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However, being "realistic" shouldn't be interpreted as less aggressive pursuit of maximum pain relief.
VAS on Present Pain ranged from "no pain" to "the worst pain possible"; VAS on Pain Relief ranged from "no pain relief" to "the maximum pain relief".
To evaluate the effectiveness of a treatment of a 50% cutoff point for the percentage of maximum pain relief is considered as a consistent clinical end point of pain half relieved, easily understood by professionals and patients.
Moreover, the ideal labour analgesic may depend on the parturient and the individual preferences as well as expectations for the birth experience since maximum pain relief may not always be of utmost importance [ 1].
Since actual pain measurements are available at all time points for each patient, it is possible to calculate for each patient the percent of maximum pain relief (%maxTOTPAR), the number of patients with at least 50% maxTOTPAR and, hence, the number-needed-to-treat (NNT) for at least 50% pain relief at different durations.
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One month after the last intra-articular injection, the mean pain relief was assessed at 35.9 (25.6) on VAS by patients (0, maximal pain relief; 100, no relief).
For each patient we then calculated the percentage of the maximum possible TOTPAR for each time point (number of hours of observation multiplied by the maximum possible pain relief of 4; for example,24 for six hours, 32 for eight hours).
The maximum of pain relief was described within the 3rd to the 8th week 27±200%).
For each patient the percentage of maximum possible pain relief (%maxTOTPAR) was determined at different time points.
Of the 9 patients who reported a maximum benefit of pain relief at baseline, 5 (2 EM/3 CM) were able to achieve pain freedom within 2 h after initiating adjunctive nVNS treatment as reported at 3 months (p = 0.03).
The opposite is probably true for patients with less severe OA, in whom maximum function and pain relief is expected.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com