급성 통증의 평가를 위한 Visual Analogue Scale (VAS)의 신뢰성 검토 : Its Usefulness as a Pain Measurement Tool in an Emergency Setting

진우제,유태영,진영호,이재백 대한응급의학회 2003 대한응급의학회지 Vol.14 No.1

Purpose: The Visual Analogue Scale (VAS), as a pain measurement tool, has been shown to be a reliable measurement for chronic pain. However, the reliability and the validity of the VAS have not been demonstrated in an acute setting where pain fluctuations might be greater than they would be for chronic pain. This study assessed the usefulness of the VAS in an emergency setting. Methods: Patients 16 years of age or older who presented with acute pain resulting from trauma or non-traumatic diseases were enrolled in this prospective, observational study. A 100-mm non-hatched, horizontal visual analogue scale was used to measure the pain severity. VAS measurements were obtained 1 minute apart at admission, 30 minutes after admission, and 1 hour after treatment. Intraclass correlation coefficients (ICCS) with 95% confidence intervals (95% Cls) and a Bland-Altman analysis were used to assess the reliability and the validity of the VAS measurements. Results: The ICCs for paired VAS scores at admission, 30 minutes after admission, and 1 hour after treatment were 0.988 (95% CI=0.98 to 0.99), 0.968 (95% CI=0.95 to 0.98), and 0.989 (95% CI=0.98 to 0.99), respectively. The Bland-Altman analysis showed that 95% of the paired measurements at admission, 30 minutes after admission, and 1 hour after treatment were within 7 mm. Conclusion: The VAS appears to be a highly reproducible instrument for measurement of acute pain in the emergency department. This study suggests that the VAS is sufficiently reliable to be used to assess acute pain.

통증평가도구에 관한 고찰

심성윤 ( Sung Youn Shim ),박히준 ( Hi Joon Park ),이준무 ( Jun Mu Lee ),이향숙 ( Hyang Sook Lee ) 대한경락경혈학회 2007 Korean Journal of Acupuncture Vol.24 No.2

Objectives: The aim of this study is to introduce pain measurement tools that are considered suitable for clinical practice and research for Korean Medicine Doctors. Methods: We analysed some widely used and also useful pain measurement tools in terms of their methods and dimensions. Results: Diagrams, scales and questions are usually used to measure pain intensity, temporal pattern, treatment including exacerbating and/or relieving factors, pain location, pain interference, pain quality, pain affect, pain duration, pain beliefs and pain history. Specific pain measurements are also available for specific conditions such as Western Ontario and McMaster Universities Osteoarthritis Index, Oswestry Disability Index and Neck Disability Index. Conclusions: Faces Pain Rating Scale, numeric rating scale, visual analogue scale, McGill Pain Questionnaire and Brief Pain Inventory and commonly used pain measurements. Specific measurements should be considered depending on research topics.

Pain measurement in oral and maxillofacial surgery

Sirintawat, Nattapong,Sawang, Kamonpun,Chaiyasamut, Teeranut,Wongsirichat, Natthamet The Korean Dental Society of Anesthsiology 2017 Journal of Dental Anesthesia and Pain Medicine Vol.17 No.4

Regardless of whether it is acute or chronic, the assessment of pain should be simple and practical. Since the intensity of pain is thought to be one of the primary factors that determine its effect on a human's overall function and sense, there are many scales to assess pain. The aim of the current article was to review pain intensity scales that are commonly used in dental and oral and maxillofacial surgery (OMFS). Previous studies demonstrated that multidimensional scales, such as the McGill Pain Questionnaire, Short form of the McGill Pain Questionnaire, and Wisconsin Brief Pain Questionnaire were suitable for assessing chronic pain, while unidimensional scales, like the Visual Analogue Scales (VAS), Verbal descriptor scale, Verbal rating scale, Numerical rating Scale, Faces Pain Scale, Wong-Baker Faces Pain Rating Scale (WBS), and Full Cup Test, were used to evaluate acute pain. The WBS is widely used to assess pain in children and elderly because other scales are often difficult to understand, which could consequently lead to an overestimation of the pain intensity. In dental or OMFS research, the use of the VAS is more common because it is more reliable, valid, sensitive, and appropriate. However, some researchers use NRS to evaluate OMFS pain in adults because this scale is easier to use than VAS and yields relatively similar pain scores. This review only assessed pain scales used for post-operative OMFS or dental pain.

Comparison of postoperative pain according to the harvesting method used in hair restorative surgery

Kim, Yang Seok,Na, Young Cheon,Park, Jae Hyun Korean Society of Plastic and Reconstructive Surge 2019 Archives of Plastic Surgery Vol.46 No.3

Background Postoperative pain is one of the most common concerns of patients undergoing hair transplantation surgery. Because most patients are satisfied with the cosmetic improvement after transplantation, amelioration of postoperative pain would help to increase patient accessibility to hair restorative surgery and greatly impact patient satisfaction with the final cosmetic results. This study was performed to investigate postoperative pain after hair transplantation. Methods In total, 241 patients (202 who underwent follicular unit transplantation [FUT] and 39 who underwent follicular unit extraction [FUE]) were eligible for the study. Postoperative pain was evaluated on postoperative days 1, 2, 3, 4, 5, and 7 using the Wong-Baker Faces Pain Scale. The patients' medical records were retrospectively reviewed for information on the harvesting method, number of transplanted grafts, size of donor design, and laxity, elasticity, and glidability of the scalp in relation to postoperative pain. Results Postoperative pain after hair transplantation, assessed with the Wong-Baker Faces Pain Scale, seemed to provide very subjective results. None of the variables were correlated with postoperative pain in the FUT group. Such pain, however, tended to disappear by postoperative day 3. Patients in the FUE group experienced significantly less severe pain than those in the FUT group. Conclusions Postoperative pain was significantly less severe in patients whose donor hair was harvested by the FUE than FUT method. Postoperative pain had almost disappeared by postoperative day 3 in the FUT group, whereas only minimal pain was present even on postoperative day 1 in the FUE group.

Comparison of postoperative pain according to the harvesting method used in hair restorative surgery

Yang Seok Kim,Young Cheon Na,Jae Hyun Park 대한성형외과학회 2019 Archives of Plastic Surgery Vol.46 No.3

Background Postoperative pain is one of the most common concerns of patients undergoing hair transplantation surgery. Because most patients are satisfied with the cosmetic improvement after transplantation, amelioration of postoperative pain would help to increase patient accessibility to hair restorative surgery and greatly impact patient satisfaction with the final cosmetic results. This study was performed to investigate postoperative pain after hair transplantation. Methods In total, 241 patients (202 who underwent follicular unit transplantation [FUT] and 39 who underwent follicular unit extraction [FUE]) were eligible for the study. Postoperative pain was evaluated on postoperative days 1, 2, 3, 4, 5, and 7 using the Wong-Baker Faces Pain Scale. The patients’ medical records were retrospectively reviewed for information on the harvesting method, number of transplanted grafts, size of donor design, and laxity, elasticity, and glidability of the scalp in relation to postoperative pain. Results Postoperative pain after hair transplantation, assessed with the Wong-Baker Faces Pain Scale, seemed to provide very subjective results. None of the variables were correlated with postoperative pain in the FUT group. Such pain, however, tended to disappear by postoperative day 3. Patients in the FUE group experienced significantly less severe pain than those in the FUT group. Conclusions Postoperative pain was significantly less severe in patients whose donor hair was harvested by the FUE than FUT method. Postoperative pain had almost disappeared by postoperative day 3 in the FUT group, whereas only minimal pain was present even on postoperative day 1 in the FUE group.

Practical statistics in pain research

( Tae Kyun Kim ) 대한통증학회 2017 The Korean Journal of Pain Vol.30 No.4

Pain is subjective, while statistics related to pain research are objective. This review was written to help researchers involved in pain research make statistical decisions. The main issues are related with the level of scales that are often used in pain research, the choice of statistical methods between parametric or nonparametric statistics, and problems which arise from repeated measurements. In the field of pain research, parametric statistics used to be applied in an erroneous way. This is closely related with the scales of data and repeated measurements. The level of scales includes nominal, ordinal, interval, and ratio scales. The level of scales affects the choice of statistics between parametric or non-parametric methods. In the field of pain research, the most frequently used pain assessment scale is the ordinal scale, which would include the visual analogue scale (VAS). There used to be another view, however, which considered the VAS to be an interval or ratio scale, so that the usage of parametric statistics would be accepted practically in some cases. Repeated measurements of the same subjects always complicates statistics. It means that measurements inevitably have correlations between each other, and would preclude the application of one-way ANOVA in which independence between the measurements is necessary. Repeated measures of ANOVA (RMANOVA), however, would permit the comparison between the correlated measurements as long as the condition of sphericity assumption is satisfied. Conclusively, parametric statistical methods should be used only when the assumptions of parametric statistics, such as normality and sphericity, are established. (Korean J Pain 2017; 30: 243-9)

Beyond measurement: a deep dive into the commonly used pain scales for postoperative pain assessment

Seungeun Choi,Soo-Hyuk Yoon,Ho-Jin Lee 대한통증학회 2024 The Korean Journal of Pain Vol.37 No.3

This review explores the essential methodologies for effective postoperative pain management, focusing on the need for thorough pain assessment tools, as underscored in various existing guidelines. Herein, the strengths and weaknesses of commonly used pain scales for postoperative pain—the Visual Analog Scale, Numeric Rating Scale, Verbal Rating Scale, and Faces Pain Scale—are evaluated, highlighting the importance of selecting appropriate assessment tools based on factors influencing their effectiveness in surgical contexts. By emphasizing the need to comprehend the minimal clinically important difference (MCID) for these scales in evaluating new analgesic interventions and monitoring pain trajectories over time, this review advocates recognizing the limitations of common pain scales to improve pain assessment strategies, ultimately enhancing postoperative pain management. Finally, five recommendations for pain assessment in research on postoperative pain are provided: first, selecting an appropriate pain scale tailored to the patient group, considering the strengths and weaknesses of each scale; second, simultaneously assessing the intensity of postoperative pain at rest and during movement; third, conducting evaluations at specific time points and monitoring trends over time; fourth, extending the focus beyond the intensity of postoperative pain to include its impact on postoperative functional recovery; and lastly, interpreting the findings while considering the MCID, ensuring that it is clinically significant for the chosen pain scale. These recommendations broaden our understanding of postoperative pain and provide insights that contribute to more effective pain management strategies, thereby enhancing patient care outcomes.

Not just sensitization: sympathetic mechanisms contribute to expand experimental referred pain

Víctor Doménech-García,Alberto Rubio Peirotén,Miren Lecea Imaz,Thorvaldur Skuli Palsson,Pablo Herrero,Pablo Bellosta-López 대한통증학회 2022 The Korean Journal of Pain Vol.35 No.3

Background: Widespread pain partially depends upon sensitization of central pain mechanisms. However, mechanisms controlling pain distribution are not completely known. The present study sought to assess skin temperature variations in the area of experimentally-induced pain and potential sex differences. Methods: Pressure-pain thresholds (PPTs) were measured on the right infraspinatus muscle. At the end of Day 0, all participants performed an eccentric exercise of the shoulder external rotators to induce muscle soreness 24 hours after. On Day 1, participants indicated on a body chart the area of pain induced by 60 seconds of suprathreshold pressure stimulation (STPS; PPT + 20%) on the right infraspinatus muscle. Skin temperature variations in the area of referred pain were recorded with an infrared thermography camera, immediately before and after the STPS. Results: Twenty healthy, pain-free individuals (10 females) participated. On Day 0, the pre-STPS temperature was higher than the post-STPS temperature on the arm (P = 0.001) and forearm (P = 0.003). On Day 1, the pre-STPS temperature was higher than the post-STPS temperature on the shoulder (P = 0.015), arm (P = 0.001), and forearm (P = 0.010). On Day 0, the temperature decrease after STPS in females was greater than in males on the forearm (P = 0.039). On Day 1, a greater temperature decrease was found amongst females compared with males at the shoulder (P = 0.018), arm (P = 0.046), and forearm (P = 0.005). Conclusions: These findings indicate that sympathetic vasomotor responses contribute to expand pressure-induced referred pain, especially among females.

간호과학 : 간호사의 미숙아 통증 사정 및 관리

배정아 ( Jung A Bae ),이자형 ( Ja Hyung Lee ) 이화여자대학교 간호과학연구소 2013 Health & Nursing Vol.25 No.1

Purpose: The purpose of this study was to examine the practice of pain assessment and management for preterm infants by nurses, thereby providing empirical data to be utilized in developing effective nursing strategies and teaching pain management. Method: The sample consisted of 141 nurses who completed a self-report questionnaire in the following areas: knowledge and administration of pain assessment scales, assessment of responses to pain, perceived levels of pain after treatment, and delivery of pain intervention, knowledge and implementation of pain intervention strategies between April 6, 2012 and April 27, 2012. Data were analyzed using SPSS 18.0 program. Result: The data showed that levels of nurses` pain relief intervention performance were lower compared to their knowledge in pain and that more education was related to higher pain-related knowledge which may lead to carrying out more pain relief intervention. Conclusion: Findings suggest that standardized pain assessment scales and development of nursing intervention strategies are needed. Efforts should be made to improve nurses` performance of pain assessment and management through continuing education. Future studies are warranted to test the effectiveness of such efforts.

Neuroticism and pain catastrophizing aggravate response to pain in healthy adults: an experimental study

( Adriana Banozic ),( Ana Miljkovic ),( Marijana Bras ),( Livia Puljak ),( Ivana Kolcic ),( Caroline Hayward ),( Ozren Polasek ) 대한통증학회 2018 The Korean Journal of Pain Vol.31 No.1

Background: The aim of this study was to investigate the association between neuroticism, pain catastrophizing, and experimentally induced pain threshold and pain tolerance in a healthy adult sample from two regions of the country of Croatia: the island of Korcula and city of Split. Methods: A total of 1,322 participants were enrolled from the Island of Korcula (n = 824) and the city of Split (n = 498). Participants completed a self-reported personality measure Eysenck Personality Questionnaire (EPQ) and pain catastrophizing questionnaire Pain Catastrophizing Scale (PCS), followed by a mechanical pain pressure threshold and tolerance test. We have explored the mediating role of catastrophizing in the relationship between neuroticism and pain intensity. Results: The results showed that pain catastrophizing partially mediated the relationship between neuroticism and pain intensity, suggesting the importance of pain catastrophizing in increasing vulnerability to pain. The results also indicated gender-related differences, marked by the higher pain threshold and tolerance in men. Conclusions: This study adds to the understanding of the complex interplay between personality and pain, by providing a better understanding of such mechanisms in healthy adults. (Korean J Pain 2018; 31: 16-26)