Comparative analysis of visual analog scales for assessing acute pain in women after radical mastectomy

Abstract

BACKGROUND: Effective quantitative assessment of acute pain as an urgent problem in clinical medicine. One of the solutions to this problem is a color discrete scale (CDS).

AIM: To determine the efficacy of the clinical usage of color discrete scale compared with linear visual analog scale to assess acute pain in women after radical mastectomy.

MATERIALS AND METHODS: This study includes a prospective, observational, and non-randomized clinical trial. A total of 110 females who underwent radical mastectomy (RM) were interviewed. We used a 100-point linear visual analog scale (lVAS) and CDS with monotonic (mCDS) and random (rCDS) color arrangement. Pain was assessed 2, 6, 12, 24, 48, and 72 h after surgery.

RESULTS: Pain scores obtained 2 h after RM were 6 (0; 30), 12 (0; 24), 8 (0; 20) points according to IVAS, mCDS, and rCDS, respectively (p >0.05). Furthermore, the pain scores were gradually reduced on all three scales and had no statistically significant difference (p >0.05). In women who underwent paravertebral blockade (PVB), pain scores were significantly less at 2, 6, 12, and 48 h after surgery (p <0.05). Spearman’s correlation coefficient for lVAS and mCDS is 0.90, 0.86 for lVAS and rCDS, and 0.90 for mCDS and rCDS (all p <0.05).

CONCLUSIONS: The CDS is an alternative, independent, and sufficient tool for quantifying pain. A strong correlation was found between the pain assessments according to CDS and lVAS. PVB significantly improves the quality of pain relief after RM.

Keywords

postoperative pain / visual analog scale / radical mastectomy / paravertebral blockade / color discrete scales

References

[1] Gerasimov AA. O stadijah razvitija hronicheskogo bolevogo sindroma. Russian Journal of Pain. 2016;2:14–5 (In Russ).

[2] Герасимов А.А. О стадиях развития хронического болевого синдрома // Российский журнал боли. 2016. Т. 2. С. 14–15.

[3] Milushkina OI, Peskov AB, Galushina IA. Algometric possibilities of the computer electroacupuncture аt the chronic abdominal pain. Journal of New Medical Technologies. 2008;15(2):152–4 (In Russ).

[4] Милушкина О.И., Песков А.Б., Галушина И.А. Альгометрические возможности компьютерной электроакупунктуры при хронической абдоминальной боли // Вестник новых медицинских технологий. 2008. Т. 15, № 2. С. 152–4.

[5] Mokhov EM, Kadykov VA, Sergeev AN, et al. Pain scoring systems and their application features in medicine (literature review). Upper Volga Medical Journal. 2019;18(2):34–7 (In Russ).

[6] Мохов Е.М., Кадыков В.А., Сергеев А.Н., и др. Оценочные шкалы боли и особенности их применения в медицине (обзор литературы). Верхневолжский медицинский журнал. 2019. Т. 18, № 2. С. 34–7.

[7] de Jesus JAL, Campos Júnior D, Storm H, et al. Skin conductance and behavioral pain scales in newborn infants. Psychol Neurosci. 2015;8(2):203–10. doi: 10.1037/h0101058

[8] de Jesus J.A.L., Campos Júnior D., Storm H., et al. Skin conductance and behavioral pain scales in newborn infants // Psychol Neurosci. 2015. Vol. 8, N 2. P. 203–10. doi: 10.1037/h0101058

[9] Fratino S, Peluso L, Talamonti M, et al. Evaluation of Nociception Using Quantitative Pupillometry and Skin Conductance in Critically Ill Unconscious Patients: A Pilot Study. Brain Sci. 2021;11:109. doi: 10.3390/brainsci11010109

[10] Fratino S., Peluso L., Talamonti M., et al. Evaluation of Nociception Using Quantitative Pupillometry and Skin Conductance in Critically Ill Unconscious Patients: A Pilot Study // Brain Sci. 2021. Vol. 11. P. 109. doi: 10.3390/brainsci11010109

[11] Levina GY, Bykov YN, Borisov AS. Diagnostics and therapy of peripheral neuropathy (literature review). Acta Biomedica Scientifica (East Siberian Biomedical Journal). 2015.1:72–6 (In Russ).

[12] Левина Г. Ю., Быков Ю. Н., Борисов А. С. Диагностика и лечение периферической нейропатической боли (обзор литературы) // Бюллетень Восточно-Сибирского научного центра Сибирского отделения Российской академии медицинских наук. 2015. Т. 1. С. 72–6.

[13] Morozov AM, Zhukov SV, Belyak MA, et al. About the possibilities of evaluating a pain syndrome using the most validized pain scales. Journal of New Medical Technologies. 2020;27(2):62–8 (In Russ).

[14] Морозов А.М., Жуков С.В., Беляк М.А., и др. О возможности оценивания болевого синдрома при помощи наиболее валидизированных шкал боли (обзор литературы) // Вестник новых медицинских технологий. 2020. Т. 27, № 2. С. 62–8.

[15] Popadyuk VI, Kastyro IV, Chuluunbaatar SS, Drozdova GA. Age-specificity in acute pain syndrome measurement in otorhinolaryngology. RUDN Journal of Medicine. 2012;(2):94–9 (In Russ).

[16] Попадюк В.И., Кастыро И.В., Чулуунбаатар С.С., Дроздова, Г.А. Возрастной аспект при оценке острого болевого синдрома в оториноларингологии // Вестник Российского университета дружбы народов. Серия: Медицина. 2012. № 2. С. 94–9.

[17] Zabolotskikh IB, Gorobets ES, Grigor’ev EV, et al. Perioperative management of geriatric patients. Russian Journal of Anаеsthesiology and Reanimatology. 2018;(1):5–20. doi: 10.17116/anaesthesiology201801-0215 (In Russ).

[18] Заболотских И.Б., Горобец Е.С., Григорьев Е.В., и др. Периоперационное ведение пациентов пожилого и старческого возраста // Анестезиология и реаниматология. 2018. № 1. С. 5–20. doi: 10.17116/anaesthesiology201801-0215

[19] Marochkov AV, Iakimov DA. Evaluation of the efficiency of using two different visual scales for quantitative measurement of acute pain. Russian journal of Anaesthesiology and Reanimatology. 2008;4:50–52 (In Russ).

[20] Марочков А.В., Якимов Д.А. Оценка эффективности применения двух различных визуальных шкал для количественного измерения острой боли // Анестезиология и реаниматология. 2008. № 4. С. 50–2.

[21] Ovechkin AM. Chronic postoperative pain syndrome – «a pitfall» of modern surgery. Regional Anesthesia and Acute Pain Management. 2016;10(1):5–18. doi: 10188.21/1993-6508-2016-10-1-5-18 (In Russ).

[22] Овечкин А.М. Хронический послеоперационный болевой синдром – подводный камень современной хирургии // Регионарная анестезия и лечение острой боли. 2016. Т.10, № 1. С. 5–18. doi: 10188.21/1993- 6508-2016-10-1-5-18

[23] Gerbershagen HJ, Aduckathil S, van Wijck AJ, et al. Pain intensity on the first day after surgery: a prospective cohort study comparing 179 surgical procedures. Anesthesiology. 2013;118(4):934–944. doi: 10.1097/ALN.0b013e31828866b3

[24] Gerbershagen H.J., Aduckathil S., van Wijck A.J., et al. Pain intensity on the first day after surgery: a prospective cohort study comparing 179 surgical procedures // Anesthesiology. 2013. Vol. 118, N 4. P. 934–944. doi: 10.1097/ALN.0b013e31828866b3

[25] Jaffe RA, Golianu B, Schmiesing CA, editors. Anesthesiologist’s manual of surgical procedures. Lippincott: Williams & Wilkins; 2014.

[26] Jaffe R.A., Golianu B., Schmiesing C.A., editors. Anesthesiologist’s manual of surgical procedures. Lippincott: Williams & Wilkins, 2014.

[27] Khoronenko VE, Malanova AS, Baskakov DS, et al. Regional and peripheral blockades for prevention of chronic post-thoracotomy pain syndrome in oncosurgical practice. Pirogov Russian Journal of Surgery. 2017;(8):58–63. doi: 10.17116/hirurgia2017858-63 (In Russ).

[28] Хороненко В.Э., Маланова А.С., Баскаков Д.С., и др. Применение регионарных и периферических блокад для профилактики хронического постторакотомического болевого синдрома в онкохирургической практике // Хирургия. Журнал им. Н.И. Пирогова. 2017. № 8. С. 58–63. doi: 10.17116/hirurgia2017858-63

[29] Tishkov DS, Bobyncev II. The study of the level of intensity of pain in patients with trigeminal neuralgia on the background of complex therapy phisiobalneotherapy. Physiotherapist. 2016;(2):23–28. (In Russ).

[30] Тишков Д.С., Бобынцев И.И. Исследование уровня интенсивности болевого синдрома у больных с невралгией тройничного нерва на фоне комплексной физиофармакотерапии // Физиотерапевт. 2016. № 2. С. 23–8.

[31] Morozov AM, Sergeev AN, Zhukov SV, et al. About the possibility of using scales of pain in the conditions of a hospital. Modern problems of science and education. 2020;(4):148. doi: 10.17513/spno.29862 (In Russ).

[32] Морозов А.М., Сергеев А.Н., Жуков С.В., Аскеров Э.М., Беляк М.А., Пахомов М.А. и др. О возможности использования шкал боли в условиях стационара // Современные проблемы науки и образования. 2020. № 4. С. 148. doi: 10.17513/spno.29862

[33] Le May S, Ballard A, Khadra C, et al. Comparison of the psychometric properties of 3 pain scales used in the pediatric emergency department: Visual Analogue Scale, Faces Pain Scale-Revised, and Colour Analogue Scale. Pain. 2018;159(8):1508–1517. doi: 10.1097/j.pain.0000000000001236

[34] Le May S., Ballard A., Khadra C., et al. Comparison of the psychometric properties of 3 pain scales used in the pediatric emergency department: Visual Analogue Scale, Faces Pain Scale-Revised, and Colour Analogue Scale // Pain. 2018. Vol. 159, N 8. P. 1508–17. doi: 10.1097/j.pain.0000000000001236

[35] Nesteruk SF, Marochkov AV, Marochkova NA. Kolichestvennaya otsenka vospriyatiya ostroy boli u beremennykh. Okhrana materinstva i detstva. 2011;(2):65–69 (In Russ).

[36] Нестерук С.Ф., Марочков А.В., Марочкова Н.А. Количественная оценка восприятия острой боли у беременных // Охрана материнства и детства. 2011. № 2. С. 65–69.

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