scholarly journals Effect of Nitrous Oxide in Reducing Pain of Propofol Injection in Adult Patients

2005 ◽  
Vol 33 (2) ◽  
pp. 235-238 ◽  
Author(s):  
P. K. Sinha ◽  
P. K. Neema ◽  
R. C. Rathod
Keyword(s):  
Nitrous Oxide ◽  
Effective Treatment ◽  
Statistical Difference ◽  
Rating Scale ◽  
Prospective Trial ◽  
Adult Patients ◽  
Double Blind ◽  
Pain Scores ◽  
Oxygen Inhalation ◽  
Pre Treatment

In a randomized, double-blind, prospective trial we compared the efficacy of pre-treatment with nitrous oxide (with or without premixed lignocaine in propofol) for the prevention of propofol-induced pain. Ninety consecutive patients were recruited in the study and divided into three groups of 30 each, who received either 50% nitrous oxide in oxygen along with lignocaine 40 mg mixed in 1% propofol 20 ml (Group NL), 50% nitrous oxide in oxygen without lignocaine in propofol (Group N), and 50% oxygen in air with lignocaine mixed in propofol 40 mg (Group L). Pain scores were graded on a four point verbal rating scale (0–3). Eighty-nine patients completed the study while one patient developed excitement, agitation and tremor during nitrous oxide in oxygen inhalation. Eleven patients (36.7%) complained of pain in the group L compared to 7 (23.3%), and 1 (3.3%), in groups N and NL respectively [group NL vs group L (P<0.001) and group NL vs N (P<0.001)]. There was no statistical difference observed between group N and group L. Inhalation of 50% nitrous oxide reduces pain on propofol injection. The combination of 50% nitrous oxide and lignocaine mixed with propofol was the most effective treatment.

scholarly journals Effects of Dexmedetomidine on Postoperative Nausea and Vomiting in Adult Patients Undergoing Ambulatory Thyroidectomy: A Randomized Clinical Trial

2021 ◽  
Vol 8 ◽  
Author(s):  
Cuiyu Xie ◽  
Caihui Zhang ◽  
Hao Sun ◽  
Yao Lu
Keyword(s):  
Relative Risk ◽  
Postoperative Nausea ◽  
Prospective Trial ◽  
Postoperative Nausea And Vomiting ◽  
Adult Patients ◽  
Nausea And Vomiting ◽  
Severe Nausea ◽  
Double Blind ◽  
Pain Scores ◽  
Significant Difference

Background: Postoperative nausea and vomiting (PONV) is a common and disturbing problem in patients undergoing ambulatory thyroidectomy. This prospective trial aimed to explore whether dexmedetomidine (DEX) combined with azasetron (AZA) can further drop the incidence of PONV in patients undergoing ambulatory thyroidectomy compared with AZA.Methods: This single-center, randomized, double-blind trial involved 172 adult patients undergoing ambulatory thyroidectomy. The individuals were randomized to DEX + AZA group and AZA group. In the DEX + AZA group, patients received dexmedetomidine 0.5 μg kg−1 for 10 min and then the infusion rate was held at 0.1 μg kg−1 h−1 until the completion of the operation, while the same amount of 0.9% saline in the AZA group. At the completion of the surgery, 10 mg azasetron was administered to every patient in both groups. The primary outcome was the incidence of 24 h PONV after ambulatory thyroidectomy. The secondary outcomes included residence time in recovery room, pain scores, severity of nausea, and adverse events.Results: No significant difference was found in the incidence of 24-h PONV between the DEX + AZA group and the AZA group [36% (30 of 84) vs. 38% (32 of 84); relative risk, 0.94; 95% confidence interval (CI), 0.63–1.40; P = 0.749]. The incidence of severe nausea was similar between the DEX + AZA group and the AZA group [57% (12 of 21) vs. 43% (9 of 21); relative risk, 1.33; 95% CI, 0.72–2.50; P = 0.355].Conclusions: Intraoperative dexmedetomidine combined with azasetron failed to drop the incidence of 24-h PONV compared with azasetron alone in patients undergoing ambulatory thyroidectomy.

scholarly journals Perioperative pregabalin for reducing pain, analgesic consumption, and anxiety and enhancing sleep quality in elective neurosurgical patients: a prospective, randomized, double-blind, and controlled clinical study

2016 ◽  
Vol 125 (6) ◽  
pp. 1513-1522 ◽  
Author(s):  
Nir Shimony ◽  
Uri Amit ◽  
Bella Minz ◽  
Rachel Grossman ◽  
Marc A. Dany ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Sleep Quality ◽  
Rating Scale ◽  
Preoperative Anxiety ◽  
Controlled Study ◽  
Double Blind ◽  
Analgesic Consumption ◽  
Pain Scores ◽  
Neurosurgical Patients ◽  
Duration Of Surgery

OBJECTIVE The aim of this study was to assess in-hospital (immediate) postoperative pain scores and analgesic consumption (primary goals) and preoperative anxiety and sleep quality (secondary goals) in patients who underwent craniotomy and were treated with pregabalin (PGL). Whenever possible, out-of-hospital pain scores and analgesics usage data were obtained as well. METHODS This prospective, randomized, double-blind and controlled study was conducted in consenting patients who underwent elective craniotomy for brain tumor resection at Tel Aviv Medical Center between 2012 and 2014. Patients received either 150 mg PGL (n = 50) or 500 mg starch (placebo; n = 50) on the evening before surgery, 1.5 hours before surgery, and twice daily for 72 hours following surgery. All patients spent the night before surgery in the hospital, and no other premedication was administered. Opioids and nonsteroidal antiinflammatory drugs were used for pain, which was self-rated by means of a numerical rating scale (score range 0–10). RESULTS Eighty-eight patients completed the study. Data on the American Society of Anesthesiologists class, age, body weight, duration of surgery, and intraoperative drugs were similar for both groups. The pain scores during postoperative Days 0 to 2 were significantly lower in the PGL group than in the placebo group (p < 0.01). Analgesic consumption was also lower in the PGL group, both immediately and 1 month after surgery. There were fewer requests for antiemetics in the PGL group, and the rate of postoperative nausea and vomiting was lower. The preoperative anxiety level and the quality of sleep were significantly better in the PGL group (p < 0.01). There were no PGL-associated major adverse events. CONCLUSIONS Perioperative use of twice-daily 150 mg pregabalin attenuates preoperative anxiety, improves sleep quality, and reduces postoperative pain scores and analgesic usage without increasing the rate of adverse effects. Clinical trial registration no.: NCT01612832 (clinicaltrials.gov)

Nitrous Oxide Reduces Pain Associated With Local Anesthetic Injections

2019 ◽  
Vol 23 (6) ◽  
pp. 602-607 ◽  
Author(s):  
Matthew J. Lin ◽  
Danielle P. Dubin ◽  
Hooman Khorasani
Keyword(s):  
Nitrous Oxide ◽  
Local Anesthetic ◽  
Rating Scale ◽  
Injection Pain ◽  
Mohs Micrographic Surgery ◽  
Micrographic Surgery ◽  
Topical Anesthetic ◽  
Pain Scores ◽  
Male Sex ◽  
Pain Rating Scale

Background Local anesthetic injections can be painful and distressing. Objective The aim of this study was to determine whether nitrous oxide, ice, vibration, or topical anesthetic improves analgesia for local anesthetic injections. Method A cohort study of 400 patients undergoing Mohs micrographic surgery with local anesthetic was conducted. Patients received no intervention ( n = 200), ice ( n = 50), topical anesthetic cream ( n = 50), vibration device ( n = 50), or nitrous oxide ( n = 50). Pain was rated using the Visual Analogue Scale (VAS) and Wong-Baker FACES Pain Rating Scale. Results Without intervention, mean VAS was 4.2 and FACES was 4.6. Nitrous oxide was the most successful in reducing pain (mean VAS 1.6 vs. 4.2, P < .01, FACES 1.2 vs. 4.6, P < .01). Topical ice reduced pain (mean VAS 3.0 vs. 4.2, P < .01, FACES 3.0 vs. 4.6, P < .01). Vibration reduced pain (mean VAS 3.5 vs. 4.2, P < .01, FACES 3.6 vs. 4.6, P < .01). Higher pain scores were associated with age <50 ( P = .02), male sex ( P = .05), and surgery on the nose, lip, ear, or eyelid ( P = .02). Conclusion Nitrous oxide, ice, and vibration reduce injection pain. These interventions are especially useful for younger males undergoing surgery on the nose, lip, ear, or eyelid.

Topical 2% Amitriptyline and 1% Ketamine in Neuropathic Pain Syndromes

2005 ◽  
Vol 103 (1) ◽  
pp. 140-146 ◽  
Author(s):  
Mary E. Lynch ◽  
Alexander J. Clark ◽  
Jana Sawynok ◽  
Michael J. L. Sullivan
Keyword(s):  
Neuropathic Pain ◽  
Rating Scale ◽  
Controlled Trial ◽  
Primary Outcome Measure ◽  
Systemic Absorption ◽  
Mcgill Pain Questionnaire ◽  
Double Blind ◽  
Blood Concentrations ◽  
Pain Syndromes ◽  
Pain Scores

Background A double-blind, randomized, placebo-controlled 3-week study evaluated the efficacy of topical 2% amitriptyline, 1% ketamine, and a combination of both in treating patients with neuropathic pain. Methods Ninety-two patients with diabetic neuropathy, postherpetic neuralgia, or postsurgical/posttraumatic neuropathic pain with allodynia, hyperalgesia, or pinprick hypesthesia were randomly assigned to receive one of four creams (placebo, 2% amitriptyline, 1% ketamine, or 2% amitriptyline-1% ketamine combined). The primary outcome measure was change in average daily pain intensity (baseline week vs. final week) using an 11-point numerical pain rating scale. Secondary outcomes included the McGill Pain Questionnaire, measures of allodynia and hyperalgesia, and patient satisfaction. Results A reduction in pain scores of 1.1-1.5 units was observed in all groups, and there was no difference between groups. Blood concentrations revealed no significant systemic absorption. Minimal side effects were encountered. Conclusion This randomized, placebo-controlled trial examining topical 2% amitriptyline, 1% ketamine, and a combination in the treatment of neuropathic pain revealed no difference between groups. Optimization of doses may be required, because another study has revealed that higher concentrations of these agents combined do produce significant analgesia.

Local Infiltrative Anesthetic Effect of Tramadol Compared to Lidocaine for Excision of Cutaneous Lesions: Pilot Randomized, Double-Blind Clinical Study

2012 ◽  
Vol 16 (2) ◽  
pp. 101-106 ◽  
Author(s):  
Despoina Kakagia ◽  
Theodosia Vogiatzaki ◽  
Savvas Eleftheriadis ◽  
Gregory Trypsiannis ◽  
Christos Iatrou
Keyword(s):  
Injection Site ◽  
Postoperative Analgesia ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Demographic Data ◽  
Randomized Study ◽  
Cutaneous Lesions ◽  
Double Blind ◽  
Lidocaine Group ◽  
Pain Scores

Background: In this double-blind, randomized study, the efficacy of tramadol, an atypical opioid, was tested versus lidocaine in excision of cutaneous lesions of the face. Methods: Eighty-eight patients were randomly assigned to receive either 2 mg/kg tramadol 2% plus adrenaline 1:200,000 (group T, n = 46) or 3 mg/kg lidocaine 2% plus adrenaline 1:200,000 (group L, n = 42) for excision of cutaneous lesions. Pain at the injection site, 2 and 20 minutes postinjection and 3, 6, and 12 hours postoperatively, was monitored on a 0 to 10 numerical rating scale (NRS). Irritation at the injection point and the duration of postoperative analgesia were also recorded. Results: There were no significant differences in demographic data, topography, size of the lesions removed, and operative time between the two groups. A tendency toward lower injection NRS pain scores was observed in group L compared to group T (p = .064). No statistically significant differences between the two groups were found at 2 and 20 minutes postinjection (p = .741 and p = .142, respectively); however, pain scores were significantly higher in group L at 3, 6, and 12 hours postoperatively (all p < .001). Erythema at the injection site was observed in nine group T and two group L patients (p = .076). No postoperative analgesics were required in the tramadol group of patients, whereas acetaminophen with or without codeine was administered in all but five lidocaine group patients during the first 12 hours. Conclusion: Tramadol may be used as a reliable local anesthetic agent, providing longer postoperative analgesia compared to lidocaine; however, it bears a higher incidence of irritation at the injection site.

A Controlled Comparison of Simulated and Real ECT

1978 ◽  
Vol 133 (6) ◽  
pp. 514-519 ◽  
Author(s):  
J. Lambourn ◽  
D. Gill
Keyword(s):  
Rating Scale ◽  
Muscle Relaxation ◽  
Control Treatment ◽  
Treatment Procedure ◽  
Double Blind ◽  
Convulsive Therapy ◽  
Pre Treatment ◽  
Controlled Evaluation ◽  
Electro Convulsive Therapy ◽  
Hamilton Rating Scale

SummaryTwo groups of 16 patients with depressive psychosis took part in a controlled evaluation of electro-convulsive therapy (ECT). One group received six brief pulse unilateral shocks under conventional anaesthesia and muscle relaxation; the second group underwent the same procedure without receiving shocks. Outcome was assessed by a separate investigator using the Hamilton Rating Scale for Depression under double-blind conditions. The results showed that this form of ECT was only superior to the control treatment for one item in the scale, a finding which could have occurred by chance. The results suggest that the ECT pre-treatment procedure has an important therapeutic effect. This casts some doubt on current views of the effectiveness of electro-convulsive therapy in general, and of brief pulse unilateral ECT in particular.

Randomized Trial of Buffered Versus Plain Lidocaine for Local Anaesthesia in open Carpal Tunnel Decompression

2004 ◽  
Vol 29 (1) ◽  
pp. 30-31 ◽  
Author(s):  
A. C. WATTS ◽  
P. GASTON ◽  
G. HOOPER
Keyword(s):  
Sodium Bicarbonate ◽  
Carpal Tunnel ◽  
Local Anaesthetic ◽  
Statistical Difference ◽  
Case Control Study ◽  
Case Control ◽  
Double Blind ◽  
Pain Scores ◽  
The Mean ◽  
Control Study

We performed a randomized double-blind case–control study in 64 consecutive patients undergoing open carpal tunnel decompression under local anaesthetic to assess the pain experienced on injection of plain lidocaine (pH 6.4) compared with lidocaine buffered with sodium bicarbonate (pH 7.4). The results showed no statistical difference in the pain scores reported by patients. The mean pain scores for all patients were low, and most patients reported that they were “not at all anxious” about receiving a similar injection in the future.

Oral Flurbiprofen Spray for Posttonsillectomy Pain

2016 ◽  
Vol 155 (1) ◽  
pp. 166-172 ◽  
Author(s):  
Togay Muderris ◽  
Fatih Gul ◽  
Gokhan Yalciner ◽  
Mehmet Ali Babademez ◽  
Sami Bercin ◽  
...  
Keyword(s):  
Placebo Group ◽  
Rating Scale ◽  
Demographic Data ◽  
Double Blind ◽  
Pain Scores ◽  
Significant Difference ◽  
Lower Pain ◽  
Numeric Pain Rating Scale ◽  
Rating Scale Data ◽  
Posttonsillectomy Pain

Objective Tonsillectomy is still one of the most common surgical procedures, but there exists no standard guideline for pain management after tonsillectomy. Our aim is to determine whether oral spray of flurbiprofen reduces pain and has an influence on other morbid outcomes following tonsillectomy. Study Design Prospective, double-blind, randomized, placebo controlled. Setting Patients at Ataturk Training and Research Hospital, Ankara, Turkey. Subjects and Methods This study was performed on 84 patients (45 in flurbiprofen group, 39 in placebo group) who underwent tonsillectomy. The patients were randomly chosen, and each used oral spray of flurbiprofen 3 times daily or placebo solution at the same regimen. Efficacy was assessed by changes in Numeric Pain Rating Scale. Data were collected at postoperative days 1, 3, 5, and 7 for pain, bleeding, and healing. Data for Mallampati scores were also collected. Results There were no significant difference between groups with respect to the demographic data. The flurbiprofen group had statistically significant lower pain scores at days 1, 3, 5, and 7 ( P = .000, P = .002, P = .001, P = .000, respectively). On days 3 and 7, pain scores were significantly different between different Mallampati groups ( P = .049, P = .015, respectively). The flurbiprofen group required less analgesic than the placebo group during the study period on days 1, 3, 5, and 7 ( P = .001, P = .001, P = .03, P = .001, respectively). Healing and side effects were not significantly different between the groups. Conclusion In this study, topical use of flurbiprofen may reduce posttonsillectomy pain without any evidence of additional complications.

A Double-Blind Study of Dothiepin Hydrochloride (Prothiaden) and Amitriptyline in Out-Patients with Masked Depression

1981 ◽  
Vol 9 (2) ◽  
pp. 103-107 ◽  
Author(s):  
L E Dahl ◽  
S J Dencker ◽  
L Lundin
Keyword(s):  
Statistical Analysis ◽  
General Practitioner ◽  
Side Effects ◽  
Statistical Difference ◽  
Rating Scale ◽  
Somatic Complaints ◽  
Double Blind Study ◽  
Double Blind Trial ◽  
Double Blind ◽  
Hamilton Rating Scale

A group of forty patients who presented to their general practitioner with depression or somatic complaints, which were considered to be due to depression, were included in a double-blind trial of dothiepin and amitriptyline. Patient improvement as judged by the Hamilton Rating Scale (HRS) and the Comprehensive Psychopathological Rating Scale (CPRS) indicated that both groups significantly improved over the 6 week period. Only in one comparison, CPRS after 1 week, was there any statistical difference between the groups and in this case dothiepin produced a better response than amitriptyline (p < 0.05). Statistical analysis of side-effects indicated that the frequency and severity of certain individual side-effects, hypotension, tiredness/sleepiness and dry mouth were significantly less with dothiepin than with amitriptyline at Week 1 (p < 0.05). The overall incidence and severity of side-effects was also less with dothiepin at all assessments during the trial.

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