scholarly journals Tramadol or Nalbuphine; Which One is Superior for Analgesia in Post-Operative Period after Percutaneous Nephrolithotomy

2021 ◽  
Vol 15 (1) ◽  
pp. 51-54
Author(s):  
Muhammad Sheraz Javed ◽  
◽  
Ghulam Mehboob Subhani ◽  
Muhammad Akmal ◽  
Muhammad Irfan Munir ◽  
...  

Background: Kidney stones has got high prevalence worldwide especially in our part of world and per-cutaneous nephrolithotomy (PCNL) is gold standard operative modality for renal stone management. Pain control after PCNL is the most important task for treating surgeon as effective pain control causes smooth patient recovery in post-operative period. For analgesia, many drugs can be used, out of which tramadol and nalbuphine always been in comparison for effective analgesic activity. Objective: To compare efficacy of tramadol and nalbuphine as potent analgesic in patients after PCNL. Study Design: A prospective randomized study. Settings: Department of Urology and Kidney Transplantation, Allied Hospital/Faisalabad Medical University, Faisalabad and Department of Urology, DHQ Hospital/Faisalabad Medical University, Faisalabad Pakistan. Duration: From September 2016 to September 2020 (4 Years). Methodology: 286 patients undergoing PCNL for either gender and sides enrolled in study according to inclusion and exclusion criteria. Patients divided into Group A (Administered with tramadol) and Group B (administered with nalbuphine) and patients evaluated for pain up to 48 hours after surgery using 11-point numerical pain rating scale rating from0-10 where 0 is no pain, 1-3 mild pain, 4-6 moderate pain, 7-9 severe pain and 10 as worst pain and use of rescue analgesia observed in either groups. Data obtained and statistical evaluation done. Results: 286 patients enrolled from age 15-75 years with mean age of 40.2 years. Among 286 patients, 161 were male and 125 were female patients. Both groups A and B having 143 patients each. Analysis showed that tramadol has superiority over nalbuphine and need of analgesia is more in patient given nalbuphine (118 vs 31) as maintenance analgesic agent in post-operative period after PCNL. Conclusion: This study showed that tramadol has superiority over nalbuphine for analgesia after PCNL.

Author(s):  
Priti A. Mehendale ◽  
Mayur T. Revadkar

Background: There is evidence regarding beneficial use of Transcutaneous Electrical Nerve Stimulation (TENS) on post Lower Segment Caesarean Section (LSCS) incision pain. However, efficacy of different types of TENS following C section pain has not yet been explored adequately.Methods: 96 women who had recently undergone LSCS were included for the study. The subjects were in the age group of 20 to 40 years (25.84±3.96); having pain intensity 4 or more on Numerical Pain Rating Scale (NPRS). They were divided into three groups by random allocation method; namely Group A: Acupuncture (Low/Motor) TENS, Group B: Conventional (High/Sensory) TENS and Group C: Control group. Group A and B received specific type of TENS twice a day for 15 minutes. Control group C did not receive any TENS intervention. All subjects received standard post-operative medications and physiotherapy. Pain intensity was recorded on NPRS pre and post intervention.Results: Both Acupuncture TENS and Conventional TENS significantly decreased post-operative pain intensity as compared to control group (p value <0.0001).Conclusions: Both, acupuncture and conventional TENS are equally effective in reducing post LSCS incision pain at a strong and non-painful intensity.


Author(s):  
Mohammed Ziauddin Sarkhil ◽  
Hemant Kumar Dutt ◽  
Rajaram S.

Background: Preemptive analgesia, involves the introduction of an analgesic regimen before the onset of noxious stimuli, with the goal of preventing sensitization of the nervous system to subsequent stimuli that could amplify pain.Methods: To determine the efficacy and safety of Lornoxicam when administered preemptively by using Wong-Baker FACES Pain Rating scale. The patients undergoing abdominal surgery were randomly categorized into group A and B of 25 each. Group A- Received Lornoxicam 8mg (1ml) one hour before surgery. Group B- Not received any analgesic before surgery. Primary measurement of the efficacy was done by using Wong-Baker Faces Pain Rating Scale at 2, 4, 8, 12 and 24 hour. All parameters were analyzed by using student t test.Results: Surgeries which were included in the study are hernia repair, open appendectomy, laparoscopic (appendectomy, cholecystectomy). Reduction in pain scores at 12th hourly and 24th hourly pain scores (<0.05) was significant. Tramadol usage decreased significantly with laparoscopic surgeries.Conclusions: In this study we could demonstrate that lornoxicam when used preemptively reduces the pain score slightly and reduces the requirement of post-operative analgesics significantly.


2019 ◽  
Vol 70 (4) ◽  
pp. 1500-1506
Author(s):  
Romina Marina Sima ◽  
Dragos Albu ◽  
Antoniu Cringu Ionescu ◽  
Mihai Dimitriu ◽  
Mihai Popescu ◽  
...  

Visual analogue scale (VAS) is a psychometric scale applied to measure subjective characteristics. The purpose of our study was to evaluate the efficiency of Ulipristal acetate (UPA) compared with Dienogest for endometriomas related pain using VAS. We performed a randomized study on women with symptomatic endometriomas. The study was realized between January 2016�December 2018. The patients were randomized in two groups: Group A- that received UPA in doses of 5 mg daily for 12�13 weeks and Group B that received 2 mg Dienogest for 12�13 weeks. Each group received de VAS (Visual Analogue Scale) questionnaire before and after treatment. 70 women wereincluded in the study with 35 patients for each group. The age the mean age was 30.20 years. For Numeric Rating Scale before treatment in the group with UPA the median value was 6 (CI= 5.26, 6.51) and for group B the median was 5 (CI= 5.13, 5.66). After treatment for group A the median value was 4 (CI= 3.58, 4.29) and for group B the median value 4 (CI= 4.23, 4.6). For FRS before treatment in the group with UPA median value was 6 (CI= 5.87, 6.58) and for the group B median was 6 (CI= 6.16, 6.57). After treatment for group A the median value was 4 (CI= 4.12, 4.73) and for group B the median value 5 (CI= 4.9, 5.06). The pain significantly improved for group A. (p[ 0.05) VAS represent a good method to evaluate the quality of pain for patients with endometriomas. The UPA and Dienogest treatment improve the VAS parameters with better results for UPA in the present study.


2021 ◽  
Vol 15 (8) ◽  
pp. 2442-2444
Author(s):  
Nighat Nasrullah Khan ◽  
Saima Riaz ◽  
Rehan Ramzan Khan ◽  
Hira Mannan ◽  
Sobia Ghafoor ◽  
...  

Objective: To compare the effects of aerobics and core stability exercises for the management of primary dysmenorrhea. Methodology: The study design was quasi-experimental, conducted in Yahya gym, Lahore, from February 2019 to July 2019. The sampling technique employed was non-probability convenient sampling with a sample size of 42 females within 18-30 years who had primary dysmenorrhea. The subjects were assigned into two groups. Group A was treated with aerobic exercises, while Group B was treated with core stability exercises with eight weeks workout plan and the results of three menstrual cycles were recorded. Stretching maneuvers were added as a standard treatment to both groups. Data were collected after 12 weeks and recorded for three menstrual cycles. Numeric Pain Rating Scale (NPRS) was used to measure pain intensity. Data were analyzed using IBM SPSS v.25. Results: Mean age of group A vs. group B participants was 25.23 ±2.64 vs. 21.38±3.41 years respectively. Mean BMI score of group A participants was 21.38±2.14 while for group B participants mean BMI score was 21.65±1.99 Kg/m2. Conclusion: This study concludes that both aerobic exercises and core stability exercises are effective to reduce the intensity of pain in primary dysmenorrhea. However aerobic exercises showed relatively better results in term of mean difference of NPRS score across both groups. Keywords: Menstruation, Primary dysmenorrhea, Exercise, Pain.


Author(s):  
Mohit Trivedi ◽  
Vishal Dixit ◽  
Syed Esam Mahmood ◽  
Sunil Kumar Mishra ◽  
S. S. Keshari

Background: Propranolol and flunarizine have proven to be useful tools in migraine prophylaxis. This trial aims the comparison of the efficacy of flunarizine, flunarizine and placebo and flunarizine and panchgavya ghrit in migraine prophylaxis.Methods: The present study was a prospective, randomized, open-label, blinded-endpoint trial. Patients with chronic migraine were randomized (1:1:1) to flunarizine and flunarizine and placebo and flunarizine and panchgavya ghrit in three treatment groups. The study was carried out in outdoor patients in the department of Psychiatry, T.S. Mishra Medical College and Hospital, Lucknow and K.G.M.U, Ayush Department, Lucknow after clearance from Institutional Ethical Committee. Data was analysed using SPSS software.Results: The prevalence of migraine was found to be higher in the age group greater than 30 years and females. Overall there was more reduction in CGI scores in flunarizine with panchgavya ghrit and the other two groups equally at the end of 4, 6 8 and 10 weeks. Decrease in MIDAS score was observed after the therapy. Clinical Global Impression rating scale employed revealed that to start with subjects scored 7 which stands for pathology interfering in many life functions which reduced drastically in Group C as compared to Group B and Group A in descending order. Pain scales namely VAS (visual analogue scale), NPRS (Numeric Pain Rating Scale), VRS (verbal rating scale) when employed denoted there was decreased migraine frequency, decreased perception of pain, less intake of abortive medication consumed by subjects implying there were reduction in number of migraine days and there was decrease in the abortive medications taken for the same. Group C scored better on pain scales followed by Group B and Group A. Lower proportion of individuals in group C had Behavioural Toxicity and Neurological Side effects as compared to Group A and B.Conclusions: Panch gavya ghrit when administered along with flunarizine was more efficacious and safe when compared with other two groups. However large multicentric RCTs of long duration and involving more number of subjects are required to ascertain these facts.


2020 ◽  
Vol 13 (4) ◽  
pp. 35-40
Author(s):  
S.V. Kotov ◽  
◽  
A.A. Nemenov ◽  
I.D. Boeva ◽  
◽  
...  

Introduction. The article analyzes the results of the clinical application of the herbal complex Renotinex®, which helps to normalize the function of the urinary tract, reduce pain, remove small stones from the kidneys and reduce the risk of recurrent stone formation. Materials and methods. At the University Clinic of Urology, Russian National Research Medical University named after N.I. Pirogov, a prospective, single-center, randomized study was carried out from November 2019 to March 2020. All patients underwent contact ureterolithotripsy. The patients were divided evenly into 2 groups: group A (n = 30) – patients receiving Renotinex® from the first day after surgery (within 1 month), and group B (n = 30) – a control group of patients not receiving specific therapy. Results. After 1 month of continuous use of the drug, there was an increase in the percentage of calculi discharge after contact ureterolithotripsy, a decrease in the severity of pain, normalization of the temperature curve and the absence of subfebrile condition in all patients. Conclusion. Renotinex® has a lithokinetic effect, its active ingredients contribute to the prevention of infectious and inflammatory complications of urolithiasis.


2021 ◽  
pp. 55-56
Author(s):  
Manasi Bhutani ◽  
Tanvi Patole

Background: The number of people is now becoming extremely health conscious hence taking up activities like marathons, sprinting and other forms of exercises to full recreational and tness needs. With an increasing number of sprinters chances of developing shin splints become higher. Warm ups, stretching and kinesio taping are great preventive measures and treatment protocols. Methodology: Group A received dynamic stretching and group B received dynamic stretching and kinesio taping. Outcome measures were time taken in seconds and pain intensity using Numerical Pain Rating Scale (NRS). Conclusion: Dynamic stretching along with Kinesio taping resulted in greater improvement in the 30-meter running time as compared to just dynamic stretching.


Author(s):  
Sowmya Sowmya ◽  
Jibu George Varghese ◽  
Poornima Poornima ◽  
Vikram Adhitya P.S.

Plantar fascitis is one of the most common cause of heel and foot pain, calcaneal taping technique places the foot in improved biomechanical position by re-positioning the calcaneal alignment closure to neutral and increasing the medial longitudinal arch height, thus reduce stress and pain. Hence this study is proposed to determine the effect of calcaneal taping technique in plantar fascitis. Total of 30 subjects diagnosed with planter fascitis was selected according to the inclusion and exclusion criteria and informed consent were obtained from the subjects involved in the study. Subjects were consecutively allocated to 2 Groups of 15 subjects each by odd and even method. Subjects in Group A (Conventional) was treated with ultrasound along with plantar fascia stretching. Group B (Experimental) was treated with ultrasound along with plantar fascia stretching and calcaneal taping technique. Patients were measured for pain with Numerical Pain Rating scale (NPRS), and functional ability measure with foot and ankle ability measure (FAAM). From statistical analysis made with the quantitative data revealed statistically significant difference between Pretest and posttest values of Group A and Group B. it has been concluded that ultrasound therapy along with plantar fascia stretching and calcaneal taping technique (Group B-Experimental group) was found to be more effective than ultrasound therapy and plantar fascia stretching (Group A-conventional group) reduces pain in the heel and increasing functional ability of the foot.


2018 ◽  
Vol 11 (6) ◽  
pp. 527-533
Author(s):  
James Gwosdz ◽  
Lattisha Bilbrew ◽  
Daniel Jupiter ◽  
Vinod Panchbhavi

Background. Ankle blocks are used in the ambulatory surgery setting to control postoperative pain, which is often worst in the first 24 hours after surgery. We conducted a trial to determine whether the timing of ankle block administration in relation to ankle tourniquet inflation has an effect on perceived pain and narcotic consumption. Methods. A prospective randomized study was conducted between August 2015 and January 2016. Patients were assigned to three groups. In group A, an ankle block was performed before ankle tourniquet inflation; in group B, immediately after ankle tourniquet inflation; and in group C, immediately after ankle tourniquet inflation with additional local anesthetic placed around the incision at the end of the procedure. Pain was assessed by a visual analogue scale (VAS) score, which was recorded at discharge, 24 hours, 48 hours, and 2 weeks after surgery. Narcotic consumption was recorded at 24 and 48 hours after surgery. Results. The only statistically significant difference in mean VAS scores occurred at 24 hours, when patients who received an ankle block after tourniquet inflation with local incisional anesthetic at closure (group C) had a mean VAS score 2.8 points lower (3.5 vs 6.3; P = .025) than those who received only an ankle block after tourniquet inflation (group B). There was no difference in narcotic consumption between groups at 24 and 48 hours. Conclusions. The timing of ankle block in relation to tourniquet inflation did not have an effect on pain control in forefoot, midfoot, and hindfoot reconstruction. The synergistic effect of an ankle block with additional incisional anesthetic at closure, is more effective than ankle block alone and is the ideal combination for postoperative pain control in foot surgery. Levels of Evidence: Therapeutic, Level II: Prospective, comparative trial


2020 ◽  
pp. 1-3
Author(s):  
Praveen S ◽  
Shashank M

Background: Dexamethasone has a long and efficient glucocorticoid structure and presents anti-inflammatory properties. When used as an adjuvant to local anaesthetics, it prolongs the duration of analgesia. The aim of this study was to determine the effect of dexamethasone as an adjuvant to levobupivacaine in TAP block given to patients who underwent caesarean section. Materials & Methods: 70 patients posted for caesarean section under spinal anaesthesia were included in the study and divided into two groups. Group A received bilateral 30 ml 0.25% levobupivacaine and 2 ml dexamethasone(8mg). Group B received bilateral 30 ml 0.25% levobupivacaine and 2 ml 0.9% NaCl in a TAP block performed with ultrasonography. The time needed for the first rescue analgesia in the postoperative period was recorded. 24hr tramadol consumption & VAS was recorded. Results: Time for first analgesic administration (tramadol) was prolonged significantly in Group A (mean ± SD- 12.24 ± 1.22hrs) as compared to Group B (mean ± SD ‑ 8.37± 1.07 hrs), P < 0.0001. Tramadol requirement for 24hrs in Group A was 115.71± 16.89 mg and for Group B was 198.57± 22.64 mg, which was statistically significant (P < 0.0001). VAS was noted at 2, 4, 6, 8, 12, 18 and 24 h. VAS was greatly reduced in group A for the first 8–10 h post‑operatively as compared to patients in group B. CONCLUSIONS: Dexamethasone when used as an adjuvant to levobupivacaine in TAP block, enhances the duration of block & decreases opioid consumption in the post- caesarean section patients.


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