scholarly journals The Effect of Transcutaneous Electrical Acupoint Stimulation on Postoperative Catheter-Related Bladder Discomfort in Patients Undergoing Transurethral Resection of the Prostate

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Dongdong Liang ◽  
ShenHui Jin ◽  
LeDan Huang ◽  
YeLong Ren ◽  
ZhongHeng Du ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Transurethral Resection ◽  
Early Postoperative Period ◽  
Control Group ◽  
Urinary Catheterization ◽  
Double Blind Study ◽  
Early Recovery ◽  
Analgesic Requirement ◽  
Double Blind ◽  
Acupoint Stimulation

Background. Catheter-related bladder discomfort (CRBD), an extremely distressing complication secondary to an indwelling urinary catheterization, is frequently reported in patients with transurethral resection of the prostate (TURP), postoperatively. A prospective, randomized, controlled, double-blind study was designed to assess the efficacy of transcutaneous electrical acupoint stimulation (TEAS) as a treatment for CRBD in patients undergoing TURP. Methods. Seventy benign prostatic hyperplasia male patients undergoing TURP under general anesthesia requiring intraoperative urinary catheterization were enrolled for the trial. An experienced acupuncturist performed TEAS for 30 minutes before general anesthesia with acupoints RN7, RN6, RN5, RN4, and RN3 and bilateral BL32, BL33, and BL34. Mean arterial pressure (MAP), heart rate (HR), oxygen saturation (SPO2), body temperature (T), and blood samples were collected during the surgery. A series of assessments included the incidence and severity of CRBD, postoperative pain, nausea and vomiting, and physical and mental state measurements. Results. The incidence of CRBD was significantly lower in TEAS group than in control group at the time T5 [9(26%) vs. 28(80%), P < 0.001 ], T9 [20(57%) vs. 28(80%), P = 0.039 ], T11 [7(20%) vs. 31(89%), P < 0.001 ], and T12 [4(11%) vs. 7(20%), P = 0.003 ]. The severity of CRBD was significantly lower in TEAS group than in control group at the time T5 [0 vs. 10 (29%), P < 0.001 ], T9 [2(6%) vs. 10(29%), P = 0.011 ], and T11 [0 vs .9(26%), P = 0.002 ]. The QoR-40 total score was higher in TEAS group at time T11 [191.7(4.4) vs. 189.1(4.3), P = 0.007 ] and T12 [195.3(1.9) vs. 193.3(3.0), P < 0.001 ]. The postoperative analgesia requirement was higher in control group [5.0(2.9) vs. 3.8(1.9), P = 0.045 ]. Conclusions. TEAS could significantly prevent the incidence and severity of CRBD, reduce the postoperative analgesic requirement in the early postoperative period, and promote the quality of early recovery in patients undergoing TURP.

The use of Preoperative Lidocaine to Prevent Stridor and Laryngospasm after Tonsillectomy and Adenoidectomy

1998 ◽  
Vol 118 (6) ◽  
pp. 880-882 ◽  
Author(s):  
CAN KOÇ ◽  
FALIH KOCAMAN ◽  
ERDINÇ AYGENÇ ◽  
CAFER ÖZDEM ◽  
ALI ÇEKIÇ
Keyword(s):  
Early Postoperative Period ◽  
Control Group ◽  
Double Blind Study ◽  
Intravenous Lidocaine ◽  
Double Blind ◽  
Lidocaine Group ◽  
Group 4 ◽  
Topical Lidocaine ◽  
Plasma Lidocaine ◽  
Sedation Scores

The most important complications from tonsillectomy and adenoidectomy are bleeding, stridor, and laryngospasm. This controlled, double-blind study was designed to investigate the effects of topical and intravenous lidocaine on stridor and laryngospasm. A total of 134 patients scheduled for elective tonsillectomy and/or adenoidectomy were randomly separated into four groups. In the topical lidocaine group 4 mg/kg of 2% lidocaine was applied to subglottic, glottic, and supraglottic areas before endotracheal intubation. Normal saline solution was used topically for the first control group. In the intravenous lidocaine group, patients were given 1 mg/kg of 2% lidocaine before extubation, and the same amount of 0.9% NaCl was given to the second control group. Postoperative stridor, laryngospasm, cyanosis, bleeding, sedation degree, and respiratory depression were observed, and plasma lidocaine levels were measured. Both topical and intravenous lidocaine groups revealed less stridor and laryngospasm than the control groups, and no difference was found between the topical and intravenous lidocaine groups except the higher sedation scores in the early postoperative period for the intravenous lidocaine group. (Otolaryngol Head Neck Surg 1998;118:880–2.)

Analgesic Effects of Gabapentin after Spinal Surgery

2004 ◽  
Vol 100 (4) ◽  
pp. 935-938 ◽  
Author(s):  
Alparslan Turan ◽  
Beyhan Karamanlıoğlu ◽  
Dilek Memiş ◽  
Mustafa Kemal Hamamcıoglu ◽  
Barış Tükenmez ◽  
...  
Keyword(s):  
Placebo Group ◽  
Side Effects ◽  
Spinal Surgery ◽  
Early Postoperative Period ◽  
Morphine Consumption ◽  
Control Group ◽  
Double Blind Study ◽  
Double Blind ◽  
Pain Scores ◽  
Incremental Dose

Background A combination of opioid and nonopioid analgesic drugs may improve the quality of postoperative analgesia as well as reduce opioid requirements and their associated side effects. Studies have shown synergism between gabapentin and morphine in animal and human experiments and in the treatment of incisional pain. Therefore, the authors investigated, in a randomized, placebo-controlled, double-blind study, the effects of gabapentin on acute postoperative pain and morphine consumption in patients undergoing spinal surgery. Methods After standard premedication, 25 patients in the control group received oral placebo, and 25 patients in the gabapentin group received 1,200 mg of gabapentin, 1 h before surgery in a randomized fashion. Anesthesia was induced with propofol and cisatracurium and was maintained with sevoflurane and remifentanil. The total intraoperative remifentanil consumption by each patient was noted. All patients postoperatively received patient-controlled analgesia with morphine (1 mg/ml) with an incremental dose of 2 mg, a lockout interval of 10 min, and a 4-h limit of 40 mg. The incremental dose was increased to 3 mg, and the 4-h limit to 50 mg, if analgesia was inadequate after 1 h. Patients were questioned for the first 1 h in the PACU and were later evaluated in the ward at 1, 2, 4, 6, 12, and 24 h. Pain scores, heart rate, oxygen saturation measured by pulse oximetry, mean blood pressure, respiratory rate, sedation, morphine use, and total dose of morphine were recorded. Results Overall, pain scores at 1, 2, and 4 h were significantly lower in the gabapentin group when compared with the placebo group. Total morphine consumption in the gabapentin group was 16.3 +/- 8.9 mg (mean +/- SD) versus 42.8 +/- 10.9 mg in the placebo patients. The incidence of vomiting and urinary retention was significantly (P &lt; 0.05) higher in the placebo group, but there was no difference in incidence of other adverse effects between the groups. Conclusions Preoperative oral gabapentin decreased pain scores in the early postoperative period and postoperative morphine consumption in spinal surgery patients while decreasing some morphine-associated side effects.

scholarly journals Effect of prewarming on body temperature in short-term bladder or prostatic transurethral resection under general anesthesia: A randomized, double-blind, controlled trial

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ángel Becerra ◽  
Lucía Valencia ◽  
Pedro Saavedra ◽  
Aurelio Rodríguez-Pérez ◽  
Jesús Villar
Keyword(s):  
Postoperative Complications ◽  
Body Temperature ◽  
General Anesthesia ◽  
Core Temperature ◽  
Transurethral Resection ◽  
Controlled Trial ◽  
Control Group ◽  
Short Term ◽  
Double Blind ◽  
Time Periods

AbstractPerioperative hypothermia causes postoperative complications. Prewarming reduces body temperature decrease in long-term surgeries. We aimed to assess the effect of different time-periods of prewarming on perioperative temperature in short-term transurethral resection under general anesthesia. Randomized, double-blind, controlled trial in patients scheduled for bladder or prostatic transurethral resection under general anesthesia. Eligible patients were randomly assigned to receive no-prewarming or prewarming during 15, 30, or 45 min using a forced-air blanket in the pre-anesthesia period. Tympanic temperature was used prior to induction of anesthesia and esophageal temperature intraoperatively. Primary outcome was the difference in core temperature among groups from the induction of general anesthesia until the end of surgery. Repeated measures multivariate analysis of covariance modeled the temperature response at each observation time according to prewarming. We examined modeled contrasts between temperature variables in subjects according to prophylaxis. We enrolled 297 patients and randomly assigned 76 patients to control group, 74 patients to 15-min group, 73 patients to 30-min group, and 74 patients to the 45-min group. Temperature in the control group before induction was 36.5 ± 0.5 °C. After prewarming, core temperature was significantly higher in 15- and 30-min groups (36.8 ± 0.5 °C, p = 0.004; 36.7 ± 0.5 °C, p = 0.041, respectively). Body temperature at the end of surgery was significantly lower in the control group (35.8 ± 0.6 °C) than in the three prewarmed groups (36.3 ± 0.6 °C in 15-min, 36.3 ± 0.5 °C in 30-min, and 36.3 ± 0.6 °C in 45-min group) (p < 0.001). Prewarming prior to short-term transurethral resection under general anesthesia reduced the body temperature drop during the perioperative period. These time-periods of prewarming also reduced the rate of postoperative complications.Study Registration Registered at ClinicalTrials.gov (Identifier: NCT03630887).

Comparative Evaluation of 0.1% Octenidine Mouthwash with 0.2% Chlorhexidine Mouthwash in Prevention of Plaque and Gingivitis – A Clinicomicrobiological Study

2021 ◽  
Vol 13 (3) ◽  
pp. 202-210
Author(s):  
Sowmya Sadanandan ◽  
Suhas S ◽  
Sanjay Venugopal ◽  
Kavitha Karur
Keyword(s):  
Antibacterial Properties ◽  
Chlorhexidine Gluconate ◽  
Control Group ◽  
Double Blind Study ◽  
Gingival Inflammation ◽  
Patient Acceptability ◽  
Double Blind ◽  
Microbiological Parameters ◽  
Group B ◽  
The Impact

Background: Our study aimed to assess the efficacy of 0.1% Octenidine mouthwash as an anti-plaque agent and to assess its effect on gingival inflammation and staining of teeth when compared to 0.2% chlorhexidine gluconate by evaluating the impact on plaque and gingival inflammation as well as on microbial load. Materials and Methods: A three week double blind study was conducted on 69 subjects, aged 20-50 years, with moderate to severe gingivitis. The study population was divided into three groups with 23 subjects in each group: Group A - control subjects received only scaling, Group B received 0.2% chlorhexidine gluconate in addition to scaling and Group C received 0.1% Octenidine mouthwash along with scaling. Clinical and microbiological parameters were recorded at baseline, on 14th day and on 21st day. Subjective and objective criteria were assessed on the 14th day and 21st day. Results: There was a statistically significant reduction in all the tested parameters within all the three groups and between the groups from baseline to 21st day. The highest mean reduction in all the parameters was seen in subjects using 0.1% Octenidine. On comparison with the control group, subjects using the mouthwashes (Group B and Group C) had better improvement in clinical and microbiological parameters from baseline to 21st day. On comparison with chlorhexidine, Octenidine mouthwash significantly reduced plaque (p<0.05) and showed better patient acceptability. However, it was comparable to chlorhexidine in other two tested parameters. Conclusion: Owing to Octenidine’s pronounced and comparable antibacterial properties, it can be a promising candidate for the use in antiseptic mouthwashes.

The Effectiveness of Group Acceptance and Commitment Therapy and Cognitive Therapy on Alexithymia and Marital Boredom, Case study: Women Affected by Marital Infidelity in Mashhad, Iran

2022 ◽  
Author(s):  
Maryam Sadeghi ◽  
Naeimeh Moheb ◽  
Marziyeh Alivandi Vafa
Keyword(s):  
Cognitive Therapy ◽  
Analysis Of Covariance ◽  
Control Group ◽  
Double Blind Study ◽  
University Counseling Center ◽  
Double Blind ◽  
University Counseling ◽  
Acceptance And Commitment ◽  
Marital Infidelity ◽  
The Mean

Introduction: The aim of current paper was to compare the effectiveness of acceptance and commitment group therapy (ACT) and group cognitive therapy (GCT) on Alexithymia and marital boredom (MB) among women affected by marital infidelity in Mashhad. Method: This clinical trial was a double- blind study with a pretest-posttest design in which two intervention groups and one control group were investigated. The study performed on women who realized their spouse infidelity and referred to Azad University Counseling Center in Mashhad in 2018. The sample consisted of 30 women who were selected by purposive sampling and were randomly assigned to two intervention groups and a control group (n=10 per group). The intervention groups were put under ACT training (twelve 90-minute sessions) and GCT training (twelve 90-minute sessions), but the control group did not receive any intervention. Data was obtained by the Toronto Alexithymia Scale-20 and Pines Marital Boredom Scale and was analyzed by multivariate analysis of covariance with SPSS (version 22) software. Results: The results showed a significant reduction in the mean score of MB in the ACT group, also there was a significant reduction in the mean score of Alexithymia in the GCT group (P <0.05). So comparing both therapies, ACT was more influential on reducing marital boredom whereas GCT was more effective on reducing alexithymia. Conclusion: Although both intervention methods were effective on Alexithymia and Marital Boredom in women affected by marital infidelity, it was demonstrated that ACT and GCT have more effect on Marital Boredom and Alexithymia, respectively.

Addition of Epinephrine to Intrathecal Bupivacaine and Sufentanil for Ambulatory Labor Analgesia

1997 ◽  
Vol 86 (3) ◽  
pp. 525-531 ◽  
Author(s):  
David C. Campbell ◽  
Robert Banner ◽  
Lesley-Ann Crone ◽  
Wendy Gore-Hickman ◽  
Ray W. Yip
Keyword(s):  
Labor Analgesia ◽  
Saline Control ◽  
Control Group ◽  
Double Blind Study ◽  
Saline Control Group ◽  
Double Blind ◽  
Prolonged Labor ◽  
Intrathecal Analgesia ◽  
Limited Duration ◽  
Effective Analgesia

Background The intrathecal combination of sufentanil and bupivacaine provides rapid, effective analgesia for labor with a limited duration. Many anesthesiologists have concerns that the use of intrathecal local anesthetics precludes maternal ambulation. This prospective, randomized, double-blind study was designed to determine whether the addition of epinephrine to the combination of sufentanil and bupivacaine would prolong intrathecal analgesia for labor. Patients' ability to ambulate was also assessed. Methods Thirty-nine patients received either an intrathecal control dose of 10 micrograms sufentanil plus 2.5 mg bupivacaine plus 0.2 ml normal saline (control group); or 10 micrograms sufentanil plus 2.5 mg bupivacaine plus 0.2 ml (0.2 mg) of epinephrine (EPI group). Results Seven patients (3 control, 4 EPI) delivered vaginally and two (1 control, 1 EPI) required cesarean delivery before requesting epidural analgesia. The duration (mean +/- SD) of intrathecal labor analgesia was prolonged significantly by the addition of epinephrine: control (n = 15): 145 +/- 23 min; EPI (n = 15): 188 +/- 25 min (P &lt; 0.0001). Maternal ambulation was demonstrated in 100% (19 of 19) of the control group and in 80% (16 of 20) of the EPI group (P = NS). Conclusions The addition of 0.2 mg epinephrine to the intrathecal combination of sufentanil and bupivacaine significantly prolonged labor analgesia without causing adverse effects to the mother or fetus. The intrathecal combination of sufentanil and bupivacaine, with or without epinephrine, provided rapid, profound labor analgesia and allowed most patients to ambulate.

The role of tolvaptan in prevention of hyponatremia in patients undergoing transurethral resection of prostate surgery- A randomized double blind study

2021 ◽  
Vol 8 (2) ◽  
pp. 321-325
Author(s):  
Dinesh Kumar Singh ◽  
B B Baj ◽  
Vipin Goyal
Keyword(s):  
Transurethral Resection ◽  
Blind Study ◽  
Transurethral Resection Of Prostate ◽  
Double Blind Study ◽  
Double Blind ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B

The aim of our study to determine the role of tolvaptan in prevention of hyponatremia in transurethral resection of prostate surgery. This is randomized double-blind study conducted in 60 ASA grade status 1 and 2 patients age group between 45-80 yrs undergoing TURP under spinal anaesthesia in urology operation theatre in Mahatma Gandhi hospital Jaipur after receiving permission from hospital ethical committee. A detailed history, complete physical examination and routine investigation were done for all patients followed by informed written consent was obtained. Patients are randomly divided into 2 groups. In group A -30 patients who received orally tab tolvaptan 15 mg and group B-30 patients who received orally tab multivitamin 2 hrs before surgery after doing electrolytes of the patients in the morning. In both groups age (in yrs), wt (in kg), ASA grade, volume of irrigating fluid (in litres), volume of prostate resected (in gm) and duration of surgery (in minutes) all demographic and surgical details data were compared. Electrolytes were compared in both groups pre and post-operatively and statistical analysis was done.There was significant difference in post-operative sodium level between the two groups (A and B). The mean level of sodium significantly reduced post-operatively in group –B (control grp). The mean level of sodium significantly increased post-operatively in group –A (tolvaptan grp). We conclude single dose of tolvaptan -15 mg found to effective in prevention of hyponatremia in patients undergoing TURP.

scholarly journals Prophylactic Intramuscular Ephedrine Prior to Caesarean Section

1992 ◽  
Vol 20 (4) ◽  
pp. 448-452 ◽  
Author(s):  
C. C. Rout ◽  
D. A. Rocke ◽  
R. Brijball ◽  
R. V. Koovarjee
Keyword(s):  
Caesarean Section ◽  
General Anaesthesia ◽  
Control Group ◽  
Double Blind Study ◽  
Double Blind ◽  
Maximum Increase ◽  
Arterial Ph ◽  
Maternal Hypertension ◽  
Acid Base Status ◽  
Umbilical Arterial Ph

Thirty healthy parturients, having given informed consent, were randomly allocated in a double-blind study to receive an intramuscular injection of either 0.9% sodium chloride (control), ephedrine 25 mg, or ephedrine 50 mg, 30 minutes prior to general anaesthesia for caesarean section. Nine patients (90%) in the 50 mg group and five patients (50%) in the 25 mg group demonstrated reactive hypertension of 20% or greater from control. The mean maximum increase in the 50 mg group was 28.2% (range 4.4–38.3%). Maternal pH was significantly lower (P = 0.03) in the ephedrine 50 mg group. Neonatal acid base status was significantly impaired in the ephedrine 50 mg group with umbilical venous pH (P = 0.0001) and umbilical arterial pH (P = 0.001) being significantly lower than the control group. The associated increase in umbilical arterial base deficit suggests a metabolic component due to fetal asphyxia related to decreased uterine blood flow. We conclude that the prophylactic administration of intramuscular ephedrine prior to spinal anaesthesia is associated with an unacceptably high incidence of maternal hypertension, and should the spinal fail and general anaesthesia be required, also results in adverse neonatal biochemical changes. The technique is therefore not to be recommended.

scholarly journals Efficacy of intravenous Tramadol in prevention of catheter-related bladder discomfort in upper urinary tract surgery

2019 ◽  
Vol 6 (2) ◽  
pp. 45-50
Author(s):  
Sujita Manandhar ◽  
Kishor Manandhar
Keyword(s):  
Urinary Tract ◽  
General Anesthesia ◽  
Normal Saline ◽  
Upper Urinary Tract ◽  
Sedation Score ◽  
Adult Patients ◽  
Urinary Catheterization ◽  
Medical Sciences ◽  
Analgesic Requirement ◽  
Ramsay Sedation Score

Introductions: Catheter-related bladder discomfort (CRBD) is common in patients with urinary catheterization. Centrally acting intravenous opioid like Tramadol inhibits detrusor activity and incidence of CRBD. Present study aims to analyze efficacy of intravenous (IV) Tramadol in prevention of CRBD in patients undergoing upper urinary tract surgery. Methods: Adult patients undergoing elective open upper urinary tract surgeries at Bir Hospital, National Academy of Medical Sciences (NAMS), Nepal, over a period of six months, requiring urinary catheterization were randomly divided into Control (C) and Tramadol (T) groups. After general anesthesia, patients in T-group received IV Tramadol 1.0 mg/kg and C-group received normal saline 30 minutes before extubation. In post-operative ward, CRBD was graded as mild, moderate or severe at 0, 1, 2 and 6 hours. Post-operative Ramsay sedation score and nausea vomiting were compared in two groups. Results: There were total 70 patients, 35 in each of groups-T and C. Incidence of CRBD in T-group was significantly low compared to the C-group at all points of evaluation (p<0.05). Postoperative sedation score, analgesic requirement and nausea vomiting were not significantly different in two groups. Conclusions: Intravenous Tramadol administered before extubation in upper urinary tract surgery reduces the incidence of CRBD.

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