Transdermal Nitroglycerine Enhances Spinal Sufentanil Postoperative Analgesia following Orthopedic Surgery 

1999 ◽  
Vol 90 (3) ◽  
pp. 734-739 ◽  
Author(s):  
Gabriela R. Lauretti ◽  
Raquel de Oliveira ◽  
Marlene P. Reis ◽  
Anita L. Mattos ◽  
Newton L. Pereira
Keyword(s):  
Adverse Effects ◽  
Visual Analog Scale ◽  
Postoperative Analgesia ◽  
Orthopedic Surgery ◽  
The Other ◽  
Control Group ◽  
Analog Scale ◽  
Analgesic Medication ◽  
Scale Scores ◽  
Pain Visual Analog Scale

Background Sufentanil is a potent but short-acting spinal analgesic used to manage perioperative pain. This study evaluated the influence of transdermal nitroglycerine on the analgesic action of spinal sufentanil in patients undergoing orthopedic surgery. Methods Fifty-six patients were randomized to one of four groups. Patients were premedicated with 0.05-0.1 mg/kg intravenous midazolam and received 15 mg bupivacaine plus 2 ml of the test drug intrathecally (saline or 10 microg sufentanil). Twenty to 30 min after the spinal puncture, a transdermal patch of either 5 mg nitroglycerin or placebo was applied. The control group received spinal saline and transdermal placebo. The sufentanil group received spinal sufentanil and transdermal placebo. The nitroglycerin group received spinal saline and transdermal nitroglycerine patch. Finally, the sufentanil-nitroglycerin group received spinal sufentanil and transdermal nitroglycerine. Pain and adverse effects were evaluated using a 10-cm visual analog scale. Results The time to first rescue analgesic medication was longer for the sufentanil-nitroglycerin group (785+/-483 min) compared with the other groups (P<0.005). The time to first rescue analgesics was also longer for the sufentanil group compared with the control group (P<0.05). The sufentanil-nitroglycerin group group required less rescue analgesics in 24 h compared with the other groups (P<0.02) and had lesser 24-h pain visual analog scale scores compared with the control group (P<0.005), although these scores were similar to the sufentanil and nitroglycerin groups (P>0.05). The incidence of perioperative adverse effects was similar among groups (P>0.05). Conclusions Transdermal nitroglycerine alone (5 mg/day), a nitric oxide generator, did not result in postoperative analgesia itself, but it prolonged the analgesic effect of spinal sufentanil (10 microg) and provided 13 h of effective postoperative analgesia after knee surgery.

Transdermal Nitroglycerine Enhances Spinal Neostigmine Postoperative Analgesia following Gynecological Surgery

2000 ◽  
Vol 93 (4) ◽  
pp. 943-946 ◽  
Author(s):  
Gabriela R. Lauretti ◽  
Ana-Paula M. Oliveira ◽  
Maria-do-Carmo C. Julião ◽  
Marlene P. Reis ◽  
Newton L. Pereira
Keyword(s):  
Adverse Effects ◽  
Visual Analog Scale ◽  
Postoperative Analgesia ◽  
Visual Analog Scale Score ◽  
Spinal Pain ◽  
Gynecologic Surgery ◽  
Control Group ◽  
Sensory Level ◽  
Analog Scale ◽  
American Society

Background Intrathecal neostigmine causes analgesia by inhibiting the breakdown of acetylcholine. Experimental data suggest that the production of endogenous nitric oxide is necessary for tonic cholinergic inhibition of spinal pain transmission. The purpose of this study was to determine whether association of transdermal nitroglycerine would enhance analgesia from a low dose of intrathecal neostigmine in patients undergoing gynecologic surgery during spinal anesthesia. Methods Forty-eight patients were randomized to one of four groups. Patients were premedicated with use of 0.05-0.1 mg/kg intravenous midazolam and received 15 mg bupivacaine plus 1 ml test drug intrathecally (saline or neostigmine, 5 microgram). Twenty to 30 min after the spinal puncture, a transdermal patch of either 5 mg nitroglycerin or placebo was applied. The control (Con) group received spinal saline and transdermal placebo. The neostigmine group received spinal neostigmine and transdermal placebo. The nitroglycerin group received spinal saline and a transdermal nitroglycerine patch. Finally, the neostigmine-nitroglycerin group received spinal neostigmine and transdermal nitroglycerine. Pain and adverse effects were evaluated using a 10-cm visual analog scale. Results Patients in the groups were similar regarding age, weight, height, and American Society of Anesthesiologists status. Sensory level to pin prick at 10 min, surgical duration, anesthetic duration, and visual analog scale score for pain at the time of administration of first rescue medication were statistically the same for all groups. The time to administration of first rescue analgesic (min) was longer in the neostigmine-nitroglycerin group (550 min; range, 458-1,440 min; median, 25-75th percentile) compared with the other groups (P < 0.001). The neostigmine-nitroglycerin group required fewer rescue analgesics in 24 h than did the control group (P < 0.0005), whereas the neostigmine group required less analgesics compared with the control group (P < 0.02). The incidence of perioperative adverse effects (nausea, vomiting, headache, back pain) was similar among groups (P > 0.05). Conclusion Although neither intrathecal 5 microgram neostigmine alone nor transdermal nitroglycerine alone (5 mg/day) delayed the time to administration of first rescue analgesics, the combination of both provided an average of 14 h of effective postoperative analgesia after vaginoplasty, suggesting that transdermal nitroglycerin and the central cholinergic agent neostigmine may enhance each other's antinociceptive effects at the dose studied.

scholarly journals EFFICACY AND SAFETY OF CURCUMA LONGA EXTRACT IN THE TREATMENT OF OSTEOARTHRITIS: A SYSTEMATIC REVIEW

2019 ◽  
pp. 140-145
Author(s):  
ALESSA FAHIRA ◽  
ALLYSA SORAYA ◽  
ARMAND ACHMADSYAH ◽  
RANI WARDANI HAKIM
Keyword(s):  
Adverse Effects ◽  
Randomized Controlled Trials ◽  
Visual Analog Scale ◽  
Curcuma Longa ◽  
Control Group ◽  
Controlled Trials ◽  
Analog Scale ◽  
Randomized Controlled ◽  
Natural Remedies

Objective: Osteoarthritis (OA) is a chronic disease caused by inflammation of the tissue and bony structure of the joint, which affects more than 235 million people worldwide. Due to the adverse effects caused by the long-term use of standard treatment of OA, the attempt to find natural remedies to treat chronic diseases continues to rise. Curcuma longa is known to have anti-inflammatory effects, which may impact the pathophysiology of OA. While many randomized controlled trials show the efficacy of Curcuma longa extract in the treatment of OA, there has been no comprehensive review of this evidence. Methods: We systematically searched PubMed, Cochrane, Scopus, ProQuest, EBSCOhost, and ScienceDirect for randomized controlled trials that evaluated Curcuma longa extract (CE extract) vs. control (placebo or other therapy). Three trials were identified. Data were then extracted from the studies and summarized descriptively. Results: Across all trials, Curcuma longa therapy was proven to reduce Visual Analog Scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores significantly compared to the control group. Adverse effects were less likely to appear in patients treated with Curcuma longa extract compared to other groups. Conclusion: CL extract is beneficial as an alternative medication for OA treatment, shown by the reduced scores of the Visual Analog Scale (VAS) and WOMAC in all studies we reviewed.

scholarly journals PCP8: ASSESSMENT OF SURGICAL ANESTHESIA AND POSTOPERATIVE ANALGESIA USING A PAIN VISUAL ANALOG SCALE

1999 ◽  
Vol 2 (3) ◽  
pp. 208
Author(s):  
Y Yfantopoulos ◽  
A Athanasiadis ◽  
A Karokis ◽  
V Tsekouras ◽  
G Yourgioti ◽  
...  
Keyword(s):  
Visual Analog Scale ◽  
Postoperative Analgesia ◽  
Analog Scale ◽  
Pain Visual Analog Scale

The effects of oral pregabalin on post-Lichtenstein herniorrhaphic pain: a randomized clinical trial

2018 ◽  
Vol 29 (4) ◽  
pp. 321-327 ◽  
Author(s):  
Mohammad Hossein Moghimi ◽  
Seyed Nejat Hosseini ◽  
Vahid Salehi ◽  
Kourosh Kamali
Keyword(s):  
Clinical Trial ◽  
Pain Relief ◽  
Adverse Effects ◽  
Randomized Clinical Trial ◽  
Visual Analog Scale ◽  
The Elderly ◽  
Control Group ◽  
Gamma Aminobutyric Acid ◽  
Analog Scale ◽  
Post Surgery

Abstract Background Pregabalin is a gamma-aminobutyric acid analog which seems to be effective in different neuropathic pains, as well as in incisional and inflammatory injuries. This study evaluated the effectiveness and safety of pregabalin on pain relief post herniorrhaphy. Methods In this randomized clinical trial, 60 men were chosen for unilateral inguinal herniorrhaphy under spinal anesthesia. The participants were randomly divided into two groups. The investigation (pregabalin) group received 300 mg of oral pregabalin 2 h before and 150 mg of pregabalin 12 and 24 h after surgery in addition to routine postoperative medication and 1 mg/kg of pethidine as needed. The control (placebo) group received placebo capsules similar to the investigation group, as well as routine medication and 1 mg/kg of pethidine as needed. All surgeries were done with the same technique. Post-surgery pain was evaluated in the walking and lying positions with a visual analog scale at 12 and 24 h and at 3 and 7 days after the surgery. Pethidine consumption and adverse effects of pregabalin were also assessed. Results The investigation group had less pain and lower visual analog scale scores at 12 and 24 h and also at 3 days after surgery and consumed less pethidine compared to the control group (p<0.05). Conclusions Pregabalin reduces pain and opioid consumption in the first 3 days after surgery. The adverse effects of pregabalin are limited to the first 12 h after surgery. Pregabalin can be suggested for pain relief, but it should be used with caution in the elderly.

Comparison of Two Concentrations of Triamcinolone Injection in the Prevention of Supratip Edema after External Rhinoplasty: A Randomized Trial

2017 ◽  
Vol 31 (6) ◽  
pp. 412-415 ◽  
Author(s):  
Babak Saedi ◽  
Amin Amali ◽  
Mina Arabpor
Keyword(s):  
Visual Analog Scale ◽  
Study Groups ◽  
Control Group ◽  
Analog Scale ◽  
Significant Difference ◽  
Triamcinolone Injection ◽  
Scale Scores ◽  
Photo Editing ◽  
Group B ◽  
External Rhinoplasty

Background A comparison of the two methods of corticosteroid (triamcinolone) use in reducing supratip edema (pollybeak deformity) after rhinoplasty. Methods Ninety patients who were candidates for rhinoplasty were randomly divided into three groups. Group A received no treatment, group B received 8 mg/mL of triamcinolone, and group C received 16 mg/mL of triamcinolone. Their effects on dorsal edema were evaluated by using the patients' and surgeons' visual analog scale scores. Also, dorsal edema was measured by using photo editing software. Results There was no significant difference in the patients' characteristics in the study groups. The surgeons' visual analog scale scores were significantly better in those patients who received triamcinolone injection than in the control group (p = 0.02). However, none of the other assessment methods showed significant differences among the study groups. There was no significant difference between the two evaluated concentrations. Conclusion Triamcinolone injection had positive temporary effects on reducing supratip edema without any important complications.

Study of Three Different Doses of Epidural Neostigmine Coadministered with Lidocaine for Postoperative Analgesia

1999 ◽  
Vol 90 (6) ◽  
pp. 1534-1538. ◽  
Author(s):  
Gabriela R. Lauretti ◽  
Raquel de Oliveira ◽  
Marlene P. Reis ◽  
Maria-do-Carmo C. Juliao ◽  
Newton L. Pereira
Keyword(s):  
Adverse Effects ◽  
Scale Score ◽  
Visual Analog Scale ◽  
Visual Analog Scale Score ◽  
Orthopedic Procedures ◽  
Control Group ◽  
Analog Scale ◽  
Analgesic Consumption ◽  
Group 2 ◽  
Group 1

Background Intrathecal neostigmine produces analgesia in volunteers and patients. However, the use of epidural neostigmine has not been investigated. The purpose of the current study was to define the analgesic effectiveness of epidural neostigmine coadministered with lidocaine and side effects in patients after minor orthopedic procedures. Methods After Institutional Review Board approval and informed consent, 48 patients (n = 12) undergoing knee surgery were randomly allocated to one of four groups and studied in a prospective way. After 0.05-0.1 mg/kg intravenous midazolam premedication, patients were randomized to receive 20 mg intrathecal bupivacaine plus epidural lidocaine (85 mg) with saline (control group); 1 microg/kg epidural neostigmine (1 microg group); 2 microg/kg epidural neostigmine (2 microg group); or 4 microg/kg epidural neostigmine (4 microg group). The concept of the visual analog scale, which consisted of a 10-cm line with 0 equaling "no pain at all" and 10 equaling "the worst possible pain" was introduced. Postoperatively, pain was assessed using the visual analog scale, and intramuscular 75 mg diclofenac was available at patient request. Results Groups were demographically the same and did not differ in intraoperative characteristics (blood pressure, heart rate, ephedrine consumption, oxyhemoglobin saturation, sensory loss before start of surgery, or duration of sensory motor block). The visual analog scale score at first rescue analgesic and the incidence of adverse effects were similar among groups (P &gt; 0.05). The time (min +/- SD) to first rescue analgesic was as follows: control group: 205+/-48; 1-microg group: 529+/-314; 2-microg group: 504+/-284; 4-microg group: 547+/-263 (P &lt; 0.05). The analgesic consumption (number of intramuscular diclofenac injections [mean, 25th-75th percentile]) in 24 h was as follows: control group: 3 [3 or 4]; 1-microg group: 1 [1 or 2]; 2-microg group: 2 [1 or 2]; 4-microg group: 2 [1-3] (P &lt; 0.05). The 24-h-pain visual analog scale score (cm +/- SD) that represents the overall impression for the last 24 h was as follows: control group: 5+/-1.6; 1-microg group: 1.6+/-1.8; 2-microg group: 1.4+/-1.6; 4-microg group: 2.2+/-1.9 (P &lt; 0.005). The incidence of adverse effects was similar among groups (P &gt; 0.05). Conclusion Epidural neostigmine (1, 2, or 4 microg/kg) in lidocaine produced a dose-independent analgesic effect (approximately 8 h) compared to the control group (approximately 3.5 h), and a reduction in postoperative rescue analgesic consumption without increasing the incidence of adverse effects.

Effect of Intermittent Hypoxia Training for Dizziness: A Randomized Controlled Trial

2019 ◽  
Vol 28 (6) ◽  
pp. 540-543
Author(s):  
Xiao Bao ◽  
Jie-Wen Tan ◽  
Ying Long ◽  
Howe Liu ◽  
Hui-Yu Liu
Keyword(s):  
Visual Analog Scale ◽  
Intermittent Hypoxia ◽  
Controlled Trial ◽  
Control Group ◽  
Analog Scale ◽  
Dizziness Handicap Inventory ◽  
Balance Confidence ◽  
Randomized Controlled ◽  
Scale Scores ◽  
Confidence Scale

Objective: To study the effect of intermittent hypoxia training (IHT) for dizziness. Design: A single-blind, randomized controlled trial. All participants were recruited from a rehabilitation department in an acute university-affiliated hospital. Intervention: Participants with dizziness were randomly assigned to 2 groups (IHT group and control group). The Dizziness Handicap Inventory, Activities-specific Balance Confidence Scale, and Vertigo Visual Analog Scale were conducted at baseline, end of the fourth week. Results: Among 52 subjects, there were18 males and 34 females, ages 35 to 62 years old (mean [SD] = 46.9 [7.93]). Time length since onset ranged from 12 to 34 months (20.2 [7.15] mo). Dizziness Handicap Inventory, Activities-specific Balance Confidence Scale, Vertigo Visual Analog Scale scores, and attack frequencies of dizziness were improved after IHT intervention in the end of the fourth week. There were significant differences between the IHT group and the control group in the Dizziness Handicap Inventory, Activities-specific Balance Confidence Scale, Vertigo Visual Analog Scale scores, and attack frequencies of dizziness at the end of the fourth week (P < .05). No adverse events occurred during the study. Conclusion: IHT could improve dizziness after intervention at the end of the fourth week. IHT could be the effective method for treating dizziness.

P–060 Dose- dependent mitigation of lead acetate toxicity in males on embryo development in female mice

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
P Dolati ◽  
M J Zamiri ◽  
A Akhlaghi ◽  
Z Jahromi
Keyword(s):  
Adverse Effects ◽  
Embryonic Development ◽  
Embryo Development ◽  
Lead Acetate ◽  
Endocrine System ◽  
Cell Number ◽  
The Other ◽  
Control Group ◽  
Male Mice ◽  
Female Mice

Abstract Study question Does quercetin (75 or 100 mg/kg BW/day) co-administration with lead acetate to male mice affects embryonic development in female mice? Summary answer The low-dose quercetin (75 mg/kg BW/day) ameliorated the adverse effects of lead acetate on mouse embryogenesis. What is known already Lead causes male infertility by impacting on endocrine system and spermatogenesis, and may exert undesirable effects on the offspring. The currently approved treatment for lead poisoning is the use of chelating agents, which form an insoluble complex with lead and shield it from biological targets; thus, reducing its toxicity. One of the main mechanisms of lead-induced toxicity is oxidative stress, and it has been reported that natural antioxidants can reduce the heavy metals toxicity. The aim of the present study was to examine the protective effects of quercetin on the toxicity induced by lead acetate on the embryogenesis in mice. Study design, size, duration Sexually mature (eight-week-old) NMRI male mice (n = 24) were randomly divided into four groups (n = 6 per group) receiving (i) distilled water (control group); (ii) lead acetate (150 mg/kg BW/day) dissolved in deionized water (LA); (iii) lead acetate (150 mg/kg BW/day) + quercetin (75 mg/kg BW/day) (LQ75); (IV) lead acetate (150 mg/kg BW/day) + quercetin (100 mg/kg BW/day) (LQ100). Treatments were applied daily as oral gavages for one cycle of the seminiferous epithelium (35 days). Participants/materials, setting, methods At the end of treatment administration, the males were joined with super-ovulated females, and the retrieved zygotes were cultured for evaluation of the embryo development (at 2-cell, 4-cell, 8-cell, and blastocyst stages), and blastocyst cell number using differential staining (propidium iodide and bisbenzimide). After incubation of capacitated sperm with oocytes, an ultraviolet light microscope was used following 3 min incubation with 25 µg⁄mL bisbenzamide solution for fertilization assessment. Main results and the role of chance Lead acetate (LA) treatment of male mice decreased the 2-cell stage compared with the control group (P &gt; 0.05). There was no difference between control and LQ75, and between LA and LQ100. The other stages of embryonic development were not significantly affected by the treatment. Overall, early embryonic development in the control and LQ75 mice were better than LQ100 and LA mice. The number of cells in the trophectoderm and inner-cell mass were not affected by treatments. However, the total blastocyst cell number in the control was higher than in the other groups; there was no significant difference between LQ100, LQ75 and LA groups. Fertilization rate was not affected by the treatments (P &lt; 0.05). Quercetin acts as a potent antioxidant at low doses, but at high doses exerts a pro-oxidant action. According to previous reports, higher concentrations of quercetin increased apoptosis and necrosis while decreasing the activities of the antioxidant enzymes. Also, it has been suggested that quercetin might disrupt the endocrine system and interfere with Sertoli cell function and sperm motility. Limitations, reasons for caution A limitation of this study is narrow dose selection; more studies are needed to determine the effective dose of quercetin in ameliorating the lead toxicity. There are also side effects of lead-quercetin chelates such as metal redistribution, essential metal loss, accumulation and persistency in intracellular sites, and peroxidation. Wider implications of the findings: Lead administration adversely impacted on the embryogenesis; on the other hand, paternal quercetin co-administration somewhat ameliorated the adverse effects of lead on mice embryogenesis. Trial registration number Not applicable

The Pain Visual Analog Scale: Is It Linear or Nonlinear?

1999 ◽  
Vol 89 (6) ◽  
pp. 1517 ◽  
Author(s):  
Paul S. Myles ◽  
Sally Troedel ◽  
Michael Boquest ◽  
Mark Reeves
Keyword(s):  
Visual Analog Scale ◽  
Analog Scale ◽  
Pain Visual Analog Scale
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