Buccal Fat Pad Excision: Hydrodissection Technique

2019 ◽  
Vol 39 (10) ◽  
pp. 1037-1045 ◽  
Author(s):  
Luis C Valencia ◽  
Giovanny F Pérez ◽  
Jordan Kaplan ◽  
Ricardo Fernández-Riera
Keyword(s):  
Postoperative Pain ◽  
Operative Time ◽  
Fat Pad ◽  
Buccal Fat Pad ◽  
Level Of Evidence ◽  
Pain Scores ◽  
Randomized Clinical Study ◽  
Maximum Pain ◽  
Group A ◽  
Group B

Abstract Background Buccal fat pad (BFP) excision is a procedure in which the fat pad is extracted in order to achieve a more youthful appearance. Objectives The aim of this study was to describe an alternative technique that utilizes hydrodissection to extract the BFP. Methods This is a controlled, prospective, randomized clinical study involving 2 groups. Group A (n = 27) underwent BFP excision with hydrodissection, during which 15 mL of a vasoconstricting anesthetic solution was injected into the BFP. Group B (n = 27) underwent BFP excision, during which 3 mL of lidocaine 2% with epinephrine was injected. All procedures were performed by the same surgeon. Variables analyzed were surgical time, intraoperative bleeding, and postoperative pain directly following surgery 2 hours after the procedure, as well as maximum pain within 72 hours of surgery and complications. Postoperative care was standardized, and patient follow-up extended over a 6-month period. Results Pain scores for 54 patients were recorded on a visual analog scale (0–10). Mean ± standard deviation transoperative pain scores were 0.5 ± 0.8 for Group A and 1.3 ± 1.3 for Group B (P = 0.01); 2 hours postoperation the scores were 1.2 ± 0.7 for Group A and 2.6 ± 1 for Group B (P < 0.0001). Maximum pain occurred within 72 hours, and scored 1.6 ± 0.6 for Group A and 3.1 ± 1 for Group B (P < 0.0001). Mean operative time was 8:18 ± 0:47 minutes for Group A and 14:08 ± 2:28 minutes for Group B (P < 0.0001). There was a positive correlation between operative time and pain. Overall, 5.5% of patients suffered postoperative complications. Conclusions BFP excision by hydrodissection is an effective procedure that decreases surgical times by facilitating extraction of the BFP with less manipulation, thereby resulting in decreased postoperative pain and a more tolerable recovery. Level of Evidence: 2

scholarly journals ELECTIVE MIDLINE LAPAROTOMY

2011 ◽  
Vol 18 (01) ◽  
pp. 106-111
Author(s):  
ARSALAN SIRAJ ◽  
ATHAR ABBAS SHAH GILANI ◽  
MUHAMMAD FAROOQ DAR ◽  
Sohail Raziq
Keyword(s):  
Postoperative Pain ◽  
Blood Loss ◽  
Wound Infection ◽  
Visual Analogue Score ◽  
P Value ◽  
Midline Laparotomy ◽  
Pain Scores ◽  
Group A ◽  
Insignificant Difference ◽  
Group B

Objectives: To compare the diathermy incision with scalpel incision in patients undergoing midline elective laparotomy. Design of Study: A prospective, experimental comparative study. Place and Duration: Department of surgery, PNS Shifa Karachi, from March 2007 to June 2008. Patients and Methods: A total of 100 patients were included in the study, and equally divided into 2 groups. Group A received scalpel incision while in group B diathermy was employed to incise all layers. Peroperative parameters including, incision time and blood loss were calculated. Postoperatively, pain was assessed by visual analogue score and wound infection documented. Results: Both groups included fifty patients each out of the total 44 females and 56 were males, with similar gender preposition in both the groups. Mean age of patients in scalpel group was 48.78 (±14.47) while it was 44.92 (±15.87) in diathermy group. The mean incision related blood loss in Scalpel group was 1.53 (±0.20) ml/cm2 and in Diathermy group was 1.43 (±0.20) ml/cm2, showing significantly less bleeding in diathermy group (p-value= 0.014). Diathermy group, with incision related time of 6.20 sec/cm2 (±0.97 sec/cm2), was significantly quicker (p-value= 0.003) than scalpel incision, with incision time of 6.76 sec/cm2 (±0.84 sec/cm2). Postoperative pain scores, recorded daily over five days, showed insignificant difference between the two groups. Conclusions: Diathermy, employed for midline laparotomy, is quicker and hemostatic, compared to the scalpel. The two are, however, similar in terms of wound infection and postoperative pain.

Caiman Versus LigaSure Hemorrhoidectomy: Postoperative Pain, Early Complications, Long-Term Follow-up, and Costs

2020 ◽  
Vol 27 (3) ◽  
pp. 272-278
Author(s):  
Chiara Eberspacher ◽  
Pietro Mascagni ◽  
Domenico Di Nardo ◽  
Daniele Pironi ◽  
Stefano Pontone ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Operative Time ◽  
Healing Time ◽  
Visual Analog Score ◽  
Historical Cohort ◽  
Long Term Follow Up ◽  
Group A ◽  
Group B

Purpose. Recently, the use of radiofrequency for hemorrhoidectomy has minimized incidence of postoperative complications. Effectiveness of LigaSure is demonstrated, but it is quite expensive. This study aims to compare LigaSure with Caiman, a cheaper instrument that uses radiofrequency for hemorrhoidectomy. Methods. A total of 35 patients were enrolled in this study between January 2015 and December 2017: 35 (Group A: Caiman) patients were matched with 35 control patients (Group B) from our historical cohort, treated with LigaSure. They were checked at 1 week after operation, at 4 weeks, and then after 2, 6, and 12 months. We considered different factors: intraoperative (operative time, number of piles removed, necessity of stiches or ligation), immediate postoperative (pain, bleeding within 4 weeks, incontinence, soiling within 4 weeks, healing time of anal wounds, return to working activities), and with a long-term follow-up. Results. There were no statistically significant differences between the 2 groups in analyzed intraoperative data: operative time (Group A 35 minutes vs Group B 33 minutes; P = .198) and stitches used. Postoperative data were comparable too, in particular pain (Group A 1 day Visual Analog Score = 6.25 vs Group B = 5.4, P = .178; Group A 1 week Visual Analog Score = 2.7 vs Group B = 1.14, P = .22) and bleeding (Group A = 2 vs Group B = 4; P = .2). Conclusions. According our initial experience, Caiman can be a safe and cheaper alternative to LigaSure for hemorrhoidectomy.

scholarly journals The Comparative Effects of Listening to Prayer Recitation and Music Therapy Intraoperatively on Postoperative Pain

2020 ◽  
Vol 17 (2) ◽  
Author(s):  
Farah Syaza Rahman ◽  
Nurlia Yahya ◽  
Nor Mohammad Md Din ◽  
Azarinah Izaham ◽  
Wan Rahiza Wan Mat
Keyword(s):  
Blood Pressure ◽  
Postoperative Pain ◽  
Music Therapy ◽  
Demographic Data ◽  
Control Group ◽  
Pharmacological Interventions ◽  
Heart Rates ◽  
Pain Scores ◽  
Group A ◽  
Group B

Introduction: Non-pharmacological interventions are considered as successful adjuncts to manage pain. We are studying the comparative effects of listening to prayer recitation and music therapy intraoperatively as non-pharmacological interventions on postoperative pain and intraoperative haemodynamics. Materials and Methods: Seventy two muslim patients with acute appendicitis requiring open, emergency appendicectomies under general anaesthesia were recruited and randomised into three groups: Group A: patients who listened to prayer recitation, Group B: patients who listened to music, Group C: control group - patients who did not listen to any prayer or music. Intraoperative blood pressure, heart rate and postoperative pain scores were monitored. Results: The demographic data, pre- and post-headphones application haemodynamics were compared. There were significantly lower heart rates at 10, 20, 30, 40, 50, 60 minutes for Group A and at 50 and 60 minutes for Group B patients when compared to Group C. Significant reduction in postoperative pain scores were seen in Group A patients at 30 minutes and 8 hours as compared to Group C patients. No significant differences in pain scores were seen between Group B and C patients. No significant differences in additional analgesic requirements postoperatively were seen in all three groups. Conclusion: Listening to prayer recitation or music intraoperatively significantly lowered intraoperative heart rates, however only prayer recitation significantly reduced postoperative pain scores as compared to the control group.

scholarly journals The treatment of chondral lesions of the knee with the microfracture technique and platelet-rich plasma

Joints ◽  
2013 ◽  
Vol 01 (04) ◽  
pp. 167-170 ◽  
Author(s):  
Andrea Manunta ◽  
Anna Manconi
Keyword(s):  
Platelet Rich Plasma ◽  
Femoral Condyle ◽  
Healing Process ◽  
International Knee Documentation Committee ◽  
Level Of Evidence ◽  
Chondral Lesions ◽  
Randomized Clinical Study ◽  
Group A ◽  
Ikdc Score ◽  
Group B

Purpose: to assess the efficacy of associating the microfracture technique with platelet-rich plasma (PRP) injections in the treatment of chondral lesions to promote acceleration and optimization of the healing process compared with the traditional microfracture approach. Methods: from September 2011 to August 2012, 20 patients (9 males and 11 females, aged 30-55 years) were treated. All presented with chondral lesions of the medial femoral condyle of the knee and a pain duration ranging from 8 to 12 months.The patients were randomized into two groups (A and B). Group A was treated with the microfracture technique and a total of three intra-articular injections of PRP. Group B was treated with microfractures alone. Clinical follow-up was performed at 3, 6 and 12 months after treatment. Clinical function was assessed on the basis of the International Knee Documentation Committee (IKDC) score. Pain was evaluated using a visual analogue scale (VAS) Results: the patients in group A had a mean baseline IKDC score of 31.2, which rose to 84.2 at 12 months. The IKDC scores in group B were at 30.1 at baseline and 81 at 12 months. Conclusions: the results of our study suggest that functional recovery and resolution of pain are obtained more quickly in PRP-treated patients. We also observed a better functional outcome in the patients treated with the combination of PRP and microfractures, even at 12 months, although the difference was not statistically significant. Level of evidence: level II, randomized clinical study.

Clinical trial to assess role of ketamine in post operative analgesia after laparoscopic cholecystectomy

2021 ◽  
Vol 23 (05) ◽  
pp. 421-432
Author(s):  
Dr. Mohammad Kheiri Mahmod ◽  
◽  
Dr. Bashar Naser Hussein ◽  
Dr. Ammar Hamid Hanoosh ◽  
◽  
...  
Keyword(s):  
Clinical Trial ◽  
Laparoscopic Cholecystectomy ◽  
Postoperative Pain ◽  
Analgesic Effect ◽  
Analgesic Requirement ◽  
Pain Scores ◽  
Post Operative Pain ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: The physiological consequences of post-operative pain including Stress response to surgery, Respiratory complications, cardiovascular complications, Thromboembolic complications, Gastrointestinal complications, Musculoskeletal complications and Psychological complications, all of which could delay or impair postoperative recovery and increase the economic cost of surgery as a result of the longer period of hospitalization. Inadequate post-operative pain control may also lead to the development of chronic pain after surgery .Aim of This study: is to evaluate the preemptive analgesic effect of intravenous ketamine in laparoscopic cholecystectomy. Patients and Methods: double blinded randomized clinical trial conducted at Al-Yarmouk teaching hospital, over a period of one year from March 2013 to March 2014 on a total of 120 adult patients scheduled for elective laparoscopic cholecystectomy, Patients were divided in to three groups of 40 patients each, the study drug administered intravenously during induction. Groups A and B received ketamine in a dose of 1 and 0.5 mg/kg, respectively, whereas group C received isotonic saline. The degree of pain at rest and deep breathing postoperatively were estimated using VAS, time of first analgesic dose, total opioid consumption, nausea, vomiting and hallucination were recorded for 24 h postoperatively. Results: postoperative pain scores were significantly low in group A when compared with the other groups at most times in the first 24 hours. Highest pain score was in group C at 0 h. Postoperative analgesic consumption was minimum in group A then group B and highest in group C. There was little significant difference in the pain scores between groups B and C. Group A had a significantly higher blood MAP than group B at 0, 0.5 and 1 h. 7.5% incidence of hallucinations were in group A. Conclusion: According to this study we conclude that preemptive ketamine in a dose of 1 mg/kg has a definitive role in reducing postoperative pain and analgesic requirement in patients undergoing laparoscopic cholecystectomy. A low dose of 0.5 mg/kg had little significant in preemptive analgesic effect and in reducing analgesic requirement.

scholarly journals Use of Pregabalin as a Pre-Medication for Post-Operative pain in patients undergoing Laparoscopic Cholecystectomy

2019 ◽  
Vol 8 (1) ◽  
pp. 29-33
Author(s):  
Tabish Hussain ◽  
Asifa Anwar Mir ◽  
Jawad Zahir ◽  
Pervaiz Minhas
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Pain ◽  
P Value ◽  
Chi Square ◽  
Vas Score ◽  
Pain Scores ◽  
Post Operative Pain ◽  
Operative Evaluation ◽  
Group A ◽  
Group B

Background: Postoperative pain creates complications by increasing circulating level of catecholamines and systemic vascular resistance, thus putting the patients on increased risks of having stroke and myocardial infarction. In addition, it increases hospital stay, causing burden over economic as well as healthcare infrastructure. The aim of this study was to determine the frequency of pain in the postoperative period while using Pregabalin as pre-medication among patients undergoing laparoscopic cholecystectomy.Material and Methods: The randomized control trail was conducted at Department of Anesthesiology, Holy Family hospital, Rawalpindi from 1st Sept 2015 to 28th Feb 2016 over a period of 6 months. A total of 200 patients undergoing laparoscopic cholecystectomy were randomly divided in group A and B by consecutive non-probability lottery method. Group A received 100 mg oral Pregabalin 1 hour before surgery and Group B were not given Pregabalin and were taken as controls. Post-operative pain was measured by visual analog scale (VAS) in terms of pain scores at 4 hours postoperatively after the arrival of patient in the post-anesthesia care unit (PACU). SPSS version 17.0 was used to analyze the data.Results: A total of 200 patients were included in the study. There were 100 patients in each group. Based on the visual analog pain scores, 9 patients were pain free in group A compared with none in group B. Similarly, there were 55 patients in group A, who reported a pain score of 1 whereas no patient in group B had a VAS score of 1. There were 29 patients in group A and only 3 patients in group B with VAS score of 2 (90.6% vs. 9.4%). For VAS score of 3, there were 6 patients in group A and 34 patients from group B (15% vs. 85%). For a VAS score of 4, there were 1 patient in group A and 61 patients in group B (1.6% vs. 98.4%). Two patients in group B experienced a VAS score of 5. All this data was significant with chi square p value of 0.0001.Conclusion: Oral Pregabalin administered prior to laparoscopic cholecystectomy was effective in reducing postoperative pain in the patients. Further studies are needed for post-operative evaluation of side effects, different dosing schedules at different time intervals for both rest and dynamic pain.

scholarly journals Effectiveness of TENS and home exercises as an adjunct to drug therapy in the management of myogenous masticatory pain: a comparative study

2021 ◽  
Vol 27 (3) ◽  
pp. 40
Author(s):  
Suresh Kandagal Veerabhadrappa ◽  
Thurka Devi Anbananthan ◽  
Chee Xin Ying ◽  
Priyadarshini Hesarghatta Ramamurthy ◽  
Seema Yadav ◽  
...  
Keyword(s):  
Temporomandibular Disorder ◽  
Prospective Clinical Study ◽  
Pain Scores ◽  
Maximum Pain ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Post Hoc ◽  
Pain Patients ◽  
One Way Anova

Introduction: Pain relief is the primary goal of treatment in patients with myogenous temporomandibular disorder. This study evaluated the effectiveness of TENS and Home exercises as an adjunct to drugs in relieving myogenous masticatory pain. Materials and methods: This prospective clinical study was conducted on 60 patients with myogenous masticatory pain. Patients were randomly allocated into three groups of 20 patients each. Patients in Group A received TENS and drugs, while patients in Group B received home exercises and drugs and Group C received drugs only. The drugs prescribed were Diclofenac 50 mg and Orphenadrine 100 mg, to be taken twice daily for 5 days. All patients were followed up for three weeks. The severity of pain was recorded using the Visual Analog Scale. Inter and intragroup differences in the pain scores were analyzed using one-way ANOVA along with post hoc Tukey's test, and Paired t-test, respectively. p < 0.05 was considered as statistically significant. Results: There was a significant reduction in the mean pain scores in all the three groups at 1st, 2nd, and 3rd post-treatment weeks as compared to the baseline scores with p < 0.001. However, when the pain scores were compared across groups, maximum pain reduction was observed in group A (0.2 ± 0.04), followed by group B (0.5 ± 0.06), and the least reduction was noticed in group C (2.1 ± 0.8). This result was significant with p < 0.001. Conclusion: Both TENS and Home exercises program were effective as adjuncts to drugs, in controlling myogenous masticatory pain, as compared to drugs alone.

scholarly journals A comparative study to evaluate milligan morgan hemorrhoidectomy versus pile suture method in management of haemorrhoids

2021 ◽  
Vol 8 (2) ◽  
pp. 664
Author(s):  
Aditya . ◽  
Kuldeep Raj ◽  
P. N. Agarwal ◽  
Md Abu Nasar
Keyword(s):  
Return To Work ◽  
Hospital Stay ◽  
Operative Time ◽  
Suture Technique ◽  
Pain Scores ◽  
Early Return ◽  
Suture Group ◽  
Group A ◽  
The Mean ◽  
Group B

Background: A pile suture technique was described originally by the Farag in 1978 was better in terms of post- operative pain, bleeding, hospital stay and early return to work which are the distressing effects of conventional Milligan Morgan  Hemorrhoidectomy which is well accepted surgical procedure for haemorrhoids. This study is designed to compare the pile suture and Milligan Morgan Hemorrhoidectomy.Methods: After fulfilling the criteria, 60 patients were randomly allocated to the group A (Pile Suture [PS] n -30) and group B (Milligan Morgan Hemorrhoidectomy [MM] n – 30). The techniques were evaluated with respect to the operative time, pain scores, bleeding, hospital stay, return to work, and recurrence.Results: The mean age of patients was 44.33 years and 42.77 years in the pile suture group and MM group respectively. Grade III or IV hemorrhoids were more common in men (i.e., 80% and 60% in the pile suture and MM group, respectively). The mean operative time was shorter in the PS 20.10 minutes versus 51.47 minutes in the MM group (P .001). The bleeding and pain scores were less in the PS. Mean hospital stay was 4 days and 6.6 days  in the PS and MM group, respectively. The patients in the pile suture group returned to their routine activities earlier (i.e., within 7.33 days) as compared with 16.87 days in the MM group.Conclusions: Therefore, pile suture method can be considered as less traumatic for the patients and method can be recommended as a safer alternative to Milligan Morgan haemorrhoidectomy. 

scholarly journals Comparative randomized controlled clinical trial of diathermy versus scalpel incision in midline laparotomy

2018 ◽  
Vol 6 (1) ◽  
pp. 28
Author(s):  
Bhavin P. Vadodariya ◽  
Nimish J. Shah ◽  
Mrudul Patel
Keyword(s):  
Postoperative Pain ◽  
Blood Loss ◽  
Controlled Clinical Trial ◽  
Complication Rates ◽  
Midline Laparotomy ◽  
Medical College ◽  
Randomized Clinical Study ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Laparotomy incisions have traditionally been made using a scalpel. Diathermy, a latest technique, is thought to increase the risk of infection, impair healing and decrease cosmesis. Recent studies suggest that diathermy may offer likely advantages with respect to blood loss, incision time and postoperative pain. The aim of this study was to compare the efficacy and safety of surgical diathermy incisions versus conventional scalpel incisions for midline laparotomy in our hospital with an aim to evaluate diathermy as an operational alternative to scalpel incision.Methods: This was a prospective randomized clinical study which was conducted in the surgical wards of Medical College & SSG hospital, Vadodara, between December 2013 and December 2014.  Patients were randomly assigned to two groups i.e. Group A (scalpel group) and Group B (diathermy group).Results: A total of 148 patients were enrolled in the study. Of these, 74 patients were randomized to Group A (scalpel group) and 74 patients to Group B (diathermy group). The two groups did not vary significantly in relation to age and sex (p>0.001). Laparotomy skin incisions using diathermy were significantly quicker than scalpel incisions (p=0.624). There was significantly less blood loss in the diathermy group compared with the scalpel group (P=0.15). The mean visual analogue scale was significantly reduced more in the diathermy group than in scalpel group patients on postoperative day 1 (p=0.81), day 3 (p=0.71) and day 5 (p=0.79) respectively. Postoperative complication rates did not differ significantly between the scalpel and diathermy groups (p=0.624).Conclusions: We concluded that diathermy incision in midline laparotomy has significant advantages compared with the scalpel because of reduced incision time, less blood loss, reduced early postoperative pain and postoperative wound infection.

scholarly journals Intraperitoneal analgesia to reduce pain after laparoscopic hysterectomy

2017 ◽  
Vol 6 (8) ◽  
pp. 3235 ◽  
Author(s):  
Amira Mohammed Badawy
Keyword(s):  
Postoperative Pain ◽  
Primary Outcome ◽  
Laparoscopic Hysterectomy ◽  
Visual Analogue Score ◽  
Local Anaesthetics ◽  
Nausea And Vomiting ◽  
Pain Scores ◽  
Post Operative Pain ◽  
Group A ◽  
Group B

Background: Laparoscopic hysterectomy is now an established operation, as it is less invasive and carries much less post-operative pain compared to open hysterectomy. However, post-laparoscopy analgesia is still a challenge. Intraperitoneal (IP) instillation of local anaesthetics has been shown to minimize postoperative pain after laparoscopic surgeries. This study was conducted to evaluate the efficacy of IP instillation of dilute analgesia prior the end of laparoscopic hysterectomy to reduce postoperative pain. The primary outcome was to assess postoperative pain scores. Secondary outcomes included assessment of postoperative analgesic requirements (type, amount, and timing), and frequency of nausea and vomiting.Methods: 20 cases were enrolled for laparoscopic hysterectomy and were divided randomly into two groups, Group A: 10 cases, where IP analgesia (Bupivacaine and Magnesium Sulphate) was instilled -under vision- prior removal of trocars, and Group B: 10 cases, where no IP analgesia was used. After surgery, Visual Analogue Score (VAS) was recorded at 6, 12, 24 hours and 7 days. Postoperative analgesic requirements (type, amount, and timing), and frequency of nausea and vomiting were also recorded.Results: The overall VAS during the first postoperative 24 hours was significantly lower in group A (P = 0.048, 0.049, and 0.003 at 6, 12, and 24 hours after surgery). Time to first of analgesia required (in hours) was longer (6.0±1.41 vs 3.20±1.48, P = 0.004) and total analgesic consumption (in mg) was lower (2.40±0.89 vs 3.30±0.67, P = 0.047) in group A compared to group B. The need for opioids was also significantly less in group A (3 cases vs 8 cases, P = 0.024). in group A, nausea and vomiting were less reported as well (P = 0.040).Conclusions: The instillation of local IP dilute analgesia is an effective and safe method for reducing pain after laparoscopic hysterectomy.

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