scholarly journals Subparalyzing Doses of Rocuronium Reduce Muscular Endurance without Detectable Effect on Single Twitch Height in Awake Subjects

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Jan Gelberg ◽  
Peter Bentzer ◽  
David Grubb
Keyword(s):  
Detectable Effect ◽  
Slight Reduction ◽  
Dominant Hand ◽  
Muscular Endurance ◽  
Adductor Pollicis Muscle ◽  
Single Twitch ◽  
Significant Difference ◽  
Blinded Study ◽  
Maximum Effort ◽  
Double Blinded

Purpose. To test the hypothesis that a low-dose rocuronium acts mainly by means of reducing muscular endurance rather than by reducing momentary force. Methods. In a randomized placebo-controlled double-blinded study, eight healthy volunteers were studied in two sets of experiments. In the first set, the subjects made a sustained maximum effort with the dominant hand for 80 seconds while squeezing an electronic handgrip dynamometer at three minutes after intravenous administration of placebo, 0.04 or 0.08 mg/kg rocuronium. Handgrip force at initiation of testing (maximum handgrip force) and after 60 seconds was evaluated. In the second set, the ulnar nerve of the subjects was electrically stimulated every tenth second for at least 10 and a maximum of 30 minutes following the administration of placebo and 0.08 mg/kg rocuronium. Single twitch height of the adductor pollicis muscle was recorded. Results. There was no significant difference in the effect on maximum handgrip force at time 0 between the three different doses of rocuronium. As compared with placebo, handgrip force after 0.08 mg/kg rocuronium was reduced to approximately a third at 60 seconds (214 N (120–278) vs. 69 (30–166); p=0.008), whereas only a slight reduction was seen after 0.04 mg/kg (187 (124–256); p=0.016). Based on these results, the sustained handgrip force after 0.2 mg/kg at 60 seconds was calculated to be 1.27% (95% CI [0.40, 4.03]) of the maximum force of placebo. No effect on single twitch height after 0.08 mg/kg rocuronium at four minutes after drug administration could be detected. Conclusions. Subparalyzing doses of rocuronium show a distinct effect on muscular endurance as opposed to momentary force. The findings support the hypothesis that low doses of rocuronium act mainly by reducing muscular endurance, thereby facilitating, for example, tracheal intubation.

scholarly journals Articaine VS Lignocaine in Orthodontic Extraction of Maxillary Premolars - A Randomized, Double-Blinded Study

2021 ◽  
Vol 10 (35) ◽  
pp. 2969-2974
Author(s):  
Meenu Jain ◽  
Namrata Dogra ◽  
Manish Gupta ◽  
Seema Grover
Keyword(s):  
Local Anaesthetics ◽  
Contralateral Side ◽  
Primary Objective ◽  
Premolar Extraction ◽  
Anaesthetic Solution ◽  
Dental Procedures ◽  
Significant Difference ◽  
Blinded Study ◽  
Maxillary Premolars ◽  
Double Blinded

BACKGROUND Local anaesthetics helps in preventing pain during surgical and dental procedures by blocking the peripheral nerves. The primary objective of this investigation was to compare and evaluate 4 % articaine hydrochloride (with 1 : 100000 adrenaline) and 2 % lignocaine hydrochloride (with 1 : 80000 adrenaline) in terms of pulpal anaesthesia, volume of anaesthetic solution administered, need of re-anaesthesia and difficulty of extraction during orthodontic extraction of maxillary first premolars. METHODS This prospective randomized, double-blinded study was conducted on 43 patients of less than 40 years of age requiring bilateral maxillary first premolar extractions for orthodontic purposes. Each patient was randomly assigned to receive either 2 % lignocaine hydrochloride or 4 % articaine hydrochloride for premolar extraction of one side and other solution was administered for premolar extraction of contralateral side spaced 1 to 3 weeks apart. In each patient, the difference in pulpal anaesthesia, volume of anaesthetic solution administered, need of re-anaesthesia, difficulty of extraction and duration of anaesthesia was assessed on administration of lignocaine hydrochloride and articaine hydrochloride. RESULTS Statistically significant difference in pulpal anaesthesia levels was found when the articaine and lignocaine groups (P > 0.05) were compared, with a higher mean pulpal anaesthesia among the articaine group. There was no difference in volume of anaesthetic solution administered on buccal and palatal side among the articaine and lignocaine groups. Only 2.3 % of patients in both the groups required re-anaesthesia on the buccal side. There was no significant difference in difficulty of extraction in both the groups. The articaine group had a longer mean duration of anaesthesia as compared to the lignocaine group which was highly significant. CONCLUSIONS Articaine may be used to replace lignocaine in orthodontic extraction of maxillary premolars with clinical advantages like higher pulpal anaesthesia and longer duration of anaesthesia. KEY WORDS Local Anaesthetic, Lignocaine Hydrochloride, Articaine Hydrochloride, Orthodontic Extraction, Prospective Study, Double-Blinded Study.

Topical 5-fluorouracil for granular myringitis: a double-blinded study

2009 ◽  
Vol 124 (3) ◽  
pp. 279-284 ◽  
Author(s):  
A M Atef ◽  
M M Hamouda ◽  
A H A Mohamed ◽  
A F A Fattah
Keyword(s):  
Treatment Options ◽  
Chronic Otitis Media ◽  
Local Application ◽  
Response To Treatment ◽  
Control Group ◽  
Petroleum Jelly ◽  
Persistent Disease ◽  
Significant Difference ◽  
Blinded Study ◽  
Double Blinded

AbstractBackground:Granular myringitis is a poorly understood disease which causes considerable discomfort and concern to affected individuals. Some cases may progress to inflammatory obliteration of the deep ear canal. Treatment options are diverse, and no single accepted treatment modality exists. Local application of 5-fluorouracil has recently been trialled in the treatment of chronic otitis media, with promising results.Aim:To investigate the efficacy and safety of topical 5-fluorouracil in cases of granular myringitis.Methods:Sixty patients with granular myringitis were enrolled in this controlled, double-blinded study. Patients were divided randomly into two equal groups. Patients in the study group (n = 30) received three successive applications of topical 5-fluorouracil 5 per cent cream, with two-week intervals between treatments. Patients in the control group (n = 30) received only local petroleum jelly cream packing at the same intervals. Follow-up appointments were scheduled every two weeks for the first three months; patients were then seen again after two years for evaluation of any persistent disease. Outcome measures were: (1) after three months, symptomatic response to treatment (i.e. quantity of aural discharge as reported by patient) and change in the amount of granulation tissue (as assessed by the physician via endoscopic examination); and (2) persistent disease after two years.Results:There was a highly statistically significant difference in the studied outcomes, comparing the study and control groups.Conclusion:Local application of 5-fluorouracil is a new treatment method for granular myringitis. In this study, it proved safe and efficacious, with no serious local reactions or complications.

scholarly journals A comparative study of caudal anesthesia with bupivacaine v/s bupivacaine with dexmedetomidine in lower abdominal surgeries in pediatric age group

Pain medicine ◽  
2021 ◽  
Vol 6 (3) ◽  
pp. 25-29
Author(s):  
Kishore Kumar N. ◽  
Sandeep Kadam
Keyword(s):  
Adverse Effect ◽  
Postoperative Analgesia ◽  
Rescue Analgesia ◽  
Pediatric Age Group ◽  
Respiratory Parameters ◽  
Caudal Anaesthesia ◽  
Significant Difference ◽  
Blinded Study ◽  
Group B ◽  
Double Blinded

Background: caudal anaesthesia has short­term effect. Alpha­2 adenoreceptors when used as adjuvant to local anaesthetic in children prolongs analgesic duration. The study is aimed to assess the efficacy of addition of dexme­detomidine with Bupivacaine in caudal block for extending postoperative analgesia and its safety profile in pediatric infra­umbilical surgeries.Method: the prospective interventional longitudinal double blinded study was conducted on 60 patients randomly divided into two groups by simple lottery method: group B who received (0.25 %) bupivacaine 1 ml/kg plus 1 ml nor­mal saline (NS), and those in group BD who received (0.25 %) bupivacaine 1 ml/kg plus 0.5 μg/kg dexmedetomidine in 1 ml NS. Post­surgery, both groups were compared in R studio v1.2.5001. Association between the adverse effect and other variables (age, gender, type of surgery, groups) were assessed by Multiple linear regression.Results: in group BD, duration of analgesia prolonged significantly (P < 0.05). In group BD, FLACC score at initial four hours and at 12th hour was significantly less (P < 0.05). Group B was more likely to receive high number of rescue analgesia (P = 0.0005; OR = 11.769). No significant difference was observed concerning hemodynamics, respiratory parameters and adverse effect between both groups (P > 0.05). Conclusion: in children, dexmedetomidine when used along with bupivacaine prolongs postoperative analgesia du­ration, without any significant side effects.

scholarly journals Comparison of morphine and fentanyl in attenuation of Intra operative stress response under general anesthesia: A randomized double blinded study

2014 ◽  
Vol 5 (4) ◽  
pp. 65-68
Author(s):  
R Krishna Prabu ◽  
P Rani ◽  
NP Madhu
Keyword(s):  
Body Weight ◽  
Stress Response ◽  
General Anesthesia ◽  
Elective Surgery ◽  
Serum Cortisol ◽  
Blood Samples ◽  
Significant Difference ◽  
Blinded Study ◽  
Cortisol Levels ◽  
Double Blinded

Background: This randomized double blinded study was done to compare the effect of intravenous morphine and fentanyl in attenuation of stress response during surgeries under general anesthesia in adults. The attenuation of stress response was analyzed with changes in serum cortisol and glucose levels one hour after induction of anesthesia. Methods: Fifty consented healthy volunteers in age group 20-50, under ASA I and ASA II posted for elective surgery were included in the study. Two groups of 25 each, group M who received 0.2 mg/kg body weight of morphine and group F who received 2 microgram/kg body weight of fentanyl before anaesthetic induction were compared. The members of two groups were randomly allocated and double blinded using sealed envelope technique. Blood samples were collected for baseline glucose and cortisol in all the subjects. One hour after the administration of study drugs, which was given at the time of induction blood samples were collected for analysis of glucose and cortisol. The changes in blood glucose and serum cortisol levels were compared at the end of the study using independent samples ‘t’ test. Results: There was no significant difference in blood sugar levels in both groups at the end of 1 hour. But there was significant increase in serum cortisol levels in group F compared to group M. Conclusion: This study concludes that morphine is better than fentanyl in attenuation of Intraoperative stress by effectively controlling serum cortisol levels. DOI: http://dx.doi.org/10.3126/ajms.v5i4.9796 Asian Journal of Medical Sciences 2014 Vol.5(4); 65-68

The New Use of an Ancient Remedy: A Double-Blinded Randomized Study on the Treatment of Rheumatoid Arthritis

2013 ◽  
Vol 41 (02) ◽  
pp. 263-280 ◽  
Author(s):  
Letian Chen ◽  
Haiyu Qi ◽  
Dezhen Jiang ◽  
Renshuo Wang ◽  
Aidong Chen ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Randomized Study ◽  
Chronic Inflammatory Disease ◽  
Onset Of Action ◽  
End Point ◽  
American College Of Rheumatology ◽  
Significant Difference ◽  
Blinded Study ◽  
Maximum Improvement ◽  
Double Blinded

Rheumatoid arthritis (RA) is the most common chronic inflammatory disease with unknown causes and unknown cures in Western medicine. This double-blinded study aimed to investigate the efficacy and safety of a widely used traditional Chinese medicine (Paeoniflorin (PAE) plus cervus and cucumis polypeptide injection (CCPI) using disease-modifying antirheumatic drugs (DMARD) as a control (methotrexate (MTX) plus leflunomide (LEF)). Patients were randomly assigned to one of the three groups: PAE + CCPI, MTX + LEF, and MTX + LEF + CCPI. The primary end point was the American College of Rheumatology 20% improvement response criteria (ACR20). The secondary end point was that of adverse effect frequencies and the speed of onset action. Our results showed that more patients in the CCPI-containing groups responded to the ACR20 during early treatment. After six months, ACR20 showed no significant difference among the three treatments. The maximum improvement in the two DMARD groups was significantly higher than that in the PAE + CCPI group (p < 0.01). CCPI made the onset action of the DMARD therapy 4.6 times faster. PAE + CCPI had significantly lower adverse event incidences than the two DMARD groups. These results indicate that PAE + CCPI appear to be a more acceptable alternative to DMARDs when patients cannot use DMARDs. CCPI appears to be a beneficial add-on to DMARDs that makes the onset of action faster, especially when patients need to relieve RA symptoms as soon as possible. Although not as effective as DMARDs, PAE appears to be a safer option to substitute DMARDs for long-term RA treatment when DMARD toxicity is an issue.

scholarly journals Long-term effects of cutting versus non-cutting instruments in FESS

2012 ◽  
Vol 50 (1) ◽  
pp. 56-66
Author(s):  
L. Mus ◽  
R. Hermans ◽  
M. Jorissen
Keyword(s):  
Scientific Evidence ◽  
Sinus Surgery ◽  
Lateral Side ◽  
Long Term Effects ◽  
Nasal Symptoms ◽  
Significant Difference ◽  
Blinded Study ◽  
Double Blinded

Background: Currently most ENT surgeons advocate using cutting instruments in Functional Endoscopic Sinus Surgery (FESS), based on the assumption of superior wound healing due to mucosal preservation. However, there is no scientific evidence of superiority of the cutting instruments. Methods: A prospective, randomized double blinded study was performed in 100 patients undergoing FESS, operated one side with non-cutting and the contra lateral side with cutting instruments. After a mean follow-up of 12 years after FESS, unilateral and global sino-nasal symptoms were scored by the patients using VAS, endoscopic abnormalities scored at both sides at the Outpatient clinic and radiologic abnormalities were described. Results: No significant differences between the sides operated by cutting and non-cutting instruments were found for sino-nasal symptomatic or for radiologic abnormalities between both sides. For the endoscopic parameters there was no difference for secretion or mucosa. Only for the presence of endoscopic synechiae there was a statistically significant difference between both groups. At the non-cutting side more synechiae were noticed, but no interference with sinus access, neither ventilation nor drainage was observed. Conclusion: FESS performed with cutting instruments results in less synechiae formation compared to non-cutting instruments. However, the presence of synechiae is not associated with more symptoms or CT scan abnormalities.

scholarly journals Comparison of twin mix and revamped twin mix in mandibular third molar surgery - A randomised controlled double blinded study

2020 ◽  
Vol 11 (4) ◽  
pp. 5821-5827
Author(s):  
Dyna Albert ◽  
Sudarssan Subramaniam Gouthaman ◽  
Muthusekhar M R
Keyword(s):  
Third Molar ◽  
Mouth Opening ◽  
Third Molar Surgery ◽  
Mandibular Third Molar ◽  
Significant Difference ◽  
Facial Swelling ◽  
Blinded Study ◽  
Mandibular Third Molar Surgery ◽  
Randomised Controlled ◽  
Double Blinded

Mandibular third molar surgery is one of the most common minor oral surgical procedures performed by oral and maxillofacial surgeons. It is vital to provide the most comfortable postoperative phase to the patient and for this reason dexamethasone, a corticosteroid, is popularly used in various routes. The intraspace injection of dexamethasone mixed with 2% lignocaine and 4% articaine named, Twin Mix and Modified Twin Mix respectively is gaining increasing popularity. 0.5% Centbucridine is a safe alternative to 2% lignocaine with more cardio stable properties. In this study we aimed to evaluate the comparability of Twin Mix(TM) and Revamped Twin Mix(RTM) (mixture of dexamethasone and centbucridine) with respect to its anesthetic properties and its effectiveness in managing postoperative sequelae following mandibular third molar surgery. For this, a randomised controlled double blinded study was conducted among patients reporting to the Out Patient Department of a dental college. The sample size of the population studied was 32, 16 in Group A (RTM) and 16 in Group B (TM). The primary outcomes measured were facial swelling and mouth opening on postoperative day(POD) 1, 3 and 7. The secondary outcomes were VAS score during the surgical procedure, duration and latency of anesthesia. The data were analysed descriptively and using Student’s t Test. Representations were given in graphical and tabular forms. The mean postoperative mouth opening and facial swelling on POD 1, 3 and 7 were comparable and did not show any statistically significant difference. Similarly, the VAS score during procedure, latency and duration of anesthesia were comparable with no statistically significant difference. In conclusion, RTM can be used as an alternative to TM due to its comparable properties.

Effect of Febuxostat on the Endothelial Dysfunction in Hemodialysis Patients: A Randomized, Placebo-Controlled, Double-Blinded Study

2017 ◽  
Vol 45 (5) ◽  
pp. 452-459 ◽  
Author(s):  
Mona Alshahawey ◽  
Sara Mahmoud Shahin ◽  
Tamer Wahid Elsaid ◽  
Nagwa Ali Sabri
Keyword(s):  
Placebo Group ◽  
Endothelial Dysfunction ◽  
Group Treatment ◽  
Hemodialysis Patients ◽  
Oxidase Inhibitor ◽  
Xanthine Oxidase Inhibitor ◽  
Study Results ◽  
Significant Difference ◽  
Blinded Study ◽  
Double Blinded

Background: Endothelial dysfunction is an important risk factor for cardiovascular diseases to occur in end-stage renal disease patients. Febuxostat, being a novel xanthine oxidase inhibitor, is apparently having a beneficial role in improving the endothelial dysfunction; however, data among hemodialysis patients are still limited. Methods: A prospective, placebo-controlled, block-randomized, double-blinded study was carried out to evaluate the effect of oral febuxostat on the endothelial dysfunction in hemodialysis patients. Fifty-seven eligible hemodialysis patients were randomly assigned to either the drug group (40 mg thrice weekly) or the placebo group. Serum Asymmetric dimethylarginine (ADMA), Serum uric acid (UA), and serum high sensitivity C-reactive protein (hsCRP) were measured at baseline and at the end of a 2-month study. Serum alanine aminotransferase (ALT), serum aspartate aminotransferase (AST), and the occurrence of pancytopenia were tested as safety parameters at baseline and at the end of study. Results: Serum UA significantly decreased from 7.5 ± 0.8 to 5.1 ± 1.2 mg/dL in the febuxostat group, while it did not change significantly in the placebo group. Treatment with febuxostat resulted in a significant decrease in the serum ADMA level from 1.027 ± 0.116 to 0.944 ± 0.104 µmol/L and the serum hsCRP level from 12.5 ± 1.65 to 12.1 ± 1.70 mg/L. Testing of serum ALT, serum AST, and pancytopenia revealed no significant difference in both groups. Conclusion: Febuxostat appears to improve hyperuricemia and endothelial dysfunction and ameliorate inflammation in hemodialysis patients with no safety concerns.

scholarly journals The Effect of Zinc Lactate added Tablets on Volatile Sulfur-containing Compounds in the Oral Cavity

2019 ◽  
Vol 13 (1) ◽  
pp. 405-409
Author(s):  
Pier F. Porciani ◽  
Simone Grandini
Keyword(s):  
Active Agent ◽  
Test Group ◽  
Significant Difference ◽  
Blinded Study ◽  
Baseline Adjustment ◽  
The Mean ◽  
Double Blinded ◽  
Sulfur Containing ◽  
Sulfur Containing Compounds ◽  
Volatile Sulfur

Background: Oral malodor is defined as breath that is offensive to others and its prevalence is around 35%. Objective: A controlled clinical double-blinded study was conducted to assess the efficacy of sugar-free tablets containing zinc lactate on oral Volatile Sulfur-containing Compounds (VSC) versus placebo tablets. Methods: All participants, who met the inclusion criteria, had to score a level of VSC ≥75 ppb at the basal measurement. Subjects were randomly assigned to one of the groups. The test tablet (0.7g) contained 0.255 mg of zinc lactate; the control tablet was identical but without the active agent. The OralChroma2© device was utilized to evaluate VSC. The levels were recorded at baseline, after sucking two tablets in succession and after 1 hour and 2 hours. Data were analyzed with SPSS and significance was set at α=0.05. Results: 186 subjects completed the trial. The mean reduction from baseline at the end of tablets sucking was, respectively, 43% (p <0.001) in the control and 67% (p <0.001) in the test group, after 1 hour, it was 6% in the control (p=NS) and 25% (p <0.001) in the test group, after 2 hours, it was 3% in the control (p=NS) and 12% (p <0.001) in the test group. The comparison between the two groups after baseline adjustment showed a statistically significant difference for reductions at the end of the sucking period (p <0.001), after 1 hour (p <0.001) and after 2 hours (p <0.05). Conclusion: Tablets containing zinc lactate can statistically reduce the oral VSC levels immediately and for over 2 hours.

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