Visual stimulation as pain relief for Hong Kong Chinese patients with leg ulcers

Analgesic potential of visual stimulation was examined in 33 patients with leg ulcers in a randomized, controlled, crossover clinical trial. Patients were alternating between wearing an eyeglass display with soundless VCD broadcast (V-sessions) and a static blank screen (B-sessions) while receiving superficial debridement and wound dressing for their leg ulcers. A significant reduction in pain scores was found during V-sessions (VAS 67.7 ± 28.4 vs. 25.6 ± 29.8 when V-sessions vs. B-sessions, with p < 0.01). Age was positively correlated with the improvement in VAS, whereas gender, residency, and the underlying medical conditions were not correlated with the improvement in pain score. The use of visual stimulation might be beneficial to both genders, in an older age group regardless of the underlying medical conditions. This is the pioneer use of visual stimulation as a non-pharmacological adjuvant to pain relief among a local Chinese population. The study will certainly add knowledge to the existing pain relief methods.published_or_final_versio

The effect of visual stimulation via the eyeglass display and the perception of pain

Hospitalization involves anxiety and pain for many people. Unfamiliar hospital settings, various diagnostic and therapeutic procedures, and the sight and sounds of medical procedures exacerbate pain and anxiety. By blocking off the anxiety-inducing sights and sounds of the hospital surroundings and creating a pleasant environment, an eyeglass display might be able to change the sensation and perception of pain. In this randomized, controlled, crossover study, 72 healthy university student volunteers were asked to wear a light-weight eyeglass that projected a feeling of watching a 52-inch television screen at 6 1/2 feet in distance while pain was produced by a modified tourniquet technique. Subjects were randomly assigned to participate in a V-session or B-session first, with subsequent cross-over. In a V-session, subjects were instructed to wear the eyeglass and watch the soundless display of natural scenery during the inflation. In a B-session, the eyeglass that subjects wore would project a static blank screen. During V-sessions, there was a significant increase in pain threshold (p < 0.001) and pain tolerance (p < 0.001). The degree of immersion was positively correlated with improvement in pain threshold, whereas the anxiety level was negatively correlated with improvement in pain threshold. These findings have implications for using visual stimulation as a positive adjunct to other methods of pain relief and for different pain conditions. This study was considered to be the pioneer use of visual stimulation in the local Chinese community as an adjunct to pain relief.published_or_final_versio

N-Acetylcysteine enhances cardiac HO-1 protein expression and antioxidant capacity in diabetic rats

INTRODUCTION: The antioxidant N-acetylcysteine (NAC) restores volatile anesthetic isoflurane-induced preconditioning against myocardial infarction in hyperglycemia (1). However, the mechanism whereby NAC restores isoflurane preconditioning cardioprotection is unclear. Elevated heme oxygenase-1 (HO-1) leads to improved postischaemic cardiac function in type 1 diabetes (2), and enhancement of cardiac antioxidant capacity facilitates postischemic myocardial functional recovery (3). Therefore, we hypothesized that NAC …postprin

The effectiveness of low-dose desmopressin in improving hypothermia-induced impairment of primary haemostasis under influence of aspirin - a randomized controlled trial.

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Effect of ketamine on chronic post-ischemia pain (CPIP) model in Sprague-Dawley rats.

Abstract no. 0136The mechanism for the development of Complex Regional Pain Syndrome (CRPS) is not yet well understood. The clinical features and recent studies of CRPS have suggested that a combination of exaggerated regional inflammatory responses in injury may contribute. A Chronic Post-ischemia Pain (CPIP) model of CRPS type I was built and it was suggested the pathogenesis of CRPS could be attributed to the involvement of ischemia-reperfusion injury and inflammatory response. In this study, we evaluated the effects of ketamine on CPIP model in Sprague-...postprin

Cancer pain managment: experience of 702 consecutive cases in a teaching hospital in Hong Kong

Effective pain control is essential in the management of patients with cancer. We present here our experience in the management of 702 patients with cancer pain by the Pain Management Team, Department of Anaesthesiology, Queen Mary Hospital. Patients were discharged from the Pain Management Team with a visual analogue scale of pain (VAS) less than 3 in 87.7% of cases, and more than 90% of patients had improved appetite and sleep on discharge. These promising results were achieved through an emphasis on comfort and function, close liaison among clinicians from different specialties, and a variety of analgesic modalities. Oral drugs remained the mainstay of treatment, supplemented by alternative routes of drug administration such as subcutaneous, intravenous and transdermal delivery. Main side effects observed included nausea (16%) and constipation (8%). Neural blockade, including coeliac plexus blockade, and intercostal nerve blockade, and administration of opioids via subarachnoid or epidural routes were also employed in selected patients.published_or_final_versio

Preventive Treatment with Ketamine attenuates the ischaemia-reperfusion response in a chronic postichaemia pain model

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Re-weighting of somatosensory inputs from the foot and the ankle for controlling posture during quiet standing following trunk extensor muscles fatigue

The present study focused on the effects of trunk extensor muscles fatigue on postural control during quiet standing under different somatosensory conditions from the foot and the ankle. With this aim, 20 young healthy adults were asked to stand as immobile as possible in two conditions of No fatigue and Fatigue of trunk extensor muscles. In Experiment 1 (n = 10), somatosensation from the foot and the ankle was degraded by standing on a foam surface. In Experiment 2 (n = 10), somatosensation from the foot and ankle was facilitated through the increased cutaneous feedback at the foot and ankle provided by strips of athletic tape applied across both ankle joints. The centre of foot pressure displacements (CoP) were recorded using a force platform. The results showed that (1) trunk extensor muscles fatigue increased CoP displacements under normal somatosensatory conditions (Experiment 1 and Experiment 2), (2) this destabilizing effect was exacerbated when somatosensation from the foot and the ankle was degraded (Experiment 1), and (3) this destabilizing effect was mitigated when somatosensation from the foot and the ankle was facilitated (Experiment 2). Altogether, the present findings evidenced re-weighting of sensory cues for controlling posture during quiet standing following trunk extensor muscles fatigue by increasing the reliance on the somatosensory inputs from the foot and the ankle. This could have implications in clinical and rehabilitative areas

Assessment of the paraspinal muscles of subjects presenting an idiopathic scoliosis: an EMG pilot study

BACKGROUND: It is known that the back muscles of scoliotic subjects present abnormalities in their fiber type composition. Some researchers have hypothesized that abnormal fiber composition can lead to paraspinal muscle dysfunction such as poor neuromuscular efficiency and muscle fatigue. EMG parameters were used to evaluate these impairments. The purpose of the present study was to examine the clinical potential of different EMG parameters such as amplitude (RMS) and median frequency (MF) of the power spectrum in order to assess the back muscles of patients presenting idiopathic scoliosis in terms of their neuromuscular efficiency and their muscular fatigue. METHODS: L5/S1 moments during isometric efforts in extension were measured in six subjects with idiopathic scoliosis and ten healthy controls. The subjects performed three 7 s ramp contractions ranging from 0 to 100% maximum voluntary contraction (MVC) and one 30 s sustained contraction at 75% MVC. Surface EMG activity was recorded bilaterally from the paraspinal muscles at L5, L3, L1 and T10. The slope of the EMG RMS/force (neuromuscular efficiency) and MF/force (muscle composition) relationships were computed during the ramp contractions while the slope of the EMG RMS/time and MF/time relationships (muscle fatigue) were computed during the sustained contraction. Comparisons were performed between the two groups and between the left and right sides for the EMG parameters. RESULTS: No significant group or side differences between the slopes of the different measures used were found at the level of the apex (around T10) of the major curve of the spine. However, a significant side difference was seen at a lower level (L3, p = 0.01) for the MF/time parameter. CONCLUSION: The EMG parameters used in this study could not discriminate between the back muscles of scoliotic subjects and those of control subject regarding fiber type composition, neuromuscular efficiency and muscle fatigue at the level of the apex. The results of this pilot study indicate that compensatory strategies are potentially seen at lower level of the spine with these EMG parameters