Pain Perception

EMLA Cream

Oral analgesic syrup (non-steroidal anti inflammatory drug)

Ibuprofen

Placebo syrup

Placebo cream

Aga khan University Hospital

The Effect of Combined Oral and Topical Analgesics to Reduce Pain Perception During Electrodiagnostic Testing

The Effect of Combined Oral and Topical Analgesics to Reduce Pain Perception During Electromyography in Pediatric Population-A Randomized Controlled Trial

Pain perception of patient during NCS and EMG tests as measured by Modified Behavioral Pain Scale or patient reported Faces Pain Scale - Revised in COTA, OA and Placebo arms.

Pain perception of patient according to guardian during NCS and EMG tests as measured by guardian-reported FPS-R

Effect of Patient demographics, Clinical characteristics and NCS / EMG procedure characteristics on patient pain scores within and across each of the intervention arms

Fazal ur Rehman

Principal Inestigator

Aga Khan University Hospital, Pakistan

Double blind placebo controlled randamized controlled trial

Local infiltration of all wound layers with liposomal bupivacaine (Exparel(R)) 20 ml diluted with 70 ml of normal saline to 90 ml for patient with a BMI of 39 and under. If BMI is 40 or more the 20 ml of liposomal bupivicaine will be diluted to 150 ml by adding 130 ml of normal saline

Local infiltration of all wound layers with saline, using to match the amount. The amount of total fluid is divided into 4 and instilled with 1-2 ml at a time in between fascial layers after fascial closure. Each 1/4 will be instilled laterally (2) and on each side of the incision(2)- extra fluid is placed subcutaneously.

Pain, Postoperative

Opioid Use

Pregnant women delivering by scheduled cesarean delivery

Exparel

Saline infiltration

Miami Valley Hospital

Liposomal Bupivacaine After Cesarean Delivery

The Effect of Local Infiltration of Liposomal Bupivacaine on Opioid Consumption at Time of Cesarean Delivery: A Randomized Controlled Trial

total opioid use, as morphine equivalents; sum of narcotic pain medications over 48 hours reported in morphine equivalents, by the Ohio Automated RX reporting system calculator, where hydrocodone 5 mg is 5 morphine equivalent dose (MED) and percocet 5 is 7.5 MED

Patient reported pain scores (0-10 where ten is the highest possible and 0 is no pain) as recorded by nursing staff, average post delivery in recovery and up to 23 hours and 59 minutes.

Patient reported pain scores (0-10 where ten is the highest possible and 0 is no pain) as recorded by nursing staff, average from 24 hours to 48 hours.

Data will be shared on a case by case basis.

Marilyn J Kindig, D.O.

Assistant Professor

Wright State University

Randomized, controlled, double blind trial

Method of administration: oral
Dose: 200 mg PO with small sip of water
Known adverse events: yellow discoloration of skin or sclera, 1-10% central nervous system effects including headache and dizziness, GI effect of cramping, < 1% acute renal failure, methemoglobinemia, hemolytic anemia, hepatitis, rash, skin pigmentation, vertigo, stomach cramps
Contraindications: to be used in caution in patients with renal impairment Cr Cl < 50ml/minute and in patients who are receiving nitric oxide, prilocaine and sodium nitrite as it can cause methemoglobinemia

Method of administration: intravenous
Dose: 25 mg
Known adverse events: nausea, vomiting, flushing or rash, hypersensitivity and anaphylactic reactions can occur following injection and immediate treatment with epinephrine should be available, skin and urine discoloration (urine may appear bright yellow for 24-36 hours), extravasation may cause skin sloughing, toxic neuritis and phlebitis, nausea, rare cardiac arrest and seizure,
Contraindications: use with caution in patients with history of hypersensitivity, allergies or asthma

Method of administration: irrigant during cystoscopy
Dose: 300cc during cystoscopy to visualize the ureters
Known adverse events: dysuria, polyuria, hyponatremia with excess absorption, potential increased risk of urinary tract infection
Contraindications when used as a genitourinary irrigation solution: anuria

Method of administration: irrigant during cystoscopy
Dose: 300cc
Known adverse events: no known significant adverse events
Contraindications: none

Method of administration: oral
Dose: 200 mg PO with small sip of water
Known adverse events: yellow discoloration of skin or sclera, 1-10% central nervous system effects including headache and dizziness, GI effect of cramping, < 1% acute renal failure, methemoglobinemia, hemolytic anemia, hepatitis, rash, skin pigmentation, vertigo, stomach cramps
Contraindications: to be used in caution in patients with renal impairment Cr Cl < 50ml/minute and in patients who are receiving nitric oxide, prilocaine and sodium nitrite as it can cause methemoglobinemia
Pyridium

A- Pyridium

Method of administration: intravenous
Dose: 25 mg
Known adverse events: nausea, vomiting, flushing or rash, hypersensitivity and anaphylactic reactions can occur following injection and immediate treatment with epinephrine should be available, skin and urine discoloration (urine may appear bright yellow for 24-36 hours), extravasation may cause skin sloughing, toxic neuritis and phlebitis, nausea, rare cardiac arrest and seizure,
Contraindications: use with caution in patients with history of hypersensitivity, allergies or asthma
Sodium Fluorescein

B- Sodium Fluorescein

Method of administration: irrigant during cystoscopy
Dose: 300cc during cystoscopy to visualize the ureters
Known adverse events: dysuria, polyuria, hyponatremia with excess absorption, potential increased risk of urinary tract infection
Contraindications when used as a genitourinary irrigation solution: anuria
Mannitol

C- Mannitol

Method of administration: irrigant during cystoscopy
Dose: 300cc
Known adverse events: no known significant adverse events
Contraindications: none
Normal Saline

Control- Normal Saline

Total

Age, Customized

Sex: Female, Male

Race/Ethnicity, Customized

This is a 10-cm visual analog scale to determine which method of evaluating ureteral patency is most satisfactory to physicians. The smiley face is at one end and the frowning face is at the other end. Smiling is 1 and frowning is 10. The scale is completed by surgeon, anesthesiologist and the circulator by placing an "x" or a "mark" anywhere on the 10 cm line towards how good and or bad each person felt about the of process of patency assessment that was used. Using a ruler, the score is determined by measuring the distance (mm) on the 10-cm line between the "no pain" anchor and the patient's mark, providing a range of scores from a minimum of 0 to a maximum of 100. A higher score indicates greater pain intensity (worse outcome).

methemoglobinemia/braken

The Effect of Combined Oral and Topical Analgesics to Reduce Pain Perception During Electrodiagnostic Testing

Liposomal Bupivacaine After Cesarean Delivery

Evaluation of Ureteral Patency in the Post-indigo Carmine Era

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