scholarly journals Efficacy of solifenacin in the prevention of short-term complications after laparoscopic radical prostatectomy

2017 ◽  
Vol 45 (6) ◽  
pp. 2119-2127
Author(s):  
Ranxing Yang ◽  
Lijie Liu ◽  
Gaofeng Li ◽  
Jianjun Yu
Keyword(s):  
Radical Prostatectomy ◽  
Short Form ◽  
Laparoscopic Radical Prostatectomy ◽  
Controlled Study ◽  
Control Group ◽  
Placebo Control ◽  
Study Group ◽  
Urinary Flow ◽  
Short Term ◽  
Night Time

Objective To evaluate the efficacy of solifenacin in the prevention of short-term complications after laparoscopic radical prostatectomy (LRP). Methods This randomized placebo-controlled study enrolled patients with histologically proven prostate cancer who underwent LRP. The patients were randomized to receive either solifenacin (5 mg once daily; study group) or placebo (control group) for the 15-day period beginning on the first day after surgery. The mean duration of detrusor overactivity (DO), the frequency of DO, the duration of macroscopic haematuria, and the days before catheter removal were recorded. The International Continence Society Short Form Male questionnaire, bladder neck stenosis episodes, and maximum urinary flow rate were evaluated at 1 month after surgery. The side-effects after using solifenacin were also recorded. Results A total of 120 patients were randomly assigned to the study group ( n = 62) or the control group ( n = 58). There were significantly lower rates of DO episodes during the daytime and night-time, haematuria and transient incontinence in the study group compared with the control group. Conclusion Solifenacin was a well-tolerated and effective treatment for the prevention of complications after LRP, with the main advantage compared with placebo being the decreased frequency of DO episodes during the daytime and night-time.

scholarly journals Effect of Ketorolac on the Prevention of Postoperative Catheter-Related Bladder Discomfort in Patients Undergoing Robot-Assisted Laparoscopic Radical Prostatectomy: A Randomized, Double-Blinded, Placebo-Controlled Study

2019 ◽  
Vol 8 (6) ◽  
pp. 759
Author(s):  
Jun-Young Park ◽  
Jun Hyuk Hong ◽  
Jihion Yu ◽  
Doo-Hwan Kim ◽  
Gi-Ho Koh ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Radical Prostatectomy ◽  
Primary Outcome ◽  
Laparoscopic Radical Prostatectomy ◽  
Controlled Study ◽  
Control Group ◽  
Robot Assisted ◽  
Pain Scores ◽  
Patient Satisfaction Scores ◽  
Double Blinded

Urinary catheterization can cause catheter-related bladder discomfort (CRBD). Ketorolac is widely used for pain control. Therefore, we evaluated the effect of ketorolac on the prevention of CRBD in patients undergoing robot-assisted laparoscopic radical prostatectomy (RALP). All patients were randomly allocated to the ketorolac group or the control group. The primary outcome was CRBD above a moderate grade at 0 h postoperatively. CRBD above a moderate grade at 1, 2, and 6 h was also assessed. Postoperative pain, opioid requirement, ketorolac-related complications, patient satisfaction, and hospitalization duration were also assessed. The incidence of CRBD above a moderate grade at 0 h postoperatively was significantly lower in the ketorolac group (21.5% vs. 50.8%, p = 0.001) as were those at 1, 2, and 6 h. Pain scores at 0 and 1 h and opioid requirement over 24 h were significantly lower in the ketorolac group, while patient satisfaction scores were significantly higher in the ketorolac group. Ketorolac-related complications and hospitalization duration were not significantly different between the two groups. This study shows ketorolac can reduce postoperative CRBD above a moderate grade and increase patient satisfaction in patients undergoing RALP, suggesting it is a useful option to prevent postoperative CRBD.

P4562Bilateral sphenopalatine ganglion block reduces blood pressure in never treated hypertensive patients. A randomized controlled study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
H Triantafyllidi ◽  
C Arvaniti ◽  
A Schoinas ◽  
D Benas ◽  
D Voutsinos ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Controlled Study ◽  
Control Group ◽  
Sham Operation ◽  
Study Group ◽  
Sphenopalatine Ganglion ◽  
Night Time ◽  
Hypertensive Patients ◽  
Sham Operation Group

Abstract Background Sphenopalatine ganglion (SPG) area is connected through sympathetic fibers with the central nervous system. We aimed to study the effect of SPG block in blood pressure (BP) in never treated patients with stage I-II essential hypertension. Methods We performed bilateral SPG block with lidocaine 2% in 53 newly diagnosed and never treated hypertensive patients (study group, mean age 49+12 years, 38 men) and a sham operation with water for injection in 11 patients (control group, mean age 51+12 years, 8 men). All patients have been subjected to 24 hour ambulatory blood pressure monitoring prior and a month after the SBG block in order to estimate any differences in blood pressure parameters derived from ABPM (blood pressure, heart rate, blood pressure load and variability). We defined as responders to SBG block those patients with a 24h average SBP decrease >5 mmHg. Results In the study group, a month after SPG block: a. 24h average SBP and DBP were reduced by 1.3+7mmHg and 1.8+5 mmHg, respectively, and b. 24h average DBP (p=0.03), daytime DBP (p=0.01) and daytime DBP load (p=0.01) were significantly decreased. Interestingly, in the responders group (14/42, 33%) a month after SPG block: a. 24h average SBP and DBP were reduced by 9+4mmHg and 6.5+3 mmHg, respectively, b. SBP and DBP were decreased during overall 24h and daytime (p<0.001) and night-time periods (p=0.002 and p=0.02, respectively) and c. SBP load was decreased during daytime and night-time while DBP load was decreased during daytime (p<0.001). As it was expected, no differences regarding BP were found in the sham operation group. BP decrease after SPG block Conclusions We have proved that the minimally invasive option of the SPG block leads to blood pressure decrease, probably through SNS modulation. Moreover, due to its short-term anesthetic effect, SPG block might act as a method of selection of those hypertensives with an activated SNS before any other invasive procedure.

Lack of Effect of Oral Melatonin on Platelet Parameters in Normal Healthy Dogs

2019 ◽  
Vol 55 (5) ◽  
pp. 226-230
Author(s):  
Melody Chen ◽  
Richard Stone
Keyword(s):  
Medication Administration ◽  
Controlled Study ◽  
Control Group ◽  
Placebo Control ◽  
Study Group ◽  
Immune Mediated ◽  
Potential Benefits ◽  
Healthy Dogs ◽  
Clinically Significant ◽  
Complete Blood Counts

ABSTRACT A randomized, prospective, blinded, placebo-controlled study on the effect of oral melatonin on platelet parameters was performed on 40 healthy dogs with normal physical examinations and no clinically significant findings on serum chemistry evaluation. Dogs were randomly assigned to the study group or the placebo-control group and administered oral melatonin or an oral inert tablet, respectively, for 28 days. Dogs in the study group were administered melatonin at 3 mg per os q 12 hr for dogs weighing &lt;15 kg and 6 mg per os q 12 hr for dogs weighing 15 kg or more. Complete blood counts were obtained at 0, 7, 14, and 28 days of medication administration. No adverse effects or sedation were noted in any dog. The placebo group had a statistically significant transient increase in both plateletcrit and mean platelet volume on day 7 relative to baseline, which was not observed in the melatonin group. Oral melatonin did not appear to have a direct thrombopoietic effect in normal healthy dogs. Future studies are required to investigate the pharmacokinetics of melatonin in dogs and the potential benefits of melatonin in both thrombocytopenia and immune-mediated diseases.

Effect of the Modified Surgeon Assisted Bilateral Transversus Abdominis Plane Block on Time Required for First Analgesic Dose after Cesarean Section under Spinal Anesthesia: Randomized placebo-control

2021 ◽  
Vol 4 (3) ◽  
pp. 01-05
Author(s):  
Ahmed Mamdouh
Keyword(s):  
Placebo Group ◽  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Interquartile Range ◽  
Transversus Abdominis ◽  
Secondary Outcome ◽  
Control Group ◽  
Placebo Control ◽  
Study Group ◽  
Tap Block

Background: The transverses abdominis plane block (TAP block) is one of the widely used regional analgesic techniques in cesarean section. There are different variations of the procedure. The aim of the present study was to evaluate the analgesic effect of the modified surgeon assisted bilateral TAP block in patients undergoing cesarean section Patients&Methods: Sixty patients undergoing cesarean section under spinal anesthesia were randomized into two groups to receive either TAP block with 40 ml of bupivacaine 0.25%(study group) or 40 ml normal saline as placebo after obtaining informed consent. All patients will receive intravenous diclofencac75mg every 12 hrs postoperatively. Postoperatively, there was an assessment every 2hrs during the first 24hrs by the visual analogue pain scale (VAPS). Time to the first analgesic request will be measured as primary outcome and all patients will receive opioid on demand or VAPS > 4 with 25mg pethidine intramuscularly. Moreover, total opioid requirement in 24hrs will be measured as secondary outcome along with postoperative complications as nausea, vomiting and abdominal distention. Complications related to the TAP procedure will be also assessed. Results: The median (interquartile range) time to the first analgesic request in the first 24hrs postoperatively was significantly shorter in the placebo group compared to the study group; 4h (4, 6) and 24h (10, 24) with p value < 0.001. Postoperative opioid requirement was significantly higher in the control group (30/30{100%}) than the study group (13/30{43.3%}). The median (interquartile range) number of opioid doses was significantly higher in the placebo group compared with the study group; 2(2, 2) and 0(0, 1) respectively. At all points in the study, pain scores both were lower in the study group (p < 0.0001). Conclusion: The modified surgeon assisted bilateral TAP block is relatively new, safe and cost effective technique which provides adequate postoperative analgesia allowing for better maternal ambulation and better postoperative recovery. Trial registration: Clinicaltrial.gov registration number: NCT04623632

Acupuncture for Low Back Pain in Pregnancy – a Prospective, Quasi- Randomised, Controlled Study

2004 ◽  
Vol 22 (2) ◽  
pp. 60-67 ◽  
Author(s):  
João Bosco Guerreiro da Silva ◽  
Mary Uchiyama Nakamura ◽  
José Antonio Cordeiro ◽  
Luiz Kulay
Keyword(s):  
Pelvic Pain ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Real Life ◽  
Acupuncture Group ◽  
Controlled Study ◽  
Control Group ◽  
Study Group ◽  
Low Back ◽  
Average Pain

This study was undertaken to investigate the effects of acupuncture in low back and pelvic pain during pregnancy under real life conditions, as compared with patients undergoing conventional treatment alone. A total of 61 conventionally treated pregnant women were allocated randomly into two groups to be treated or not by acupuncture. Twenty-seven patients formed the study group and 34 the control group. They reported the severity of pain using a Numerical Rating Scale from 0 to 10, and their capacity to perform general activities, to work, and to walk. We also assessed the use of analgesic drugs. Women were followed up for eight weeks and interviewed five times, at two-week intervals. All women completed the study. In the study group the average pain during the study period showed a larger reduction (4.8 points) than the control group (−0.3 points) (P<0.0001). Average pain scores decreased by at least 50% over time in 21 (78%) patients in the acupuncture group and in five (15%) patients in the control group (P<0.0001). Maximum pain and pain at the moment of interview were also less in the acupuncture group compared with the control group. The capacity to perform general activities, to work and to walk was improved significantly more in the study group than in the control group (P<0.05). The use of paracetamol was lower in the acupuncture group (P<0.01). These results indicate that acupuncture seems to alleviate low back and pelvic pain during pregnancy, as well as to increase the capacity for some physical activities and to diminish the need for drugs, which is a great advantage during this period.

scholarly journals Effect of Acute Increases in Intraocular Pressure on Corneal Pachymetry in Rabbit Eyes Treated with Timolol Maleate

2018 ◽  
Vol 12 (1) ◽  
pp. 314-321
Author(s):  
Cristina Sánchez-Barahona ◽  
Gema Bolívar ◽  
Dimitrios G. Mikropoulos ◽  
Anastasios G. Konstas ◽  
Miguel A. Teus
Keyword(s):  
Intraocular Pressure ◽  
Anterior Chamber ◽  
Central Corneal Thickness ◽  
Corneal Thickness ◽  
Rabbit Model ◽  
Controlled Study ◽  
Control Group ◽  
Study Group ◽  
Timolol Maleate

Objective: To evaluate in an in vivo rabbit model, the effect of topical timolol maleate therapy on the central corneal thickness response to acute intraocular pressure increases. Method: In this prospective and interventional controlled study, the central corneal thickness and intraocular pressure were measured in vivo in 12 rabbit eyes treated with topical timolol maleate for 1 month and in 12 controls at baseline, and after the intraocular pressure (measured by direct cannulation of the anterior chamber) was increased to 15 and 30 mmHg using a forced saline infusion into the anterior chamber. Results: There were no significant differences in the basal central corneal thickness values (control group, 373.2±12.9 µm; study group, 377.5±19.2 µm, p=0.5) or the central corneal thickness values when the intraocular pressure was increased to 15 mmHg (control group, 335.2±14.3 µm; study group, 330.0±32.1 µm, p=0.6) and to 30 mmHg (study group, 318.8±25.3 µm; control group, 329.8±21.0 µm, p=0.3). Conclusion: Rabbit corneas treated with topical timolol maleate for 1 month did not show a strain response to acute intraocular pressure increases that differed from control eyes. This is in contrast to a previous finding in which rabbit eyes treated with prostaglandin analogues had a greater decrease in central corneal thickness in response to a sudden intraocular pressure increase compared with untreated corneas.

scholarly journals Effectiveness of Preoperative Chlorhexidine Mouthwash on Pain After Lower Posterior Teeth Removal: A Randomized, Double-Blind Clinical Trial

2020 ◽  
Vol 12 (4) ◽  
pp. 112-119
Author(s):  
Abbas Haghighat ◽  
Shaqayeq Ramezanzade
Keyword(s):  
Control Group ◽  
Placebo Control ◽  
Study Group ◽  
Mouth Rinse ◽  
Pain Level ◽  
Double Blind ◽  
Posterior Teeth ◽  
Post Operative Pain ◽  
Double Blind Clinical Trial ◽  
Significant Difference

Background: Pain is one of the most common complications after tooth extraction and pain control is a crucial part of the procedure. The purpose of this study was to investigate the influence of 0.2% (w/v) chlorhexidine (CHX) gluconate mouth rinse on the severity of post-extraction pain. Methods: A prospective, randomized, double-blind trial was conducted among 170 subjects. Subjects were instructed to rinse with 15 mL of CHX mouth rinse (study group) or placebo (control group) 0.5 to 1 hour before extraction. Post-operative pain was evaluated considering the number of taken rescue analgesics and using a visual analog scale (VAS) that each case completed 6, 12, 24, and 48 hours after the surgery. The Mann-Whitney U test was performed in this regard. Results: There were no significant differences between the two groups regarding demographic variables (P>0.05). The preoperative use of CHX mouth rinse showed a better performance in mitigating the perceived pain. A significant difference in the pain level (P=0.001) was found only at the 6th hour postoperatively although there was no significant difference in the pain level between the two groups (P>0.05) at all other times (12th, 24th, 48th hours). The total number of analgesics that were taken by the study group was significantly lower compared to the control group (P=0.042). Conclusions: The preoperative CHX mouth rinse could be a beneficial choice for reducing pain after simple tooth extractions.

scholarly journals Enhanced recovery after surgery protocol for prostate cancer patients undergoing laparoscopic radical prostatectomy

2018 ◽  
Vol 47 (1) ◽  
pp. 114-121 ◽  
Author(s):  
Chunhua Lin ◽  
Fengchun Wan ◽  
Youyi Lu ◽  
Guojun Li ◽  
Luxin Yu ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Cancer Patients ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
The Body ◽  
Laparoscopic Radical Prostatectomy ◽  
Control Group ◽  
Tube Removal ◽  
Hospitalization Costs

Objective To determine the value of an enhanced recovery after surgery (ERAS) protocol for prostate cancer patients undergoing laparoscopic radical prostatectomy (LRP). Methods We conducted a retrospective cohort study using clinical data for 288 patients who underwent LRP in our hospital from June 2010 to December 2016. A total of 124 patients underwent ERAS (ERAS group) and the remaining 164 patients were allocated to the control group. ERAS comprised prehabilitation exercise, carbohydrate fluid loading, targeted intraoperative fluid resuscitation and keeping the body warm, avoiding drain use, early mobilization, and early postoperative drinking and eating. Results The times from LRP to first water intake, first ambulation, first anal exhaust, first defecation, pelvic drainage-tube removal, and length of hospital stay (LOS) were all significantly shorter, and hospitalization costs and the incidence of postoperative complications were significantly lower in the ERAS group compared with the control group. No deaths or reoperations occurred in either group, and there were no readmissions in the ERAS group, within 90 days after surgery. Conclusion ERAS protocols may effectively accelerate patient rehabilitation and reduce LOS and hospitalization costs in patients undergoing LRP.

Evaluation of red cell distribution width (RDW) as a septic marker in comparison with clinical scores and C-reactive protein

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ali Ahmed Naga ◽  
Mohammed Ismaeil Abdel Fattah ◽  
Walid Hamed Nofal ◽  
Mohammed Abd-elsalam AlMenshawe
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Controlled Study ◽  
Control Group ◽  
Study Group ◽  
Distribution Width ◽  
Clinical Scores ◽  
Group I ◽  
Significant Difference ◽  
Sepsis And Septic Shock

Abstract Background Challenges of diagnosing and treating sepsis only seem more difficult as incidence increases, patients become older and sicker, and pathogenic organisms evolve. New understanding of inflammatory mediators and pathways, immunity, and genetic variability in this disease state suggests that the current definitions of SIRS, sepsis, severe sepsis, and septic shock are oversimplified. Objective The aim of our study is to evaluate the level of RDW, CRP and clinical scores "SOFA and APACHI" as markers in patients with sepsis and their levels on the outcome and resolution of sepsis in ICU. Methodology We conducted a prospective observational controlled study on 90 adult persons of both sex, 45 of them are adult patients and served as the study group (Group I), and the other 45 are healthy adult volunteers and served as the control group (Group II). The study group represented patients admitted to the ICU of Intensive Care Unit at Damanhour Medical National Institute who fulfilled the diagnostic criteria for sepsis, severe sepsis and septic shock on arrival to ICU according to the SCCM/ ESICM/ ACCP/ ATS/SIS International Sepsis Definitions Conference. Results. In the present study we found that CRP measured on admission was not a predictor of mortality, while that measured at day 5 and day 10 predicted mortality, where there was no statistically significant difference in CRP levels between survivors and non-survivors at the day of admission while there were statistically significant differences between survivors and non survivors according to CRP levels at day 5 (p = 0.001*) and at day 10 (p = 0.001*). It was found also that there were statistically significant differences between survivors and non-survivors according to RDW at day 1(p = 0.011*) and at day 5(p = 0.009*), at day 10 was found there was no statistically significant difference between survivors and non-survivors (p = 0.338). Conclusion RDW is a new promising cheap and readily available biomarker that can be able to diagnose patients with sepsis with accuracy comparable to CRP. Also, RDW at admission is able to predict mortality.

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