Browsing by Subject "Post-operative"
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Item Pain Management Experiences Among Hospitalized Postcraniotomy Brain Tumor Patients(Wolters Kluwer, 2021) Foust Winton, Rebecca E.; Draucker, Claire B.; Von Ah, Diane; School of NursingBackground: Brain tumors account for the majority of central nervous system tumors, and most are removed by craniotomies. Many postcraniotomy patients experience moderate or severe pain after surgery, but patient perspectives on their experiences with pain management in the hospital have not been well described. Objective: The aim of this study was to describe how patients who have undergone a craniotomy for brain tumor removal experience pain management while hospitalized. Methods: Qualitative descriptive methods using semistructured interviews were conducted with patients on a neurological step-down unit in an urban teaching hospital in the Midwest United States. Interviews focused on how patients experienced postcraniotomy pain and how it was managed. Narratives were analyzed with standard content analytic procedures. Results: Twenty-seven participants (median age, 58.5 years; interquartile range, 26-41 years; range, 21-83 years) were interviewed. The majority were white (n = 25) and female (n = 15) and had an anterior craniotomy (n = 25) with sedation (n = 17). Their pain experiences varied on 2 dimensions: salience of pain during recovery and complexity of pain management. Based on these dimensions, 3 distinct types of pain management experiences were identified: (1) pain-as-nonsalient, routine pain management experience; (2) pain-as-salient, routine pain management experience; and (3) pain-as-salient, complex pain management experience. Conclusions: Many postcraniotomy patients experience their pain as tolerable and/or pain management as satisfying and effective; others experience pain and pain management as challenging. Implications for practice: Clinicians should be attuned to needs of patients with complex pain management experiences and should incorporate good patient/clinician communication.Item Pain Quality Among Hospitalized Postcraniotomy Brain Tumor Patients(Wolters Kluwer, 2021) Foust Winton, Rebecca E.; Draucker, Claire B.; Von Ah, Diane; School of NursingPurpose/aims: The aim of this study was to describe how persons given a diagnosis of a brain tumor who have had a craniotomy describe the quality of their pain after surgery. Design: A qualitative descriptive design was used. Methods: Qualitative descriptive methods as described by Sandelowski guided this study. Semistructured interviews were conducted with patients hospitalized on a neurological step-down unit in an urban teaching hospital in the Midwestern United States. Interviews focused on the quality of participants' pain after surgery. Narratives were analyzed using standard content analysis. Results: Twenty-seven participants were interviewed. Most were White and female. Most underwent a craniotomy using an anterior approach with sedation. Participants described the quality of their pain with 6 different types of descriptors: pain as pressure, pain as tender or sore, pain as stabbing, pain as throbbing, pain as jarring, and pain as itching. Conclusions: Participants' descriptions of their pain quality after surgery provide a different understanding than do numerical pain ratings. Clinicians should use questions to explore patients' individual pain experiences, seeking to understand the quality of patients' pain and their perceptions.Item Ridge Dimensional Changes: A Comparative Study of Socket Compression After Dental Extraction with No Compression(2013) Bennett, Duane Everett, II, 1984-; Prakasam, Sivaraman; Blanchard, Steven B.; Parks, Edwin T. (Edwin Thomas), 1955-; Ghoneima, Ahmed; John, Vanchit (Vanchit Kurien), 1965-Exodontia, or extraction of teeth, has been a well-documented dental treatment that forms one of the foundations of dentistry. The steps associated with extracting teeth have changed little in the last century and these steps are largely part of the dogma of dentistry. One such step is that of socket compression post-extraction. Rationale for socket compression after extraction is manifold. They include: shorter healing times, fewer dry sockets and re-approximating walls that were stretched in the elevation and delivery stages of extractions. The purpose of this study was to determine if post-extraction ridge compression negatively affected alveolar ridge dimensions when compared to sites that are not compressed post-extraction. Secondary outcome measures will identify if socket compression/re-approximation affects the rate of soft tissue closure or occurrence of alveolar osteitis. In this study, 14 subjects were recruited. Eight subjects formed the compression group, while six formed the non-compression group. The subjects in the compression group received compression of their alveolar ridges after extraction to approximate their original pre-extraction width. The subjects in the non-compression group did not receive ridge compression. Each subject had pre-extraction and post-extraction CBCT scans along with post-operative follow up visits at 1, 2, and 4 weeks post-extraction. The present investigation found that with respect to changes in ridge width, sites that were compressed did not lose significantly more dimension than those that were not. With respect to ridge height, sites that were compressed did not lose significantly more dimension than those that were not. Sites that were compressed and sites that were not, healed at approximately the same rate, with respect to soft tissue closure. While the results showed a lack of statistical significance between both groups, there appears to be a trend towards the ridge compression group having a smaller ridge width. Such a trend was not noted with soft tissue closure, thereby invalidating the rationale for socket compression after extraction. One of the limitations of this pilot study is the small sample size. Further validation of these results must be done with a larger sample size in order to provide clinical guidance to dental practitioners.Item Use of Analgesics in Postoperative Pain Control by Board Certified Pediatric Dentists(2006) Murphy, Ryan; Weddell, James A.; Parks, Edwin; Jackson, Richard; Dean, Jeffrey A.; Eckert, George; Sanders, Brian J.; Sanders, Brian J.Purpose: The purpose of this study is to investigate what post-operative analgesic agents if any, are provided by clinicians for their pediatric dental patients. The study will also evaluate the clinician's philosophy toward pain management in the child patient and look for trends in these philosophies, as well as trends in where they currently practice with regards to pain management and specific analgesic agents. Methods: An on-line survey (appendix A) was sent to gather data from board certified pediatric dentists. The American Board of Pediatric Dentistry (ABPD) website was used to obtain an e-mail directory of addresses of all registered ABPD members. This e-mail provided them with a link to an online survey site where they could access the survey. The online survey site used was surveymonkey.com. The survey was available on-line for 3 months. Mantel-Haenszel and chi-square tests were used to check the relationships of hours of patient care, years of experience, and region of the country with other items in the survey. Results: Responses were received from 210 (27%). The region distribution of the responders was compared to the region distribution of all pediatric dentists. The distributions were found to be similar (p=0.81 using a one-sample chi-square test). Conclusions: Ibuprofen and acetaminophen are recommended most frequently for over the counter (OTC) post-operative pain control by board certified pediatric dentists. Acetaminophen with codeine is prescribed most frequently for post-operative pain control by board certified pediatric dentists. The majority of board certified pediatric dentists adhere to the same philosophies with regard to post-operative pain management as taught in their respective post graduate programs.