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Low dose fentanyl infusion versus 24% oral sucrose for pain management during laser treatment for retinopathy of prematurity—an open label randomized clinical trial
摘要： To compare the efficacy of low dose fentanyl infusion and 24% oral sucrose in providing optimal pain relief during laser for retinopathy of prematurity (ROP), we enrolled fifty-eight spontaneously breathing preterm infants undergoing laser. The preterm infants were randomized to either fentanyl infusion (1 mcg/kg/hr) or 24% oral sucrose (2 ml). We evaluated and compared the proportion of time spent crying during the procedure, salivary cortisol before and after the procedure, premature infant pain profile- revised (PIPP-R) scores during the procedure, apnoea during and after the procedure, need for mechanical ventilation, and feed intolerance and urinary retention 24 h after the procedure between the two groups. We found that the proportion of time spent crying during the procedure was significantly less in the fentanyl group [62.5% (50.7–74.2) vs 73.8% (55.6–83.4); P = 0.02]. Average PIPP-R score during the procedure was significantly less in the fentanyl group [7.2 vs 9.0; (mean difference of ? 1.8; P = 0.01)]. There was no difference in other outcomes between the two groups.
关键词： Pain,Laser therapy,Fentanyl,Retinopathy of prematurity
更新于2025-09-12 10:27:22
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Changes in facial temperature measured by digital infrared thermal imaging in patients after transnasal sphenopalatine ganglion block
摘要： Sphenopalatine ganglion block (SPGB) is a technique developed in the 1990s for the management of head and neck pain patients. Recently, transnasal sphenopalatine ganglion block (TN-SPGB) has been widely used for these patients; however, no objective methods exist for validating the success of TN-SPGB. In this study, we measured the changes in facial temperature before and 30 minutes after TN-SPGB by using digital infrared thermal imaging (DITI) to validate its success. The medical records of patients, who underwent TN-SPGB and facial DITI between January 2016 and December 2017, were reviewed. TN-SPGB and facial DITI were performed 36 times in 32 patients. The changes in facial temperatures measured at the forehead (V1), maxillary area (V2), and mandibular area (V3) by using DITI before and 30 minutes after TN-SPGB were recorded and compared. The temperatures on the ipsilateral and contralateral sides of these areas were also compared. The comparison between pain relief group and pain maintenance group was analyzed. After TN-SPGB, the temperature decreased signi?cantly on both sides of V1 (P = .0208, 0.0181). No signi?cant differences were observed between the ipsilateral and contralateral sides (P > .05). There was no correlation between changes in temperature and changes in pain score in the pain regions after the procedure (P > .05). The temperature decreased signi?cantly in V1 area at 30 minutes after TN-SPGB compared with the temperature before TN-SPGB. Based on these results, we propose using DITI to measure temperature changes as an objective method for verifying the success of TN-SPGB.
关键词： face,pain management,sphenopalatine ganglion block,temperature
更新于2025-09-12 10:27:22
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Comparison of navigated laser and conventional single-spot laser system for induced pain during panretinal photocoagulation
摘要： To compare the panretinal photocoagulation (PRP)–induced pain response between novel navigated laser (Navilas) and conventional single-spot laser. The eyes were randomly assigned to Navilas or conventional laser. Contralateral eyes underwent PRP with the other system with 30 min resting interval. Pulse duration was 100 ms in conventional laser and 30 ms or 100 ms in Navilas and power setting was enough to create gray-white light burn on both devices. Pain response was evaluated by verbal scale (VS) (0–4) and visual analog scale (VAS) (0–10) after each PRP application. The mean age of 70 patients (140 eyes) was 62.52 ± 9.49 years. Mean power and spot numbers for Navilas and conventional laser were 291.9 ± 85.3 mW vs 368.4 ± 72.0 mW, and 375.4 ± 108.4 vs 374.2 ± 105.0 (p < 0.001 and p = 0.53, respectively). Pain scores for Navilas and conventional laser were 1.19 ± 0.73 and 1.99 ± 0.84 for VS and 2.41 ± 1.65 and 4.74 ± 2.17 for VAS (p < 0.001 and p < 0.001). More comfortable PRP is achieved with Navilas system in comparison with conventional single-spot laser system. However, small number of patients treated with same pulse duration and different contact lenses used for two systems should be taken into consideration. Besides, we did not report comparative clinical efficiency of either laser system.
关键词： Proliferative diabetic retinopathy,PRP,Navilas,Pain,Panretinal photocoagulation
更新于2025-09-11 14:15:04
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Using prerecorded hemodynamic response functions in detecting prefrontal pain response: a functional near-infrared spectroscopy study
摘要： Currently, there is no method for providing a nonverbal objective assessment of pain. Recent work using functional near-infrared spectroscopy (fNIRS) has revealed its potential for objective measures. We conducted two fNIRS scans separated by 30 min and measured the hemodynamic response to the electrical noxious and innocuous stimuli over the anterior prefrontal cortex (aPFC) in 14 subjects. Based on the estimated hemodynamic response functions (HRFs), we first evaluated the test–retest reliability of using fNIRS in measuring the pain response over the aPFC. We then proposed a general linear model (GLM)-based detection model that employs the subject-specific HRFs from the first scan to detect the pain response in the second scan. Our results indicate that fNIRS has a reasonable reliability in detecting the hemodynamic changes associated with noxious events, especially in the medial portion of the aPFC. Compared with a standard HRF with a fixed shape, including the subject-specific HRFs in the GLM allows for a significant improvement in the detection sensitivity of aPFC pain response. This study supports the potential application of individualized analysis in using fNIRS and provides a robust model to perform objective determination of pain perception.
关键词： test–retest reliability,detection sensitivity,hemodynamic response function,anterior prefrontal cortex,pain,near-infrared spectroscopy
更新于2025-09-10 09:29:36
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Epidemiology of Persistent Postsurgical Pain Manifesting as Dry Eye-like Symptoms After Cataract Surgery
摘要： To evaluate the epidemiology of persistent postsurgical pain (PPP) manifesting as dry eye (DE)-like symptoms 6 months after surgery. Methods: This single-center study included 119 individuals whose cataract surgeries were performed by a single surgeon at the Bascom Palmer Eye Institute and who agreed to participate in a phone survey 6 months after surgery. Patients were divided into 2 groups: the PPP group was defined as those with a Dry Eye Questionnaire-5 score $6 and without PPP as those with a Dry Eye Questionnaire-5 score ,6 at 6 months after cataract surgery. Results: Mean age of the study population was 73 6 8.0 years; 55% (n = 66) were female. PPP was present in 34% (n = 41) of individuals 6 months after surgery. Factors associated with an increased risk of PPP were female sex [odds ratio (OR) = 2.68, 95% confidence interval (CI) = 1.20–6.00, P = 0.01], autoimmune disorder (OR = 13.2, CI = 1.53–114, P = 0.007), nonocular chronic pain disorder (OR = 4.29, CI = 1.01–18.1, P = 0.06), antihistamine use (OR = 6.22, CI = 2.17–17.8, P = 0.0003), antireflux medication use (OR = 2.42, CI = 1.04–5.66, P = 0.04), antidepressant use (OR = 3.17, CI = 1.31–7.68, P = 0.01), anxiolytic use (OR = 3.38, CI = 1.11–10.3, P = 0.03), and antiinsomnia medication use (OR = 5.28, CI = 0.98–28.5, P = 0.047). PPP patients also reported more frequent use of artificial tears (P , 0.0001), higher ocular pain levels (P , 0.0001), and greater neuropathic ocular pain symptoms, including burning (P = 0.001), wind sensitivity (P = 0.001), and light sensitivity (P , 0.0001). Conclusions: PPP in the form of persistent DE-like symptoms is present in approximately 34% of individuals 6 months after cataract surgery. The frequency of PPP after cataract surgery is comparable to that of other surgeries including laser refractive surgery, dental implants, and genitourinary procedures.
关键词： dry eye symptoms,persistent postsurgical pain,cataract surgery,epidemiology
更新于2025-09-04 15:30:14