Alexander Dotto1,2, Dustin Dunsmuir3,4, Terri Sun3,5, Lily Y L Chiu3, Ronald Ree3,5, J Mark Ansermino3,4,6, Cynthia H Yarnold3,5. 1. Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, Vancouver, BC, Canada. alex.dotto@alumni.ubc.ca. 2. School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada. alex.dotto@alumni.ubc.ca. 3. Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, Vancouver, BC, Canada. 4. BC Children's Hospital Research Institute, Vancouver, BC, Canada. 5. Department of Anesthesia, Providence Health Care, St. Paul's Hospital, Vancouver, BC, Canada. 6. Department of Pediatric Anesthesia, BC Children's Hospital, Vancouver, BC, Canada.
Abstract
PURPOSE: Peripheral nerve blocks (PNBs) provide excellent perioperative analgesia but can increase the risk of severe postoperative pain once the block wears off. Poor adherence to discharge instructions may increase this risk. Panda-Nerve Block (Panda) is an app that alerts the patient to assess their PNB, score their pain, and take scheduled pain medication. We assessed the usability and feasibility of Panda for assisting patients after receiving a PNB. METHODS: Twenty-nine patients tested Panda in three rounds, for two to seven days, postoperatively to assess and manage their pain and PNB. Feedback was provided via phone interview and the Computer System Usability Questionnaire (CSUQ). Additionally, each user's usage log was analyzed for parameters such as alert response times. Feasibility was determined by alert responses that occurred before the next alert, with a goal of greater than 50%. User adherence was measured as percentage compliance with alerts within one hour; usability and user satisfaction were determined from the CSUQ and interviews. RESULTS: A median [interquartile range (IQR)] of 68 [34-93]% responded before the next alert during the first 48 hr of app use, and 83 [54-92]% responded before the next alert with 87 [75-96]% of these within one hour. There were no significant differences in usage between rounds. Ninety-three percent of patients reported Panda to be easy to use and helpful, and 79% of patients would use Panda again. Critical themes included changes to the layout and appearance, clarification of the language of the PNB check, and requests for dynamic adjustments to the medication schedule based on user responses. CONCLUSION: Panda-Nerve Block is a feasible method for PNB patients to manage postoperative pain with a high response rate. Future work should include providing two-way communication for patients and clinicians and assessing its effect on pain outcomes. TRIAL REGISTRATION: www.clinicaltrials.gov (NCT03369392); registered 5 December 2017.
PURPOSE: Peripheral nerve blocks (PNBs) provide excellent perioperative analgesia but can increase the risk of severe postoperative pain once the block wears off. Poor adherence to discharge instructions may increase this risk. Panda-Nerve Block (Panda) is an app that alerts the patient to assess their PNB, score their pain, and take scheduled pain medication. We assessed the usability and feasibility of Panda for assisting patients after receiving a PNB. METHODS: Twenty-nine patients tested Panda in three rounds, for two to seven days, postoperatively to assess and manage their pain and PNB. Feedback was provided via phone interview and the Computer System Usability Questionnaire (CSUQ). Additionally, each user's usage log was analyzed for parameters such as alert response times. Feasibility was determined by alert responses that occurred before the next alert, with a goal of greater than 50%. User adherence was measured as percentage compliance with alerts within one hour; usability and user satisfaction were determined from the CSUQ and interviews. RESULTS: A median [interquartile range (IQR)] of 68 [34-93]% responded before the next alert during the first 48 hr of app use, and 83 [54-92]% responded before the next alert with 87 [75-96]% of these within one hour. There were no significant differences in usage between rounds. Ninety-three percent of patients reported Panda to be easy to use and helpful, and 79% of patients would use Panda again. Critical themes included changes to the layout and appearance, clarification of the language of the PNB check, and requests for dynamic adjustments to the medication schedule based on user responses. CONCLUSION: Panda-Nerve Block is a feasible method for PNBpatients to manage postoperative pain with a high response rate. Future work should include providing two-way communication for patients and clinicians and assessing its effect on pain outcomes. TRIAL REGISTRATION: www.clinicaltrials.gov (NCT03369392); registered 5 December 2017.
Authors: Débora O Cumino; Joaquim E Vieira; Luciana C Lima; Livia P Stievano; Raquel A P Silva; Ligia A S T Mathias Journal: Eur J Anaesthesiol Date: 2017-03 Impact factor: 4.330
Authors: Lily Y L Chiu; Terri Sun; Ronald Ree; Dustin Dunsmuir; Alexander Dotto; J Mark Ansermino; Cynthia Yarnold Journal: Can J Anaesth Date: 2019-02-22 Impact factor: 5.063
Authors: Jennifer N Stinson; Lindsay A Jibb; Cynthia Nguyen; Paul C Nathan; Anne Marie Maloney; L Lee Dupuis; J Ted Gerstle; Benjamin Alman; Sevan Hopyan; Caron Strahlendorf; Carol Portwine; Donna L Johnston; Mike Orr Journal: J Med Internet Res Date: 2013-03-08 Impact factor: 5.428
Authors: Richard Gordon-Williams; Andreia Trigo; Paul Bassett; Amanda Williams; Stephen Cone; Martin Lees; Brigitta Brandner Journal: Pain Res Manag Date: 2021-04-02 Impact factor: 3.037