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Lbrahim Farooq Pasha, Atiq Ur Rehman, Asim Niaz Naqvi, Syed Junaid Ismail, Salman Ashfaq, and Muhammad Asad Qureshi. "Use of Numeric Rating Scale (NRS) as Visual Analogue Scale (VAS): Is this Clinically Significant?" Pakistan Armed Forces Medical Journal 73, no. 5 (2023): 1120–222. http://dx.doi.org/10.51253/pafmj.v73i5.4453.
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Objective: To analyze statistically significant differences between the Numeric Rating Scale (NRS) and Visual Analogue Scale (VAS) in low back pain (LBP) patients. Study Design: Prospective longitudinal Study. Place and Duration of Study: Orthopaedic and Spine Department, Combined Military Hospital, Peshawar Pakistan, from Sep 2019 to May 2020. Methodology: The study included two hundred one patients with low back pain presented to the Orthopedic and Spine OPD.All patients were asked to record their pain with a Visual Analogue Scale (VAS) at the start of the visit and a Numerical Rating Scale (NRS) at the exit, at approximately 5-7 minute intervals in the Outpatient Department. Results: Two hundred one patients were included in the study. The mean age of the patients was 41.5 years (range 15-75). Thecomparison of pain measurements with the Numerical Rating Scale (NRS) showed a mean of 7.408(SD1.853), whereas with the Visual Analogue Scale (VAS), it was 6.864 (SD1.954). This showed higher readings with NRS compared to VAS, with a mean difference of 0.544 (p-value was <0.001). Conclusion: The numerical Rating Scale (NRS) tends to produce higher pain readings than the Visual Analogue Scale (VAS). Treatment guidelines should be considered when interpreting studies that have used VAS interchangeably and wrongly reported it as NRS.
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Firdous, Shagufta, Zankhana Mehta, Carlos Fernandez, Bertarnd Behm, and Mellar Davis. "A comparison of Numeric Pain Rating Scale (NPRS) and the Visual Analog Scale (VAS) in patients with chronic cancer-associated pain." Journal of Clinical Oncology 35, no. 31_suppl (2017): 217. http://dx.doi.org/10.1200/jco.2017.35.31_suppl.217.
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217 Background: Though numerical rating scales (NRS) are frequently used, a subset of patients do not understand the abstract nature on NRS and use quality descriptors of severity. We used a visual analog scale (VAS) using descriptors of “good day”, “average day” and “bad day” along a 10-cm line and compared it to a NRS in patients with cancer diagnosis and pain 1 month or longer. Methods: Eligible patients were verbally consented and completed the two scales. We asked patients thoughts about which they felt was the more appropriate scale to gauge their pain. The scales were compared by the distance from the extreme left of the line to the mark the patient placed on the VAS. Additional data included demographic and diagnosis information. The VAS and NRS were compared using two-sample t-tests or Wilcoxon rank-sum tests and Pearson’s chi-square or Fisher’s exact tests, as appropriate. The relationship between the numeric pain scale and the visual analog scale is described using Pearson’s correlation coefficient. Results: Full data was provided from 94 patient surveys who completed surveys. The mean age was 61 years old, 56.4% were female, and 78.0% had metastatic cancer. Numerous cancer types were reported with gastrointestinal and lung cancers being the most common (30.1% and 23.7%, respectively). The mean NRS rating reported by patients was 5.9 and for the VAS 4.9. Sixty patients (63.8%) preferred the NRS, 32 (34.0%) preferred the VAS, and 2 (2.1%) reported no preference. Patients who preferred the NRS reported a higher NRS rating than patients who preferred the VAS (mean NRS of 6.3 compared to 5.2, p = 0.0409). VAS ratings were higher among patients who preferred the NRS but the difference was not statistically significant (mean rating of 5.2 vs. 4.4, p = 0.1894). There were no differences in patient characteristics between the two groups. There was a moderate association between patients’ NRS and VAS ratings. The Pearson correlation coefficient was 0.653 (p < 0.0001). Conclusions: Majority of patients of all ages and both genders prefer NRS. Future studies involving larger number of patients and adding a question about the reason of scale preference may provide better understanding for scale preference.
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Paruchuri, Mounika* Veeragandam Satyanarayana Shaik Mabu Subhani Chevula Nikhila Gangisetty Sampath Manchala Vamsi Vardhan. "The Role of Pain Scales in The Assessment of Pain." International Journal of Pharmaceutical Sciences 3, no. 2 (2025): 322–26. https://doi.org/10.5281/zenodo.14810676.
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The purpose of this study is to examine the literature on the Visual Analogue Scale, Verbal Rating Scale, and Numerical Rating Scale—three widely used pain rating scales. The evaluation offers the details required to comprehend the scales' primary characteristics. It is easy to misinterpret data produced by pain-rating scales. Clinicians can make appropriate use of these tools by understanding their key aspects with the aid of this review. A Medline review using PubMed was conducted without regard to the age of the papers that were retrieved. Before being included, papers were reviewed for methodological soundness. The original search terms were Visual Analogue Scale (VAS), Verbal Rating Scale (VRS), Numerical/numeric Rating Scale (NRS), pain rating scales, pain measurement, and VAS. Additional papers and search phrases were produced using the reference lists of the articles that were obtained. Only papers written in English were looked at. Although the Visual Analogue Scale presents more practical challenges than either the Verbal Rating Scale or the Numerical Rating Scale, all three pain-rating measures are valid, dependable, and suitable for use in clinical practice. The Numerical Rating Scale produces data that can be statistically analysed for auditing purposes and has good sensitivity for general uses. It is likely that patients who are looking for a sensitive pain rating scale would select this one. Patients like the Verbal Rating Scale for ease of use, however it is insensitive and the results it generates may be misinterpreted
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Choi, Sang Sik. "Pain Relief Scale Is More Highly Correlated with Numerical Rating Scale than with Visual Analogue Scale in Chronic Pain Patients." Pain Physician 2;18, no. 2;3 (2015): E195—E200. http://dx.doi.org/10.36076/ppj/2015.18.e195.
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The pain relief scale (PRS) is a method that measures the magnitude of change in pain intensity after treatment. The present study aimed to evaluate the correlation between PRS and changes in pain determined by the visual analogue scale (VAS) and numerical rating scale (NRS), to confirm the evidence supporting the use of PRS. Sixty patients with chronic spinal pain that had a VAS and NRS recorded during an initial examination were enrolled in the study. One week later, the patients received an epidural nerve block, then VAS, NRS, and PRS assessments were performed. Differences between VAS and NRS were compared to the PRS and scatter plots and correlation coefficient were generated. The differences and magnitude of decrease in the VAS and NRS raw data were converted to percentile values, and compared to the PRS. Both VAS and NRS values exhibited strong correlations (> 0.8) with PRS. Further, the differences between the VAS-PRS R (0.859) and NRS-PRS R (0.915) were statistically significant, (P = 0.0259). Compared to PRS, the VAS and NRS percentile scores exhibited higher correlation coefficients than scores based on the raw data differences. Furthermore, even when converted to a percentile, the NRS%-PRS R (0.968) was higher than the VAS%-PRS R (0.904), P = 0.0001. The results indicated that using the PRS together with NRS in pain assessment increased the objectivity of the assessment compared to using only VAS or NRS, and may have offset the limitations of VAS or NRS alone. Key words: Pain relief scale, numerical rating scale, visual analogue scale, pain measurement, pain intensity measurement, pain intensity scale
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Thong, Ivan S. K., Mark P. Jensen, Jordi Miró, and Gabriel Tan. "The validity of pain intensity measures: what do the NRS, VAS, VRS, and FPS-R measure?" Scandinavian Journal of Pain 18, no. 1 (2018): 99–107. http://dx.doi.org/10.1515/sjpain-2018-0012.
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Abstract Background and aims: The Numerical Rating Scale (NRS), Visual Analogue Scale (VAS), Verbal Rating Scale (VRS), and Faces Pain Scale-Revised (FPS-R) are valid measures of pain intensity. However, ratings on these measures may be influenced by factors other than pain intensity. The purpose of this study was to evaluate the influence of non-pain intensity factors on the pain intensity scales. Methods: We administered measures of pain intensity (NRS, VAS, VRS, FPS-R), pain unpleasantness, catastrophizing, depressive symptoms, and pain interference to 101 individuals with chronic lower back or knee pain. Correlation analyses examined the associations among the pain intensity scales, and regression analyses evaluated the contributions of the non-pain intensity factors (depressive symptoms, and pain unpleasantness, catastrophizing, and interference) to the VAS, VRS, and FPS-R ratings, while controlling for NRS, age, and gender. Results: Although the NRS, VAS, VRS, FPR-S, scales were strongly associated with one another, supporting their validity as measures of pain intensity, regression analyses showed that the VRS also reflected pain interference, the FPS-R also reflected pain unpleasantness, and the VAS was not associated with any of the additional non-pain intensity factors when controlling for NRS, age, and gender. Conclusions: The VAS appears to be most similar to the NRS and less influenced by non-pain intensity factors than the VRS or FPS-R. Although the VRS and FPS-R ratings both reflect pain intensity, they also contain additional information about pain interference and pain unpleasantness, respectively. These findings should be kept in mind when selecting pain measures and interpreting the results of research studies using these scales. Implications: The influence of pain interference and pain unpleasantness on VRS and FPS-R, respectively should be kept in mind when selecting pain measures and interpreting the results of research studies using these scales.
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Ruskin, Danielle, Chitra Lalloo, Khushnuma Amaria, et al. "Assessing Pain Intensity in Children with Chronic Pain: Convergent and Discriminant Validity of The 0 To 10 Numerical Rating Scale in Clinical Practice." Pain Research and Management 19, no. 3 (2014): 141–48. http://dx.doi.org/10.1155/2014/856513.
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BACKGROUND: In clinical practice, children are often asked to rate their pain intensity on a simple 0 to 10 numerical rating scale (NRS). Although the NRS is a well-established measure for adults, no study has yet evaluated its validity for children with chronic pain.OBJECTIVES: To examine the convergent and discriminant validity of the NRS as it is used within regular clinical practice to document pain intensity for children with chronic pain. Interchangeability between the NRS and an analogue pain measure was also assessed.METHODS: A cohort of 143 children (mean [± SD] age 14.1±2.4 years; 72% female) rated their pain intensity (current, usual, lowest and strongest levels) on a verbally administered 0 to 10 NRS during their first appointment at a specialized pain clinic. In a separate session that occurred either immediately before or after their appointment, children also rated their pain using the validated 0 to 10 coloured analogue scale (CAS).RESULTS: NRS ratings met a priori criteria for convergent validity (r>0.3 to 0.5), correlating with CAS ratings at all four pain levels (r=0.58 to 0.68; all P<0.001). NRS for usual pain intensity differed significantly from an affective pain rating, as hypothesized (Z=2.84; P=0.005), demonstrating discriminant validity. The absolute differences between NRS and CAS pain scores were small (range 0.98±1.4 to 1.75±1.9); however, the two scales were not interchangeable.CONCLUSIONS: The present study provides preliminary evidence that the NRS is a valid measure for assessing pain intensity in children with chronic pain.
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Divya, Amaravadi, and Yerramilli Aparna. "A study on the Comparison of Pain Assessment Scales used in a Tertiary Care Centre." American Journal of PharmTech Research 13, no. 1 (2023): 34–44. https://doi.org/10.5281/zenodo.7628179.
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ABSTRACT Pain is a major public health issue throughout the world and represents a major clinical, social and economic problem. It is a single centre, prospective, observational study done at Apollo hospitals, Jubilee hills, Hyderabad for a period of 6 months (January’17-June’17). A total of 121 patients were considered of the age group (18-80) years with complaints of pain admitted in Medical ICU, Neurology ICU, Surgical ICU, Cardiac ICU and General wards. The cases were observed for types of pain and to compare the agreement between the Numerical Rating Scale (NRS), Visual Analogue Scale (VAS), Verbal Rating Scale (VRS) & Faces scale in non- sedated patients & Critical Care Pain Observation Scale (CPOT) & Behavioral Pain Scale (BPS) in sedated patients. Out of 121 patients the most common type of pain was nociceptive pain. Kappa test was used to assess agreement between scales. A substantial agreement of 0.63 was seen between NRS and Faces (uni-dimensional scale) in non-sedated patients while almost perfect agreement of 0.92 was seen between CPOT and BPS (multi-dimensional scale) in sedated patients. On comparing scales it was observed that greater agreement was between NRS and Faces while assessing pain in non-sedated patients and CPOT and BPS while assessing pain in sedated patients. Therefore, it can be said that the association or use of these scales might improve in better pain score assessment which would ease the pain management practices in a hospital setting. <strong>Keywords</strong>: NRS, VAS, FACES, CPOT, BPS, Pain.
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Leblebici, Metin, Berna Dincer, Cemile Savcı, Filiz Soyhan, and Orhan Alimoğlu. "Assessment of postoperative pain intensity after laparoscopic cholecystectomy: Comparative analysis of three rating scales in terms of scores and patient preferences." Gevher Nesibe Journal IESDR 7, no. 16 (2022): 75–81. http://dx.doi.org/10.46648/gnj.321.
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Objective: To compare three rating scales in assessment of postoperative pain intensity after laparoscopic cholecystectomy Methods: A total 102 patients who underwent elective laparoscopic cholecystectomy surgery were participated on a voluntary basis in this cross-sectional questionnaire survey. The questionnaire form elicited items on sociodemographic characteristics of patients, pain characteristics and the pain intensity assessment via three scales including Visual Analogue Scale (VAS), Numerical Rating Scale (NRS), Verbal Descriptor Scale (VDS). Results: Mean(SD) VAS, VDS and NRS scores were 4.7(1.3), 2.8(0.7) and 4.5(1.2), respectively. VDS (67.6%) was the most commonly preferred scale by patients, as followed by VAS (23.5%) and NRS (8.8%). Positive significant correlations were noted between each scale (r: ranged from 0.809 between VAS and VDS to 0.865 between VDS and NRS, p<0.001 for each). There was a high level of inter-scale concordance overall (Cronbach's alpha: 0.910), including VAS x VDS (Cronbach's alpha: 0.820), VAS x NRS (Cronbach’s alpha=0.906) and VDS x NRS (Cronbach’s alpha=0.868). Conclusion: In conclusion, our findings demonstrate that all three scales (VAS, NRS, VDS) provide reliable and valid data with strong correlations and a high level of inter-scale concordance in assessing postoperative pain intensity in laparoscopic cholecystectomy patients. However, VDS appears to be the best scale in assessing pain intensity after laparoscopic cholecystectomy surgery with respect to patient preference rates as well as its strong correlation with other scales, particularly the NRS.
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Welsh, Elizabeth M., George Gettinby, and Andrea M. Nolan. "Comparison of a visual analogue scale and a numerical rating scale for assessment of lameness, using sheep as a model." American Journal of Veterinary Research 54, no. 6 (1993): 976–83. http://dx.doi.org/10.2460/ajvr.1993.54.06.976.
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Summary A study was designed to compare use of an numerical rating scale (nrs) and a visual analogue scale (vas) for subjective assessment of lameness, using sheep as a model. The nrs consisted of 5 divisions, 0, 1, 2, 3, and 4; 4 of these divisions (1–4) described lameness. The vas used a 100-mm horizontal line with vertical bars at either end; one end was labeled 'sound' and the other was labeled 'could not be more lame.' Two independent observers graded lameness in 62 sheep, and between- and within-observer differences were assessed for each scoring system to compare the nrs with the vas. Results indicated no significant differences between the 2 observers scoring lameness, using either the vas or the nrs. The scores obtained, using the vas, were not normally distributed, although differences between scores for the 2 observers were. The nrs scores followed a normal distribution pattern. Investigation of repeated measurement for the same sheep, using both scales, revealed no significant difference between either. A comparison of the nrs and vas scores made by each observer indicated that although correlation was good (observer 1; r = 0.94; observer 2; r = 0.95), there was not perfect agreement. The maximal nrs score of 4 was associated with vas values > 68 mm, indicating that the nrs divisions did not reflect equal increases in lameness. The vas and nrs scores for each observer were highly reproducible, although they were more variable for sheep that were regarded as moderately lame. Results indicate that although the nrs and vas compared favorably with respect to repeatability, reproducibility, and use by 2 observers, the vas is inherently more sensitive. In addition, the nrs and vas should not be used interchangeably.
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Pereira, Lílian Varanda, Gilberto de Araújo Pereira, Louise Amália de Moura, and Rayanne Rodrigues Fernandes. "Pain intensity among institutionalized elderly: a comparison between numerical scales and verbal descriptors." Revista da Escola de Enfermagem da USP 49, no. 5 (2015): 804–10. http://dx.doi.org/10.1590/s0080-623420150000500014.
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AbstractOBJECTIVECorrelating two unidimensional scales for measurement of self-reported pain intensity for elderly and identifying a preference for one of the scales.METHODA study conducted with 101 elderly people living in Nursing Home who reported any pain and reached ( 13 the scores on the Mini-Mental State Examination. A Numeric Rating Scale - (NRS) of 11 points and a Verbal Descriptor Scale (VDS) of five points were compared in three evaluations: overall, at rest and during movement.RESULTSWomen were more representative (61.4%) and the average age was 77.0±9.1 years. NRS was completed by 94.8% of the elderly while VDS by 100%. The association between the mean scores of NRS with the categories of VDS was significant, indicating convergent validity and a similar metric between the scales.CONCLUSIONPain measurements among institutionalized elderly can be made by NRS and VDS; however, the preferred scale for the elderly was the VDS, regardless of gender.
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Pertek, Hatipoğlu Fatma. "Assessment of Pain Scales Used in Endodontic Postoperative Pain Evaluation: Frequency, Advantages, and Limitations." Journal of Endodontics and Restorative Dentistry 3, no. 1 (2024): 2–5. https://doi.org/10.5281/zenodo.14947995.
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<strong>Objectives:</strong> Postoperative pain is a critical outcome in endodontic research and clinical practice, directly impacting patient satisfaction and treatment success. Various pain assessment tools, such as the Visual Analog Scale (VAS) and Numeric Rating Scale (NRS), are employed to quantify and evaluate pain. This study aimed to analyze the frequency of use of different pain assessment tools in endodontic postoperative pain research across different databases. <strong>Materials and Methods:</strong> A bibliometric analysis was performed using PubMed, Web of Science, and Scopus. The search strategy included commonly used pain scales: VAS, NRS, Heft-Parker Visual Analog Scale, Verbal Rating Scale, Faces Pain Scale, Short-Form McGill Pain Questionnaire, and Brief Pain Inventory. The results were synthesized to determine the prevalence of these scales in published research. <strong>Results:</strong> VAS was the most frequently used tool, with 571 studies in PubMed (75.4%), 581 in Scopus (77.8%), and 346 in Web of Science (74.1%). The NRS followed, with 65 (8.6%), 71 (9.5%), and 51 (10.9%) studies, respectively. Other scales, such as the Heft-Parker Visual Analog Scale, Verbal Rating Scale, and Faces Pain Scale, were used less frequently. Comprehensive tools like the Short-Form McGill Pain Questionnaire and Brief Pain Inventory had minimal representation. <strong>Conclusion: </strong>VAS and NRS dominate endodontic postoperative pain research, reflecting their ease of use and widespread acceptance. Less commonly used tools, while valuable in specific contexts, are underrepresented. Future research should explore the reasons for this disparity and assess the potential of hybrid tools to standardize pain evaluation practices.
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Cheung, H. N., Y. S. Chan, and N. H. Hsiung. "Validation of the 5-D Itch Scale in Three Ethnic Groups and Exploring Optimal Cutoff Values Using the Itch Numerical Rating Scale." BioMed Research International 2021 (December 13, 2021): 1–7. http://dx.doi.org/10.1155/2021/7640314.
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Background. Chronic pruritus is a common and distressing condition that has serious emotional and psychosocial consequences. Due to its subjective nature, self-report questionnaires are widely implemented as cost-effective measures to gauge the severity of chronic pruritus. The current study is aimed at validating the 5-D itch scale in three ethnic groups—Black, Asian, and Hispanic—with the well-validated Itch Numerical Rating Scale (NRS) and Worst Itch NRS (WI-NRS) and developing its cutoff value using receiver operating characteristics (ROC) and inspection of the area under the curve (AUC) across ethnic groups. At the same time, it is aimed at comparing the concurrent prevalence of itch and depression in these populations, who often form ethnic minorities in many countries. The current study addresses the knowledge gap of cultural adaptation of the 5-D pruritus scale for greater usage. Methods. Community samples of three ethnic groups were recruited from an online platform of Qualtrics and administered the self-report questionnaires of Itch-NRS, 5-D itch scale, and Patient Health Questionnaire-9 (PHQ-9) to measure their pruritus domains, itch intensity, depression screening, and its severity. Informed consent was obtained from all participants. Subgroup analysis was conducted, including concurrent validity and cutoff values compared between each ethnic group. Concurrent prevalence of itch and depression was evaluated using the cutoff value of Itch-NRS and PHQ-9. Result. A total of 2323 participants were included in the study. A significant positive correlation ( p < 0.001 ) was found between the Itch-NRS, WI-NRS, and 5-D itch scale. The cutoff value of the 5-D itch scale was established for the three ethnic groups using ROC, with a cutoff value of Itch-NRS as a reference. Conclusions. The 5-D itch scale has demonstrated sound psychometric properties in three ethnic groups and is closely related to Itch-NRS. The analysis of the cutoff value of the 5-D itch scale suggests that different cutoff values should be considered to reduce the inflation of pruritus severity.
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Ungar, Omer J., Oren Cavel, Yahav Oron, Anat Wengier, Oshri Wasserzug, and Ophir Handzel. "A Subjective Rating Scale for Initial Assessment of Sudden Unilateral Sensorineural Hearing Loss." Audiology and Neurotology 22, no. 3 (2017): 154–59. http://dx.doi.org/10.1159/000479723.
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Objective: To examine the value of a subjective numerical rating scale (NRS) in the initial evaluation of patients suspected of suffering from unilateral sudden sensorineural hearing loss (SSNHL) until a formal audiogram is available. Study Design: Prospective noncontrolled clinical study. Methods: Thirty-one consecutive patients referred to the emergency department due to suspected unilateral SSNHL and with no other aural pathology by history or physical examination were enrolled. Patients were asked to characterize the severity of their hearing loss using an NRS of 1 (normal hearing) to 6 (complete deafness). SSNHL was defined as an SNHL of at least 30 dB over 3 consecutive frequencies that occurred in 3 days or less. A formal audiogram was obtained subsequently as soon as available. Results: Twenty-four patients were treated with steroids and met the audiometric criteria of SSNHL. All scored their NRS as 3 or more. None of the 7 patients whose NRS grades were ≤2.5 met the criteria for SSNHL. Two patients were treated with steroids although their hearing did not meet the audiometric criteria for SSNHL as the hearing loss was limited to 2 consecutive frequencies. The NRS score for both was <3. Conclusion: In addition to the patient's history and physical examination, a NRS can be a useful tool in the preliminary assessment of patients suspected of having SSNHL until audiometry becomes available. In the scale of 1-6, an NRS score of 3 or more reliably predicts the need to treat the patient with steroids according to the accepted criteria.
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Kadović, Marija, Stipe Ćorluka, and Stjepan Dokuzović. "Nurses’ Assessments Versus Patients’ Self-Assessments of Postoperative Pain: Knowledge and Skills of Nurses for Effective Pain Management." International Journal of Environmental Research and Public Health 20, no. 9 (2023): 5678. http://dx.doi.org/10.3390/ijerph20095678.
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Postoperative pain is the most common form of acute pain. Nurses contribute to effective pain management with their knowledge and skills. The aims of this research were to examine differences between nurses’ assessments and patients’ self-assessments of postoperative pain, differences in the mentioned (self) assessments with respect to characteristics of both groups of respondents, and the correlation between the NRS and the VRS scale. The study included 103 nurses employed at a hospital and 103 patients treated in the surgical departments after the surgical procedures. Data were collected using the standardized Numerical rating scale (NRS) and Verbal rating score (VRS). The median of patients’ self-assessments of pain intensity on the NRS scale was 4, while the nursing assessment of patients’ pain was 3, with no significant difference (p = 0.083). No significant differences were found on the VRS scale between nurse assessments and patient self-assessments of current pain intensity. The pain was described as moderate by 35% of participants, including 35.9% nurses and 35% patients. Significant positive correlations were recorded between values on the VRS and NRS scales for nurses (Rho = 0.812; p < 0.001) and patients (Rho = 0.830; p < 0.001). The results of this study may have implications for the improvement of postoperative pain management protocols, with regular use of pain assessment scales and individualization of analgesic prescriptions.
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Day, J., W. Ye, W. Tillett, and L. C. Coates. "POS1084 COMPARISON OF NUMERICAL RATING SCALE (NRS) AND VISUAL ANALOGUE SCALE (VAS) IN THE PATIENT REPORTED OUTCOME MEASURES OF 3VAS AND 4VAS IN PSORIATIC ARTHRITIS." Annals of the Rheumatic Diseases 80, Suppl 1 (2021): 821.1–821. http://dx.doi.org/10.1136/annrheumdis-2021-eular.3598.
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Background:There is a recognised need for a feasible continuous composite measure in routine clinical care for psoriatic arthritis (PsA). Two multidimensional composite Visual Analogue Scales (VAS) have been proposed; the 3 and 4VAS1, but there may be some advantages to using a numerical rating scale (NRS) over VAS in patient reported outcomes. VAS is a 100mm horizontal line, and the NRS a 21-point scale ranging from 0 to 10 in increments of 0.5. NRS are simple and faster to score, less susceptible to measurement error and may reduce the floor and ceiling effects, whereby patients avoid using the extremes of the scale. A previous study has demonstrated good agreement between VAS and NRS for the separate patient reported outcome measures in PsA, which correlate with disease severity and life impact.2Objectives:To test the performance of NRS, compared with VAS, in the composite 3 and 4VAS scores.Methods:Data were collected prospectively across three UK hospital trusts from 2018-2019, as part of a study assessing the use of NRS in patient reported outcome measures in PsA.2 Patients completed the VAS and NRS for pain, arthritis, skin psoriasis, and global disease activity. The 3 VAS comprises of a physician global VAS, patient global VAS and patient skin VAS and the 4 VAS comprises of the physician global VAS, patient pain VAS, joint VAS and skin VAS. NRS and VAS versions of the patient reported measures were tested. Physician global scores were not available from the study data, therefore only the patient reported components are included. Agreement between the scales was assessed using the intraclass correlation coefficients (ICCs), with a two-way mixed absolute agreement model, and Bland-Altman plots. Spearman’s rank correlation coefficients were used to assess dependency between scale scores and clinical parameters including tender and swollen joint count, PsAID12 and HAQDI.Results:Data from 209 patients were analysed. 60.0% were male, with mean age of 51.7 years and median PsA duration of 7.0 years. Mean 3VAS score was 3.57 and the mean NRS-3VAS was 3.79, with ICC 0.98 (95% CI 0.96-0.98). Mean 4VAS was 3.71 and NRS-4VAS was 3.90 with ICC 0.98 (95% CI 0.97-0.98). Average NRS scores were slightly higher than VAS scores. The Bland-Altman plots comparing NRS and VAS for the patient-reported components of 3VAS and 4VAS are demonstrated in Figure 1. 64.1% patients reported a preference for NRS over VAS. Correlation of the 3/4VAS with PSAID, HAQ and joints counts are reported in Table 1. Visual representation of the NRS and VAS scales for 3VAS and 4VAS as histograms demonstrated that there is marginally less floor effect using NRS compared to VAS.Conclusion:There is good agreement between VAS and NRS for the patient-reported components of 3VAS and 4VAS, supporting that VAS scores are reproducible as NRS scores. Both NRS and VAS versions of the 3 and 4VAS scales correlate with disease activity and life impact.2 There may be advantages in testing the 3/4VAS as NRS moving forward.References:[1]Tillett W et al. J Rheumatol. 2021; in press[2]Ye W et al. J Rheumatol. 2020 Dec 1:jrheum.200928.Table 1.Spearman’s correlations of the 3 and 4 VAS scores with TJC, SJC, PsAID and HAQPatient ReportedTJCSJCPsAIDHAQDI without aids3 VAS vas0.510.440.880.624 VAS vas0.540.470.890.653 VAS nrs0.490.430.890.634 VAS nrs0.530.460.920.67Key: 3VAS; Patient global and skin VAS, 4 VAS: Patient pain, joint and skin VAS. 3 and 4 NRS; Numeric Rating Scale (NRS). TJC/ SJC: Tender/Swollen Joint count. PSAID: Psoriatic Arthritis Impact of Disease. HAQDI: Stanford Heath Assessment Questionnaire.Acknowledgements:Dr Day and Dr Ye contributed equally to the development of this abstract.Disclosure of Interests:Julia Day: None declared, Weiyu Ye: None declared, William Tillett Speakers bureau: AbbVie, Amgen, Celgene, Lilly, Janssen, Novartis, Pfizer Inc., and UCB, Consultant of: AbbVie, Amgen, Celgene, Lilly, Janssen, Novartis, MSD, Pfizer Inc., and UCB, Grant/research support from: AbbVie, Celgene, Eli Lilly, Janssen and UCB, Laura C Coates Speakers bureau: AbbVie, Amgen, Biogen, Celgene, Gilead, Eli Lilly, Janssen, Medac, Novartis, Pfizer, and UCB., Consultant of: AbbVie, Amgen, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Eli Lilly, Gilead, Janssen, Novartis, Pfizer, and UCB;, Grant/research support from: AbbVie, Amgen, Celgene, Eli Lilly, Pfizer, and Novartis.
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Paluwih, Natya Ayu, Riama Marlyn Sihombing, and Kinanthi Lebdawicaksaputri. "THE DIFFERENCE OF PAIN SCALE USING NUMERIC RATING SCALE AND VISUAL ANALOG SCALE IN POST-OPERATIVE PATIENTS." Nursing Current Jurnal Keperawatan 7, no. 1 (2019): 52. http://dx.doi.org/10.19166/nc.v7i1.2224.
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Post-operative pain is acute and subjective therefore the perceived pain intensity will be different. In one of the western Indonesia Hospitals in measuring the pain threshold using 2 tools namely Numeric Rating Scale and Wong Baker Face. Measurement of the pain intensity can be done with NRS and VAS scale. The objective of this research was to identify the difference of pain scale using the NRS and VAS scale in post-operative patients. The research method was descriptive quantitative using comparative approach. The study was conducted on 1 November 2017 – 12 December 2017.The population of the study are the post-operative patients at the In-Patient wards in a private hospital in Western Part of Indonesia. The samples were obtained using purposive sampling with n = 41. Research instrument consists of observation sheet using NRS and VAS scale. The results showed most respondents during the first eight hours using NRS scale had mild pain (80.5%); first 16 hours had light pain (63.4%); and had mild pain in the first 24 hours (85.4%). Using VAS scale, most of the respondents on the first eight hours has mild pain (87.8%); first 16 hours has mild pain (68.3%); and has mild pain in the first 24 hours (87.8%). The conclusion of this study is there is no difference in pain scale of post-operative patients using VAS scale and NRS scale. So, hospitals can also use the VAS scale to assess pain scale in post-operative patients.
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Ouchi, Akira, Hideaki Sakuramoto, Ruriko Kikuchi, et al. "Effectiveness of the visually enlarged numerical rating scale for pain management in mechanically ventilated patients: A retrospective before-and-after study." International Journal of Critical Care 17, no. 3 (2023): 128–42. http://dx.doi.org/10.29173/ijcc53.
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Background: Self-report pain assessment scales help avoid underestimating patients’ pain.
 Aims: To assess the effectiveness of the visually enlarged 0–10 numerical rating scale (NRS-V) for pain management in mechanically ventilated patients.
 Methods: The NRS-V was used at each bedside during the intervention phase. Patients mechanically ventilated for ≥48 h were included. The pain assessment rates using the NRS and patient outcomes were compared between the control and intervention groups.
 Findings: Overall, 196 patients were enrolled (control group, 97; intervention group, 99). The pain assessment rate using the NRS was significantly higher during the intervention than during the control phase (63.3% vs 36.7%, P<0.001). On multivariate regression analysis, the intervention was associated with a decreased agitation incidence (Poisson coefficient, -0.82; 95% confidence interval, -1.47– -0.16).
 Conclusion: NRS-V was associated with an increased pain assessment rate and a decreased agitation incidence in mechanically ventilated patients.
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Mustufa, Chawre, Huwaina Abd Ghani, Moksha Nayak, Mohd Fadhli Khamis, Zaihan Ariffin, and Normastura Abd Rahman. "Translation and Validation of Rating-of-Fatigue Scale to be Used in Nonsurgical Endodontic Re-treatment." Journal of Pharmacy and Bioallied Sciences 16, Suppl 5 (2024): S4785—S4791. https://doi.org/10.4103/jpbs.jpbs_1200_24.
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ABSTRACT Background: This study aimed to translate and validate the rating-of-fatigue (ROF) scale in the Kannada language. Methods: This current study involved two steps, where forward translation, backward translation, cross-cultural adaptation, and test of a pre-final version of the ROF scale were conducted in the first step. Content validity, face validity, and construct validity of the ROF scale were performed in five stages. This study enlisted the help of eight experts to create the ROF scale in the Kannada language. Moreover, 50 patients participated by responding to a variety of Likert scale and numeric scale questionnaires that surveyed the intention of measuring the ROF scale. The content validity and face validity were assessed by using the index prepared for the content validity and face validity, respectively, along with mean and standard deviation (SD). The correlation between the Kannada version of the ROF measure and a numerical rating scale-facial rating scale (NRS-FRS) was assessed by the Pearson’s correlation coefficient (PCC). Moreover, a comparison of the mean value of ROF and NRS-FRS was performed by the paired t-test. Results: The Kannada version of the ROF scale was prepared after getting consensus from all the experts. The fatigue questionnaire met a high level of expert content validity (0.93) and showed that most experts opined high relevance (1.00) for measuring dental fatigue. The fatigue questionnaire meets a high level of response in face validity (0.92) based on the face validity indices. PCC showed a high level of construct validity (r = 0.819) of the ROF scale. No significant difference (P = 0.858) was observed between ROF and NRS-FRS by the paired t-test. Conclusion: The Kannada version of the ROF scale is a valid tool to assess dental fatigue.
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H, Andy, Sugeng Budi Santoso, and RTH Supraptomo. "Perbandingan Efektivitas Kombinasi Fentanyl–Paracetamol dan Fentanyl–Ketorolac terhadap Numerical Rating Scale (NRS) Post Operasi Seksio Sesarea." Jurnal Anestesi Obstetri Indonesia 3, no. 2 (2020): 80–8. http://dx.doi.org/10.47507/obstetri.v3i2.49.
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Latar Belakang: Nyeri post operasi seksio sesarea merupakan nyeri sedang berat dengan intensitas akut. Saat ini terdapat dua kombinasi obat anti nyeri yang umum digunakan untuk mengatasi nyeri post operasi seksio sesarea yaitu kombinasi parasetamol-fentanyl serta kombinasi ketorolac-fentanyl. Interaksi kedua obat tersebut dapat menurunkan ambang nyeri yang dapat kita periksa dengan skor Numerical Rating Scale (NRS). Tujuan: Untuk mengetahui adanya perbedaan efektivitas antara pemberian kombinasi parasetamol-fentanyl dengan ketorolac-fentanyl dalam mengatasi nyeri post operasi seksio sesarea.Subjek dan Metode: Penelitian eksperimental dengan pendekatan uji klinis menggunakan 30 subjek pasien hamil dengan umur 20-40 tahun dengan status fisik ASA I-II yang akan menjalani operasi seksio sesarea dengan spinal anestesi lidocain 5% hiperbarik. Grup pertama diberikan 1000mg paracetamol dan 0,3mcg/kg/jam fentanyl intravena sebagai analgesik. Grup ke 2 diberikan ketorolac 30mg dan fentanyl o,3mcg/kg/jamPada penelitian ini dilakukan analisis univariat dan bivariat. Hasil: Hasil uji beda terhadap karakteristik subyek penelitian didapatkan pada kelompok parasetamol dan fentanyl terdapat perbedaan yang signifikan pada post operasi dengan nilai p=0,005 (p<0,05), pada ketorolac dan fentanyl terdapat perbedaan yang signifikan post operasi dengan nilai p=0,023 (p<0,05) dSimpulan: Kombinasi parasetamol fentanyl lebih efektif dibandingkan dengan ketorolac fentanyl.
 
 The Comparison of the Effectiveness of Combination Fentanyl-Paracetamol with Fentanyl–Ketorolac on Numerical Rating Scale (NRS) Post Caesarean Section
 Abstract
 Background: Postoperative cesarean section pain is moderate-to-severe pain with acute intensity. There are two common anti-pain drug combinations used to treat post-cesarean section pain, namely the parasetamol-fentanyl combination and the ketorolac-fentanyl combination. The interaction of the two drugs can lower the pain threshold which we can check with the Numerical Rating Scale (NRS) score.Objective: To determine the difference in effectiveness between the combination of parasetamol-fentanyl and ketorolac-fentanyl in dealing with post-cesarean section surgery pain.Subject and Method: This study is an experimental study with a clinical trial approach using 30 subjects of pregnant patients aged 20-40 years with ASA I-II physical status who will undergo cesarean section surgery with hyperbaric 5% lidocaine spinal anesthesia. The first group were given 1000 mg parasetamol and 0.3 mcg/kg/h fentanyl intravenous as analgesics. The second group were given ketorolac 30 mg and fentanyl 0.3 mcg/kg/h intravenously. In this study, univariate and bivariate analyzes were performed. Results: The results of different tests on the characteristics of research subjects were found in the paracetamol and fentanyl groups, there was a significant difference in the post-operation with a value of p = 0.005 (p <0.05), in ketorolac and fentanyl there was a significant difference post-surgery with a value of p = 0.023 (p <0.05) where the paracetamol and fentanyl groups with NRS scores tended to fall, and the ketorolac and fentanyl groups with NRS scores tended to increase.Conclusion: The combination of parasetamol and fentanyl was more effective than ketorolac and fentanyl.
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Kim, Hakkyeom, Jiyoon Park, Jiseong Moon, et al. "A Case Report on Korean Medical Treatment for a Patient with Chronic Nausea and Vomiting Syndrome." Journal of Internal Korean Medicine 42, no. 5 (2021): 967–75. http://dx.doi.org/10.22246/jikm.2021.42.5.967.
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This study investigated the case of a nineteen-year-old female patient with chronic nausea, vomiting, and abdominal distension, who was diagnosed with CNVS and Spleen-Qi deficiency. Subjective symptoms were recorded with the Numerical Rating Scale (NRS) every morning, and the Gastrointestinal Symptom Rating Scale (GSRS) was used on the days of admission and discharge. For eleven days following admission, she took <i>Bojungikki-tang-gagam</i> and received acupuncture and moxibustion therapy. After three days of treatment, her nausea and vomiting ceased, and abdominal distension improved from NRS 3 to 0 after seven days of treatment. The GSRS score for the specific symptoms improved from 3 to 2; however, the total score remained largely unchanged (from 20 to 21). This case suggests that Korean medical treatment may improve CNVS.
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Okifuji, Akiko, Reiko Mitsunaga, Yuri Kida, and Gary W. Donaldson. "The visual time analog scale: simple, novel measurement approach to assess pain in patients with chronic pain." Pain Management 11, no. 4 (2021): 357–68. http://dx.doi.org/10.2217/pmt-2020-0036.
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Aim: We conducted a preliminary evaluation of a newly developed, time-based visual time analog (VITA) scale for measuring pain in chronic pain patients. Materials & methods: 40 patients with chronic back pain rated their pain over four visits using numerical (pain) rating scale (NRS) and VITA assessing pain intensity by distributing the amount of time spent on ‘not aware of pain’ (blue), ‘aware of nothing but pain’ (red) and time in between (yellow). Results: The NRS scores were correlated with the VITA Red but not with VITA Blue. The psychometric analyses revealed that VITA achieved greater reliability and sensitivity than did NRS. Conclusion: The results provide preliminary support for VITA scale for assessing pain intensity in patients with chronic pain.
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Nimmaanrat, Sasikaan. "Measuring Pain Intensity in Elderly Patients." PSU Medical Journal 1, no. 2 (2021): 77–81. http://dx.doi.org/10.31584/psumj.2021247735.
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Pain intensity is considered as the fifth vital sign. However, it is the only vital sign which is subjective, with there being many pain measurement tools for adults to rate their level of pain. Additionally, there is an increasing number of aging populations throughout the world, and pain measurement in this group of people is challenging as geriatrics have both physical and cognitive impairment.
 The most frequently utilized pain measurement tools are; the Visual Analogue Scale (VAS), Verbal Rating Scale (VRS), Numerical Rating Scale (NRS); and faces scales [Faces Pain Scale (FPS) and Faces Pain Scale-Revised (FPS-R) are the faces scales studied most often] tend to be valid for measuring pain severity in cognitively intact elderly. When problems arise, the VAS is the pain measurement tool found to have more difficulties (including higher rates of failure) than the other tools. In elderly with cognitive deficits, fewer difficulties tend to occur as the tools become simpler, with the most valid and useful tools in the following order: the FPS/FPS-R, the VRS, the 0-10 NRS, and the VAS. Furthermore, simpler pain measurement tools tend to be favored over more complicated tools. Keywords: aging; elderly; geriatrics; older; pain measurement; pain measurement tools
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Lindsay, Eduardo A., Gerardo Olivella, Manuel Rodríguez, et al. "NUMERICAL RATING SCALE AS A PREDICTOR OF AN UNDERLYING PATHOLOGY IN PEDIATRIC BACK PAIN USING MAGNETIC RESONANCE IMAGE AS DIAGNOSTIC TOOL." Orthopaedic Journal of Sports Medicine 9, no. 7_suppl3 (2021): 2325967121S0004. http://dx.doi.org/10.1177/2325967121s00043.
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Background & Objectives: Recently, constant and night pain has been discarded as adequate clinical markers to predict the presence of an underlying pathology in pediatric back pain. The pain intensity has been recognized as an important domain in the pain assessment. Numerical Rating Scale (NRS) is one of the most common validated tools to assess pediatric pain intensity in children above 8 years of age. The aim of this study is to assess NRS as a predictor of underlying pathologies found by magnetic resonance image (MRI) in pediatric back pain. We hypothesize that a higher NRS score is associated with a high sensitivity, specificity and likelihood ratio to identify the present of organic pathology in pediatric chronic back pain. Methodology: After obtaining Institutional Review Board approval, a retrospective electronical medical record review was conducted. All pediatric patients who reported back pain lasting > 4 weeks between 2009 to 2018 were enrolled in the study. As per regular protocol, a pediatric orthopedic surgeon evaluated all patients who presented with back pain. After a non-diagnostic history, physical examination and spinal x-ray; spine MRI was order. Pain was graded with the use of NRS from 0 to 10. Patients were divided in two groups: NRS (1-5) & NRS (6-10). Variables such as gender, age, pain frequency, night pain, neurological exam, and the presence of an underlying pathology were compared between both groups. Patients that presented with injury due to trauma, previous diagnosis of back pain or cervical pain were excluded. Results: A total of 467 patients were evaluated in the study. Mean age of subjects was 15 years; 69% being female. An underlying pathology was identified in 131/315 (41.6%) patients with NRS (6-10), and 55/152 (36.2%) patients with NRS (1-5) (P=0.27). Patients with NRS (6-10) had two times more probability of suffering constant pain (P<0.03) and three times more likely of having an abnormal neurological examination (P<0.05). See table 1. Conclusion: Evaluation and treatment of children and adolescent with chronic back pain is challenging. Our study shows a strong association between NRS high (6-10) and constant pain and/or abnormal neurological exam. However, the use of NRS of (6-10) was not found as adequate predictor for the presence of an underlying organic pathology in children and adolescent patients. Therefore, physicians should not rely only high NRS score to recommend advance imaging study to assess chronic back pain in children and adolescent patients. Summary [Table: see text]
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Jensen, Mark P., Elena Castarlenas, Rubén Roy, et al. "The Utility and Construct Validity of Four Measures of Pain Intensity: Results from a University-Based Study in Spain." Pain Medicine 20, no. 12 (2019): 2411–20. http://dx.doi.org/10.1093/pm/pny319.
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Abstract Objective Pain intensity is the most commonly assessed domain in pain research and clinical settings. To facilitate cross-cultural research, knowledge regarding the psychometric properties of pain intensity measures in individuals from different countries is needed. However, the majority of this research has been conducted in English-speaking countries. Design Survey study. Setting University. Subjects Four hundred nineteen college students. Methods Participants were asked to complete four measures assessing average pain intensity: 1) the 0–10 numerical rating scale (NRS-11), 2) the 100-mm visual analog scale (VAS), 3) the four-point verbal rating scale (VRS-4), and 4) the Faces Pain Scale–Revised (FPS-R). Results The rates of incorrect completion of the four scales were uniformly low (range = 1–2%). The NRS-11 had the highest preference rate (31%), although a substantial number of participants also preferred each of the other three scales (range = 22–24%). The findings support the utility and construct validity of all four pain intensity scales in this Spanish-speaking sample. Conclusions When considered in light of research from other non-English-speaking samples indicating significant psychometric weaknesses for the NRS-11 and VAS and relative strengths of the FPS-R in some groups, the findings suggest that the FPS-R might be the most appropriate pain intensity scale to use when comparisons across populations from different countries is a goal. More research is needed to determine the extent to which demographic (i.e., age, education levels, socioeconomic status) vs cultural factors (i.e., country of origin) influence the reliability, validity, and utility of different pain measures.
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Choi, Gyu-cheol, Ji-eun Bae, Jae-won Park, Dong-jin Kim, and Jeong-su Hong. "A Case Report on a Patient Treated with Combined Korean Medicine for Chronic Headache with Digestive Symptoms." Journal of Internal Korean Medicine 42, no. 5 (2021): 923–90. http://dx.doi.org/10.22246/jikm.2021.42.5.923.
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Objectives: The purpose of this study was to examine the effect of combined Korean medical treatment on chronic headache with digestive symptoms.Methods: We collected data from October to December 2020 and evaluated the efficacy of combined Korean medical treatment using the Korean Headache Impact Test-g (KHIT-6), European Quality of Life Five Dimensions (EQ5D) Scale, and Numerical Rating Scale (NRS) at admission, after two weeks of hospitalization, and on discharge.Results: At the end of treatment, the patient had increased EQ5D and reduced KHIT-6 and NRS scores.Conclusions: After the combined Korean medical treatment, the patient showed improvement, suggesting the efficacy of treatment.
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Ahmed Qureshi, Absar, Shadia Hamoud Alshahrani, Premalatha Paulsamy, Krishnaraju Venkatesan, and Pranave Sethuraj. "Effectiveness of the quadriceps strengthening exercise on pain and functional ability of the women with Osteoarthritis (OA)." International Journal of Current Research in Chemistry and Pharmaceutical sciences 8, no. 9 (2021): 1–6. http://dx.doi.org/10.22192/ijcrcps.2021.08.09.001.
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A Quasi experimental design was adopted for this study to find out the effectiveness of quadriceps strengthening exercise program on pain and functional ability of women with knee osteoarthritis (OA). Fifty women with OA were selected in which first 25 women were enrolled in the control group and second 25 women were allotted in the exercise group. Assessments were performed at baseline and at 8 weeks. The functional ability was assessed using the Timed Up and Go (TUG) test and Numerical Rating Scale (NRS) was used to assess the pain level .For the exercise group, quadriceps strengthening exercises were taught and asked the patients to follow the exercise schedule for 8 weeks. The study results show that the pain and functional abilty scores were improved in the exercise group and the difference was statistically significant (p<0.001). The study concluded that a simple quadriceps strengthening exercise programme can significantly improve self reported knee pain and functional ability among women with Knee osteoarthritis. Keywords: Osteoarthritis, Pain, Functional Ability, Exercise, Quadriceps strengthening, Timed Up and Go (TUG) test, Numerical Rating Scale (NRS)
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Jang, Hye-yeon, Sang-gu Yu, Do-hyeong Kim, and Young-su Lee. "A Case Report on a Fibromyalgia Patient with Gastrointestinal Symptoms Treated with Odu-tang." Journal of Internal Korean Medicine 42, no. 5 (2021): 863–71. http://dx.doi.org/10.22246/jikm.2021.42.5.863.
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Objective: The purpose of this study was to investigate the effects of Korean medical treatment on a fibromyalgia patient with gastrointestinal symptoms, using herbal medicines selected according to new rather than existing standards.Method: A 52-year-old female patient with fibromyalgia was treated with <i>Odu-tang</i> and acupuncture, cupping, and moxibustion for 22 days. To evaluate the treatment, we used the Numerical Rating Scale (NRS), American College of Rheumatology’s Preliminary Diagnostic Criteria (ACR), and Korean Gastrointestinal Symptom Rating Scale (KGSRS).Result: Following treatment, pantalgia diminished, NRS, and ACR scores improved, and the GSRS score decreased from 29 to 11.Conclusion: This study suggests that Korean medical treatment could effectively reduce pain and improve digestive symptoms in patients with fibromyalgia. It also presents a new method that considers individual characteristics when choosing herbal medicine.
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Gajasinghe, Seneth, Mandika Wijayaratna, and Anuja Abayadeera. "Correlation between numerical rating scale (NRS) and visual analogue scale (VAS) in assessment of pain in post operative patients." Sri Lankan Journal of Anaesthesiology 18, no. 2 (2010): 81. http://dx.doi.org/10.4038/slja.v18i2.2445.
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Mustaqe, Emiljan, Elias Liolis, Eleni Bekou, et al. "Pain Scales: Types and Comparison." Medical Science and Discovery 11, no. 12 (2024): 395–98. https://doi.org/10.36472/msd.v11i12.1232.
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Objective: Pain is a common and significant symptom in clinical practice, particularly among emergency and cancer patients. This article explores various pain scales and their clinical applications, alongside postoperative pain management in oncologic patients. A review of unidimensional pain scales, including the Numeric Rating Scale (NRS), Visual Analog Scale (VAS), Verbal Rating Scale (VRS), and Faces Pain Rating Scale (FPS), is presented. Additionally, the pathophysiology and pharmacological and non-pharmacological strategies for managing postoperative pain in cancer patients are discussed. Pain scales vary in sensitivity, ease of use, and clinical suitability. NRS is widely preferred for its simplicity and statistical applicability, whereas VAS offers higher sensitivity but practical limitations. Postoperative pain in oncologic patients is influenced by surgical trauma, psychological factors, and pre-existing pain conditions, with inadequate management leading to systemic complications and increased cancer recurrence risk. Effective management incorporates both non-opioid and opioid analgesics based on pain severity. Pain assessment tools and effective management strategies are critical for improving patient outcomes in clinical settings. Tailored approaches, particularly in oncologic postoperative care, can mitigate complications and enhance quality of life.
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Gladman, Dafna, Peter Nash, Hitoshi Goto, et al. "Fatigue numeric rating scale validity, discrimination and responder definition in patients with psoriatic arthritis." RMD Open 6, no. 1 (2020): e000928. http://dx.doi.org/10.1136/rmdopen-2019-000928.
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ObjectivesThis study assessed the psychometric properties of the fatigue numeric rating scale (NRS) and sought to establish values for clinically meaningful change (responder definition).MethodsUsing disease-specific clinician-reported and patient-reported data from two randomised clinical trials of patients with psoriatic arthritis (PsA), the fatigue NRS was evaluated for test–retest reliability, construct validity and responsiveness. A responder definition was also explored using anchor-based and distribution-based methods.ResultsTest–retest reliability analyses supported the reproducibility of the fatigue NRS in patients with PsA (intraclass correlation coefficient=0.829). Mean (SD) values at baseline and week 2 were 5.7 (2.2) and 5.7 (2.4), respectively. Supporting construct validity of the fatigue NRS, moderate-to-large correlations with other assessments measuring similar concepts as measured by Sackett’s conventions were demonstrated. Fatigue severity was reduced when the underlying disease activity was improved and reductions remained consistent at week 12 and 24. A 3-point improvement was identified as being optimal for demonstrating a level of clinically meaningful improvement in fatigue NRS after 12–24 weeks of treatment.ConclusionsFatigue NRS is a valid and responsive patient-reported outcome instrument for use in patients with PsA. The established psychometric properties from this study support the use of fatigue NRS in clinical trials and in routine clinical practice. Robust validation of reliability for use in routine clinical practice in treating patients with active PsA in less active disease states and other more diverse ethnic groups is needed.
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Jeter, Kirby, Siobhan Blackwell, Lucy Burke, et al. "Cancer symptom scale preferences: does one size fit all?" BMJ Supportive & Palliative Care 8, no. 2 (2016): 198–203. http://dx.doi.org/10.1136/bmjspcare-2015-001018.
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ObjectivesPatients with advanced cancer do not report all symptoms, so assessment is best done systematically. However, for such patients, completion rates of some symptom instruments are <50%. Symptoms can be quantified by various scales including the Categorical Response Scale (CRS), Numerical Rating Scale (NRS) and Visual Analogue Scale (VAS). Patient preferences for CRS, NRS and VAS in symptom assessment and their clinical utility in 3 cancer symptoms: pain, tiredness and appetite loss were determined.MethodsA prospective survey was conducted involving cancer admissions to a 36-bed palliative care unit.Results100 inpatients were recruited, aged 38–93 years (x̅ =71 years; SD=11.6), with median Eastern Cooperative Oncology Group (ECOG) scores of 2 (range 0–4). VAS was the least preferred measure. 52% of patients choose the same scale for all 3 symptoms and 44% for 2, with 4% choosing a different individual scale per symptom. There was moderate agreement between participant scale preference and observer determined ease of scale completion (loss of appetite: κ=0.36; pain: κ=0.49; tiredness: κ=0.45). Participants preferred CRS for appetite loss (48%) and tiredness (40%) and NRS for pain (44%).ConclusionsVAS was the least favoured scale and should be used cautiously in this population. Most participants had a scale preference with high intrapatient consistency between scales. CRS was preferred for appetite loss and tiredness and NRS for pain. Consideration should be given to individualised cancer symptom assessment according to patient scale preference.
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Owen, Claire E., Max Yates, Helen Twohig, et al. "Toward a Core Outcome Measurement Set for Polymyalgia Rheumatica: Report from the OMERACT 2018 Special Interest Group." Journal of Rheumatology 46, no. 10 (2019): 1360–64. http://dx.doi.org/10.3899/jrheum.181050.
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Objective.To report the progress of the Outcome Measures in Rheumatology (OMERACT) Polymyalgia Rheumatica (PMR) Working Group in selecting candidate instruments for a core outcome measurement set.Methods.A systematic literature review identified outcomes measured and instruments used in PMR studies, and a respondent survey and raw data analysis assessed their domain match and feasibility.Results.Candidate instruments were identified for pain [visual analog scale/numerical rating scale (VAS/NRS)], stiffness (VAS/NRS and duration), and physical function (Health Assessment Questionnaire–Disability Index/modified Health Assessment Questionnaire). Domain match and feasibility assessments were favorable; however, validation in PMR was lacking.Conclusion.Further assessment of candidate instruments is required prior to recommending a PMR core outcome measurement set.
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Wickboldt, Nadine, Georges Savoldelli, and Benno Rehberg-Klug. "Continuous Assessment of Labour Pain using Handgrip Force." Pain Research and Management 20, no. 3 (2015): 159–63. http://dx.doi.org/10.1155/2015/281976.
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BACKGROUND: Assessment of dynamic changes in painful experiences, such as labour, using conventional rating scales (eg, numerical rating scale [NRS]) has limitations. An alternative for continuous pain evaluation could be a signal generated by voluntary action of the parturient. Remifentanil administration for obstetric analgesia could be improved by these dynamic measures of labour pain. In the present study, handgrip force was measured by a dynamometer to signal labour pain.OBJECTIVES: To evaluate: whether continuous monitoring of labour pain using handgrip force allows for determination of pain measurement during contractions; and the correlation between handgrip force and pain intensity on NRS.METHODS: The present observational, single-centre study included 43 parturients. After calibration of the dynamometer for individual hand muscle strength, pain was recorded during early and late labour using a dynamometer and an NRS. The primary end point was the correlation coefficient between NRS ratings and peak intensity recorded by the dynamometer.RESULTS: All dynamometer-registered readings were also registered by the external tocogram. All contractions recorded by external tocogram were also registered by the dynamometer. Handgrip force was moderately correlated with pain scores on the NRS. Mean handgrip force during contractions had the highest correlation coefficient (Pearson’s r=0.67) compared with peak handgrip force (r=0.56) and area under the curve of handgrip force (r=0.55).CONCLUSIONS: Pain intensity and duration can be assessed continuously using handgrip force measured via a dynamometer. The feedback of intensity and duration of pain could optimize patient-controlled remifentantil application for obstetric analgesia and other situations of highly variable pain intensity.
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Yang, Ji-hae, Jie-yoon Kang, In-cheol Chae, et al. "A Case Report of Korean Medicine Treatment of Lateral Medullary Infarction with Central Dizziness and Hypoesthesia." Journal of Internal Korean Medicine 42, no. 5 (2021): 982–90. http://dx.doi.org/10.22246/jikm.2021.42.5.982.
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Objectives: The aim of this study was to report the effectiveness of Korean medicine treatment for a patient with lateral medullary infarction who presented with central dizziness and hypoesthesia.Methods: The patient was treated with Korean medicine treatment, including acupuncture, moxibustion, and herbal medicine. We measured the progress of the case using the Numerical Rating Scale (NRS).Results: After the treatment, the NRS scores for dizziness and hypoesthesia decreased.Conclusions: This study suggests that Korean medicine treatment might be effective for lateral medullary infarction in patients who present with central dizziness and hypoesthesia.
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Lee, Yu-jin, Minjin Kwon, Na-youn Kim, and Yu-Ra Im. "Case Report: The Complex Korean Medicine Treatment of Abdominal and Lower Back Pain after Laparoscopic Hysterectomy." Journal of Internal Korean Medicine 44, no. 2 (2023): 197–206. http://dx.doi.org/10.22246/jikm.2023.44.2.197.
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Objectives: This study reports the effect of Korean medicine treatment on a patient with abdominal and lower back pain after a laparoscopic hysterectomy.Methods: The patient received Korean herbal medicine, pharmacopuncture treatment, and acupuncture treatment for six days. We measured the numeric rating scale (NRS), Oswestry Disability Index (ODI), Range of Motion (ROM), and Life-5 Dimensions scale (EQ-5D) to assess symptom changes.Results: After treatment, the patient showed decreased numeric rating scale (NRS) and Oswestry Disability Index (ODI), as well as augmented Range of Motion (ROM) and European Quality of Life 5 Dimensions scale (EQ-5D).Conclusion: The results indicate that Korean medicine treatment is effective management for patients with abdominal and lower back pain after a laparoscopic hysterectomy.
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Dugas, A. F., B. A. Murphy, N. Wells, M. S. Dietrich, and K. Dwyer. "Assessment of cancer pain." Journal of Clinical Oncology 25, no. 18_suppl (2007): 19500. http://dx.doi.org/10.1200/jco.2007.25.18_suppl.19500.
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19500 Background: This study investigates: 1) The concordance between patients and staffs’ standard use of the numerical rating scale (NRS) for pain, in which 1–4 is mild pain, 5–6 is moderate and 7 and above is severe; 2) The relative importance of functional impairment secondary to pain in patients’ pain ratings. Methods: Patients with cancer and current or previous pain (N=178) were asked to complete a fifteen minute interview with open-ended questions about their perception of pain. Results: When asked to define mild, moderate and severe pain according to the NRS, 65% of patients gave numbers that did not meet standard definitions as noted above. When asked to define mild, moderate and severe pain in general, 38% differentiated severity of pain based on its impact on their ability to fulfill activities of daily living (ADLs) and 39% differentiated it based on their emotional reactions. When asked to define tolerable pain, 28% described it in terms of its impact on ADLs, while 30% described it in terms of the NRS. For those patients who used a NRS, the mean value for tolerable pain was 4.9 (range 2–8) and the mean value for intolerable pain was 8.1 (range 5–10). 26% of patients defined satisfactory pain control based its impact on ADLs while only 2% defined it according to a NRS. 68% of patients reported that pain interfered with their ADLs, however only 33% reported that pain medication interfered. Conclusions: There is discordance between the standard definition of the NRS and patient perceptions of it, suggesting it should be supplemented by other types of pain assessment. Based on NRS, patients tolerate higher levels of pain than expected. Patient satisfaction with pain control is more dependent upon ability to complete ADLs than on a numerical rating of pain. Therefore, patients’ ability to function at an acceptable level should be part of the standard pain assessment. No significant financial relationships to disclose.
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Shrestha, Bikash Lal, and Ram Chaya Man Amatya. "Correlation of numeric rating scale with pure tone audiogram for assessing hearing loss." Bangladesh Journal of Medical Science 13, no. 1 (2013): 25–29. http://dx.doi.org/10.3329/bjms.v13i1.13285.
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Objective: Hearing loss is the public health problem affecting all the age groups. For the assessment of hearing loss pure tone audiogram (PTA) is the gold standard but cannot be easily available in rural areas. So, the main aim of our study is to see the correlation of numeric rating scale with the pure tone audiogram for assessing the hearing loss. Materials and methods: This was the prospective, non randomized and longitudinal study performed in two hundred patients with unilateral hearing loss. For the study purpose, the numeric rating scale (NRS) was divided into 5 parts as that of degree of hearing loss and the PTA was also divided into 5 parts to see the correlation with the NRS findings. The analysis was done using SPSS 16.0 Software. Results: The total frequency of unilateral hearing loss was 1.79%. 125(62.5%) patients fell within 16 25years.The mean age was 23.2+/-9.7. Females were affected more than males. Most of the patients who were in high school had unilateral hearing loss. Students and housewives accounted for 87.5%. 89% patients had conductive hearing loss, 10% had sensorineural hearing loss whereas only 1% patients had mixed hearing loss. The most of patients reported NRS2 and NRS3 which was 85.5%. Regarding the PTA analysis, 91% patients fell within mild and moderate hearing loss. There was high degree of correspondence in mild hearing loss between NRS and PTA. The Pearsons correlation showed the statistically significant correlation between NRS and PTA with p=0.00 Conclusion: The NRS scale can be used as an optional measure for PTA in assessing the hearing loss mainly in rural areas for screening where there is lack of PTA. DOI: http://dx.doi.org/10.3329/bjms.v13i1.13285 Bangladesh Journal of Medical Science Vol. 13 No. 01 January 2014: 25-29
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Choi, Ga-Young, Yu-Kyeong Park, Sang Ha Woo, et al. "Facial Chuna Manual Therapy and Acupuncture Treatment for the Sequelae of Peripheral Facial Nerve Palsy: Two Clinical Cases." Journal of Acupuncture Research 39, no. 1 (2022): 70–75. http://dx.doi.org/10.13045/jar.2021.00269.
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Two patients with sequelae of peripheral facial nerve palsy were treated with Facial Chuna Manual Therapy (FCMT) and acupuncture over 6 months. The House-Brackmann (HB) scale, facial nerve grading system 2.0 (FNGS), the scale of Peitersen, the scale of Murata, and the Numeric Rating Scale (NRS) were used to assess the effects of treatment. The HB scale, FNGS and NRS scores showed improvement for both patients (Case 1: HB scale 5 to 3, FNGS 4 to 2, NRS 10 to 5; Case 2: HB scale 5 to 3, FNGS 4 to 3, NRS 10 to 2.5) following 6 months of treatment. The scores for the Peitersen and Murata scales showed improvement over 6 months in Case 1 (Peitersen 2 to 1, Murata 10 to 7), but there was no change in Case 2 over the test period (4 months). FCMT and acupuncture may help patients with sequelae of facial palsy.
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Lee, Chan, Im-hak Cho, Gi-yoon Heo, et al. "Analysis of the Numeric Rating Scale (NRS) Used in Clinical Studies Based on Randomized Controlled Studies." Journal of Internal Korean Medicine 42, no. 4 (2021): 510–31. http://dx.doi.org/10.22246/jikm.2021.42.4.510.
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Objectives: The purpose of this study was to review the status of numeric rating scale (NRS) usage and suggest the potential for use in multicenter retrospective studies of various diseases.Methods: Articles published from 2011 to 2021 that used the keywords “NRS", “Multi-center", and “RCT" were identified in foreign databases, including EMBASE, PubMed, CENTRAL. The articles were analyzed according to their use of "NRS" by symptoms and by disease group using the major classifications of the Korean Standard Classification of Diseases (KCD-7).Results: Classification by symptom in a total of 288 articles illustrates that the NRS was not only commonly used in pain evaluation but also for non-pain symptoms. In usage with non-pain symptoms, chief complaint of patients was the most common at 79%, and other factors included treatment satisfaction, evaluation of daily life, and sleep quality. In disease classification according to the KCD-7, the NRS was commonly used in connection with musculoskeletal and connective tissue diseases but was also utilized in various other disease groups.Conclusions: This study confirms usage of the NRS in multi-center RCTs, as the NRS was widely used in all types of diseases and symptoms. Considering the result and the advantages of the NRS, it is recommended for use as a daily evaluation tool for the collection of common data in multicenter retrospective studies.
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Cho, Eun-chai, Minjun Lee, and Jae-hwan Lew. "A Case Study of Cerebral Infarction Patients with Dysesthesia and Weakness Treated with Sunghyuangjunggi-san (Xingxiang zhengqi san)." Journal of Internal Korean Medicine 45, no. 3 (2024): 488–96. http://dx.doi.org/10.22246/jikm.2024.45.3.488.
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Objectives: The purpose of this study was to address a case of cerebral infarction with dysesthesia and weakness.Methods: A patient diagnosed with cerebral infarction with dysesthesia and weakness was treated with Korean medicine therapies including herbal medication (Sunhyunagjunggi-san) for 8 days. To evaluate the therapeutic effect, we used the National Institute of Health Stroke Scale (NIHSS) and Numerical Rating Scale (NRS).Results: After the treatment, the NIHSS and NRS scores dramatically decreased, and the symptoms no longer disturbed the patient. Although the symptoms of dysesthesia did not disappear completely, fine therapeutic effects were noted.Conclusion: These results suggested that Korean medicine therapies with Sunghyuangjunggi-san have a beneficial effect on the dysesthesia and weakness of cerebral infarction.
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Kwak, Min-jae, Dong-joo Kim, Kyeong-hwa Lee, et al. "A Case Report of Korean Medicine in the Treatment of Idiopathic Parkinson’s Disease with Chronic Pain and Gait Disturbance." Journal of Internal Korean Medicine 45, no. 5 (2024): 839–49. http://dx.doi.org/10.22246/jikm.2024.45.5.839.
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Objective: This case study reports on the effectiveness of Korean medicine in the treatment of a patient with idiopathic Parkinson’s disease who complained of pain and gait disturbance and had a history of suicide attempts due to pain.Methods: A patient diagnosed with idiopathic Parkinson’s disease was treated with adjuvant Korean therapy, including herbal medicine and pharmacopuncture. Evaluations were performed using the numerical rating scale (NRS), King’s Parkinson’s disease pain scale (KPPS), unified Parkinson’s disease rating scale (UPDRS), and a three-dimensional gait analysis.Results: After 9 days of inpatient Korean medicine treatment, the NRS score decreased from 6 to 1, and the KPPS score decreased from 70 to 26. The total UPDRS Part III score decreased from 26 to 21. From the gait analysis, gait speed, stride length, swing phase, and kinematic parameters were shown to have improved. Additionally, pain relief persisted with herbal medicine after discharge.Conclusion: This study suggests that Korean medicine, including pharmacopuncture and Jakyakgamcho-tang, is effective in managing severe pain and related gait disturbances in Parkinson’s disease.
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Kim, Chae-eun, Seung-ho Sun, Tae-hyun Baek, and Seung-hee Han. "A Case Report of Alcoholic Hepatitis with Megaloblastic Anemia Treated with Korean Medicine." Journal of Internal Korean Medicine 45, no. 3 (2024): 444–55. http://dx.doi.org/10.22246/jikm.2024.45.3.444.
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Objectives: This study aimed to report a case of alcoholic hepatitis with megaloblastic anemia that improved with Korean medicine treatment.Methods: A 27-year-old woman with alcoholic hepatitis and megaloblastic anemia was treated with herbal medicine, acupuncture, and moxibustion. The responses before and after treatment were evaluated using blood tests, ultrasound imaging, the Checklist Individual Strength (CIS), and the numerical rating scale (NRS).Results: Post-treatment, blood tests showed improved liver function test, lipid test, and anemia work-up. Ultrasound imaging showed improvement in the superoinferior diameter of right lobe, from 13.02 to 11.09, and the fatty liver improved. The CIS score decreased from 107 to 55. Fatigue diminished from NRS 10 to NRS 3, and dizziness dropped from NRS 5 to NRS 1. The abdominal distension slightly decreased, from NRS 7 to NRS 5.Conclusion: Korean medicine treatment might be effective for treating alcoholic hepatitis with megaloblastic anemia.
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Kumar, Ashutosh, Saleem Azhar, Swati Rai, Mansha Zarabi, Om Suman Bharti, and Kafilul Bari Khan. "Assessment of pain levels in patients undergoing periodontal versus endodontic treatment: A cross-sectional observational study." Bioinformation 21, no. 06 (2025): 1779–83. https://doi.org/10.6026/973206300211779.
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Pain levels in patients undergoing periodontal and endodontic treatment is of interest. Using pain assessment tools like the Visual Analog Scale (VAS), Numerical Rating Scale (NRS), and McGill Pain Questionnaire (MPQ), we assessed pain before, during, and after treatment. Results indicated that endodontic treatment caused higher pain levels, especially post-operatively, compared to periodontal treatment. The findings highlight the need for tailored pain management strategies in endodontics. These insights can guide clinicians in improving pain management for patients undergoing dental procedures.
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Shibutani, Yuma, Haruna Sato, Shinya Suzuki, et al. "A Case Series on Pain Accompanying Photoimmunotherapy for Head and Neck Cancer." Healthcare 11, no. 6 (2023): 924. http://dx.doi.org/10.3390/healthcare11060924.
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One of the most severe side effects of photoimmunotherapy (PIT) for head and neck cancer is pain. As there are presently no detailed reports on pain and pain management in PIT, we conducted a retrospective case series study. We conducted a retrospective study of five patients who had received PIT at the National Cancer Center Hospital East between January 2021 and June 2022 using medical chart data. All patients experienced pain, evidenced by an increased numerical rating scale (NRS) after PIT, regardless of the illumination method. The daily change in mean NRS rating shows that the pain was highest on the day of PIT, with ratings of 6.8 and 7.8 for the frontal and cylindrical diffuser methods, respectively; it dropped the following day quickly. Four of the five patients received fentanyl injections for postoperative pain management beginning on postoperative day (POD) 0. All patients who underwent therapy using a cylindrical diffuser required postoperative pain management with opioid drugs. Pain after PIT tended to be most intense immediately after or one hour after illumination and declined the following day, suggesting the need to have a pain relief plan in place in advance.
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Moon, Young-ho. "A Case Study of Yulgyuk and Banui Syndrome in a Patient with Systemic Sclerosis." Journal of Internal Korean Medicine 43, no. 3 (2022): 469–76. http://dx.doi.org/10.22246/jikm.2022.43.3.469.
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Objectives: This study aimed to report on a systemic sclerosis patient diagnosed with Yulgyuk and Banui syndrome improved by Korean medical treatment.Methods: We treated a 70-year-old woman who had swallowing disorders and frequent vomiting caused by systemic sclerosis with herbal medicine and acupuncture treatment for six months. Treatment was evaluated with a numerical rating scale (NRS).Results: After treatment, swallowing disorders and frequent vomiting decreased. The NRS decreased from 8 to 3.Conclusions: This case suggests that Korean medical treatment was effective for alleviating a swallowing disorder and frequent vomiting caused by systemic sclerosis as a conservative treatment.
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Kim, Chae-eun, Da-young An, Woohyeon Noh, et al. "Case Report on Headache Treated with Korean Medicine in a Patient with Epilepsy." Journal of Internal Korean Medicine 44, no. 2 (2023): 129–37. http://dx.doi.org/10.22246/jikm.2023.44.2.129.
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Objective: This study reports a clinical case of headache accompanied by epilepsy that showed improvement with Korean medicine treatments.Methods: A 67-year-old woman with headache was treated with Korean medicine therapies, including <i>Cheongshimondam-tang</i>, acupuncture, electroacupuncture, and cupping, for 14 days. The response before and after treatment was evaluated using the Numerical Rating Scale, Headache Impact Test-6 (HIT-6), and Quality of Life in Epilepsy-10 (QOLIE-10).Results: After the treatments, the headache was relieved from NRS 8 to NRS 1, and anxiety decreased from NRS 7 to NRS 2. The HIT-6 changed from 66 to 48, and the QOLIE-10 dropped from 44 to 30.Conclusion: This study suggests that combined Korean medicine treatments might be a therapeutic option for relieving headache with epilepsy.
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Laksono, Ristiawan Muji, Buyung Hartiyo Laksono, Faundra Arieza Firdaus, Isngadi Isngadi, and Djudjuk Rahmad Basuki. "Comparative analysis of the efficacy of intravenous tramadol plus ketorolac vs adductor canal block for postoperative pain in total knee arthroplasty." Anaesthesia, Pain & Intensive Care 29, no. 3 (2025): 502–6. https://doi.org/10.35975/apic.v29i3.2534.
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Background & objectives: postoperative pain is a significant factor for the distress and sleep disturbance for the patients undergoing surgeries, and it is equally true for the knee arthroplasty. Anesthetists have employed various means to control pain including various analgesic drugs. For the last few decades, there has been an increased tendancy to use regional blocks. This study aimed to compare the efficacy of Adductor Canal Block (ACB) with intravenous analgesia using tramadol plus ketorolac to relieve postoperative pain in knee arthroplasty. Methodology: This study was conducted in 32 patients undergoing total knee arthroplasty. Group A received intravenous analgesia tramadol plus ketorolac (n=15), while group B received ACB (n=17) postoperatively. Numeric Rating Scale (NRS) was used to to assess the pain at rest and on motion. Range of Motion (ROM) on flexion and extension, was examined in both groups on postoperative days 0, 1, 2, 3, and 4. Patients who had NRS-rest and NRS-motion >3, received, intravenous fentanyl 50 µg. The data obtained were statistically analyzed using the One-Way ANOVA test and Spearman test on SPSS 18.0 software. Results: Intravenous analgesia group (Group A) significantly had greater ROM for flexion than the ACB group (P = 0.001), but not in the ROM-extension (P = 0.351). There was no significant difference in the NRS-rest and NRS-motion (P = 1.000). However, the NRS of the intravenous analgesia group was lower than the ACB group. Conclusion: Intravenous analgesia with tramadol ketorolac is better than adductor canal block in providing a greater range of motion. However, both techniques did not have a significant difference in the Numeric Rating Scale. Gender and age are considered to be confounding factors for the study. Abbreviations: ACB: Adductor Canal Block, ROM: Range of Motion, NRS: Numeric Rating Scale, NSAIDs: Non-Steroidal Anti-Inflammatory Drugs Keywords: Adductor Canal Block; Intravenous analgesia; Numeric Rating Scale; Pain; Pain management; postoperativetive pain; total knee replacement Citation: Laksono RM, Laksono BH, Firdaus FA, Isngadi, Basuki DR. Comparative analysis of the efficacy of intravenous tramadol plus ketorolac vs adductor canal block for postoperative pain in total knee arthroplasty. Anaesth. pain intensive care 2025;29(3):502-506. DOI: 10.35975/apic.v29i3.2534 Received: August 07, 2024; Revised: March 29, 2024; Accepted: April 09, 2025
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Pratitdya, Ginong, Nancy M. Rehatta, and Dedi Susila. "PERBANDINGAN INTERPRETASI SKALA NYERI ANTARA NRS-VAS-WBFS OLEH PASIEN PASCA OPERASI ELEKTIF ORTHOPEDI DI RSUD Dr. SOETOMO." Care : Jurnal Ilmiah Ilmu Kesehatan 8, no. 3 (2020): 447. http://dx.doi.org/10.33366/jc.v8i3.1802.
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Health management is still a challenge in health services. An instrument that can cure pain is easy, easy, with accurate interpretation and can be used by every party involved in pain management. The purpose of this study was to analyze the Numeric Rating Scale (NRS), Visual Analogue Scale (VAS), and Wong Baker Faces Scale (WBFS), which can be interpreted well by postoperative care patients. The research method used was an observational analytic study with a cross-sectional study design that analyzed the scale application (NRS, VAS, WBFS) in patients after elective orthopedic surgery at RSUD Dr. Soetomo Surabaya. This study analyzed primary data of postoperative patients which contained socio-demographic characteristics, type of anesthesia given, pain scores and patient interpretation of pain scales through special instruments. The results showed that 102 research subjects were needed. The pain scale interpretation instrument was declared valid and reliable (Cronbach Alpha> 0.60). Mean pain scores from the VAS scale (4.29), NRS (4.82) and WBFS (4.81). No significant difference was obtained NRS scale and WBFS scale (Sig> 0.05). Mean interpretation of pain scale from the VAS scale (13.62), NRS (17.14) and WBFS (21.33). There was a significant difference in the pain score of the VAS scale against the NRS scale, also the WBFS scale (Sig
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Min, Baek Ki, Joon Soo Jin, Do Eun Lee, Won Bin Shin, Jin Hyeon Shin, and In Ae Youn. "The Effect of Complex Korean Medical Treatment with Acupotomy on Irritable Bowel Syndrome: A Case Report." Journal of Acupuncture Research 37, no. 1 (2020): 59–63. http://dx.doi.org/10.13045/jar.2019.00311.
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The effects of complex Korean medicine treatment including acupotomy, on irritable bowel syndrome (IBS) are reported in this case study. A 54-year-old woman with diarrheal symptoms that alternatively improved and worsened for many years and worsening abdominal pain visited the emergency room and was diagnosed with IBS; she was admitted for approximately 2 weeks at the Acupuncture and Moxibustion Department of National Medical Center (NMC). Numerical rating scale (NRS), irritable bowel syndrome?quality of life (IBS-QOL), and gastrointestinal symptom rating scale (GSRS) scores were evaluated on the day of hospitalization, midway through the hospitalization period, and on the day of discharge. Abdominal pain was measured daily using NRS, and the score decreased from 8 at admission to 0 at discharge. The IBS-QOL percentile score improved from 42 points to 100 points. The total GSRS score also improved, from 30 points to 2 points. These results suggest that complex Korean medicine treatment with acupotomy, is useful for treating internal diseases, such as IBS, as well as musculoskeletal disorders.
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Lee, Ji-yoon, Kwon-jun Jang, Jung-min Yang, et al. "A Case Report on Managing the Side Effects of Anti-tuberculosis Drugs for Nontuberculous Mucobacteriosis (NTM) by Concurrently using Traditional Korean Medicine and Antibiotics." Journal of Internal Korean Medicine 42, no. 5 (2021): 1148–59. http://dx.doi.org/10.22246/jikm.2021.42.5.1148.
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Objectives: This study investigated the effect of combined Korean medical treatment and antibiotics on a patient diagnosed with nontuberculous mycobacterial lung disease.Methods: The patient had been treated with antibiotics since July 2020 concurrently with <i>Maekmoondong-tang</i>, <i>Banhasasim-tang</i>, <i>Gwakhyangjunggi-san</i> and <i>Bojungikgi-tang</i>. The improvement of symptoms was evaluated using scores for the numerical rating scale (NRS), the Medical Research Council (MRC) dyspnea scale, C-reactive protein (CRP) levels, and computed tomography (CT).Results: Following treatment, the NRS, MRC dyspnea scale and CT images significantly improved. Also, CRP levels remained in the normal range during treatment.Conclusions: Traditional Korean medical treatment combined with antibiotics could be effective for treating patients with nontuberculous mycobacterial lung disease.