BACKGROUND Uterine evacuation (EVAC) and manual vacuum aspiration (MVA) are commonly performed minor gynaecological procedures, often being done on an out-patient basis. These procedures are associated with pain, but the severity and extent of the pain experienced, especially in the post-procedure period, is not well studied. OBJECTIVES The aim of this study was to determine whether patients who underwent EVAC and MVA procedures, experienced pain postoperatively; and if so, to quantify the degree of pain experienced. These patients were at Chris Hani Baragwanath Academic Hospital (CHBAH). The objectives of this study were to determine whether patients (having undergone EVAC and MVA) experienced pain postoperatively, and to also determine the intensity of the pain. Additionally, to ascertain whether patient age, gestational age or the duration of the procedure, had any impact on the pain experienced. METHOD A sample of 53 patients were selected, presenting for EVAC and MVA at CHBAH. There were 26 patients in the EVAC group and 27 in the MVA group. Information was collected from patient interviews and their hospital files and subsequently recorded on data sheets. Data collected on each data sheet included: patient age, gestation, procedure (EVAC or MVA), reason for procedure, length/duration of procedure and analgesia received prior to and during the procedure. Pain was assessed at intervals of 10 minutes, 40 minutes, 2 hours and 3 hours post-procedure. This was achieved using a ratio, which was determined from a visual analogue scale (VAS). Patients who had pain greater than 3/10 on the VAS score, received rescue analgesia in the form of diclofenac, 1mg/kg diluted in 250 ml of Ringer‘s lactate, over 30 minutes intravenously. RESULTS Patients in the MVA group experienced significantly more pain immediately postoperatively than the patients in the EVAC group. However, there were no significant differences found in pain experienced between the two groups at 40 minutes and thereafter. CONCLUSION Patients undergoing EVAC do experience pain, but if multimodal analgesia is provided, the pain experienced is not significant. Patients undergoing MVA experience significant pain post-procedure. It is recommended that improved analgesia protocols should be instituted.

The present study examined psychological factors associated with individual variation in children's adjustment following minor surgery, and focused specifically on the process of coping with postoperative pain. Sixty children and adolescents (7 to 16 yrs) were interviewed on the day following surgery. They provided ratings and descriptions of their postoperative pain experience, perceived capacity for pain control, spontaneous coping strategies, and emotional distress. Parents also provided information about their efforts (both historical and present) to facilitate their child's coping, their own emotional distress, and perceptions of their child's distress following surgery. Thirdly, nurses rated children's pain behaviours displayed on the ward. Finally, information about analgesic medications and physical complications following surgery was recorded from children's medical charts. Qualitative data concerning the process of coping with postoperative pain and specific parental influences on children's coping were presented within a conceptual model adapted from the adult stress and coping literature. The data were also analyzed for age/developmental differences between older children (10 to 16 yrs) and younger children (7 to 9 yrs). Finally the predictive role of demographic, child coping process, and parental influence variables, in accounting for variations in child coping outcome, was analyzed. Results indicated that children and adolescents experienced moderate to severe pain following minor surgery. They reportedly tried a number of different cognitive and behavioural methods to deal with postoperative pain. Also, parents took an active role in facilitating children's coping. Age group differences were revealed in children's descriptions of postoperative pain, their reported ways of coping with pain, and their perceptions of control over pain and recovery. Age effects were interpreted with caution, however, since age and sex were confounded in this sample. Children who reported the most pain and emotional distress following surgery also reported more catastrophizing cognitions, felt less in control of their recovery, and reported having tried a greater number of behavioral coping strategies to manage pain. These results emphasize the role of children's appraisal processes in predicting coping effectiveness, and demonstrate that more coping does not imply better outcome. Future research directions and potential clinical appplications that follow from these findings were discussed. / Arts, Faculty of / Psychology, Department of / Graduate

Thesis (M.S.)--University of Wisconsin-Madison, 1988. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 120-125).

Thesis (M.A.)--York University, 2004. Graduate Programme in Kinesiology and Health Science. / Typescript. Includes bibliographical references (leaves 85-101). Also available on the Internet. MODE OF ACCESS via web browser by entering the following URL: http://gateway.proquest.com/openurl?url%5Fver=Z39.88-2004&res%5Fdat=xri:pqdiss&rft%5Fval%5Ffmt=info:ofi/fmt:kev:mtx:dissertation&rft%5Fdat=xri:pqdiss:MQ99325

Diss. (sammanfattning) Linköping : Univ., 2001. / Härtill 5 uppsatser.

Thesis (doctor of medicine)--Universitetet i Lund.

Thesis (doctor of medicine)--Universitetet i Lund.

A review of the literature identified that few research studies have been published which examined the post-operative pain of children, particularly those between the ages of 4 and 7 years. As a result, theoretical literature has been the major contributor to the understanding of the concept of children's post-operative pain. Therefore, the purpose of this study was to describe the post-operative pain of hospitalized children aged 4 to 7 years on the first postoperative day, through a self-reported measure of pain intensity levels as well as descriptions of the children's overt behaviours used to express pain. Data were gathered on the pain intensity levels (using the PCT) and overt behaviours of 11 children between the ages of 4 and 8 years on the first post-operative day between the hours of 0800 and 2000. In addition, data regarding parental presence and the administration of analgesics were also collected for these children. Findings related to pain intensity scores provided the basis for three important conclusions. First, all of the children were able to place a value on their pain using the PCT. Second, all of the children were experiencing some degree of post-operative pain possibly related to the lack of consistent administration of analgesia. Third, parental presence did not influence the pain intensity scores reported by the children. Findings related to the overt behaviours exhibited by children also provided the basis for three important conclusions. First, the most frequent behaviours identified were not those normally associated with feelings of pain. The researcher believed that this lack of expected response was as a result of the children's ability to adapt and cope with the pain. Second, behavioural measurement of pain may not be a reliable and valid measure of post-operative pain. Third, parental presence or absence did not influence the overt behaviours exhibited. / Applied Science, Faculty of / Nursing, School of / Graduate

Meng, Zhaoyu. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2010. / Includes bibliographical references (leaves 61-74). / Abstracts in English and Chinese. / Declaration of Origination --- p.II / Abstract --- p.III / Acknowledgement --- p.VII / Table of Contents --- p.VIII / List of Tables --- p.XI / List of Figures --- p.XII / List of Abbreviations --- p.XIII / Chapter Chapter 1. --- Review of postoperative pain --- p.1 / Chapter Chapter 2. --- Candidate Genes --- p.6 / Chapter 2.1 --- μ Opioid Receptor Gene --- p.6 / Chapter 2.2 --- ATP-binding cassette B1 (ABCB1) / multiple drug resistance 1 (MDR1) gene --- p.10 / Chapter 2.3 --- Catechol-O-methyltransferase (COMT) gene --- p.10 / Chapter 2.4 --- βArrestin2 gene --- p.11 / Chapter 2.5 --- Transient receptor potential (TRP) gene --- p.11 / Chapter 2.6 --- GTP cyclohydrolase 1 (GCHl)gene --- p.12 / Chapter Chapter 3. --- Hypothesis and Experimental Design --- p.15 / Chapter 3.1 --- Hypothesis --- p.15 / Chapter 3.2 --- Objectives --- p.15 / Chapter 3.3 --- Experimental design --- p.15 / Chapter 4.4 --- Role in this study --- p.16 / Chapter Chapter 4. --- Methods --- p.17 / Chapter 4.1 --- Patients --- p.17 / Chapter 4.2 --- Anesthetic procedure --- p.17 / Chapter 4.3 --- Postoperative management --- p.18 / Chapter 4.4 --- Patient follow-up --- p.19 / Chapter 4.5 --- Definition of endpoints --- p.19 / Chapter Chapter 5. --- Genotyping --- p.22 / Chapter Chapter 6 --- Statistical Analysis and Sample Size --- p.24 / Chapter 6.1 --- Statistical analysis --- p.24 / Chapter 6.2 --- Sample size --- p.26 / Chapter Chapter 7. --- "Demographic, genotype and haplotype result" --- p.28 / Chapter 7.1 --- Patient characteristics --- p.28 / Chapter 7.2 --- Genotypes and haplotypes --- p.30 / Chapter Chapter 8. --- Acute postoperative pain --- p.35 / Chapter Chapter 9. --- Morphine consumption for early postoperative pain --- p.41 / Chapter 9.1 --- Patients using alternative analgesia --- p.41 / Chapter 9.2 --- Result in the patients using morphine alone --- p.41 / Chapter Chapter 10. --- Opioid-related Side Effects --- p.47 / Chapter Chapter 11. --- Chronic postoperative pain --- p.49 / Chapter 11.1 --- Patient characteristics --- p.49 / Chapter 11.2 --- Association of genetic polymorphisms and Chronic postoperative pain --- p.51 / Chapter Chapter 12. --- Discussion --- p.54 / Chapter 12.1 --- Acute postoperative pain --- p.54 / Chapter 12.2 --- Chronic postoperative pain --- p.57 / Chapter Chapter 13. --- Conclusion --- p.60 / References --- p.61 / Appendix I. Morphine Consumption and and Number of Demands for Patient Controlled Analgesia (PCA) in Patients with Different Genotypes --- p.75 / Appendix II. Opioid Related Symptom Distress Scale Score on Day 1 and Overall Score of Each Day in Patients with Different Genotypes --- p.79 / Appendix III. Opioid Related Symptoms Distress Scale Score in Patients with Different Genotypes --- p.83

Thesis (M.S.)--University of Michigan, 1984.