scholarly journals Comparison in Sedative Effects between Dexmedetomidine and Midazolam in Dental Implantation: A Randomized Clinical Trial

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Li Wang ◽  
Yi Zhou ◽  
Tiejun Zhang ◽  
Lili Huang ◽  
Wei Peng
Keyword(s):  
Vital Signs ◽  
Pain Scores ◽  
Dental Implantation ◽  
Group I ◽  
Random Manner ◽  
The Difference ◽  
American Society ◽  
American Society Of Anesthesiologists ◽  
Adrenergic Receptor Agonist ◽  
Alternative Drugs

Dexmedetomidine refers to an α2-adrenergic receptor agonist causing potent sedative, analgesic, and minimal respiratory depression compared with alternative drugs. The present study was aimed at comparing the efficaciousness and safety of midazolam and dexmedetomidine as sedatives for dental implantation. We recruited 60 patients belonging to group I or II of the American Society of Anesthesiologists (ASA) and treated them with either midazolam or dexmedetomidine in a random manner. Patients’ duration of analgesia after surgery, surgeon and patient degrees of satisfaction, Observer’s Assessment of Alertness/Sedation Scale (OAAS) scores after drug administration, visual analogue scale (VAS) pain scores, and vital signs were recorded variables. Patients administered dexmedetomidine had significantly lower OAAS scores than those administered midazolam (p<0.05). Patients administrated dexmedetomidine had a significantly longer analgesia duration after the surgical procedure than those administered midazolam, and the difference was statistically significant (p<0.05). Dexmedetomidine had a significantly larger number of surgeons satisfied with the level of sedation/analgesia than midazolam (p<0.05). Accordingly, it is considered that dexmedetomidine can achieve better postoperative analgesia, surgeon satisfaction, and sedation than midazolam.

scholarly journals The Effect of Incisional and/or Intraperitoneal Local Anesthetic Application on Postoperative Pain during Laparoscopic Cholecystectomy

2016 ◽  
Vol 1 (05) ◽  
Author(s):  
Oguz Ugur Aydin ◽  
Eda Uysal Aydin ◽  
Ozgur Dandin ◽  
Diğdem Ozer Etik ◽  
Nedım Cekmen ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Placebo Group ◽  
Postoperative Pain ◽  
Shoulder Pain ◽  
Postoperative Pain Control ◽  
Combined Application ◽  
Pain Scores ◽  
Group I ◽  
American Society ◽  
American Society Of Anesthesiologists

Objective - In this study, we aimed to determine the effect of levobupivacaine (LB) application by intraperitoneal, incisional, and both together on postoperative pain after laparoscopic cholecystectomy. Materials and Methods - One hundred ASA (American Society of Anesthesiologists) I-II patients undergoing laparoscopic cholecystectomy were recruited in the study. The patients were randomized into four groups: placebo group (P), incisional group (I), intraperitoneal group (IP), and the combined (incisional+intraperitoneal) group (C). In the postoperative period, pain in the patients during resting and coughing was evaluated after 30 min, 2, 4, 8, 12, and 24 hours by employing visual analogue scale (VAS) for pain. Applied analgesic quantity, shoulder pain, and the existence of nausea-vomiting were also recorded. Results - Pain scores during resting and coughing were significantly lower in the combined group compared with others. Pain scores were similar in the incision and intraperitoneal groups, whereas in the placebo group were significantly lower. The analgesic need was lowest in the combined group and highest in the placebo group. There was no shoulder pain either in the combined or intraperitoneal groups. Nausea-vomiting rates were similar in all groups. Conclusions - We conclude that combined application of 0.25 % levobupivacaine can be used as an effective and safe method for postoperative pain control after laparoscopic cholecystectomy.

scholarly journals Effect of Intravenous Dexamethasone on Propofol Injection Pain: A Randomized Placebo Controlled Study

2020 ◽  
Vol 25 (1) ◽  
pp. 28-33
Author(s):  
Muhammad Sazzad Hossain ◽  
Md Afzalur Rahman ◽  
Mamunur Rashid ◽  
Monirul Islam ◽  
Anisur Rahman Babu ◽  
...  
Keyword(s):  
Normal Saline ◽  
Saline Group ◽  
Controlled Study ◽  
Injection Pain ◽  
Moderate Pain ◽  
Dexamethasone Group ◽  
Group I ◽  
Elective Surgical Procedure ◽  
American Society ◽  
American Society Of Anesthesiologists

Background and aim of study: Pain on propofol injection (POPI) is a common problem. None of the commonly used methods completely attenuate the pain. Inflammatory response to propofol contributes to the pain. This study was conducted to compare the efficacy of dexamethasone in attenuation of pain following intravenous injection of propofol. Materials and methods: A total of 80 adult patients were scheduled in this study with either sex, ASA (American Society of Anesthesiologists) grade I and II, for routine elective surgical procedure under general anesthesia. The patients enrolled were divided randomly into two groups of 40 patients each. Group I received 0.15 mg/kg of intravenous dexamethasone in 5 ml normal saline and Group II (placebo group) received 5 ml of 0.9% intravenous normal saline, following exsanguination and occlusion of the vein of the arm. This was followed by 0.5 mg/kg of propofol intravenously.The patients were asked to report their pain during injection of propofol according to the McCririck and Hunter scale. Results: The incidence of pain experienced in dexamethasone group was 45% patients and in saline group was 70% patients (p<0.05). The severity of POPI was also lower in dexamethasone group than the saline group (p<0.05). The incidence of mild and moderate pain in dexamethasone groups versus saline group was 30% versus 45% and 15% versus 25% respectively p<0.05. There was no severe pain recorded in any groups. Conclusion: Pretreatment with intravenous dexamethasone (0.15 mg/kg) before injection of propofol is effective and safe in reducing the incidence and severity of pain on propofol injection (POPI). Bangladesh J Otorhinolaryngol; April 2019; 25(1): 28-33

scholarly journals Oxycodone for prevention of etomidate-induced myoclonus: a randomized double-blind controlled trial

2018 ◽  
Vol 46 (5) ◽  
pp. 1839-1845
Author(s):  
Wei Wang ◽  
Jie Lv ◽  
Qi Wang ◽  
Lei Yang ◽  
Wanyou Yu
Keyword(s):  
General Anesthesia ◽  
Intravenous Injection ◽  
Adverse Reactions ◽  
Controlled Trial ◽  
Vital Signs ◽  
Physical Status ◽  
Double Blind ◽  
American Society ◽  
American Society Of Anesthesiologists

Objective This study was performed compare the effectiveness of oxycodone and fentanyl in reducing the incidence and severity of etomidate-induced myoclonus. Methods In total, 162 patients with an American Society of Anesthesiologists physical status of I or II were assigned at random to three groups. Patients assigned to Group O received 0.1 mg/kg of oxycodone (n = 54), those assigned to Group F were given 1 µg/kg of fentanyl (n = 54), and those assigned to Group S were given an equal volume of saline intravenously 2 minutes prior to administration of 0.3 mg/kg of etomidate (n = 54). The incidence and severity of myoclonus was evaluated 2 minutes after etomidate administration. The patients’ vital signs, coughing, nausea, dizziness, and other related adverse reactions were also recorded. Results The incidence of myoclonus was significantly lower in Group O (0.0%) than in Group F (31.5%) and Group S (72.2%); the intensity was also lowest in Group O. All patients in each group had stable cardiovascular profiles. Conclusions Intravenous injection of 0.1 mg/kg of oxycodone 2 minutes prior to etomidate is more effective in preventing etomidate-induced myoclonus during general anesthesia than is 1 µg/kg of fentanyl.

Comparison of Laryngeal Mask with Endotracheal Tube for Anesthesia in Endoscopic Sinus Surgery

2008 ◽  
Vol 22 (6) ◽  
pp. 653-657 ◽  
Author(s):  
Ahmed Atef ◽  
Ahmed Fawaz
Keyword(s):  
Endotracheal Tube ◽  
Endoscopic Sinus Surgery ◽  
Laryngeal Mask ◽  
Sinus Surgery ◽  
Controlled Hypotension ◽  
Operative Field ◽  
Group I ◽  
Surgical Conditions ◽  
American Society ◽  
American Society Of Anesthesiologists

Background The purpose of this study was to compare surgical conditions, including the amount of intraoperative bleeding as well as intraoperative blood pressure, during functional endoscopic sinus surgery (FESS) using flexible reinforced laryngeal mask airway (FRLMA) versus endotracheal tube (ETT) in maintaining controlled hypotension anesthesia induced by propofol-remifentanil total i.v. anesthesia (TIVA). Methods Sixty normotensive American Society of Anesthesiologists I—II adult patients undergoing FESS under controlled hypotension anesthesia caused by propofol-remifentanil-TIVA were randomly assigned into two groups: group I, FRLMA; group II, ETT. Hemorrhage was measured and the visibility of the operative field was evaluated according to a six-point scale. Results Controlled hypotension was achieved within a shorter period using laryngeal mask using lower rates of remifentanil infusion and lower total dose of remifentanil. Conclusion In summary, our results indicate that airway management using FRLMA during controlled hypotension anesthesia provided better surgical conditions in terms of quality of operative field and blood loss and allowed for convenient induced hypotension with low doses of remifentanil during TIVA in patients undergoing FESS.

scholarly journals Pre-Emptive Analgesic Effect of Intravenous Paracetamol in Modified radical mastectomy

2018 ◽  
Vol 2 (1) ◽  
pp. 22-26
Author(s):  
Bhawana Wagle ◽  
Yogesh Regmi ◽  
Sudhir Shrestha ◽  
Pradeep Thapa ◽  
Suraj VishowKarma ◽  
...  
Keyword(s):  
Radical Mastectomy ◽  
Analgesic Efficacy ◽  
Modified Radical Mastectomy ◽  
Analgesic Requirement ◽  
Analgesic Effects ◽  
Institutional Ethics ◽  
Pain Scores ◽  
Group I ◽  
Group Ii ◽  
American Society

Background: Modified radical mastectomy (MRM) is associated with significant post-operative pain. Intravenous (iv) paracetamol provides pain relief in most patients who have undergone MRM. It has been observed from previous studies conducted on patients undergoing other surgeries like abdominal surgeries that the analgesic efficacy of iv paracetamol improves when used Pre-emptively. There are no studies done previously on use of iv paracetamol Pre-emptively in MRM. Objective: The purpose of the study was to determine the post-operative analgesic effects of Pre-emptive intravenous (iv) paracetamol in MRM. Materials and Methods: Following institutional ethics committee approval, fourty American Society of Anesthesiology (ASA) physical status I-II patients were assigned in a randomized manner into two groups: Group I received iv paracetamol 1g, in 100mL, 15 minutes before induction and Group II received iv paracetamol 1g, in 100 mL, at the end of the surgery. The time to first analgesic use and the total analgesic consumed in 24 hours was recorded. Visual Analog Scale (VAS) pain scores were obtained from all patients at 0, 30 minutes, 1, 2, 6, 12 and 24 hours after the end of the Surgery. Results: Time to first analgesic requirement was significantly longer in Group I compared to Group II (p = 0.0329). Rescue analgesic consumption and post-operative VAS pain scores recorded were significantly lower in Group I compared to Group II (p < 0.05) until 24 after surgery. Conclusion: Pre-emptive iv paracetamol in comparison to intra- operative paracetamol, provided effective and reliable post- operative analgesia after modified radical mastectomy.

scholarly journals A Comparative Evaluation of Dexamethasone and Tramadol as Adjuvant to Levobupivacaine in Supraclavicular Block

2020 ◽  
Vol 5 (1) ◽  
pp. 100-102
Author(s):  
Rangit Priyakar Pandey ◽  
Richa Chandra
Keyword(s):  
Motor Block ◽  
Sensory Block ◽  
Group I ◽  
Significant Difference ◽  
The Mean ◽  
Group Ii ◽  
The Difference ◽  
American Society ◽  
Supraclavicular Block ◽  
Plexus Block

Background: The present study was conducted to evaluate and compare dexamethasone and tramadol as adjuvant to levobupivacaine in supraclavicular block. Subjects and Methods: The present study was conducted on 50 patients of American Society of Anesthesiologists (ASA) grade I and II. Patients were divided in to two groups of 25 each. In group I, 30 ml of 0.5% levobupivacaine hydrochloride plus 2 ml tramadol (100 mg) was used. In group II, 30 ml of 0.5% levobupivacaine hydrochloride plus 2 ml dexamethasone (8 mg) was used. Visual Analogue Scale was used. The onset of sensory and motor block was evaluated.Results: The mean onset of sensory block in group I was 5.41 minutes and in group II was 3.86 minutes, motor onset was 9.12 minutes in group I and 7.25 minutes in group II, duration of sensory block in group I was 12.14 hours and in group II was 15.34 hours, duration of motor block in group I was 14.34 hours and I group II was 16.23 hours, duration of analgesia in group I was 16.1 hour and in group II was 18.4 hours. The difference was significant difference (P<0.05). The mean VAS score in group II was better as compared to group I (P <0.05). Conclusion:Authors found that dexamethasone is a better adjuvant than tramadol when added to levobupivacaine in supraclavicular brachial plexus block.

scholarly journals Surgeon’s physical and mental stress while performing laparoscopic cholecystectomy

2017 ◽  
Vol 4 (4) ◽  
pp. 111-117
Author(s):  
Mukund Raj Joshi ◽  
Tanka P Bohara ◽  
Anuj Parajuli ◽  
Shail Rupakheti
Keyword(s):  
Patient Outcome ◽  
Laparoscopic Cholecystectomy ◽  
Mental Stress ◽  
Analogue Scale ◽  
Laparoscopic Cholecystectomy Group ◽  
The Difference ◽  
Clinically Significant ◽  
American Society ◽  
American Society Of Anesthesiologists ◽  
Additional Port

Background: Laparoscopic cholecystectomy is performed either by four port or three port. Although the overall patient outcome has been studied with comparable results, surgeon’s stress level has not been addressed commonly.Objective: To compare the difference in surgeon’s physical and mental stress between three port and four port laparoscopic cholecystectomy.Methods: This prospective randomized comparative study was carried out from January 2014 to August 2014 in patients undergoing laparoscopic cholecystectomy with American technique. Patients were randomized into four port laparoscopic cholecystectomy group and three port laparoscopic cholecystectomy group. Surgery was performed by experienced laparoscopic surgeons. At the end of procedure, surgeons were given questionnaire to evaluate physical and mental stress faced by them based on Visual Analogue Scale. The results obtained were compared.Results: Total 60 cases were evaluated, 30 in each group. Mean age of patients and American society of Anesthesiologists score were not different. Surgeon’s perception regarding physical and mental stress while performing in two different groups was analyzed. The difference is not statistically significant. Neither any of the three port group needed to add additional port nor any of the patients were converted to open surgery. None of the patient in either group developed clinically significant complication.Conclusion: Both the four and three port laparoscopic cholecystectomy techniques are comparable in regards to patient outcome as well as to the physical and mental stress experienced by the surgeons.

scholarly journals Comparison of oxycodone hydrochloride and sufentanil used in painless fiberbronchoscopy

2018 ◽  
Vol 16 ◽  
pp. 205873921877420
Author(s):  
Ke Zhang ◽  
Tianke Xiao ◽  
Zuqi Chen ◽  
Shuguang Xiong ◽  
Xiaohong Wang
Keyword(s):  
Heart Rate ◽  
Recovery Time ◽  
Adverse Reactions ◽  
Vital Signs ◽  
Fiberoptic Bronchoscopy ◽  
Group A ◽  
Oxycodone Hydrochloride ◽  
American Society ◽  
Group B ◽  
American Society Of Anesthesiologists

The study was designed to understand the effects of oxycodone hydrochloride and sufentanil used in painless fiberoptic bronchoscopy. A total of 90 patients aged 3–84 years undergoing painless fiberoptic bronchoscopy were selected, American Society of Anesthesiologists (ASA): I–III criteria—the equal number of subjects were randomly divided into sufentanil group (group A) and oxycodone hydrochloride group (group B). The vital signs, surgical examination and anesthesia, the effect of anesthesia, and adverse reactions were compared between the two groups during the operation. The change of heart rate and changes of hemodynamics in group B were found to be lower than in group A. The number of breaths was significantly lower than group B. The decrease of SpO2 in group A was higher than in group B. Cases of SpO2 <90% was higher in group A than in group B. The dosage of propofol and the recovery time in group A was significantly higher than in group B. The incidence of nausea and vomiting in group A was higher than in group B. Oxycodone hydrochloride combined with propofol used in painless fiberoptic bronchoscopy could improve the safety and efficiency of analgesia compared to sufentanil combined with propofol. The effect was found to have stable hemodynamics and fewer adverse reactions.

A Multicenter Clinical Study of the Safety and Activity of Maleimide-Polyethylene Glycol–modified Hemoglobin (Hemospan®) in Patients Undergoing Major Orthopedic Surgery

2006 ◽  
Vol 105 (6) ◽  
pp. 1153-1163 ◽  
Author(s):  
Christina Olofsson ◽  
Torbjörn Ahl ◽  
Torsten Johansson ◽  
Sune Larsson ◽  
Per Nellgård ◽  
...  
Keyword(s):  
Polyethylene Glycol ◽  
Adverse Events ◽  
Spinal Anesthesia ◽  
Vital Signs ◽  
Standard Of Care ◽  
Holter Monitoring ◽  
Serious Adverse Events ◽  
Major Orthopedic Surgery ◽  
American Society ◽  
American Society Of Anesthesiologists

Background Hemospan (Sangart Inc., San Diego, CA), a polyethylene glycol-modified hemoglobin with unique oxygen transport properties, has successfully completed a phase I trial in healthy volunteers. Because adverse events are expected to increase with age, the authors conducted a phase II safety study of Hemospan in elderly patients undergoing elective hip arthroplasty during spinal anesthesia. Methods Ninety male and female patients, American Society of Anesthesiologists physical status I-III, aged 50-89 yr, in six Swedish academic hospitals were randomly assigned to receive either 250 or 500 ml Hemospan or Ringer's acetate (30 patients/group) before induction of spinal anesthesia. Safety assessment included vital signs and Holter monitoring from infusion to 24 h, evaluation of laboratory values, and fluid balance. The hypothesis to be tested was that the incidence of adverse events would be no more frequent in patients who received Hemospan compared with standard of care (Ringer's acetate). Results Three serious adverse events were noted, none of which was deemed related to study treatment. Liver enzymes, amylase, and lipase increased transiently in patients in all three groups. There were no significant differences in electrocardiogram or Holter parameters, but there was a suggestion of more bradycardic events in the treated groups. Hypotension was less frequent in the treated patients compared with controls. Conclusions In comparison with Ringer's acetate, Hemospan mildly elevates hepatic enzymes and lipase and is associated with less hypotension and more bradycardic events. The absence of a high frequency of serious adverse events suggests that further clinical trials should be undertaken.

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