pain relief was assessed using a numeric rating scale. RESULTS Significant clinical improvement based on mean CMS scores was observed after 6 months in group A (X=79.43, SD=10.33) compared with group B (X=57.91, SD=6.53). Likewise, after 6 months, a significant decrease in VAS scores was found in group A (X=2.09, SD=1.54) compared with group B (X=5.36, SD=0.78). Calcific deposits disappeared in the same percentage of patients in both groups. LIMITATIONS The small sample size and lack of a control group were limitations of the study. CONCLUSIONS In ESWT for SCT, an energy level of 0.20 mJ/mm² appears to be more effective than an energy level of 0.10 mJ/mm² in pain relief and functional improvement.
4.
[Clinical observation on "Jianying point"-injection combined with massage for treatment of periarthritis of shoulder].
Liao, BN, Zhang, S, Zhang, LM
Zhongguo zhen jiu = Chinese acupuncture & moxibustion. 2007;(4):261-3
Abstract
OBJECTIVE To search for a clinically effective therapy for periarthritis of shoulder. METHODS One hundred and forty cases were randomly divided into a treatment group and a control group, 70 cases in each group. The treatment group were treated with "Jianying point" -injection combined with massage, and the control group with routine acupuncture therapy. The pain scores and the comprehensive scores of motor function before and after treatment in the two groups were compared between the two groups. RESULTS The different value of the pain scores before and after treatment was 31.54+/-2.82 in the treatment group and 15.03+/-4.07 in the control group, with a very significant difference between the two groups (P<0.01); after treatment, the comprehensive score of motor function of the shoulder joint was 139.64+/-12.34 in the treatment group and 80.32+/-16.29 in the control group, with a very significant difference between the two groups (P<0.01). CONCLUSION "Jiunying point" -injection combined with massage has clinically an obvious effect on periarthritis of shoulder.