scholarly journals The Effects of a Preoperative Steroid/Anesthetic Injection on Post-Tonsillectomy Pain

2003 ◽  
Vol 82 (4) ◽  
pp. 305-308 ◽  
Author(s):  
Timothy M. Cupero ◽  
Sam Y. Kim ◽  
Andrew B. Silva

We conducted a placebo-controlled, single-blind study to determine the efficacy of a local preoperative injection of a steroid/anesthetic combination in preventing post-tonsillectomy pain. We randomized 21 adults to receive either triamcinolone/bupivacaine on the left side and saline on the right or vice versa. Injections were administered in the area of the tonsillar pillars following intubation and prior to tonsillectomy. Based on the “generalized estimating equations” model of statistical analysis, we found no significant difference in the degree of postoperative pain between the active-treatment and control sides.

1993 ◽  
Vol 21 (1) ◽  
pp. 93-96 ◽  
Author(s):  
L. Cade ◽  
J. Ashley

Many patients present to day surgery clinics for vaginal termination of pregnancy, a procedure which is frequently complicated by postoperative abdominal pain. We have assessed the efficacy of prophylactic paracetamol 1000 mg given orally shortly before surgery in 834 such patients in a randomised, placebo-controlled, double-blind study. Postoperative pain was reported in 35 % of patients, with no significant difference between treated and control patients. This negative finding was unexpected and is so far unexplained, given the usual efficacy of oral paracetamol in relieving this type of pain after it has occurred.


2002 ◽  
Vol 30 (3) ◽  
pp. 220-229 ◽  
Author(s):  
YK Kang ◽  
YH Park ◽  
BY Ryoo ◽  
YJ Bang ◽  
KS Cho ◽  
...  

Control of nausea and vomiting is very important in determining patient compliance with cisplatin chemotherapy. A multicentre, randomized, single-blind study was conducted to compare the tolerability and efficacy of ramosetron with those of granisetron over 24 h following cisplatin administration to cancer patients. In eight study centres, a total of 194 adult patients were randomly assigned to receive either intravenous ramosetron 0.3 mg or intravenous granisetron 3.0 mg. The anti-emetic effect of ramosetron determined from the no-vomiting rate lasted longer, but there was no significant difference in the number of acute vomiting episodes or the severity of nausea between the two groups. In the tolerability evaluation, there were no statistically significant differences between the two groups, except for a higher incidence of dull headache in the granisetron group. Ramosetron and granisetron appear to have equivalent efficacy and tolerability profiles, but the effects of ramosetron on the prevention of acute vomiting in patients undergoing cisplatin chemotherapy were longer lasting.


2021 ◽  
pp. 1-8
Author(s):  
Sevde Aksu ◽  
Pelin Palas Karaca

<b><i>Aim:</i></b> The research was conducted as a randomized controlled pilot study to evaluate the effects of reflexology on lactation in mothers who delivered by cesarean section (CS). <b><i>Methods:</i></b> A single-blind randomized controlled experimental study was conducted with a total of 60 postpartum women in the reflexology application (<i>n</i> = 30) and control groups (<i>n</i> = 30). After the CS, the mothers in the control group were given approximately 3-h routine nursing care after recovering from the effects of anesthesia; the introductory information form was applied, and the Breastfeeding Charting System and Documentation Tool (LATCH) and visual analog scale (VAS) for the signs of the onset of lactation were implemented on the first and second days. Reflexology was applied to the women in the intervention group after an average of 3 h following the mother’s condition had become stable and she had recovered from the effects of anesthesia. Reflexology was applied a total of 20 min – 10 min for the right foot, 10 min for the left foot – twice a day with 8-h intervals on the first and second days after CS. After the last reflexology application, the LATCH and VAS for the signs of the onset of lactation were applied. <b><i>Results:</i></b> Of the women, 70% breastfed their babies within 60 min after delivery; 46.7% of the mothers received breastfeeding training and 81.7% needed support for breastfeeding after the CS. The LATCH breastfeeding scores of the women in the intervention group on both days were significantly higher compared to those of the women in the control group (<i>p</i> &#x3c; 0.001). On the first day after the CS, apart from breast pain, there was no significant difference between the two groups in terms of breast heat and breast tension (<i>p</i> &#x3e; 0.05). On the second day after the CS, apart from breast tension, there was no significant difference between the groups in terms of breast heat and breast pain (<i>p</i> &#x3c; 0.05). In the study, women in the intervention group were found to have higher scores in terms of all three symptoms compared to the control group (<i>p</i> &#x3c; 0.05). <b><i>Conclusions:</i></b> In the study, it was determined that LATCH scores and signs of the onset of breastfeeding increased in the mothers who received reflexology after CS.


2013 ◽  
Vol 60 (1) ◽  
pp. 3-10 ◽  
Author(s):  
Steven Smith ◽  
Al Reader ◽  
Melissa Drum ◽  
John Nusstein ◽  
Mike Beck

Abstract The purpose of this prospective, randomized, single-blind study was to determine the anesthetic efficacy of 127.2 mg lidocaine with 50 μg epinephrine compared to 127.2 mg lidocaine with 50 μg epinephrine plus 0.5 M mannitol in inferior alveolar nerve (IAN) blocks. Forty subjects randomly received 2 IAN blocks consisting of a 3.18 mL formulation of 127.2 mg lidocaine with 50 μg epinephrine and a 5 mL formulation of 127.2 mg lidocaine with 50 μg epinephrine (3.18 mL) plus 0.5 M mannitol (1.82 mL) in 2 separate appointments spaced at least 1 week apart. Mandibular anterior and posterior teeth were blindly electric pulp tested at 4-minute cycles for 60 minutes postinjection. Pain of solution deposition and postoperative pain were also measured. No response from the subject to the maximum output (80 reading) of the pulp tester was used as the criterion for pulpal anesthesia. Total percent pulpal anesthesia was defined as the total of all the times of pulpal anesthesia (80 readings) over the 60 minutes. One hundred percent of the subjects had profound lip numbness with both inferior alveolar nerve blocks. The results demonstrated that a 5 mL formulation of 127.2 mg lidocaine with 50 μg epinephrine plus 0.5 M mannitol was significantly better than the 3.18 mL formulation of 127.2 mg lidocaine with 50 μg epinephrine for all teeth. Solution deposition pain and postoperative pain were not statistically different between the lidocaine/mannitol formulation and the lidocaine formulation without mannitol. We concluded that adding 0.5 M mannitol to a lidocaine with epinephrine formulation was significantly more effective in achieving a greater percentage of total pulpal anesthesia than a lidocaine formulation without mannitol.


1976 ◽  
Vol 4 (1) ◽  
pp. 74-78 ◽  
Author(s):  
J Borges ◽  
C Zavaleta

The effect of a new analgesic compound ( propoxyphene, acetaminophen, caffeine, hydroxyzine) was investigated in a single-blind study comparing it with plain acetaminophen administered to forty patients with tension headache. For the study, patients were assigned to one of two groups of twenty each. Starting dose for each group was one to two tablets followed by one tablet every four to six hours. The results show that 90% clinical success was obtained with the analgesic compound, while a 45% success was obtained with plain acetaminophen. This is a statistically significant difference. Side-effects observed with analgesic compound were primarily drowsiness and dizziness of mild intensity; acetaminophen caused gastro-intestinal alterations ( nausea, vomiting) and dizziness of greater severity. Therapy was withdrawn in 20% of patients taking acetaminophen because of side-effects. The dosage of analgesic compound required to control each episode of tension headache way smaller than that of acetaminophen. These results can be explained by a possible potentiation of pharmacological activity of the compound's components. It can be concluded that the analgesic compound is a new and effective combination for the symptomatic treatment of tension headache.


2019 ◽  
Vol 47 (1) ◽  
Author(s):  
Jackson Schade ◽  
Maria Eduarda Gomes das Neves Oliveira ◽  
Renato Silva de Souza ◽  
Ivan Deconto ◽  
William Timboni Teixeira ◽  
...  

Background: Tendon injuries are common in horses and are commonly associated with lameness and athletic career disruption. Adhesions formed between the tendons and the surrounding tissues compromise the sliding and movement of the structures, compromising their functionality. Therefore, the control of adhesion formation is critical to restore the structural integrity of the tendon, as well as its biomechanical function. The aim of this study was to evaluate the behavior of the biosynthetic cellulose membrane implanted in foals with surgically induced tendinitis of the superficial digital flexor.Materials, Methods & Results: Six healthy foals were used, which underwent tendinitis induction in the superficial digital flexor of the right and left forelimbs. The lesions was induced by local ischemia by crushing the tendon with hemostatic forceps. The biosynthetic cellulose membranewas implanted only in the right forelimb, involving the superficial digital flexor tendon in the region of the ischemia and the left forelimb was used as control. After surgery, both forelimb were immobilized with synthetic plaster cast for 15 days. Ultrasonography was performed in six foals immediately before (M0), at 15° (M1) at and 30° (M2) day, and three were evaluate at 45° (M3) and 60° (M4) day after surgery. Incisional biopsies were performed in three animals on the 30° day and in three animals on the 60° day after surgery. Histopathological examination involved the analysis of tissue disorganization, presence and type of inflammatory infiltrate and neovascularization, according to the score of 0 to 3. Ultrasonography allowed visualization of the membrane, which was characterized as a continuous hyperechoic line at the edges of the tendon at 15 days (M1). In addition, at 30 and 45 days after surgery, interruption of the hyperechoic line and reduction of echogenicity were observed, and no echogenic lines were observed at 60 days after surgery. During the biopsies, the fragments obtained from the treated limb were presented with easily detachable layers and separate layers of tissue during histological cutting and the slides preparations. There was no significant difference in relation to the histopathological scores between the treated and control member. The inflammatory infiltrate was predominantly of mononuclear cells and fibroblasts, with identification of giant cell in a foal at 30 days. Neovascularization was observed in all limbs, treated and controls at 30 days and in two treated limbs and three control at 60 days. It was possible to identify the synthetic cellulose membrane by histopathology in only two limbs treated at 30 days and in no limb at 60 days.Discussion: The degree of tendonitis induced in the present study was considered mild according to ultrasonographic analysis at 15 days after surgery. This fact limited the evaluation of the biosynthetic cellulose membrane in the prevention of adhesions, since they were not observed in both groups. However, the ability of the membrane to minimize adhesion formation can be suggest by the macroscopically observed individualization of the tissue layers during histological sections and slides preparation. Ultrasonographic analysis allowed the visualization of the membrane, as well as its positioning and the absorption process. Therefore, ultrasonography can be used in post-implantation monitoring of the membrane. The comparison of the histopathological scores demonstrates the biocompatibility of the biosynthetic cellulose membrane when implanted in foals submitted to surgically induced tendinitis, since there was no difference when compared to treated and control limbs. Therefore, it can be used safely in the treatment of tendon injuries in horses.


1989 ◽  
Vol 17 (4) ◽  
pp. 440-443 ◽  
Author(s):  
D. C. Oxorn ◽  
G. S. Whatley

Twenty-four patients who were to undergo cholecystectomy were randomised into two groups, one to receive postoperative analgesia with interpleural bupivacaine, 20 ml of a 0.5% solution with adrenaline 5 μg/ml, and the other to receive intramuscular pethidine, 1 mg/kg. Preoperative and postoperative pulmonary function, postoperative pain scores, and days from operation to hospital discharge were recorded and statistically compared. There was no significant difference in pain scores, nor in days to discharge; however, postoperative pulmonary mechanics were significantly poorer in the interpleural group. A hypothesis to explain the differences is offered.


Author(s):  
Zahra Alizadeh ◽  
Nastaran Keyhanian ◽  
Sara Ghaderkhani ◽  
Simin Dashti-Khavidaki ◽  
Raheleh Shokouhi Shoormasti ◽  
...  

No effective antiviral drugs and vaccines are available for the treatment of patients with severe coronavirus 2019 (COVID-19). Therefore, available, safe, and inexpensive drugs and supplements such as melatonin are among the proposed options for controlling inflammation. We did a randomized, single-blind study in Imam Khomeini Hospital between June 30, 2020, and August 5, 2020. Mild to moderate COVID-19 patients aged 25-65 years were eligible to enter the study based on chest CT scan, clinical symptoms, and physician diagnosis. The intervention group was prescribed 6 mg of oral melatonin for 2 weeks, which consumed half an hour before bedtime every night in low light conditions. Clinical symptoms and C-reactive protein (CRP) were measured before and after treatment in the melatonin received and control (regular medications) groups. Among screened patients with COVID-19, 14 patients were assigned to receive melatonin, and 17 patients were considered as controls. A significant difference (p=0.005) between CRP 1 and CRP 2 levels (before and after using melatonin) was found in the melatonin group while this difference (p=0.069) was not significant in the control group. Also, the percentage of recovery (based on symptoms) in patients who took melatonin was higher than that of patients in the control group (85.7% VS 47.1%).  The result of this study confirmed the effectiveness of melatonin in mild to moderate outpatients with COVID-19. More clinical trials on elderly, diabetic, obese patients and severe cases are suggested in future studies.   


2020 ◽  
Vol 2 (3) ◽  
pp. 99-107
Author(s):  
Zahra Sativani ◽  
Riza Pahlawi

The activities of children more involve the foot. One of the common problems in the foot is flexible flatfoot. A disturbance in the process of the formation of the arch foot could result in a deformation of the foot and increases the risk of an injury due to postural balance change. Normally, the arch of the foot formed the first five years for the age range of 2-6 years. The right choices of the intrinsic muscle exercises of the foot can prevent deformation and improve postural balance. This study aimed to discuss the effectiveness of foot strengthening exercise to improving postural balance and functional ability of foot on a flexible flatfoot 6-10 years old. This study was pre-experimental research with two groups of pre-post test design. The subjects of this research were 30 students that had been divided into two groups, case, and control. Each group consists of 15 students selected used purposive sampling method based on the criteria of inclusion that had been set. There was a significant difference after foot strengthening exercise between the case and control group, p-value = 0,000. The foot strengthening exercise could improve the postural balance and functional ability of the foot on a flexible flatfoot 6-10 years old.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A233-A233
Author(s):  
Hannah P Fricke ◽  
Chandler J Krajco ◽  
Celeste M Sheftel ◽  
Julia F Charles ◽  
Laura L Hernandez

Abstract Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed class of antidepressants during pregnancy and lactation. SSRIs decrease bone mineral density (BMD) across all ages and sexes. Lactation is also characterized by increased bone resorption to mobilize calcium and achieves this via a serotonin-induced hormonal cascade. This serotonin-mediated bone loss is normally restored after weaning but is persistent when an SSRI is administered during the peripartum period. Our lab has previously shown that administration of the SSRI fluoxetine (FLX) during both gestation and lactation results in compromised bone health of the dam, which is characterized by a decreased bone mineral density (BMD). Along with this, we have also shown a decrease in BMD and femoral length in the offspring of the FLX-treated dams at weaning. We hypothesize that FLX usage during lactation only will impact the bone health of the dam as well as the bone health of her offspring due to exposure to FLX via the dam’s milk. Female C57BL/6 mice were randomized to receive the SSRI fluoxetine hydrochloride (20 mg/kg) or saline daily from the beginning of lactation (D0) through the end of lactation (D21), resulting in the following treatments: FLX dams (n=13) and control dams (n=13). The offspring of the treated dams were then harvested at weaning (3 weeks of age). During the peripartal period, the BMD of the dam was monitored via dual x-ray absorptiometry (DEXA). A baseline scan was taken at 6 weeks of age, at the end of pregnancy (E17.5), the beginning of lactation (D2), peak lactation (D10), and at the end of lactation (D21). There was no significant difference in the BMD of the FLX dams compared to the control dams at 6 weeks of age (p=0.9992), E17.5 (p=0.9995), D2 (p&gt;0.9999), or D10 (p&gt;0.9999). However, at D21, the FLX dams had a decreased BMD compared to the control dams (p=0.0493). Along with the decreased BMD of the FLX dams at weaning, there was a significant decrease in femur length in the pups of the FLX dams (p=0.0040). When the pups were separated by sex, the decreased femur length was observed in both the male (p=0.0413) and female (p=0.0047) offspring. These data suggest that fluoxetine use during lactation only results in a decreased BMD of the treated dams, as well as decreased femur length in the exposed offspring in both sexes.


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