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The aim of this study is to assess whether distraction (lack of attentional focus) and attention (cognitive load) are differentially involved in the analgesic effect of virtual reality (VR) immersions during a cold pressor test (CPT).
Thirty-one participants were randomlyassigned to four experimental conditions (high and low cognitive load, attention with or without a reminder of the pain stimuli) and performed three CPTs. Pain was assessed based on the duration of the CPT (pain tolerance), a visual analog rating scale of perceived pain intensity during the CPT and the subjective pain scale of the Short form McGill Pain Questionnaire (SF-MPQ).
The statistical analyses revealed that VR immersions were associated with less pain compared to the baseline (all p <0.001), but for the experimental manipulations, only the conditions where there was an increase in cognitive load (ie, from low cognitive load at Immersion 1 to high cognitive load at Immersion 2) were effective for increasing pain tolerance (significant Time X Conditions interaction). The interactions were not significant for pain intensity assessed with the VAS or the SF-MPQ.
The results suggest that increases in cognitive load play an important role in the analgesic effect of VR immersion, although the combination of attentional focus and cognitive load may be important. Suggestions are given for designing a replication study.
The results suggest that increases in cognitive load play an important role in the analgesic effect of VR immersion, although the combination of attentional focus and cognitive load may be important. Suggestions are given for designing a replication study.
Microvascular decompression (MVD) surgery is considered as an effective method with which to treat trigeminal neuralgia (TN). However, sometimes MVD surgery fails due to incomplete decompression of the responsible vessels caused by a poor visual field. In this study, we evaluated the benefits of endoscopic visualization and the value of full endoscopic vascular decompression (EVD) by describing the surgical results of 20 patients with TN after EVD.
This was a retrospective study in a single institution of 20 patients with TN who received EVD between April 2018 and October 2019. All patients underwent EVD via the suboccipital retrosigmoid approach without microscopy at any stage. Abnormal muscle response (AMR) and brainstem auditory evoked potentials (BAEPs) were routinely monitored throughout the procedure. Follow-up was conducted by outpatient and telephone interviews. The degree of facial pain was graded using the Barrow Neurological Institute (BNI) pain intensity score; a BNI of 1 was considered as the best result while a BNI of 2 or 3 was considered as a satisfactory result. Follow-up time ranged from 8 to 24 months, with a mean of 18±4.36 months.
All 20 patients with severe preoperative pain (BNI of 5) achieved immediate relief or complete control of pain after surgery (BNI of 1 to 2). Vascular conflicts were observed during surgery in all of the patients. None of the patients experienced hearing loss, facial paralysis, intracranial infection, cerebrospinal fluid leakage, cerebral hemorrhage, or death, following the operation.
When carried out by surgeons with endoscopic experience, EVD can provide a clear surgical field of view and reduce the risk of surgical injury. Our findings indicate that EVD is a safe and effective surgical method for the treatment of TN.
When carried out by surgeons with endoscopic experience, EVD can provide a clear surgical field of view and reduce the risk of surgical injury. Our findings indicate that EVD is a safe and effective surgical method for the treatment of TN.
Oxycodone has affinities for both kappa- and mu-opioid receptors. Therefore, it has been used for postoperative analgesia of surgeries in which visceral pain is expected to be the main cause of pain. Nirmatrelvir However, there are few studies of the 551 potency ratio of oxycodone to fentanyl when using it as intravenous patient-controlled analgesia (IV-PCA). Thus, we compared the analgesic and adverse effects of IV-PCA using the 551 potency ratio of oxycodone to fentanyl in patients who underwent robot-assisted laparoscopic gastrectomy.
This retrospective study included 100 patients using an automatic PCA pump with oxycodone or fentanyl who underwent robot-assisted laparoscopic gastrectomy between January and November 2017. All patients were provided with an IV-PCA consisting of 20 μg/kg of fentanyl or 1.1 mg/kg of oxycodone mixed with 0.9% normal saline solution to a total volume of 250 mL, which was infused basally at a rate of 0.1 mL/h with a bolus dose of 1 mL and lockout time of 6 min. The primary and secondary nts undergoing robot-assisted laparoscopic gastrectomy.
Although pain after laparoscopic surgery is assumed to be minor, many women still suffer from unexpected postoperative pain. Thus, we aimed to assess whether additional intraoperative administration of sufentanil could help to improve postoperative pain and related agitation, stress, and inflammation response in patients undergoing laparoscopic myomectomy.
Forty female patients with uterine myoma scheduled for laparoscopic myomectomy under general anesthesia were randomized to receive sufentanil (group T, n=20) or normal saline (group C, n=20) 1h before the end of the surgery. The postoperative pain, agitation, stress, inflammation, and adverse effects were measured.
As the primary outcome, the visual analog scale (VAS) pain score was significantly reduced in group T as compared with group C at each measured time point in a post-anesthesia care unit (PACU), VAS 5 min (31.5 ± 2.7 vs 40.6 ± 5.6) (
<0.001), VAS 30 min (36.5 ± 4.5 vs 46.0 ± 2.9) (
<0.001), VAS 1h (37.8 ± 4.0 vs 48.6 ± 5.5) (
<0.dergoing laparoscopic myomectomy, administration of sufentanil 1 h before the end of surgery shows excellent analgesic and sedative effects, alleviated postoperative stress and inflammatory responses, reduced incidence of cough, without prolonging anesthetic recovery time and increasing adverse reactions.[This corrects the article DOI 10.2147/JPR.S203721.].
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