A way to improve neuro regional analgesia: what adjuvant is the best? A narrative review.

BACKGROUND: The concept of quality of life (QoL) is today an integral part of the health-care system and clinical, medical, and social research. Untreated chronic pain in children increases the risk of developing mental disorders later in life. The pediatric QoL inventory 3.0 (PedsQL™) is one of the most valid and widely used tools for assessing pediatric QoL. AIM: The study was to assess QoL in children with chronic postsurgical pain 7 days, 3 months, and 6 months after surgery with different analgesic techniques by means of the PedsQL™ 3.0 Family Impact Module questionnaires. METHODS: Following the inclusion and exclusion criteria, a total of 80 children undergoing treatment at the surgical department of a Communal Non-Profit Enterprise “Ivano-Frankivsk Regional Children’s Clinical Hospital of Ivano-Frankivsk Regional Council” were enrolled in the study. Among them, 60 children underwent anterior abdominal wall surgery with various types of anesthetic techniques. The patients were asked to fill in the questionnaires repeatedly 3 and 6 months after hospital discharge. RESULTS: QoL in patients with chronic pain syndrome reduced significantly (p < 0.001) on the scales of physical functioning, emotional functioning, social functioning, cognitive functioning, communication, worry, daily activities, family relationships, as well as pediatric QoL summary score, parent QoL summary score, and family functioning summary score 3 and 6 months after surgery with conventional analgesic techniques. CONCLUSIONS: Chronic pain syndrome reduces QoL in children aged 7–18 years after anterior abdominal wall surgery by reducing their physical, emotional, social, and cognitive functioning. The myofascial block in conjunction with general anesthesia accelerates patient’s recovery, relieves pain, and reduces emotional stress.

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Section: Discussionsupporting

confidence: 76%

PedSQL™ Family Impact Module as an Instrument foe Quality of Life Assessment (PedsQL™) in Children with Chronic Postsurgical Pain

Dmytriiev

Dobrovanov

2023

Open Access Maced J Med Sci

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“…The results of our study confirmed that inadequate perioperative analgesia and neglecting the principles of multimodal analgesia could result in the development of chronic pain syndrome [6,7,38]. According to QoL questionnaires, in patients with pain in the early postoperative period, the indicators on some scales reduced significantly as compared to children without pain.…”

Section: Discussionsupporting

confidence: 71%

Efficacy of regional analgesia in prevention of chronic postsurgical pain in children on the PEDSQL General Well-Being Scale and Pediatric Pain Questionnaire

Semkovych

2023

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Introduction. In pediatrics, regional anesthesia is one of the most valuable and safest means of perioperative pain management and chronic pain prevention. Pediatric Quality of Life Inventory 3.0 General Well-Being Scale and Pediatric Pain Questionnaire allow for assessing the impact of pain on children and their families via studying changes in Quality of Life scores for the scales of Present Pain and Worst Pain, General Well-Being and General Health. Purpose - to assess the impact of regional analgesia on the prevention of chronic postsurgical pain using PedsQL™ 3.0 questionnaires. Materials and methods. Following the inclusion and exclusion criteria, a total of 80 children were enrolled in the study. Among them, there were 60 children who underwent anterior abdominal wall surgery with various types of anesthetic management and were treated at the surgical department of a Communal Non-Profit Enterprise “Ivano-Frankivsk Regional Children’s Clinical Hospital of Ivano-Frankivsk Regional Council”. All patients were divided into 4 groups. The Group 0, the control group, included 20 children who had no surgical pathology and met inclusion criteria. The Group I comprised 20 children who underwent anterior abdominal wall surgery under general anesthesia using the transversalis fascia plane block combined with the quadratus lumborum block-4 via a single injection. The Group II included 20 children who underwent anterior abdominal wall surgery under general anesthesia using morphine. The Group III comprised 20 children who underwent anterior abdominal wall surgery under general anesthesia using the transversalis fascia plane block. Results. The prevalence of chronic pain syndrome in children who received conventional analgesia was the highest - 19.81±0.21%. Children who underwent conventional analgesia, while staying in the surgical department, had significantly higher the Face, Legs, Activity, Cry, Consolability scale and Visual Analogue Scale scores as compared to those who received other forms of regional analgesia. Discussion. Three and six months after surgery, in patients who received conventional analgesia, quality of life significantly reduced (p<0.001) on the scales of General Well-Being, General Health, Present Pain, and Worst Pain. This shows the need for using effective minimally invasive regional analgesia techniques in the perioperative period. Conclusions. Chronic pain syndrome reduces quality of life in children by reducing their general well-being and general health due to high indicators of present and worst pain. Regional analgesia techniques are a priority for the prevention of chronic pain syndrome. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the author.

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“…As with every advanced development in science and technology, AI and machine learning as a field of study have received both significant support and criticism regarding the scientific and ethical aspects and data protection issues. [25][26][27] Criticism was caused by the complexity of technical support for controlling big data, which is the basis for the application of AI technology. Studies have been conducted on this issue.…”

Section: Discussionmentioning

confidence: 99%

Automated differential diagnostics of respiratory diseases using an electronic stethoscope

Arhypenko,

Panaskin,

Babko

2023

Polish Journal of Medical Physics and Engineering

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Introduction: The outbreak of the coronavirus infection, which has escalated into a pandemic, has worsened the already unfavourable situation with respiratory system diseases in Ukraine. The burden on doctors has significantly increased, necessitating the exploration of simplified and expedited methods for conducting routine respiratory examinations. The research aims to describe a model for creating an automated differential diagnosis of respiratory noise using an electronic stethoscope, combining medical and clinical information about the types of respiratory noise characterizing the normal or pathological state of the respiratory system with a means of its information and technical processing. Material and methods: The research methods were analysis of theoretical information about the types of respiratory noise, analysis of technical information for choosing an information technology tool for processing biological signals; synthesis of the results; modelling. Results: The research resulted in a model of automated differential diagnosis based on the principle of auscultation, which includes the process of extracting the sound of air movement inside and outside the lungs and the classification of the extracted sounds. Automation of this process concerned only the classification of the extracted sounds since the principle of extraction itself was the same for both mechanical and automatic implementations. Conclusions: The automatic classification process was intended to reduce the time of the procedure and reduce the influence of the human factor, eliminating the possibility of medical error. To implement the process, a deep machine learning method was used, the array of information for which was to be a created phonotheque of acoustic signals of the respiratory system, which would include all types of respiratory noise concerning normal or pathological processes in the body.

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A way to improve neuro regional analgesia: what adjuvant is the best? A narrative review.

Cited by 5 publications

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PedSQL™ Family Impact Module as an Instrument foe Quality of Life Assessment (PedsQL™) in Children with Chronic Postsurgical Pain

PedSQL™ Family Impact Module as an Instrument foe Quality of Life Assessment (PedsQL™) in Children with Chronic Postsurgical Pain

Efficacy of regional analgesia in prevention of chronic postsurgical pain in children on the PEDSQL General Well-Being Scale and Pediatric Pain Questionnaire

Automated differential diagnostics of respiratory diseases using an electronic stethoscope

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