The Use of a Fine-Gauge Needle to Reduce Pain in Open Carpal Tunnel Decompression: A Randomized Controlled Trial

2005 ◽  
Vol 30 (6) ◽  
pp. 615-617 ◽  
Author(s):  
A. C. WATTS ◽  
J. MCEACHAN
Keyword(s):  
Carpal Tunnel ◽  
Local Anaesthetic ◽  
Controlled Trial ◽  
Verbal Response ◽  
Controlled Study ◽  
Response Scale ◽  
Randomized Controlled ◽  
Vas Scores ◽  
The Mean ◽  
23 Gauge

This randomized controlled study on 86 patients compared the level of pain experienced by patients on instillation of local anaesthetic into the palm with a 23-gauge and a 27-gauge (dental) needle in open carpal tunnel decompression. Patients were asked to score the amount of pain they experienced during the injection of the local anaesthetic and their level of anxiety about future injections using a visual analogue scale (VAS) and a four-point verbal response scale (VRS). The mean pain and anxiety scores on the VAS were significantly lower in the dental needle group. There was significant correlation between the pain and anxiety VAS scores. When infiltrating local anaesthetic into the palm for open carpal tunnel decompression, the use of a fine (dental) needle can reduce the pain on that occasion and the anxiety concerning future injections likely to be experienced by the patient.

scholarly journals Pain Levels after Local Anaesthetic with or without Hyaluronidase in Carpal Tunnel Release: A Randomised Controlled Trial

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
G. Yeo ◽  
A. Gupta ◽  
G. Ding ◽  
H. Skerman ◽  
M. Khatun ◽  
...  
Keyword(s):  
Carpal Tunnel ◽  
Local Anaesthetic ◽  
Controlled Trial ◽  
Carpal Tunnel Release ◽  
Controlled Study ◽  
Control Group ◽  
Vas Scores ◽  
Randomised Controlled ◽  
Anaesthetic Injection ◽  
Local Anaesthetic Injection

Purpose. Hyaluronidase is an enzyme that temporarily liquefies the interstitial barrier, allowing easy dispersal of local anaesthetic through cleavage of tissue planes. This prospective, blinded, randomised controlled study investigates the utility of adding hyaluronidase to local anaesthetic in the setting of carpal tunnel release.Methods. 70 consecutive carpal tunnel release patients were recruited and randomised into a control group only receiving local anaesthetic and a hyaluronidase group receiving both hyaluronidase and local anaesthetic. Pain scores were rated using the visual analogue scale (VAS) by patients immediately after local anaesthetic injection and again immediately after the carpal tunnel release.Results. Preoperative VAS scores, taken after local anaesthetic injection, were greater than postoperative VAS scores. Postoperative VAS scores were significantly lower in the hyaluronidase group and tourniquet times were significantly shorter in the hyaluronidase group.Conclusion. Hyaluronidase addition to local anaesthetic in carpal tunnel release resulted in significant reductions in operative time and pain immediately after operation.

Study on the prevention of infection in terminal cancer patients applying epidural analgesia by adding cefazolin to anesthetics: a randomized controlled trial

2020 ◽  
Vol 50 (8) ◽  
pp. 867-872
Author(s):  
Pengcheng Xie ◽  
Zhanfang Li ◽  
Jingli Yang ◽  
Yiming Wu
Keyword(s):  
Epidural Analgesia ◽  
Bacterial Culture ◽  
Controlled Trial ◽  
Terminal Cancer ◽  
Randomized Controlled ◽  
Conventional Drug ◽  
Epidural Puncture ◽  
Vas Scores ◽  
The Mean

Abstract Objective To observe the antibacterial effect of adding cefazolin into anesthetics in patients with terminal cancer undergoing long-term epidural analgesia. Methods Patients undergoing epidural analgesia with terminal cancer were randomly divided into two groups: the conventional drug group (group C) and the cefazolin group (group G). Both groups were given levobupivacaine and morphine, while cefazolin was added to group G. The mean arterial pressure (MAP), heart rate (HR), respiratory rates (R), visual analogue scale (VAS) scores, satisfaction and complications of patients in the two groups were observed. 3 ml of the used analgesic was taken for bacterial culture when replacing the new analgesic case. Results HR, MAP, R, VAS scores, dosages of morphine, satisfaction of the analgesic and the complications were not significantly different between the two groups (P > 0.05). The overall satisfaction of patients in group G was significantly higher than that in group C (P < 0.05). One patient’s anesthetics in group C were infected with colibacillus. Four patients in group C got infected in their epidural puncture sites. There was no infection in group G (P < 0.05). Conclusion Adding cefazolin to local anesthetics could effectively prevent bacterial infection and ensured the safety of epidural analgesia for patients with terminal cancer.

Pain and outcomes of carpal tunnel release under local anaesthetic with or without a tourniquet: a randomized controlled trial

2018 ◽  
Vol 43 (8) ◽  
pp. 808-812 ◽  
Author(s):  
Hafiz J. Iqbal ◽  
Ashtin Doorgakant ◽  
Nader N. T. Rehmatullah ◽  
Ashok L. Ramavath ◽  
Prasad Pidikiti ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Carpal Tunnel ◽  
Local Anaesthetic ◽  
Local Anaesthesia ◽  
Controlled Trial ◽  
Carpal Tunnel Release ◽  
Similar Degree ◽  
Level Of Evidence ◽  
Randomized Controlled ◽  
Anaesthetic Mixture

We conducted a prospective randomized controlled trial to investigate carpal tunnel decompression under local anaesthesia. Carpal tunnel decompression was performed in 37 wrists using local anaesthesia and an arm tourniquet and 36 without tourniquet but with a local anaesthetic mixture containing adrenaline. Patients who underwent carpal tunnel decompression using a tourniquet experienced a significantly greater degree of pain when compared with those who did not have a tourniquet. Pain and hand function improved to a similar degree in both groups. We conclude that carpal tunnel decompression performed with a tourniquet causes patients unnecessary pain with no additional benefit as compared with the wide-awake carpal tunnel decompression without use of a tourniquet. Level of evidence: I

Warm or refrigerated local anaesthetic for open carpal tunnel release: a single blind randomized controlled study

2009 ◽  
Vol 35 (3) ◽  
pp. 232-233 ◽  
Author(s):  
P. J. Tomlinson ◽  
J. Field
Keyword(s):  
Carpal Tunnel ◽  
Local Anaesthetic ◽  
Room Temperature ◽  
Carpal Tunnel Release ◽  
Randomized Controlled Study ◽  
Controlled Study ◽  
Randomized Controlled ◽  
Pain Scores ◽  
Open Carpal Tunnel Release ◽  
Patients Experience

The aim of this randomized controlled study was to determine whether administration of lignocaine with adrenaline is less painful when injected at room temperature compared to refrigerated temperature. A cohort of 50 patients undergoing unilateral carpal tunnel decompression was randomized to room temperature or refrigerated local anaesthetic. Pain scores were assessed using a 10 mm visual analogue scale. Mean pain scores were 4.0 (SD ± 1.5) for room temperature and 6.5 (SD ± 1.7) for refrigerated local anaesthetic ( P < 0.001). This study demonstrates that patients experience greater pain levels with administration of local anaesthetic at refrigerated temperatures prior to open carpal tunnel release.

A Prospective, Randomized, Controlled Trial of Forearm Versus Upper Arm Tourniquet Tolerance

2002 ◽  
Vol 27 (4) ◽  
pp. 359-360 ◽  
Author(s):  
A. C. MAURY ◽  
W. S. ROY
Keyword(s):  
Randomized Controlled Trial ◽  
Healthy Volunteers ◽  
Local Anaesthetic ◽  
Controlled Trial ◽  
Hand Surgery ◽  
Upper Arm ◽  
Tourniquet Time ◽  
Randomized Controlled ◽  
Prospective Randomized Controlled Trial ◽  
The Mean

This prospective, randomized, controlled trial studied the duration of upper and forearm tourniquet tolerance in 24 fit, healthy volunteers. Upper arm and forearm tourniquets were applied to either arm and inflated simultaneously. The time to request for deflation was recorded for each tourniquet. The mean tolerance for the upper arm tourniquet was 18 (range 10–26) min and for the forearm tourniquet was 25 (range 12–52) min. Under the conditions of this study, forearm tourniquets were tolerated for a mean of 7 min longer than upper arm tourniquets. The increase in tourniquet time afforded by a forearm tourniquet is clinically important in hand surgery performed under local anaesthetic.

scholarly journals Ultrasound-guided erector spinae plane block versus rhomboid intercostal block for postoperative analgesia following thoracotomy: a prospective, randomized, controlled study

2021 ◽  
Author(s):  
Tahsin Şimşek ◽  
Fatih Dogu Geyik ◽  
Aynur Kaynar Simsek ◽  
Yucel Yuce ◽  
Kemal Tolga Saracoglu ◽  
...  
Keyword(s):  
Postoperative Analgesia ◽  
Controlled Trial ◽  
Erector Spinae ◽  
Controlled Study ◽  
Control Group ◽  
Randomized Controlled ◽  
Erector Spinae Plane Block ◽  
Number Of Patients ◽  
Vas Scores ◽  
Intercostal Block

Introduction For pain relief after thoracotomy, opioids and thoracic paravertebral and epidural interventions are frequently used. In recent years, interfascial blocks such as the erector spinae plane block (ESPB) and rhomboid intercostal block (RIB) have started to be used for analgesia. We aimed to compare the postoperative analgesic effect of ESPB, RIB, and a control group in pain management after open thoracotomy. Material and methods This is a randomized controlled trial. A total of 75 patients were included in three groups as the ESPB, RIB, and control (C) groups. In block groups, the blockage was performed with 20 ml 0.25% bupivacaine. In Group C, no procedures other than the standard postoperative analgesia protocol were performed. The postoperative analgesic consumptions of the patients, time of first analgesic need, and visual analog scale (VAS) values were recorded. Results The mean 24-hour tramadol consumption was 124±29.08 mg in group ESPB and 116±28.65 mg in group RIB, and the results were statistically similar (p>0.05). In Group C, the consumption is 204±44.06 mg; significantly higher than group ESPB and group RIB (p=0.004). Time to the first analgesic requirement was 355±55.69 min in group ESPB and 339.12±54.39 min in group RIB. There was no difference between groups (p>0.05). In Group C, this time was 218.91±56.73 minutes. We observed that group ESPB and group RIB needed analgesics later (p=0.006). VAS scores and the number of patients requiring analgesics were similar in group ESPB and group RIB (p>0.05). In Group C, on the other hand, VAS scores and the number of patients requiring analgesics were higher than both groups in which block was applied (p<0.05). Conclusion ESPB and RIB were similar and they are more effective in comparison to the standard protocol in the control group, whereas the former did not have superiority over each other.

scholarly journals Effectiveness of Community-Delivered Functional Power Training Program for Frail and Pre-frail Community-Dwelling Older Adults: a Randomized Controlled Study

2021 ◽  
Author(s):  
Nien Xiang Tou ◽  
Shiou-Liang Wee ◽  
Wei Ting Seah ◽  
Daniella Hui Min Ng ◽  
Benedict Wei Jun Pang ◽  
...  
Keyword(s):  
Older Adults ◽  
Muscle Strength ◽  
Controlled Trial ◽  
Community Dwelling ◽  
Controlled Study ◽  
Power Training ◽  
Frail Older Adults ◽  
Frailty Status ◽  
Randomized Controlled ◽  
Community Dwelling Older Adults

AbstractTranslation of community-based functional training for older adults to reduce frailty is still lacking. We evaluated the effectiveness and implementation of a community-delivered group-based functional power training (FPT) program for frail older adults within their neighborhoods. A two-arm, multicenter assessor-blind stratified randomized controlled trial was conducted at four local senior activity centers in Singapore. Sixty-one community-dwelling older adults with low handgrip strength were randomized to intervention (IG) or control (CG) group. The IG underwent the FPT program (power and balance exercises using simple equipment) delivered by a community service provider. The 12-week program comprised 2 × 60 min sessions/week. CG continued usual activities at the centers. Functional performance, muscle strength, and frailty status were assessed at baseline and 3 months. Program implementation was evaluated using RE-AIM framework. The program was halted due to Coronavirus Disease 2019-related suspension of senior center activities. Results are reported from four centers, which completed the program. IG showed significantly greater improvement in the Short Physical Performance Battery test as compared to CG (p = 0.047). No effects were found for timed up and go test performance, muscle strength, and frailty status. The community program exhibited good reach, effectiveness, adoption, and implementation. Our study demonstrated that FPT was associated with greater improvement in physical function in pre-frail/frail participants as compared to exercise activities offered at local senior activity centers. It is a feasible intervention that can be successfully implemented for frail older adults in their neighborhoods. Trial registration ClinicalTrials.gov, NCT04438876. Registered 19 June 2020–retrospectively registered.

scholarly journals Efficacy of axial TheraTogs on gait pattern in children with dyskinetic cerebral palsy: a randomized controlled trial

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Shamekh Mohamed El-Shamy ◽  
Ehab Mohamed Abd El Kafy
Keyword(s):  
Cerebral Palsy ◽  
Physical Therapy ◽  
Muscle Tone ◽  
Controlled Trial ◽  
Gait Pattern ◽  
Controlled Study ◽  
Control Group ◽  
Randomized Controlled ◽  
Gait Parameters ◽  
Experimental Group

Abstract Background TheraTogs promotes proprioceptive sense of a child with cerebral palsy and improves abnormal muscle tone, posture alignment, balance, and gait. Therefore, the aim of this study was to investigate the efficacy of TheraTogs orthotic undergarment on gait pattern in children with dyskinetic cerebral palsy. Thirty children with dyskinetic cerebral palsy were selected for this randomized controlled study. They were randomly assigned to (1) an experimental group that received TheraTogs orthotic undergarment (12 h/day, 3 days/week) plus traditional physical therapy for 3 successive months and (2) a control group that received only traditional physical therapy program for the same time period. Gait parameters were measured at baseline and after 3 months of intervention using Pro-Reflex motion analysis. Results Children in both groups showed significant improvements in the gait parameters (P < 0.05), with significantly greater improvements in the experimental group than in the control group. Conclusions The use of TheraTogs may have a positive effect to improve gait pattern in children with dyskinetic cerebral palsy. Trial registration This trial was registered in the ClinicalTrial.gov PRS (NCT03037697).

scholarly journals The impact of vildagliptin on the daily glucose profile and coronary plaque stability in impaired glucose tolerance patients with coronary artery disease: VOGUE—A multicenter randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hiroyuki Yamamoto ◽  
Akihide Konishi ◽  
Toshiro Shinke ◽  
Hiromasa Otake ◽  
Masaru Kuroda ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Controlled Trial ◽  
Control Group ◽  
Randomized Controlled ◽  
Fibrous Cap ◽  
Multicenter Randomized Controlled Trial ◽  
The Mean ◽  
Artery Disease ◽  
Fibrous Cap Thickness ◽  
The Impact

Abstract Background The impact of reduction in glycemic excursion on coronary plaques remains unknown. This study aimed to elucidate whether a dipeptidyl peptidase 4 inhibitor could reduce the glycemic excursion and stabilize the coronary plaques compared with conventional management in coronary artery disease (CAD) patients with impaired glucose tolerance (IGT). Methods This was a multicenter, randomized controlled trial including CAD patients with IGT under lipid-lowering therapy receiving either vildagliptin (50 mg once a day) or no medication (control group) regarding glycemic treatment. The primary endpoint was changes in the minimum fibrous cap thickness and lipid arc in non-significant native coronary plaques detected by optical coherence tomography at 6 months after intervention. Glycemic variability expressed as the mean amplitude of glycemic excursion (MAGE) measured with a continuous glucose monitoring system was evaluated before and 6 months after intervention. Results A total of 20 participants with 47 lesions were allocated to either the vildagliptin group (10 participants, 22 lesions) or the control group (10 participants, 25 lesions). The adjusted difference of mean changes between the groups was − 18.8 mg/dl (95% confidence interval, − 30.8 to − 6.8) (p = 0.0064) for the MAGE (vildagliptin, − 20.1 ± 18.0 mg/dl vs. control, 2.6 ± 12.7 mg/dl), − 22.8° (− 40.6° to − 5.1°) (p = 0.0012) for the mean lipid arc (vildagliptin, − 9.0° ± 25.5° vs. control, 15.8° ± 16.8°), and 42.7 μm (15.3 to 70.1 μm) (p = 0.0022) for the minimum fibrous cap thickness (vildagliptin, 35.7 ± 50.8 μm vs. control, − 15.1 ± 25.2 μm). Conclusions Vildagliptin could reduce the MAGE at 6 months and may be associated with the decreased lipid arc and increased minimum FCT of the coronary plaques in CAD patients with IGT as compared with the control group. These findings may represent its potential stabilization effect on coronary plaques, which are characteristic in this patient subset. Trial registration Registered in the UMIN clinical trial registry (UMIN000008620), Name of the registry: VOGUE trial, Date of registration: Aug 6, 2012, URL: https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000010058

scholarly journals Manual Therapy in Cervical and Lumbar Radiculopathy: A Systematic Review of the Literature

2021 ◽  
Vol 18 (11) ◽  
pp. 6176
Author(s):  
Tomasz Kuligowski ◽  
Anna Skrzek ◽  
Błażej Cieślik
Keyword(s):  
Manual Therapy ◽  
Functional Outcomes ◽  
Web Of Science ◽  
Current Knowledge ◽  
Controlled Trial ◽  
Future Research ◽  
Lumbar Radiculopathy ◽  
Inclusion Criteria ◽  
Randomized Controlled ◽  
The Mean

The aim of this study was to describe and update current knowledge of manual therapy accuracy in treating cervical and lumbar radiculopathy, to identify the limitations in current studies, and to suggest areas for future research. The study was conducted according to PRISMA guidelines for systematic reviews. A comprehensive literature review was conducted using PubMed and Web of Science databases up to April 2020. The following inclusion criteria were used: (1) presence of radiculopathy; (2) treatment defined as manual therapy (i.e., traction, manipulation, mobilization); and (3) publication defined as a Randomized Controlled Trial. The electronic literature search resulted in 473 potentially relevant articles. Finally, 27 articles were accepted: 21 on cervical (CR) and 6 in lumbar radiculopathy (LR). The mean PEDro score for CR was 6.6 (SD 1.3), and for LR 6.7 (SD 1.6). Traction-oriented techniques are the most frequently chosen treatment form for CR and are efficient in reducing pain and improving functional outcomes. In LR, each of the included publications used a different form of manual therapy, which makes it challenging to summarize knowledge in this group. Of included publications, 93% were either of moderate or low quality, which indicates that quality improvement is necessary for this type of research.

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