Pre-emptive triple analgesia protocol for tonsillectomy pain control in children: double-blind, randomised, controlled, clinical trial

2013 ◽  
Vol 127 (4) ◽  
pp. 383-391 ◽  
Author(s):  
A M A El-Fattah ◽  
E Ramzy
Keyword(s):  
Postoperative Pain ◽  
Visual Analogue Scale ◽  
Analogue Scale ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Double Blind ◽  
Post Surgery ◽  
Scale Scores ◽  
Randomised Controlled ◽  
At Home

AbstractIntroduction:This double-blind, controlled, parallel-group study was designed to determine the efficacy of pre-emptive triple analgesia for paediatric post-tonsillectomy pain management.Materials and methods:One hundred and thirty-five children were randomised into two groups: pre-emptive triple analgesia (n = 55) and control (n = 80). Pain was assessed using a visual analogue scale (in hospital) and the Parent's Postoperative Pain Measure (at home), and scores recorded.Results:Visual analogue scale scores on awakening and for 6 hours post-surgery were significantly better in the study group than the control group (p < 0.05). The Parent's Postoperative Pain Measure scores of control group children were significantly higher within the first 3 post-operative days (p = 0.000), with a greater percentage of children experiencing significant pain and requiring more analgesia.Conclusion:The proposed multimodal, pre-emptive analgesia protocol for paediatric post-tonsillectomy pain results in less post-operative pain, both in hospital or at home.

scholarly journals Improving postoperative pain management in subpectoral tissue expander implant reconstruction of the breast using an elastomeric pump

2015 ◽  
Vol 97 (5) ◽  
pp. 364-368 ◽  
Author(s):  
A Chaudhry ◽  
S Hallam ◽  
A Chambers ◽  
AK Sahu ◽  
S Govindarajulu ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Visual Analogue Scale ◽  
Local Anaesthetic ◽  
Analogue Scale ◽  
Breast Surgery ◽  
Infusion Pump ◽  
Intervention Group ◽  
Tissue Expander ◽  
Control Group ◽  
The Mean

Introduction Postoperative pain after breast surgery is one of the major factors contributing to delay in mobilisation and prolonged hospital stay. A retrospective analysis was performed of patients undergoing skin sparing mastectomy and insertion of a subpectoral implant. The aim was to determine whether the use of an elastomeric local anaesthetic pump improved pain control and length of stay. Methods Twenty-five consecutive patients undergoing the above procedure were sited with an elastomeric local anaesthetic infusion pump intraoperatively, in addition to standard regular and pro re nata analgesia. The control group comprised 25 patients undergoing the same procedure in the same year who received standard analgesia alone. Visual analogue scale scores were recorded for the duration of inpatient stay, as was any further analgesic requirement. Results The median age was 51 years (range: 26–75 years) in the intervention group and 50 years (range: 28–70 years) in the control group. The mean visual analogue scale score was 0.28 (standard deviation [SD]: 0.61) at 24 hours for the intervention group and 1.84 (SD: 0.37) for the control group (p<0.0001). The mean length of stay was 1.8 days (SD: 0.71 days) for the intervention group and 2.28 days (SD: 0.94 days) for the control group (p=0.15). There were no complications involving catheter placement, leakage or toxicity relating to use of the local anaesthetic. Conclusions There was significantly reduced pain with the use of the local anaesthetic infusion pump. The elastomeric pump is a step towards enhanced patient recovery after breast surgery in the case of skin sparing mastectomy and subpectoral tissue expander reconstruction.

scholarly journals Impact of Epley manoeuvre on self-perceived disability: A randomised controlled trial in primary care

2020 ◽  
Author(s):  
Ricard Carrillo Muñoz ◽  
Jose Luis Ballve Moreno ◽  
Ivan Villar Balboa ◽  
Yolanda Rando Matos ◽  
Oriol Cunillera Puertolas ◽  
...  
Keyword(s):  
Primary Care ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Double Blind ◽  
Perceived Disability ◽  
Randomised Controlled ◽  
The Impact

Abstract Background: Posterior canal benign paroxysmal positional vertigo (pc-BPPV) causes physical, functional, and emotional impairment. The treatment of choice is the Epley manoeuvre (EM). The purpose of the study was to compare the impact of the EM and a sham manoeuvre in primary care on self-perceived disability.Method: Randomised, double-blind, sham-controlled clinical trial conducted in primary care with a follow-up of 1 year. Patients aged ≥18 years old diagnosed with pc-BPPV according to the Dix-Hallpike test (DHT) were randomised to an intervention (EM) group or a control (sham manoeuvre) group. The main study covariables were age, sex, history of depression and anxiety, presence of nystagmus in the DHT, patient-perceived disability assessed with the Dizziness Handicap Inventory-screening version (DHI-S). Data were analyzed using bivariate and multivariate mixed Tobit analyses. Results: Overall, 134 patients were studied: 66 in the intervention group and 68 in the control group. Median age was 52 years (interquartile range [IQR], 38.25–68.00 years) and 76.12% of the patients were women. The DHT triggered nystagmus in 40.30% of patients. The median total DHI-S score for the overall sample at baseline was 16 (IQR, 8.00–22.00); 16 [IQR, 10.5–24.0] vs 10 [6.0–14.0] for women vs men (P<0.001) and 16 [IQR, 10.0-24.0] vs 12 [IQR, 8.0–18.0] for patients without nystagmus vs those with nystagmus (P=0.033).Patients treated with the EM experienced a mean reduction of 2.03 points in DHI-S score over the follow-up period compared with patients in the sham group. Conclusion: Pc-BPPV affects the quality of life of primary care patients. A single EM can improve self-perceptions of disability by around 2 points on the DHI-S scale, Trial registration: ClinicalTrials.gov Identifier: NCT01969513. Retrospectively registered. First Posted: October 25, 2013. https://clinicaltrials.gov/ct2/show/NCT01969513

scholarly journals Comparison of the efficacy of oral oxycodone and oral codeine in the treatment of post-craniotomy pain – a randomized, double-blind trial

2019 ◽  
Author(s):  
Rui Min Lee ◽  
Beatrice Chin Ling Lim ◽  
Chin Ted Chong ◽  
Mandy Pei-Pei Lim
Keyword(s):  
Side Effects ◽  
Analogue Scale ◽  
Controlled Trial ◽  
Similar Efficacy ◽  
Control Group ◽  
Double Blind Trial ◽  
Double Blind ◽  
Scale Scores ◽  
Double Blinded ◽  
Experimental Group

Abstract Background Post-craniotomy pain has been reported to be moderate to severe. Management of post-craniotomy pain is often inadequate, yet limited by the side effects of opioids. We aim to find out the efficacy of oral oxycodone as compared to oral codeine for the treatment of post-craniotomy pain in our institution.Methods A randomized, double blinded controlled trial was used to evaluate the efficacy of oral oxycodone versus oral codeine. 40 patients were randomized to the control group of codeine (n = 20) or the experimental group receiving oxycodone (n = 20) in addition to regular oral paracetamol for both groups of patients.Results There was no difference in the visual analogue scale scores at 24 hours (2.78 versus 1.85, p = 0.11) or side effects in the oxycodone group compared with the codeine group.Conclusions Oral oxycodone had similar efficacy as oral codeine in the management of post-craniotomy pain.

scholarly journals Effects of Dexmedetomidine on Intraoperative Hemodynamics, Recovery Profile and Postoperative Pain in Patients Undergoing Laparoscopic Cholecystectomy: A Randomized Controlled Trial

2020 ◽  
Author(s):  
Qin Ye ◽  
Fangjun Wang ◽  
Hongchun Xu ◽  
Le Wu ◽  
Xiaopei Gao
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Laparoscopic Cholecystectomy ◽  
Postoperative Pain ◽  
Visual Analogue Scale ◽  
Systolic Blood Pressure ◽  
Analogue Scale ◽  
Hemodynamic Stability ◽  
Scale Scores ◽  
Respiratory Recovery

Abstract Background: To investigate the optimal dose of dexmedetomidine to maintain hemodynamic stability, prevent of cough and minimize postoperative pain for patients undergoing laparoscopic cholecystectomy.Methods: 120 patients were randomly divided into D1, D2, D3 and NS groups, and dexmedetomidine 0.4, 0.6, 0.8ug/kg and normal saline were administrated respectively. Patients' heart rate, systolic blood pressure and diastolic blood pressure were measured at T1-T7. The incidence of cough was recorded. Other parameters were noted, the time of spontaneous respiratory recovery and extubation, visual analogue scale scores and dosage of tramadol.Results: The heart rate, systolic blood pressure and diastolic blood pressure of D2 and D3 groups has smaller fluctuations at T2-3 and T7 compared with NS and D1 groups (P < 0.05). The incidence of cough was lower in D2 and D3 groups than NS group (P < 0.05). The visual analogue scale scores and tramadol dosage of D2 and D3 groups were lower than NS group (P < 0.05). The time of spontaneous respiratory recovery and extubation in D3 group was longer than that in D1 and D2 groups (P < 0.05). Conclusions: Intravenous infusion of 0.6ug/kg dexmedetomidine before induction can maintain hemodynamic stability, decrease cough during emergence, relieve postoperative pain of patients undergoing laparoscopic cholecystectomy.Trial registration: ChiCTR1900024801, registered at the Chinese Clinical Trial Registry, principal investigator: Qin Ye, date of registration: July 28, 2019.

scholarly journals Intraoperative Use of Analgesics in Tonsillar Fossa and Postoperative Evaluation with Visual analogue Scale Scores—A Prospective, Randomized, Placebo-Controlled, Double-Blind Clinical Trial

2019 ◽  
Vol 24 (01) ◽  
pp. e62-e67
Author(s):  
Montasir Junaid ◽  
Muhammad Sohail Halim ◽  
Maisam Abbas Shiraz Onali ◽  
Sadaf Qadeer ◽  
Hareem Usman Khan ◽  
...  
Keyword(s):  
Visual Analogue Scale ◽  
Normal Saline ◽  
Local Anesthetics ◽  
Analogue Scale ◽  
Double Blind Study ◽  
Postoperative Evaluation ◽  
Double Blind ◽  
Tonsillar Fossa ◽  
Double Blind Clinical Trial ◽  
Scale Scores

Abstract Introduction Posttonsillectomy pain results in significant morbidity to the patients. There is a disagreement in the literature regarding the use of local anesthetics during tonsillectomy. The aim of this placebo-controlled, double-blind study is to evaluate the effect of peritonsillar administration of local anesthetics. Objective To evaluate the role of intraoperative use of analgesics in tonsillar fossa and postoperative evaluation with visual analogue scale (VAS) scores in achieving pain relief after tonsillectomy procedure Methods In this study, 180 patients were randomized to 1 of the 6 groups: bupivacaine infiltration, lidocaine infiltration, normal saline infiltration, bupivacaine packing, lidocaine packing, and normal saline packing. Pain caused by speaking, swallowing, and on rest was assessed using VAS at 4, 8, 12, 16 hours, and at discharge. Results Significant analgesia was obtained in patients who received bupivacaine infiltration and packing compared with placebo (p < 0.05). The majority of the study subjects had no postoperative complications, and patients receiving bupivacaine infiltration required less additional analgesics in the first 24 hours after surgery. Conclusion We advocate the use of bupivacaine infiltration or packing immediately following the procedure to achieve adequate postoperative analgesia.

scholarly journals The Modified Iliopubic Tract Repair—A Pain-Free Alternative

2018 ◽  
Vol 04 (02) ◽  
pp. e82-e86
Author(s):  
Iqbal Ali ◽  
Vashisht Dikshit ◽  
Kshitij Manerikar ◽  
Mirat Dholakia ◽  
Maitreyee Save
Keyword(s):  
Postoperative Pain ◽  
Visual Analogue Scale ◽  
Laparoscopic Repair ◽  
Analogue Scale ◽  
Neurological Complications ◽  
Preperitoneal Repair ◽  
Scale Scores ◽  
Lower Pain ◽  
Delayed Complications ◽  
Return To Activity

Background The open preperitoneal repair offers the benefits of placing the mesh in the preferred position while avoiding the disadvantages of laparoscopic repair. Methods A total of 60 patients with bilateral inguinal hernias were randomized to undergo either the standard Lichtenstein meshplasty or the modified iliopubic tract repair in a teaching hospital. Outcomes measured were immediate postoperative pain, return to activity, and delayed neurological complications. Results Patients who underwent the iliopubic tract repair walked out of bed faster than the Lichtenstein group (6.3 hours vs 7.4 hours, p < 0.0001) and experienced significant lower pain as charted by visual analogue scale scores (3.28 vs 2.71 on day 1, 2.16 vs 1.71 on day 2, 1.92 vs 1.08 on day 3; p < 0.05). Delayed complications like chronic inguinal pain and numbness were not seen in the iliopubic tract group. However, this difference was not statistically significant (p > 0.05). Conclusion The iliopubic tract repair offers an excellent alternative to the Lichtenstein meshplasty, and is associated with lower postoperative pain, earlier return to work, and lower delayed neurological complications.

scholarly journals Preoperative Oral Pregabalin Reduces Acute Pain after Thoracotomy

2018 ◽  
Vol 6 (9) ◽  
pp. 1606-1610 ◽  
Author(s):  
Hossein Sattari ◽  
Morteza Hashemian ◽  
Mohammad Reza Lashkarizadeh ◽  
Hamid Jalalifard
Keyword(s):  
Postoperative Pain ◽  
Visual Analogue Scale ◽  
Analogue Scale ◽  
Intervention Group ◽  
Nausea And Vomiting ◽  
New Drugs ◽  
Control Group ◽  
P Value ◽  
Case Group ◽  
Significant Difference

BACKGROUND: Nowadays pain control is one of the most important challenges for physicians, surgeons and anesthesiologists. New drugs and procedures to control pain have always been a major topic for researches. AIM: In this study, we evaluated the effects of preoperative pregabalin administration on relieving postoperative pain after thoracotomy surgery. MATERIALS AND METHODS: This study is a randomised, double-blind clinical trial, performed on 60 patients who underwent thoracotomy at Afzalipour hospital in Kerman, Iran. They were divided into case and control groups. Two hours before surgery an oral capsule of 300 mg pregabalin or placebo was given to patients. All patients similarly underwent general anaesthesia. Pain, nausea and vomiting were evaluated based on the visual analogue scale (VAS) and frequency. This study was verified and obtained the ethics committee code of K/92/489 from Kerman University of Medical Sciences. RESULTS: The average age of the pregabalin group was 39.7 ± 5.8 years and the control group 41.3 ± 6.1 years. The average pain score after regaining consciousness was 6.1 ± 0.2 in the case group and 7.9 ± 0.1 in the control group, and there was a significant difference between the 2 groups (p-value = 0.002). In the control group, 2 patients and the intervention group 3 patients, experienced nausea and vomiting. There was a significant difference between the overall average pethidine consumption and the average visual analogue scale in both groups. CONCLUSION: Pregabalin administration before thoracotomy is effective to reduce postoperative pain in patients. More research is needed to determine the optimal dose of pregabalin for preoperative administration.

Randomized Controlled Trial Comparing the Effects of Vessel Sealing Device and Milligan Morgan Technique on Postoperative Pain Perception after Hemorrhoidectomy

2015 ◽  
Vol 32 (4) ◽  
pp. 258-261 ◽  
Author(s):  
Mehmet Onur Gülseren ◽  
Tolga Dinc ◽  
Vasfi Özer ◽  
Baris Yildiz ◽  
Mükerrem Cete ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Visual Analogue Scale ◽  
Analogue Scale ◽  
Pain Perception ◽  
Controlled Trial ◽  
The Third ◽  
Vessel Sealing ◽  
Scale Scores ◽  
The Difference ◽  
Group 2

Background: The aim of this study was to compare postoperative pain perception after Milligan Morgan and Ligasure™ techniques in hemorrhoidectomy. Methods: Fifty-four patients diagnosed with Grade 3-4 hemorrhoids requiring surgery between May 2013 and September 2013 were enrolled in the study. Patients were randomized into either the Ligasure™ hemorrhoidectomy group (Group 1, n = 26) or the Milligan Morgan hemorrhoidectomy group (Group 2, n = 28). Results: The difference between visual analogue scale scores on postoperative day 1 was not statistically significant but on the third postoperative day, the Ligasure™ group had higher visual analogue scale scores (4 ± 2.61) when compared to the Milligan Morgan hemorrhoidectomy group (2.43 ± 1.20). This difference on the third postoperative day visual analogue scale scores was statistically significant (p < 0.025). Conclusions: Ligasure™ does not seem to have an advantage in postoperative pain when compared to Milligan Morgan hemorrhoidectomy.

scholarly journals Effects of dexmedetomidine on intraoperative hemodynamics, recovery profile and postoperative pain in patients undergoing laparoscopic cholecystectomy: a randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Qin Ye ◽  
Fangjun Wang ◽  
Hongchun Xu ◽  
Le Wu ◽  
Xiaopei Gao
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Laparoscopic Cholecystectomy ◽  
Postoperative Pain ◽  
Visual Analogue Scale ◽  
Systolic Blood Pressure ◽  
Analogue Scale ◽  
Hemodynamic Stability ◽  
Scale Scores ◽  
Respiratory Recovery

Abstract Background To investigate the optimal dose of dexmedetomidine to maintain hemodynamic stability, prevent of cough and minimize postoperative pain for patients undergoing laparoscopic cholecystectomy. Methods One hundred twenty patients were randomly divided into D1, D2, D3 and NS groups, and dexmedetomidine 0.4, 0.6, 0.8μg/kg and normal saline were administrated respectively. Patients’ heart rate, systolic blood pressure and diastolic blood pressure were measured at T1-T7. The incidence of cough was recorded. Other parameters were noted, the time of spontaneous respiratory recovery and extubation, visual analogue scale scores and dosage of tramadol. Results The heart rate, systolic blood pressure and diastolic blood pressure of D2 and D3 groups has smaller fluctuations at T2–3 and T7 compared with NS and D1 groups (P < 0.05). The incidence of cough was lower in D2 and D3 groups than NS group (P < 0.05). The visual analogue scale scores and tramadol dosage of D2 and D3 groups were lower than NS group (P < 0.05). The time of spontaneous respiratory recovery and extubation in D3 group was longer than that in D1 and D2 groups (P < 0.05). Conclusions Intravenous infusion of 0.6μg/kg dexmedetomidine before induction can maintain hemodynamic stability, decrease cough during emergence, relieve postoperative pain of patients undergoing laparoscopic cholecystectomy. Trial registration ChiCTR1900024801, registered at the Chinese Clinical Trial Registry, principal investigator: Qin Ye, date of registration: July 28, 2019.

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