Preoperative Anxiolysis and Postoperative Recovery in Women Undergoing Abdominal Hysterectomy

2001 ◽  
Vol 94 (3) ◽  
pp. 415-422 ◽  
Author(s):  
Zeev N. Kain ◽  
Ferne B. Sevarino ◽  
Christine Rinder ◽  
Sharon Pincus ◽  
Gerianne M. Alexander ◽  
...  
Keyword(s):  
Treatment Group ◽  
Postoperative Pain ◽  
Abdominal Hysterectomy ◽  
Group Differences ◽  
Mcgill Pain Questionnaire ◽  
Patient Controlled Analgesia ◽  
Significant Group ◽  
Time Points ◽  
Clinical Recovery ◽  
To Receive

Background Every year, millions of patients receive sedatives for reduction of anxiety before surgery, but there is little objective data on the effect of this treatment on postoperative outcomes. To address this issue, the effects of benzodiazepine administration were evaluated in women undergoing abdominal surgery. Methods Patients were randomized to receive 1 mg of oral lorazepam the night before surgery and 5 mg of intramuscular midazolam on the morning of surgery (n = 34), or to receive a placebo the night before surgery and on the morning of surgery (n = 36). Postoperative pain (Visual Analogue Scale for pain, McGill Pain Questionnaire) and analgesic consumption (patient-controlled analgesia), and clinical recovery parameters such as time to discharge from hospital were evaluated after surgery. Results Patient-controlled analgesia use showed a marginal main effect of treatment group (F(1,51) = 2.8; P = 0.047). Post boc analysis demonstrated that patient-controlled analgesia consumption was significantly lower in the treatment group only during the first 4 h of patient-controlled analgesia use after surgery (P = 0.027). There were no significant group differences at any later postoperative time points (P = not significant). There were no group differences in the cumulative Percocet (Pfizer, New York, NY) consumption in the postoperative period (P = not significant). Further, self-reported postoperative pain did not differ significantly between groups at any of the time points (P = not significant). There were also no group differences with regard to any postoperative clinical recovery parameters. Conclusions Benzodiazepines administered before surgery have minimal beneficial effects on the postoperative clinical course of women undergoing abdominal hysterectomy.

scholarly journals An Examination Of A Brief Intervention Targeting Causal Attributions For Daytime Fatigue

2021 ◽  
Author(s):  
Andrea L. Harris
Keyword(s):  
Brief Intervention ◽  
Causal Attributions ◽  
Cognitive Change ◽  
Mood States ◽  
Group Differences ◽  
Information Control ◽  
Post Intervention ◽  
Significant Group ◽  
To Receive

Research has shown that poor sleepers focus primarily on their sleep as a cause of daytime fatigue rather than the multitude of other possible causes of fatigue. This can create sleep-related anxiety and further perpetuate the insomnia. In order to lessen the increased focus on sleep, the present study investigated whether people could learn to consider other attributions for fatigue via an information-based intervention, and whether this cognitive change would have implications for relevant mood states. Participants were randomized to receive either “causes of fatigue” information (FI), or generic sleep-information (control), and were tested pre- and post-intervention. FI participants were significantly more likely to consider non-sleep-related attributions for fatigue at post-intervention, relative to control participants. There were no significant group differences on relevant mood states. These results demonstrate that attributions or fatigue are amenable to change via an information-based intervention; thus, this research explores one avenue toward refining insomnia treatments.

Olanzapine versus placebo for out-patients with anorexia nervosa

2011 ◽  
Vol 41 (10) ◽  
pp. 2177-2182 ◽  
Author(s):  
E. Attia ◽  
A. S. Kaplan ◽  
B. T. Walsh ◽  
M. Gershkovich ◽  
Z. Yilmaz ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Psychological Symptoms ◽  
Medication Management ◽  
Empirical Support ◽  
Metabolic Effects ◽  
Group Differences ◽  
Double Blind ◽  
Significant Group ◽  
End Of Treatment ◽  
To Receive

BackgroundAnorexia nervosa (AN) is a serious psychiatric illness associated with significant morbidity and mortality. There is little empirical support for specific treatments and new approaches are sorely needed. This two-site study aimed to determine whether olanzapine is superior to placebo in increasing body mass index (BMI) and improving psychological symptoms in out-patients with AN.MethodA total of 23 individuals with AN were randomly assigned in double-blind fashion to receive olanzapine or placebo for 8 weeks together with medication management sessions that emphasized compliance. Weight, other physical assessments and measures of psychopathology were collected.ResultsEnd-of-treatment BMI, with initial BMI as a covariate, was significantly greater in the group receiving olanzapine [F(1, 20)=6.64, p=0.018]. Psychological symptoms improved in both groups, but there were no statistically significant group differences. Of the 23 participants, 17 (74%) completed the 8-week trial. Participants tolerated the medication well with sedation being the only frequent side effect and no adverse metabolic effects were noted.ConclusionsThis small study suggests that olanzapine is generally well tolerated by, and may provide more benefit than placebo for out-patients with AN. Further study is indicated to determine whether olanzapine may affect psychological symptoms in addition to BMI.

scholarly journals An Examination Of A Brief Intervention Targeting Causal Attributions For Daytime Fatigue

2021 ◽  
Author(s):  
Andrea L. Harris
Keyword(s):  
Brief Intervention ◽  
Causal Attributions ◽  
Cognitive Change ◽  
Mood States ◽  
Group Differences ◽  
Information Control ◽  
Post Intervention ◽  
Significant Group ◽  
To Receive

Research has shown that poor sleepers focus primarily on their sleep as a cause of daytime fatigue rather than the multitude of other possible causes of fatigue. This can create sleep-related anxiety and further perpetuate the insomnia. In order to lessen the increased focus on sleep, the present study investigated whether people could learn to consider other attributions for fatigue via an information-based intervention, and whether this cognitive change would have implications for relevant mood states. Participants were randomized to receive either “causes of fatigue” information (FI), or generic sleep-information (control), and were tested pre- and post-intervention. FI participants were significantly more likely to consider non-sleep-related attributions for fatigue at post-intervention, relative to control participants. There were no significant group differences on relevant mood states. These results demonstrate that attributions or fatigue are amenable to change via an information-based intervention; thus, this research explores one avenue toward refining insomnia treatments.

Comparison of Auditory, Language, Memory, and Attention Abilities in Children With and Without Listening Difficulties

2020 ◽  
Vol 29 (4) ◽  
pp. 710-727
Author(s):  
Beula M. Magimairaj ◽  
Naveen K. Nagaraj ◽  
Alexander V. Sergeev ◽  
Natalie J. Benafield
Keyword(s):  
Auditory Processing ◽  
Short Term Memory ◽  
Group Differences ◽  
Long Term Memory ◽  
Short Term ◽  
Significant Group ◽  
Term Memory ◽  
Memory And Attention ◽  
Speed And Accuracy

Objectives School-age children with and without parent-reported listening difficulties (LiD) were compared on auditory processing, language, memory, and attention abilities. The objective was to extend what is known so far in the literature about children with LiD by using multiple measures and selective novel measures across the above areas. Design Twenty-six children who were reported by their parents as having LiD and 26 age-matched typically developing children completed clinical tests of auditory processing and multiple measures of language, attention, and memory. All children had normal-range pure-tone hearing thresholds bilaterally. Group differences were examined. Results In addition to significantly poorer speech-perception-in-noise scores, children with LiD had reduced speed and accuracy of word retrieval from long-term memory, poorer short-term memory, sentence recall, and inferencing ability. Statistically significant group differences were of moderate effect size; however, standard test scores of children with LiD were not clinically poor. No statistically significant group differences were observed in attention, working memory capacity, vocabulary, and nonverbal IQ. Conclusions Mild signal-to-noise ratio loss, as reflected by the group mean of children with LiD, supported the children's functional listening problems. In addition, children's relative weakness in select areas of language performance, short-term memory, and long-term memory lexical retrieval speed and accuracy added to previous research on evidence-based areas that need to be evaluated in children with LiD who almost always have heterogenous profiles. Importantly, the functional difficulties faced by children with LiD in relation to their test results indicated, to some extent, that commonly used assessments may not be adequately capturing the children's listening challenges. Supplemental Material https://doi.org/10.23641/asha.12808607

Behavioral and emotional differences between children of divorce and children from intact families: Clinical significance and mediating processes *This study is part of a dissertation () supported from the German research community.

2002 ◽  
Vol 61 (1) ◽  
pp. 5-14 ◽  
Author(s):  
Andreas Schick
Keyword(s):  
Self Esteem ◽  
Research Community ◽  
Children Of Divorce ◽  
Group Differences ◽  
Significant Group ◽  
Intact Families ◽  
Divorce Adjustment ◽  
Theoretical Assumptions ◽  
German Research ◽  
Clinically Significant

The following study is based on a sample of 241 9-13-year-old children (66 children from divorced parents, 175 children from non divorced parents). They were examined for differences regarding anxiety, self-esteem, different areas of competence, and degree of behavior problems. With a focus on the children’s experiences, the clinically significant differences were examined. Clinically significant differences, revealing more negative outcomes for the children of divorce, were only found for social anxiety and unstable performance. The frequency of clinical significant differences was independent of the length of time the parents had been separated. The perceived destructiveness of conflict between the parents one of four facets of interparental conflict in this study functioned as a central mediator of the statistically significant group differences. The children’s perception of the father’s social support was a less reliable indicator of variance. Further studies should try to make underlying theoretical assumptions about the effects of divorce more explicit, to distinguish clearly between mediating variables, and to investigate them with respect to specific divorce adjustment indicators.

PREEMPTIVE ANALGESIA WITH AMITRIPTYLINE IN WOMEN UNDERGOING ABDOMINAL HYSTERECTOMY: A RANDOMIZED CLINICAL TRIAL

2020 ◽  
pp. 2-5
Author(s):  
Antônio Henriques De França Neto ◽  
Alexandre Magno Nóbrega Marinho ◽  
Eveline Pereira De Arruda Agra ◽  
Priscilla Guimarães Alves ◽  
Josikwylkson Costa Brito ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Postoperative Pain ◽  
Pressure Pain Threshold ◽  
Abdominal Hysterectomy ◽  
Tricyclic Antidepressant ◽  
Preemptive Analgesia ◽  
Chi Square ◽  
Double Blind ◽  
Exact Test ◽  
Student’S T

The concept of preemptive analgesia, albeit long-standing, has reemerged. Consequently, recent research has focused on testing a variety of drugs preoperatively to prevent the occurrence of postoperative pain, a major factor of morbidity. Amitriptyline is a tricyclic antidepressant used to treat chronic pain. Because amitriptyline acts on pain transmission pathways, it could theoretically be used as an agent for the prevention of postoperative pain. This study evaluated the effectiveness of amitriptyline in preventing pain in patients submitted to hysterectomy, the most commonly performed gynecological surgery. A randomized, double-blind clinical trial was conducted with 145 patients, 72 of these receiving amitriptyline and 73 placebo. All patients were evaluated at 6, 12, 24 and 48 hours after surgery using a visual analog scale (VAS) for pain and algometry to determine the pressure-pain threshold. Statistical analysis was conducted using the chi-square test of association, Student's t-test, and the Mann-Whitney test, with Fisher's exact test being used whenever appropriate. No statistically signicant difference was found between the two groups with respect to pain at any of the time points evaluated, leading to the conclusion that at a dose of 25 mg, amitriptyline is ineffective in preventing postoperative pain in patients submitted to abdominal hysterectomy

SIMULTANEOUS PHARMACOKINETICS OF MORPHINE AND MORPHINE-6-B-D-GLUCURONIDE DURING PATIENT-CONTROLLED ANALGESIA THERAPY FOR POSTOPERATIVE PAIN

Analgesia ◽  
1995 ◽  
Vol 1 (4) ◽  
pp. 524-527 ◽  
Author(s):  
Thomas H. Kramer ◽  
Ray H. d’Amours ◽  
Lester A. Zuckerman ◽  
Catherine Buettner
Keyword(s):  
Postoperative Pain ◽  
Patient Controlled Analgesia
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