6
views
0
recommends
+1 Recommend
2 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Renal colic and childbirth pain: female experience versus male perception

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Introduction Renal colic is often described by patients as the worst pain ever experienced.1 Pain during childbirth is also similarly described.2 To date, no study has comparatively evaluated the pain of renal colic to that of childbirth in female patients who have experienced both. Furthermore, no such study has evaluated the perception that men with renal colic have with respect to the pain experienced during childbirth. Here we present our cross-sectional observational study to address these questions. The primary objectives of our study were to answer these questions and highlight the severity of renal colic which is not always faced and treated aggressively. Materials and methods Fifty-nine patients across two centers (Rotherham General Hospital, UK and Chesterfield Royal Hospital, UK) were asked to complete a visual analog scale questionnaire to assess the severity of their renal colic (minimum: 1, maximum: 10). All patients had confirmed ureteric stones on CT imaging and were asked if their renal colic was the most painful condition they have ever suffered. All primiparas and multiparas females were asked if their renal colic was more painful than childbirth. All men were asked to provide an opinion on what they imagined would be more painful – their renal colic or the pain associated with childbirth. The study gained ethical approval from Chesterfield Royal Hospital Research and Ethics Department. All patients provided written consent to in order to participate in the study. Results Thirty-six male and 23 female patients fully completed the questionnaire with age, stone size, and numerical pain rating score recorded (Table 1). There were no statistically significant differences in these parameters between male and female patients (p>0.05, Student’s t-test). From the male cohort of patients, 88.9% (n=32) stated that it was the worst pain they had ever experienced and for the female cohort this was 78.2% (n=19). From the female cohort of patients, 19 had given birth previously with 63.3% (n=12) saying that renal colic was more painful and a further 15.7% (n=3) felt that the intensity of pain was similar. Twenty-one percent of (n=4) female patients who had experienced both childbirth and renal colic stated that childbirth was a more painful experience. In contrast, the majority of male patients imagined that the pain from their renal colic was less painful (40%) or comparable (23.4%) to that of childbirth. Discussion The results of our study suggest that renal colic was the worst pain for the majority of female patients who have experienced both forms of pain. In contrast, 63.4% of men imagined that the pain of childbirth is worse or as severe as that from their renal colic. Renal colic should be managed by a swift stepwise and progressive analgesia regime. Pain associated with childbirth is well recognized and follows involvement of the pain team or anesthetist in pain control during labor. In contrast, renal colic pain is managed generally in the acute setting by either emergency care practitioners or the urologist. Optimal pain management in renal colic patients in the shortest possible time is vital as this group can on occasion be left with inadequate analgesia for lack of understanding of the intensity pain.3 Our study has several limitations. They include limitations in numbers with only 19 women who experienced both renal colic and childbirth. We assessed labor pain retrospectively which will include an element of recall bias. Further work could potentially include assessing female patients in their acute pain phase of labor and who have experienced renal colic pain prior to childbirth. To conclude, our study underlines and highlights the urgency and importance required when administering effective analgesia for female and male patients presenting with renal colic as that would be expected from those experiencing childbirth.

          Related collections

          Most cited references 3

          • Record: found
          • Abstract: found
          • Article: found
          Is Open Access

          Therapeutic Approaches for Renal Colic in the Emergency Department: A Review Article

          Context: Renal colic is frequently described as the worst pain ever experienced, and management of this intense pain is necessary. The object of our review was to discuss different approaches of pain control for patients with acute renal colic in the emergency department. Evidence Acquisition: Studies that discussed the treatment of renal colic pain were included in this review. We collected articles from reputable internet databases. Results: Our study showed that some new treatment approaches, such as the use of lidocaine or nerve blocks, can be used to control the severe and persistent pain of renal colic. Conclusions: Some new approaches are discussed and their impact on renal colic pain control was compared with traditional therapies. The effectiveness of the new approaches in this review is similar or even better than in traditional treatments.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: found
            Is Open Access

            Time of Admission, Gender and Age: Challenging Factors in Emergency Renal Colic - A Preliminary Study

            Background Nephrolithiasis is a relatively common problem and a frequent Emergency Department (ED) diagnosis in patients who present with acute flank/abdominal pain. The pain management in these patients is often challenging. Objectives To investigate the most effective dose of morphine with the least side effects in emergency renal colic patients. Materials and Methods 150 renal colic patients who experienced a pain level of 4 or greater, based on visual analog scale (VAS) at admission time were included. Pain was scored on a 100 mm VAS (0 = no pain, 100 = the worst pain imagined). When patients arrived at ED, a physician would examine the patients and assessed initial pain score, then filled a questionnaire according to the patient information. Patients were assigned to receive 2.5 mg morphine sulfate intravenously. We monitored patients’ visual analog scale (VAS), and adverse events at different time points (every 15 minutes) for 90 minutes. Additional doses of intravenous morphine (2.5 mg) were administered if the patient still had pain. (Max dose: 10 mg). The cumulative dose of morphine, defined as the total amount of morphine prescribed to each patient during the 90 minutes of the study, was recorded. Patients were not permitted to use any nonsteroidal anti-inflammatory drugs as coadjuvant analgesics during the study period. Subjects with inadequate pain relief at 90 minutes received rescue morphine and were excluded from the study. The primary end point in this study was pain relief at 90 minutes, defined as either VAS 0.05). Older patients responded sooner to morphine than the young. Most of the patients had a pain score of 90 -100 (77.3 %) at the beginning that was reduced to 29.4% during the 30 minutes follow up. During the first hour, we found that 94.7% of the patients had no pain or significant pain reduction and only 2.1% of the patients still had pain. Conclusions We conclude that there were no significant differences among the gender, time of admission and side - effects in renal colic patients in response to morphine.
              Bookmark
              • Record: found
              • Abstract: not found
              • Article: not found

              Pain relief: past and present

               M Yerby (2000)
                Bookmark

                Author and article information

                Journal
                J Pain Res
                J Pain Res
                Journal of Pain Research
                Journal of Pain Research
                Dove Medical Press
                1178-7090
                2017
                05 July 2017
                : 10
                : 1553-1554
                Affiliations
                [1 ]Division of Surgery and Interventional Science, University College London, London, UK
                [2 ]Urology Department, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
                [3 ]Urology Department, Raigmore Hospital, Inverness, UK
                [4 ]Psychiatry Department, Highbury Hospital, Nottingham, UK
                [5 ]Urology Department, Chesterfield Royal Infirmary, Chesterfield, UK
                [6 ]Urology Department, Rotherham General Hospital, Rotherham, UK
                Author notes
                Correspondence: Saiful Miah, Division of Surgery and Interventional Science, 4th Floor, University College London Medical School Building, 21 University Street, London, WC1E 6AU, UK, Tel +44 20 7679 9060, Email saiful.miah@ 123456ucl.ac.uk
                Article
                jpr-10-1553
                10.2147/JPR.S135901
                5505545
                © 2017 Miah et al. This work is published and licensed by Dove Medical Press Limited

                The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

                Categories
                Research Letter

                Anesthesiology & Pain management

                Comments

                Comment on this article