Abdullah M. Kaki

Identifying neuropathic pain among patients with chronic low-back pain: use of the Leeds Assessment of Neuropathic Symptoms and Signs pain scale.

Background and Objectives Although the literature contains information about prevalence and incidence of low-back pain (LBP), little information is available about the contribution of the neuropathic element to LBP. Our study was designed to investigate the prevalence of neuropathic pain among a sample of chronic LBP patients in Saudi Arabia by use of the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) pain scale. Methods A total of 1,169 patients from 117 centers agreed to participate in the study over a period of 6.5 months. The LANSS pain scale was applied to each patient in an interview format. The characteristics of pain and sensory dysfunction were tested and recorded. Results According to the LANSS pain scale, 639 patients (54.7%) had scores of 12 points or more, which suggested a neuropathic type of pain, and 530 patients (45.3%) had scores of less than 12, which suggested a nociceptive type of pain. Factors that are associated with neuropathic pain are advanced age, female gender, increased height, white race, hypertension and diabetes, a history of smoking, previous back surgery, and previous medications. Conclusion Neuropathic pain is a major contributor to chronic LBP, and the LANSS pain scale is a useful tool to distinguish patients with neuropathic pain from those with nociceptive pain.

Dexmedetomidine in combination with morphine PCA provides superior analgesia for shockwave lithotripsy

PurposeTo compare the analgesic effects of dexmedetomidine/morphine with those of tramadol/midazolam in patients undergoing extracorporeal shockwave lithotripsy (ESWL) for urinary calculi.MethodsSixty patients were randomized to receive either dexmedetomidine 1 μg·kg−1 iv followed by 0.5 μg·kg−1·hr−1 infusion together with morphine patient-controlled analgesia [(PCA); 2 mg bolus, five minutes lockout, 2 mg·hr−1 infusion; (Group DEX)], or tramadol 1.5 mg·kg−1 pre-mixed with midazolam 30μg·kg−1 iv followed by tramadol PCA [20 mg bolus, five minute lockout, 20 mg·hr−1 infusion; (Group TRA)]. Pain was assessed at baseline and every 15 min thereafter. Patients’ and urologist’s satisfaction with analgesia and sedation were determined on a seven-point scale ranging from 1 (extremely dissatisfied) to 7 (extremely satisfied). Patient’s discharge time was also documented.ResultsVisual analogue scale scores over time were consistently lower in Group DEX compared with Group TRA (P = 0.001). Patients’ satisfaction with analgesia (5 ± 1 vs 4 ± 2, P = 0.012) and with sedation (6 ± 1 vs 5 ± 1, P = 0.020), and urologist’s satisfaction (6 ± 1 vs 4 ± 2, P = 0.001) were all higher amongst Group DEX patients compared with Group TRA. There was no difference between discharge times of patients in Group DEX compared with those in Group TRA [85 (60, 115) min vs 65 (40,95) min, P = 0.069].ConclusionDexmedetomidine in combination with morphine PCA provided better analgesia for ESWL and was associated with higher patients’ and urologist’s satisfaction when compared with a tramadol/midazolam PCA combination.RésuméObjectifComparer les effets analgésiques des dexmédétomidine/morphine combinées avec ceux d’un mélange tramadol/midazolam chez des patients qui subissent une lithotripsie extracorporelle par ondes de choc (LEOC) pour calculs urinaires.MéthodeSoixante patients ont été répartis au hasard dans le groupe DEX pour recevoir 1 μg·kg−1 de dexmédétomidine iv suivi d’une perfusion à 0,5 μg·kg−1·h−1 combinée à de la morphine en analgésie autocontrôlée (AAC); [bolus de 2 mg, une période réfractaire de cinq minutes, une perfusion de 2 mg·h−1] ou dans le groupe TRA recevant 1,5 mg·kg−1 de tramadol prémélangé avec 30 μg·kg−1 de midazolam iv suivi de tramadol en AAC [bolus de 20 mg, période réfractaire de cinq minutes, perfusion à 20 mg·h−1]. La douleur a été évaluée au départ et toutes les 15 min par la suite. Le degré de satisfaction des patients et de l’urologue concemant l’analgésie et la sédation a été évalué sur une échelle en sept points de 1 (très insatisfait) à 7 (très satisfait). Le moment du congé a été aussi noté.RésultatsLes scores de l’échelle visuelle analogique ont été constamment plus bas chez les patients du Groupe DEX comparé au Groupe TRA (P = 0,001). Le degré de satisfaction des patients face à l’analgésie (5 ± 1 vs 4 ± 2, P = 0,012) et à la sédation (6 ± 1 vs 5 ± 1, P = 0,020), et celui de l’urologue (6 ± 1 vs 4 ± 2, P = 0,001) ont été plus élevés parmi les patients du Groupe DEX. Les patients des deux groupes ont reçu leur congé selon des délais comparables: Groupe DEX comparé au Groupe TRA [85 (60, 115) min vs 65 (40,95) min, P = 0,069].ConclusionLa dexmédétomidine combinée à la morphine en AAC fournit une meilleure analgésie pour la LEOC, et est associée à un plus haut degré de satisfaction des patients et de l’urologue, que le mélange en AAC de tramadol/midazolam.

Intravenous acetaminophen vs oral ibuprofen in combination with morphine PCIA after Cesarean delivery.

PurposeTo compare the effects ofiv acetaminophen with those of oral ibuprofen with respect to postoperative pain control and morphine requirements in patients receiving morphine patient-controllediv analgesia (PCIA) after Cesarean delivery.MethodsForty-five term patients scheduled for Cesarean delivery were randomized to receive acetaminophen 1 giv every six hours plus oral placebo (group A) or ibuprofen 400 mgpo every six hours plusiv placebo (group I); the first dose of study drug was given 30 min preoperatively. Postoperatively, all patients received PCIA for 48 hr using morphine bolus dose 2 mgiv, lockout interval ten minutes, and no basal infusion. Visual analogue scale (VAS; 0 to 10) at rest and morphine requirements were recorded every hour for four hours then every four hours for a total of 48 hr postoperatively. Patient satisfaction was recorded on a ten-point scale (from 1 to 10) 48 hr postoperatively.ResultsVisual analogue scale scores decreased similarly in both groups over time, however, there were no differences between groups at any time during the study period (estimated marginal means: 1.4 ± SEM 0.2vs 1.9 ± SEM 0.2 for groups A and I, respectively,P = 0.124). Cumulative doses of postoperative morphine were 98 ± 37vs 93 ± 33 mg for groups A and I, respectively (P = 0.628). Patient satisfaction with analgesia was high in both groups (9 ± 1vs 9 ± 1,P = 0.93).ConclusionIntravenous acetaminophen is a reasonable alternative to oral ibuprofen as an adjunct to morphine patient-controlled analgesia after Cesarean delivery.RésuméObjectifComparer les effets de l’acétaminophène iv à ceux de l’ibuprofène par voie orale quant au soulagement de la douleur et à la consommation de morphine chez les patientes recevant de la morphine dans le cadre d’une analgésie iv contrôlée par le patient (AICP) après une césarienne.MéthodeQuarante-quatre patientes se présentant pour une césarienne ont reçu, de façon aléatoire, soit de l’acétaminophène 1 g iv toutes les six heures plus un placebo (groupe A), soit de l’ibuprofène 400 mg po toutes les six heures plus un placebo iv (groupe I), la première dose étant donnée 30 min avant la chirurgie. Après la chirurgie, toutes les patientes ont bénéficié d’une AICP avec morphine pendant 48 h, à la dose de 2 mg iv, avec un intervalle d’interdiction de dix minutes et aucune perfusion continue. On a noté les échelles visuelles-analogiques de douleur (EVA; 0 à 10) au repos et les besoins en morphine toutes les heures pendant quatre heures, puis toutes les quatre heures pour un total de 48 h suivant la chirurgie. La satisfaction des patientes a été évaluée selon une échelle à dix niveaux (de 1 à 10) après 48 h.RésultatsLes scores d’EVA ont diminué avec le temps de façon semblable dans les deux groupes. Toutefois, on n’a retrouvé de différences significatives entre les groupes à aucun moment (moyenne marginale estimée: 1,4 ± ETM 0,2 vs 1,9 ± ETM 0,2 pour les groupes A et I, respectivement, P = 0,124). Les doses cumulatives de morphine étaient de 98 ± 37 vs 93 ± 33 mg pour les groupes A and I, respectivement (P = 0,628). Le niveau de satisfaction était élevé dans les deux groupes (9 ± 1 vs 9 ± 1, P = 0,93).ConclusionL’acétaminophène par voie iv est une alternative acceptable à l’ibuprofène par voie orale comme adjuvant dans le cadre d’une analgésie à la morphine contrôlée par le patient.

Anesthesiologist-controlled versus patient-controlled propofol sedation for shockwave lithotripsy

PurposeTo compare anesthesiologist-controlled sedation (ACS) with patient-controlled sedation (PCS), with respect to propofol requirements, sedation, and recovery, in patients undergoing extracorporeal shockwave lithotripsy for urinary calculi.MethodsSixty-four patients were randomized, in this doubleblind study, to receive propofol sedation according to one of two regimens: infusion of 200 μg·kg-1·min-1 for ten minutes reduced thereafter to 50-150 μg·kg-1·min-1 titrated by an anesthesiologist, according to patient response (group ACS), or propofol administered by patient-controlled analgesia (bolus dose 300 μg·kg-1, lockout interval three minutes, no basal infusion), (group PCS). All patients received midazolam 10 μg·kg-1 iv and fentanyl 1 μg·kg-1 iv preoperatively, followed by fentanyl infused at a rate of 0.5 μg·kg-1·hr-1 throughout the procedure. Sedation and analgesia were assessed using the A-line ARX index and visual analogue scale, respectively. Psychomotor recovery and readiness for recovery room discharge were assessed using the Trieger dot test and postanesthesia discharge score, respectively. Patient satisfaction was assessed on a sevenpoint scale (1-7).ResultsIn comparison to group PCS, patients in group ACS received more propofol (398 ± 162 mg vs 199 ± 68 mg, P < 0.001), were more sedated (A-line ARX index: 35 ± 16 vs 73 ± 16,P < 0.001), experienced less pain (visual analogue scale: 0 ± 0 vs 3 ± 1, P < 0.001), and were more satisfied (median [Q1, Q3]: 7 [7, 7] vs 6 [6, 7],P < 0.001). In contrast, patients in group PCS had faster psychomotor recovery (Trieger dot test median [Q1, Q3]: 8 [4, 16] vs 16 [12, 26] dots missed, P = 0.002) and achieved postanesthesia discharge score ≥ 9 earlier (median [Q1, Q3]: 40 [35, 60] vs 88 [75, 100] min,P < 0.001) compared with group ACS.ConclusionIn comparison to PCS for patients undergoing extracorporeal shockwave lithotripsy, propofol/fentanyl ACS is associated with increased propofol administration, deeper sedation levels, and greater patient comfort. However, ACS is associated with slower recovery and a longer time to meet discharge criteria, when compared to PCS.RésuméObjectifComparer la sédation contrôlée par ľanesthésiologiste (SCA) á la sédation contrôlée par le patient (SCP) quant aux demandes de propofol, á la sédation et á la récupération chez des patients devant subir une lithotripsie á ondes de choc électrohydraulique pour urolithiase.MéthodeSoixante-quatre patients, répartis au hasard pour une étude á double insu, ont reçu : soit une sédation par une perfusion de propofol de 200 μg·kg-1·min-1 pendant dix minutes, réduite ensuite á 50 -150 μg·kg-1·min-1 ajustée par un anesthésiologiste en fonction de la réaction du patient (groupe SCA), soit du propofol en analgésie autocontrôlée (bolus de 300 μg·kg-1, période réfractaire de trois minutes, sans perfusion initiale), (groupe SCP). Avant ľopération, tous les patients ont reçu 10μg·kg-1 de midazolam iv et 1 μg·kg-1 de fentanyl iv, puis une perfusion de fentanyl á 0,5 μg·kg-1·h-1 tout au long de ľintervention. La sédation et ľanalgésie ont été évaluées par ľindex A-line ARX et ľéchelle visuelle analogique (EVA), respectivement. La récupération psychomotrice et ľétat permettant de quitter la salle de réveil ont été évalués par le Trieger Dot Test et les critères de sortie de la salle de réveil, respectivement. La satisfaction du patient a été évaluée sur une échelle de sept points 1-7).RésultatsComparés aux patients du groupe SCP, ceux du groupe SCA ont reçu plus de propofol (398 ± 162 mg vs 199 ± 68 mg, P < 0,001), et plus de sédatifs (index A-line ARX : 35 ± 16 vs 73 ± 16, P < 0,001), éprouvé moins de douleur (EVA : 0 ± 0 vs 3 ± 1, P < 0,001) et ont été plus satisfaits (médiane [Q1, Q3] : 7 [7, 7] vs 6 [6, 7], P < 0,001). Par ailleurs, les patients du groupe SCP ont connu une récupération psychomotrice plus rapide (mé diane du Trieger dot test [Q1, Q3] : 8 [4, 16] vs 16 [12, 26] points manqués, P = 0,002) et ont atteint les critères de sortie de la salle de réveil ≥ 9 plus tôt (médiane [Q1, Q3] : 40 [35, 60] vs 88 [75, 100] min, P < 0,001).ConclusionComparée á la SCP pour une lithotripsie á ondes de choc électrohydraulique, la SCA au propofol/fentanyl est associée á une plus grande consommation de propofol, á des niveaux de sédation plus profonds et á un plus grand confort du patient. Mais la SCA, comparée á la SCP, retarde la récupération et prolonge le temps en salle de réveil.Objectif Comparer la sedation controlee par ľanesthesiologiste (SCA) a la sedation controlee par le patient (SCP) quant aux demandes de propofol, a la sedation et a la recuperation chez des patients devant subir une lithotripsie a ondes de choc electrohydraulique pour urolithiase.

La sédation au propofol contrôlée par ľanesthésiologiste ou le patient pour la lithotripsie par ondes de choc

PurposeTo compare anesthesiologist-controlled sedation (ACS) with patient-controlled sedation (PCS), with respect to propofol requirements, sedation, and recovery, in patients undergoing extracorporeal shockwave lithotripsy for urinary calculi.MethodsSixty-four patients were randomized, in this doubleblind study, to receive propofol sedation according to one of two regimens: infusion of 200 μg·kg-1·min-1 for ten minutes reduced thereafter to 50-150 μg·kg-1·min-1 titrated by an anesthesiologist, according to patient response (group ACS), or propofol administered by patient-controlled analgesia (bolus dose 300 μg·kg-1, lockout interval three minutes, no basal infusion), (group PCS). All patients received midazolam 10 μg·kg-1 iv and fentanyl 1 μg·kg-1 iv preoperatively, followed by fentanyl infused at a rate of 0.5 μg·kg-1·hr-1 throughout the procedure. Sedation and analgesia were assessed using the A-line ARX index and visual analogue scale, respectively. Psychomotor recovery and readiness for recovery room discharge were assessed using the Trieger dot test and postanesthesia discharge score, respectively. Patient satisfaction was assessed on a sevenpoint scale (1-7).ResultsIn comparison to group PCS, patients in group ACS received more propofol (398 ± 162 mg vs 199 ± 68 mg, P < 0.001), were more sedated (A-line ARX index: 35 ± 16 vs 73 ± 16,P < 0.001), experienced less pain (visual analogue scale: 0 ± 0 vs 3 ± 1, P < 0.001), and were more satisfied (median [Q1, Q3]: 7 [7, 7] vs 6 [6, 7],P < 0.001). In contrast, patients in group PCS had faster psychomotor recovery (Trieger dot test median [Q1, Q3]: 8 [4, 16] vs 16 [12, 26] dots missed, P = 0.002) and achieved postanesthesia discharge score ≥ 9 earlier (median [Q1, Q3]: 40 [35, 60] vs 88 [75, 100] min,P < 0.001) compared with group ACS.ConclusionIn comparison to PCS for patients undergoing extracorporeal shockwave lithotripsy, propofol/fentanyl ACS is associated with increased propofol administration, deeper sedation levels, and greater patient comfort. However, ACS is associated with slower recovery and a longer time to meet discharge criteria, when compared to PCS.RésuméObjectifComparer la sédation contrôlée par ľanesthésiologiste (SCA) á la sédation contrôlée par le patient (SCP) quant aux demandes de propofol, á la sédation et á la récupération chez des patients devant subir une lithotripsie á ondes de choc électrohydraulique pour urolithiase.MéthodeSoixante-quatre patients, répartis au hasard pour une étude á double insu, ont reçu : soit une sédation par une perfusion de propofol de 200 μg·kg-1·min-1 pendant dix minutes, réduite ensuite á 50 -150 μg·kg-1·min-1 ajustée par un anesthésiologiste en fonction de la réaction du patient (groupe SCA), soit du propofol en analgésie autocontrôlée (bolus de 300 μg·kg-1, période réfractaire de trois minutes, sans perfusion initiale), (groupe SCP). Avant ľopération, tous les patients ont reçu 10μg·kg-1 de midazolam iv et 1 μg·kg-1 de fentanyl iv, puis une perfusion de fentanyl á 0,5 μg·kg-1·h-1 tout au long de ľintervention. La sédation et ľanalgésie ont été évaluées par ľindex A-line ARX et ľéchelle visuelle analogique (EVA), respectivement. La récupération psychomotrice et ľétat permettant de quitter la salle de réveil ont été évalués par le Trieger Dot Test et les critères de sortie de la salle de réveil, respectivement. La satisfaction du patient a été évaluée sur une échelle de sept points 1-7).RésultatsComparés aux patients du groupe SCP, ceux du groupe SCA ont reçu plus de propofol (398 ± 162 mg vs 199 ± 68 mg, P < 0,001), et plus de sédatifs (index A-line ARX : 35 ± 16 vs 73 ± 16, P < 0,001), éprouvé moins de douleur (EVA : 0 ± 0 vs 3 ± 1, P < 0,001) et ont été plus satisfaits (médiane [Q1, Q3] : 7 [7, 7] vs 6 [6, 7], P < 0,001). Par ailleurs, les patients du groupe SCP ont connu une récupération psychomotrice plus rapide (mé diane du Trieger dot test [Q1, Q3] : 8 [4, 16] vs 16 [12, 26] points manqués, P = 0,002) et ont atteint les critères de sortie de la salle de réveil ≥ 9 plus tôt (médiane [Q1, Q3] : 40 [35, 60] vs 88 [75, 100] min, P < 0,001).ConclusionComparée á la SCP pour une lithotripsie á ondes de choc électrohydraulique, la SCA au propofol/fentanyl est associée á une plus grande consommation de propofol, á des niveaux de sédation plus profonds et á un plus grand confort du patient. Mais la SCA, comparée á la SCP, retarde la récupération et prolonge le temps en salle de réveil.Objectif Comparer la sedation controlee par ľanesthesiologiste (SCA) a la sedation controlee par le patient (SCP) quant aux demandes de propofol, a la sedation et a la recuperation chez des patients devant subir une lithotripsie a ondes de choc electrohydraulique pour urolithiase.

Addition of dexmedetomidine to bupivacaine in transversus abdominis plane block potentiates post-operative pain relief among abdominal hysterectomy patients: A prospective randomized controlled trial.

Background: Dexmedetomidine is an alpha 2 adrenergic agonist, prolongs analgesia when used in neuraxial and peripheral nerve blocks. We studied the effect of addition of dexmedetomidine to bupivacaine to perform transversus abdominis plane (TAP) block. Materials and Methods: A total of 50 patients scheduled for abdominal hysterectomy were divided into two equal groups in a randomized double-blinded way. Group B patients (n = 25) received TAP block with 20 ml of 0.25% bupivacaine and 2 ml of normal saline while Group BD (n = 25) received 0.5 mcg/kg (2 ml) of dexmedetomidine and 20 ml of 0.25% bupivacaine bilaterally. Time for first analgesic administration, totally used doses of morphine, pain scores, hemodynamic data and side-effects were recorded. Results: Demographic and operative characteristics were comparable between the two groups. The time for the first analgesic dose was longer in Group BD than Group B (470 vs. 280 min, P < 0.001) and the total doses of used morphine were less among Group BD patients in comparison to those in Group B (19 vs. 29 mg/24 h, P < 0.001). Visual analog scores were significantly lower in Group BD in the first 8 h post-operatively when compared with Group B, both at rest and on coughing (P < 0.001). In Group BD, lower heart rate was noticed 60 min from the induction time and continued for the first 4 h post-operatively (P < 0.001). Conclusions: The addition of dexmedetomidine to bupivacaine in TAP block achieves better local anesthesia and provides better pain control post-operatively without any major side-effects.

Use of Airtraq, C-Mac, and Glidescope laryngoscope is better than Macintosh in novice medical students' hands: A manikin study

Background and Aim: Obtaining patent airway is a crucial task for many physicians. When opportunities to practice intubations on patients are really limited, skill gaining methods are needed. We conducted a study among novice 6th year medical students to assess their ability to intubate the trachea in normal airway in manikin using four airway tools. Setting and Design: Prospective, cohort study conducted at simulation center of university-based, tertiary care hospital. Methods: Fifty medical students performed either oral or nasal tracheal intubation using the following four intubating tools: C-Mac videolaryngoscope, Glidescope, and Airtraq in comparison with regular Macintosh laryngoscope. Intubation time, visualization of glottic opening, ease of intubation, satisfaction of participants, incidence of dental trauma, and the need for optimization manoeuvres′ use among different airway tools were recorded. Results: In oral intubation, Airtraq was better than others in regard to intubation time, glottic opening, ease of intubation, and the need for external laryngeal pressure application, followed by Glidescope, C-Mac, and finally Macintosh laryngoscope (P<0.001). Airtraq and Glidescope associated with less dental trauma than C-Mac and Macintosh. In nasal route, fastest intubation time was reported with Airtraq followed by Glidescope, C-Mac, and lastly Macintosh. Airtraq, Glidescope, and C-Mac were similar to each other and better than the Macintosh in regard to ease of intubation, satisfaction, and number of attempts (P≤0.008). Conclusions: New devices like Airtraq, Glidescope, and C-Mac are better than the regular Macintosh when used by novice medical students for oral and nasal intubation on manikin.

Does Patient Position Influence the Reading of the Bispectral Index Monitor

BACKGROUND: Bispectral index (BIS) was developed to monitor patients’ level of consciousness under general anesthesia. Several factors have been found to alter BIS readings without affecting the depth of anesthesia. We conducted a study to assess the impact of changing patients’ position on BIS readings. METHODS: General anesthesia was administered to 40 patients undergoing minor surgeries. Patients were kept in neutral position (supine) for 15 min and BIS readings, mean arterial blood pressure, heart rate, end-tidal carbon dioxide, and end-tidal isoflurane were recorded. Patients were then shifted to head-down position (30°), neutral position, and lastly head-up position (30°) each of 15-min duration and the data were recorded. RESULTS: There was a significant increase in BIS values in head-down position (median 47 vs 40) compared with neutral position, whereas head-up position significantly decreased BIS (39 vs 41) compared with neutral position (P < 0.05). CONCLUSION: Changing a patient’s position significantly affects the BIS values, which might affect the interpretation of anesthetic depth.

How Long Can Patients Sit Up for Before Lying Down after Combined Spinal-Epidural Anesthesia For Cesarean Delivery? A Randomized Trial

Objective: Sitting patients up for 5 min after spinal anesthesia decreases hypotension and ephedrine requirement. This study aimed at determining how long patients can sit up for after combined spinal-epidural (CSE) anesthesia without requiring epidural supplementation. Methods: Ninety women booked for elective cesarean section under CSE anesthesia were randomized to sit up for 5 min (group 1), 7 min (group 2), or 9 min (group 3) after spinal anesthetic administration before lying down supine with a tilt. Sensory anesthesia level, systolic blood pressure, heart rate, ephedrine requirement, rescue epidural use, and time to achieving a modified Bromage score of two were documented by a blinded observer. Results: The maximum height of sensory anesthesia was [T3 (1) vs. T4 (1) vs. T5 (1) for groups 1-3, respectively, P<0.001]. Group 1 required more ephedrine (16.7% vs. 3.3% vs. 0%, P=0.024). Changes over time in systolic blood pressure (P=0.117) and heart rate (P =0.793), and time to achieving a modified Bromage score of two [112 (17) vs. 110 (16) vs. 100 (28) min, P=0.437] were similar amongest groups. Rescue epidural anesthesia was required in eight (26.7%) patients in group 3 compared to none in the other groups (P<0.001). Conclusion: Sitting the patient up for up to 7 min after CSE anesthesia for cesarean section reduced intraoperative ephedrine requirement without affecting the success of the spinal anesthetic. In contrast, sitting up for 9 min resulted in the need for rescue epidural anesthesia without additional benefit.

The effect of wet cupping on quality of life of adult patients with chronic medical conditions in King Abdulaziz University Hospital

Objectives: To assess the effect of wet cupping on health-related quality of life (HRQOL) of adult patients with chronic medical conditions, who were referred to the Cupping Clinic of King Abdulaziz University Hospital (KAUH), Jeddah, Kingdom of Saudi Arabia. Methods: A controlled, quasi-experimental study design was carried out among 629 patients referred for cupping from the KAUH Specialty Clinics, during the period from January to December 2014. Patients in the intervention group (309 patients) completed a pre-test included WHO quality of life-BREF, received one wet-cupping session, and filled-out the post-test (1 month later). Patients in the control group (320 patients) completed the pre-test during their enrollment in the study and post-test one month later. Both groups received their ordinary treatment. Descriptive and inferential statistics were performed. Results: Pain was the most common cause for cupping referral. After cupping intervention, the mean scores of most of the HRQOL domains, especially the physical domain, improved significantly among patients in the intervention group. The mean total score of physical HRQOL domain was 61.6 ± 13.6 before cupping, and reached 69.7 ± 12.6 after intervention (paired t-test=11.3, p=0.000). Improvements in HRQOL were noticed for almost all types of pain and other medical conditions. Conclusion: There are promising effects in favor of using wet cupping for improving HRQOL of patients with chronic conditions. Cupping is recommended as a complementary treatment modality for chronic medical conditions, especially pain.