The Peripheral Analgesic Effect of Meperidine in Reducing Propofol Injection Pain Is Not Naloxone-Reversible

1998 ◽  
Vol 23 (2) ◽  
pp. 197-200 ◽  
Author(s):  
Wei-Wu Pang ◽  
Martin S. Mok ◽  
Shyuan Huang ◽  
Yung-Tai Chung ◽  
Min-Ho Hwang
Keyword(s):  
Analgesic Effect ◽  
Venous Occlusion ◽  
Injection Pain ◽  
Double Blind ◽  
Perioperative Analgesia ◽  
Tourniquet Release ◽  
Group A ◽  
Group B ◽  
Group D ◽  
Blind Manner

Background and ObjectivesMeperidine is frequently used in general anesthesia and perioperative analgesia. In addition to its opioid action, meperidine possesses some local anesthetic properties. A preliminary study using the tourniquet venous retention technique found meperidine to be more effective in reducing propofol injection pain than fentanyl or morphine, both of which were slightly better than placebo. This study was undertaken to evaluate whether this peripheral analgesic effect of meperidine is affected by naloxone.MethodsIn a randomized, double-blind manner, after venous occlusion with a tourniquet, meperidine 40 mg was given intravenously to patients in group A (n = 31), meperidine 40 mg followed by naloxone 0.04 mg to group B (n = 32), meperidine 40 mg followed by naloxone 0.2 mg to group C (n = 30), and normal saline placebo to group D (n = 30). The venous retention of drug(s) was maintained for 1 minute, followed by tourniquet release and intravenous administration of propofol 100 mg. Pain assessment was made immediately after the propofol injection.ResultsAll three groups given meperidine had significantly less propofol injection pain (P < .01) than the group given saline placebo, and there was no difference among groups A, B, and C.ConclusionThe peripheral analgesic effect of meperidine in reducing propofol injection pain is not mediated by its opioid activity.

scholarly journals Management of Pain During Propofol Injection Using Intravenous Nitroglycerine

KYAMC Journal ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. 202-205
Author(s):  
Muhammad Sazzad Hossain ◽  
Mohammad Mamunur Rashid ◽  
Md Anisur Rahman Babu ◽  
Afsana Sultana ◽  
Md Sirajul Islam Mahfuz ◽  
...  
Keyword(s):  
Placebo Group ◽  
Venous Occlusion ◽  
Saline Group ◽  
Injection Pain ◽  
Group A ◽  
American Society ◽  
Group B ◽  
Double Blinded ◽  
American Society Of Anesthesiologists ◽  
To Receive

Background: Propofol is an intravenous (IV) anesthetic agent, can irritate the skin, mucous membrane and venous intima. The main drawback is the pain at injection site following its intravenous injection. Objectives: This study was performed to evaluate the effect of intravenous nitroglycerine on pain in patients following propofol injection. Materials and Methods: Eighty adult patients of both sexes, aged 20-50 years, according to American Society of Anesthesiologists (ASA) physical status were divided into two equal groups (n=40) to receive 200 mcg intravenous nitroglycerine diluted in 10 ml saline (group A) and 10 ml normal saline as placebo (group B) at an ambient operating room temperature in a randomized and double blinded fashion to compare the pain-relieving effects of the drugs during propofol injection before the patients lost consciousness. The pain on propofol injection was assessed according to the Mc Crirrick and Hunter scale. Results: The overall incidence and severity of pain were significantly less in Groups A (nitroglycerine group) than group B (placebo group) (p< 0.05). The incidence of mild and moderate pain in Group A versus group B was 25% vs 45% and 15% vs 30% respectively (p<0.05). The incidence of score '0' (no pain) was higher in Group A (60%) than Group B (25%) (p<0.05). Conclusion: Pretreatment with 200 mcg nitroglycerine with venous occlusion for one minute is effective pretreatment in alleviating propofol injection pain when compared to placebo. KYAMC Journal Vol. 10, No.-4, January 2020, Page 202-205

scholarly journals Intraoperative and Postoperative Analgesia Using Intravenous Opioid, Clonidine and Lignocaine

1994 ◽  
Vol 22 (1) ◽  
pp. 15-21 ◽  
Author(s):  
M. de Kock ◽  
P. Lavandhomme ◽  
J. L. Scholtes
Keyword(s):  
Side Effects ◽  
Postoperative Analgesia ◽  
Randomised Trial ◽  
Skin Incision ◽  
Time Interval ◽  
Colonic Surgery ◽  
Double Blind ◽  
Group A ◽  
Group B ◽  
Group D

The postoperative analgesia afforded after colonic surgery by IV opioid, clonidine and lignocaine given intra- and postoperatively was evaluated. In a double-blind randomised trial, 80 male patients scheduled for colonic resection under general anaesthesia received fentany 15 μg.kg−1 at induction and another 4 μg.kg−1 before skin incision (group A) or fentanyl (same dose) plus clonidine 4 μg.kg−1 in 20 min + 2 μg.kg−1.h−1 (group B, C) or fentanyl plus clonidine (same dosage) plus lignocaine 2 mg.kg−1 before skin incision, repeated before peritoneal incision and retractor placement (group D). In the four groups, intraoperative boluses of fentanyl 2 μg.kg−1 were given in response to the painful stimulation of the procedure. Postoperative pain was managed with PCA delivering 2 mg morphine per request in group A, 1.5 mg morphine in group B, 1.5 mg morphine + 15 μg clonidine in group C and 1.2 mg morphine + 15 μg clonidine + 23 mg lignocaine in group D. Postoperative analgesia was assessed by recording the analgesic demands (met and unmet) and the dose of morphine delivered at 6, 12, 18, 24, 36 hours. Side-effects, pain and sedation analogue scores were also recorded. A nalgesic demands and delivered morphine dose were reduced, at any time interval considered, in groups B, C, D, compared with A (P <0.001). No differences were noted between the groups B, C, D. Pain analogue scores were better in groups B, C, D compared with group A (P <0.001). Sedation and side-effects were not increased in groups B, C, D. Intraoperative clonidine was the major determinant of the reduction in analgesic demands and morphine delivered. Lignocaine, at the dose used, failed to afford any additional benefit.

scholarly journals Anesthetic effect of different doses of butorphanol in patients undergoing gastroscopy and colonoscopy

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shun Lv ◽  
Defeng Sun ◽  
Jinglin Li ◽  
Lin Yang ◽  
Zhongliang Sun ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Body Movement ◽  
Trial Registration ◽  
Injection Pain ◽  
Optimal Dosage ◽  
Anesthetic Effect ◽  
Group A ◽  
Group B ◽  
Group D ◽  
Different Doses

Abstract Background This study aimed to investigate the anesthetic effect of butorphanol with different doses in patients undergoing gastroscopy and colonoscopy. Methods 480 patients undergoing gastroscopy and colonoscopy were recruited and randomly divided into four groups to receive different doses of butorphanol (Group A = 2.5 μg/kg, Group B = 5 μg/kg, Group C = 7.5 μg/kg and Group D = 10 μg/kg). Butorphanol was administered 5 min before propofol infusion. The primary outcome was the incidence of body movement. Secondary outcomes were postoperative recovery time, length of stay in the Post-Anesthesia Care Unit (PACU), the total dose of propofol, and the incidence of intraoperative hypoxemia, propofol injection pain, cough, postoperative nausea and vomiting, drowsiness, and dizziness. Results The incidence of body movement and the dose of propofol in Group C and D were lower than those in Group A and B (P < 0.05). The incidence and intensity of propofol injection pain and the incidence of cough in Group B, C, and D were lower than those in Group A (P < 0.05). The length of stay in PACU and the incidence of postoperative drowsiness and dizziness were higher in Group D than in Group A, B, and C (P < 0.05). Conclusion Intravenous pre-injection of 7.5 μg/kg butorphanol with propofol can be the optimal dosage for patients undergoing gastroscopy and colonoscopy. Trial registration: Trial registration: Chinese Clinical Trial Registry, ChiCTR2000031506. Registered 3 April 2020—Retrospectively registered, http://www.medresman.org.cn.

scholarly journals Efficacy of Lignocaine in Alleviating Potassium Chloride Infusion Pain

1992 ◽  
Vol 20 (2) ◽  
pp. 196-198 ◽  
Author(s):  
E. T. M. Lim ◽  
S. T. Kloo ◽  
W. A. Tweed
Keyword(s):  
Adverse Effect ◽  
Potassium Chloride ◽  
Bolus Dose ◽  
Isotonic Saline ◽  
Injection Pain ◽  
Double Blind Study ◽  
Double Blind ◽  
Group A ◽  
Set Up ◽  
Group B

A double-blind study was set up to investigate the effect of pretreatment with lignocaine on the incidence of potassium chloride infusion pain. Twenty-eight patients were randomly allocated into two equal groups. Patients in both groups were hypokalaemic and were scheduled for replacement consisting of potassium chloride 20 mmol diluted to 100 ml in dextrose 5% solution administered over two hours. Group A (lignocaine) patients were pretreated with a bolus dose lignocaine 3 ml 1%, Group B (control) received isotonic saline 3 ml. The incidence of potassium chloride infusion pain was significantly reduced in Group A. There was no adverse effect reported. This study demonstrates the efficacy of bolus dose of lignocaine in alleviating injection pain for the duration of a two-hour continuous infusion.

scholarly journals Comparison of Efficacy of Diclofenac and Paracetamol as Preemptive Analgesic Agent

2018 ◽  
Vol 11 (3) ◽  
pp. 1699-1706
Author(s):  
Vinishdharma Thenarasu ◽  
Deepa Gurunathan ◽  
M.P. Santhosh Kumar
Keyword(s):  
Analgesic Effect ◽  
Treatment Options ◽  
Preemptive Analgesia ◽  
Double Blind ◽  
Over The Counter ◽  
Dental Procedures ◽  
Double Blind Clinical Trial ◽  
Group A ◽  
Inflammatory Drugs ◽  
Group B

Extraction of teeth has been a common, routine dental procedure done in clinics which may lead to moderate to severe pain postoperatively. Any pain postoperatively may cause a discomfort in particpants and affects their routine lifestyle. Preemptive analgesics plays an important role in reducing postoperative pain and distress associated with painful dental procedures. Nonsteroidal anti-inflammatory drugs are one of the treatment options to be used as pain relief for surgical teeth extraction. Wherelse, another commonly prescribed drug over-the-counter is Paracetamol. The purpose of this study is to evaluate the analgesic effect of both the drug as an preemptive analgesia. This study is a double blind , clinical trial. Twenty particpants were randomised into two group. Group A receiving Paracetamol (500mg) and Group B receiving Diclofenac (100mg) orally, 30 minute before the extraction is done. The pain intensity and the duration of the analgesia is evaluated using the Visual Analog Scale (VAS). Patient who were given Diclofenac (100mg) show a higher analgesic effect compare to Paracetamol (500mg).However, the analgesic effect in patient received Diclofenac is much more longer then patient received Paracetemol. Two different drug has been used in this study to evaluate their efficacy as an preemptive analgesic and it can be concluded that Diclofenac is more effective then Paracetamol as an preemptive analgesia.

scholarly journals Pain during intravenous Propofol injection and its prevention in the pediatric population. A randomized controlled trial.

2020 ◽  
Vol 27 (01) ◽  
pp. 185-190
Author(s):  
Hamid Raza ◽  
Maqsood Ahmed Siddiqui ◽  
Ahmed Uddin Soomro ◽  
Kamlaish
Keyword(s):  
Adverse Events ◽  
Incidence Rate ◽  
Normal Saline ◽  
Pediatric Population ◽  
Injection Pain ◽  
P Value ◽  
Care Hospital ◽  
Group A ◽  
Group B ◽  
Group D

Objectives: The aim of our study is to observe the pain difference as experienced by the pediatric patient when administered different preparations of propofol utilizing the verbal rating scale. Study Design: Prospective double-blind randomized control trial. Setting: A large tertiary care hospital in Karachi, Pakistan. Period: 6 months from June 2016 to November 2016. Material & Methods: The final patient population included in the study was n= 180 and were divided into six groups. These patients received general anesthesia and underwent surgery. Patients in Group A received 2ml of normal saline and a mixture of propofol and normal saline after waiting for half a minute. Group B patients received 0.5mg/kg Lidocaine followed by normal saline after waiting for half a minute. Group C received 2ml of normal saline followed by a mixture of propofol and Lidocaine after half a minute. Group D received 0.2mg/kg of Ketamine followed by a mixture of normal saline and propofol. Group E patients received 2ml of normal saline followed by a mixture of propofol and Ketamine half a minute later. And finally, patients belonging to group F received 2ml of normal saline followed by a mixture of propofol M/LCT and normal saline half a minute later respectively. Results: The gender, age, body weight and ASA grade of all the pediatric patients were similar having a P value of >0.05. The incidence rate of propofol injection pain in the groups were found to be Group A= 76.66%, Group B= 66.66%, Group C= 50%, Group D= 60%, Group E= 63.33%, Group F= 60% respectively. The incidence rate for adverse events was significantly lower in all the groups as compared to Group A that is the normal saline and propofol group having a p-value of less than 0.01. And the incidence rate of adverse events was lower in Groups C, D, E, and F were significantly lower than Group B having a p-value of less than 0.05. All the experimental groups had significantly lower scores of the VRS scale as compared to the control group (Group A) and the intergroup differences were found to be statistically significant having a p-value of less than 0.01. Conclusion: In our study, we found that the injection pain of propofol administration in the pediatric population was significantly reduced when using M/LCT pre-injection, 0.5mg/kg lidocaine or 0.2mg/kg of Ketamine. Another good combination is mixing 180mg propofol with 40mg of lidocaine or mixing propofol with 16mg of Ketamine.

scholarly journals Does Combination Therapy with Desmopressin and Tolterodine Improve the Treatment Outcomes of Patients with Monosymptomatic Nocturnal Enuresis? A Randomized Clinical Controlled Trial

ISRN Urology ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Fahimeh Kazemi Rashed ◽  
Davoud Nourizade ◽  
Sakineh Hajebrahimi ◽  
Kamaleddin Hasanzade ◽  
Abdolreza Otoofat
Keyword(s):  
Partial Response ◽  
Nocturnal Enuresis ◽  
Controlled Trial ◽  
Double Blind ◽  
Group A ◽  
Monosymptomatic Nocturnal Enuresis ◽  
The Mean ◽  
Group B ◽  
Blind Manner ◽  
Age And Sex

Several therapeutic options have been described for children with nocturnal enuresis, but still their efficacy and outcomes are controversial. This study compares the combined Desmopressin and Tolterodine efficacy versus Desmopressin alone efficacy in the treatment of nocturnal enuresis. One hundred children 5–16 years old with nocturnal enuresis were enrolled in a randomized trial study and were assigned to two equal groups. In a double-blind manner, we used 2 mg of Tolterodine tablet plus 20 μg of nasal Desmopressin in group A and 20 μg of nasal Desmopressin plus placebo in group B. The two groups were matched for age and sex (P = 0.547, P = 0.414). The mean number of the wet nights was reduced in both groups (P < 0.001, P < 0.001). Upon ICCS scoring in the Tolterodine + Desmopressin group, 27 (54%) had full response, 17 (34%) had partial response, and 5 (10%) had an unsuccessful outcome. In the Desmopressin + placebo group, 17 (34%) had full response, 23 (46%) had partial response, and 10 (20%) had an unsuccessful outcome. The response in the Tolterodine + Desmopressin group was significantly higher (P = 0.049). Regarding the results, combined Tolterodine plus Desmopressin is slightly more effective than monotherapy.

scholarly journals Effects of Different Doses of Dexmedetomidine on Intraocular Pressure after Suxamethonium in Non-ocular Surgeries: A Randomised Controlled Trial

2021 ◽  
Author(s):  
Saswati Das ◽  
Mousumi Das ◽  
Lingaraj Sahu ◽  
Gayatree Mohanty ◽  
Akshya Kumar Parida
Keyword(s):  
Intraocular Pressure ◽  
Controlled Trial ◽  
Optimum Dose ◽  
Control Group ◽  
Double Blind Study ◽  
Double Blind ◽  
Open Globe ◽  
Group A ◽  
Group B ◽  
Group D

Introduction: Succinylcholine causes a rise in Intraocular Pressure (IOP) and is deleterious in patients with open globe injuries. Dexmedetomidine, by its virtue of central sympatholytic action can help prevent this rise in IOP. Aim: To find out the optimal dose of Dexmedetomidine in preventing the rise of IOP after administration of Suxamethonium. Materials and Methods: One hundred American Society of Anesthesiologists (ASA) I or II patients posted for non-ophthalmic surgery were included in this randomised, prospective, double blind study. Patients were randomly allocated to four groups. Group A (n=25) received Dexmedetomidine 0.6 μg/kg, Group B (n=25) received Dexmedetomidine 0.8 μg/kg, Group C (n=25) received Dexmedetomidine 1 μg/kg, Group D (n=25) received Normal Saline (NS) over a period of 10 minutes and IOP was measured at different points in time. Results: Premedication with Dexmedetomidine at doses of 0.6 μg/kg, 0.8 μg/kg and 1 μg/kg intravenous (IV) were equally effective in attenuation of the rise in IOP associated with Succinylcholine administration. The IOP recorded was 15.53±1.10 mm of Hg in Group A, 14.49±0.94 mm of Hg in Group B, 14.72±1.03 mm of Hg in Group C as compared to 20.12±1.40 mm of Hg in the control group (Group D) after 60 seconds of injecting Suxamethonium. It also significantly obtunded the sympathetic response to laryngoscopy and intubation. However, the incidence of side effects increased with incremental doses. Conclusion: Dexmedetomidine 0.6 μg/kg IV premedication is the optimum dose to be used for attenuating the rise in IOP associated with Succinylcholine administration in situations where rise of IOP may be detrimental.

Pregabalin As A Premedicant To Attenuate Pressor Response In Patients Undergoing Laparoscopic Cholecystectomy: A Prospective, Randomized, Double-Blind, Placebo-Controlled Study

2020 ◽  
Vol 11 (3) ◽  
pp. 3418-3423
Author(s):  
Sweety Agrawal ◽  
Shubdha Bhagat ◽  
Pratibha Deshmukh ◽  
Amol Singham
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Pressor Response ◽  
Controlled Study ◽  
Double Blind ◽  
Co2 Insufflation ◽  
Ramsay Sedation Scale ◽  
Minute Interval ◽  
Group A ◽  
Group B ◽  
Induction Of Anaesthesia

The present study was done to evaluate the ability of oral pregabalin to attenuate the pressor response to airway instrumentation in patients undergoing laparoscopic cholecystectomy under general anesthesia. Sixty-four adult patients aged between 25-55 year of either gender belonging to ASA-1 or ASA2 physical status weighing 50-70 kg were enrolled in this study. Thirty-two patients each were randomized to group A, or group B. Patients in group A received tablet Pregabalin (150mg) and those in group B received placebo orally one hour before induction of anaesthesia. Heart rate, blood pressure, and sedation were assessed preoperatively before giving the tablets and after 30 minutes, and just before induction of anaesthesia. Intraoperative, pulse rate, mean arterial pressure, ECG in the lead II, SPO2 and ETCO2 were monitored. All the above parameters were noted during laryngoscopy and intubation, 3 minutes after CO2 insufflation, and then at every 10-minute interval till the end of surgery. These parameters were also recorded after extubating the patient. The Ramsay sedation scale was used to assess the sedation at the baseline, one hour after drug intake , one hour after extubation and 4 hour after surgery. Any adverse effects in the postoperative period were recorded. The result of our study shows that pre-emptive administration of oral pregabalin 150 mg significantly reduced the pressor response at the time of laryngoscopy and intubation, after CO2 insufflation and just after extubation. We conclude that oral pregabalin premedication is effective in successful attenuation of hemodynamic pressor response to laryngoscopy, intubation and pneumoperitoneum in patients undergoing laparoscopic cholecystectomy

Pharmacokinetics and Safety Assessment of Anti-HIV Dapivirine Vaginal Microbicide Rings with Multiple Dosing

2020 ◽  
Author(s):  
Lungwani Muungo
Keyword(s):  
Ex Vivo ◽  
Oral Treatment ◽  
Plasma Concentrations ◽  
Vaginal Ring ◽  
Vaginal Fluid ◽  
Cervical Tissue ◽  
Double Blind ◽  
Group A ◽  
Group B ◽  
Anti Hiv

Objectives: Self-administered vaginal rings are a promising method for delivery of topical anti-HIV microbicidesand might offer an adherence advantage over daily or coitally-dependent dosage forms such as gels. This trialassessed the safety and pharmacokinetic aspects of the Dapivirine Vaginal Ring-004 when worn as multiple rings oversequential periods of ring use by healthy, sexually-active, HIV-negative women.Methods: This double-blind trial was conducted among 48 women (18-40 years). Participants were randomlyassigned to two groups (A or B) and received (3:1) either the dapivirine or a placebo vaginal ring. Group A used tworings over a 56-day period and Group B used three rings over a 57-day period. Safety evaluations were conductedthroughout the trial. Dapivirine concentrations were measured in plasma, vaginal fluid and cervical tissue samplescollected during and after the 56 days (Group A) or 57 days (Group B) of vaginal ring use.Results: Ring-004 was safe and well tolerated in all participants. The pharmacokinetic profile demonstrated arapid increase in plasma and vaginal fluid concentrations and achieved concentrations in vaginal fluids and cervicaltissue well above the in vitro IC99 in cervical tissue (3.3 ng/mL) that were sustained for a 28 to 35-day ring use period(approximately 3000 times higher in vaginal fluids and 14 -1000 times higher in cervical tissue). Drug levels wereassociated with significant inhibitory activity of genital secretions against HIV ex vivo, a biomarker of pharmacodynamics.Individual plasma dapivirine concentrations did not exceed 553 pg/mL and were well below plasma concentrations atthe maximum tolerated dose for oral treatment (mean Cmax 2286 ng/mL).Conclusions: The consecutive use of several rings over a period of up to 57 days was safe and well tolerated, andPK data indicate that a single Ring-004 is likely to be protective for at least 35 days.

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