scholarly journals An Investigation of the Effectiveness of Bupivacaine Applied to the Abdominal Wall and Fallopian Tubes in Reducing Pain after Laparoscopic Tubal Ligation

1986 ◽  
Vol 14 (2) ◽  
pp. 148-151 ◽  
Author(s):  
P. T. Cook ◽  
T. F. Lambert
Keyword(s):  
General Anaesthesia ◽  
Analogue Scale ◽  
Tubal Ligation ◽  
The Other ◽  
Fallopian Tubes ◽  
Moderate Pain ◽  
Double Blind ◽  
Pain Scores ◽  
Significant Difference ◽  
Low Incidence

Sixty women having laparoscopic sterilisation performed under general anaesthesia were randomly allocated to one of two groups. Intraoperatively, one group had bupivacaine applied topically to the fallopian tubes and injected into the skin wounds, while the other group received no local anaesthetic. A double-blind investigation utilising a visual analogue scale failed to demonstrate a statistically significant difference in postoperative pain between the two groups. In both groups there was a significant reduction in mean pain scores between ½ and 7 hours, but there was no further reduction between 7 hours and 17 hours. At 7 hours, only 10% of patients scored their pain as 3 or greater (out of a possible 10). It is concluded that the use of bupivacaine as described is not a useful adjuvant to general anaesthesia and that the low incidence of even moderate pain at 7 hours confirms the view that these patients are suitable for management in the day-stay unit.

Azelastine in the Prophylactic Treatment of Bronchial Asthma: An Italian Multicentre Comparison with Ketotifen

1989 ◽  
Vol 17 (3) ◽  
pp. 218-225 ◽  
Author(s):  
L. Ambrosi ◽  
F. Bariffi ◽  
M. Carino ◽  
E. Catena ◽  
G. Ceccarelli ◽  
...  
Keyword(s):  
Bronchial Asthma ◽  
Double Blind Study ◽  
Double Blind ◽  
Significant Difference ◽  
Effective Prophylaxis ◽  
Daily Dosage Regimen ◽  
Forced Expiratory Flow ◽  
Expiratory Flow ◽  
Low Incidence ◽  
Clinical Measures

The prophylactic effectiveness of the phthalazinone derivative, azelastine was compared with ketotifen. A total of 111 patients, aged 18 – 65 years, from 10 centres was entered into this randomized, double-blind study. All patients had reversible asthma. After 1 week on placebo, patients were allocated to either 8 mg/day azelastine once or twice daily, or to 1 mg ketotifen, twice daily, for a further 12 weeks. Azelastine was more effective in improving respiratory function (forced expiratory flow in 1 s and peak expiratory flow rate) when given in the once daily regimen, whereas clinical measures (number of weekly asthma attacks) were most improved by twice daily dosing. There was no significant difference between the effectiveness of azelastine and that of ketotifen. Treatments were equally well tolerated and a low incidence of side-effects was reported. In conclusion, 8 mg/day azelastine, in either a single or twice daily dosage regimen may be regarded as providing effective prophylaxis against bronchial asthma.

Early Aneurysm Surgery and Preventive Therapy with Intravenously Administered Nimodipine: A Multicenter, Double-Blind, Dose-Comparison Study

Neurosurgery ◽  
1990 ◽  
Vol 26 (3) ◽  
pp. 458-464 ◽  
Author(s):  
Joachim M. Gilsbach ◽  
Hans J. Reulen ◽  
Bengt Ljunggren ◽  
Lennart Brandt ◽  
Hans v. Holst ◽  
...  
Keyword(s):  
Preventive Therapy ◽  
Neurological Dysfunction ◽  
Comparison Study ◽  
Double Blind ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Dose Comparison ◽  
Significant Difference ◽  
Low Incidence

Abstract A European, multicenter. prospective, randomized. double-blind, dose-comparison study on preventive therapy with intravenously administered nimodipine was performed to evaluate the efficacy and tolerability of two different doses: 2 and 3 mg/h. Two hundred four patients fulfilled the criteria for enrollment in the study; surgery within 72 hours after the last subarachnoid hemorrhage, and age between 16 and 72 years. All patients who had Hunt and Hess grades of I to III were operated upon: patients who had poor Hunt and Hess grades (IV-V) were operated on according to the surgeon's choice. This treatment regimen was associated with a low incidence of delayed neurological dysfunction with no significant difference between the two dosage groups: three patients (1.5%) remained severely disabled and two (1%) moderately disabled due to vasospasm with or without additional complications. Among the patients with Hunt and Hess grades of IV or V. the long-term outcome was favorable (good-fair) for 40% and unfavorable for 60%. Among the patients with grades of I to III, the long-term outcome was favorable for 89% and unfavorable for 11%.

scholarly journals Post-Cholecystectomy Pulmonary Function following Interpleural Bupivacaine and Intramuscular Pethidine

1989 ◽  
Vol 17 (4) ◽  
pp. 440-443 ◽  
Author(s):  
D. C. Oxorn ◽  
G. S. Whatley
Keyword(s):  
Postoperative Pain ◽  
Pulmonary Function ◽  
Postoperative Analgesia ◽  
The Other ◽  
Pulmonary Mechanics ◽  
Postoperative Pulmonary Function ◽  
Pain Scores ◽  
Significant Difference ◽  
Group A ◽  
To Receive

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.

The Impact of Alvimopan on Return of Bowel Function After Major Spine Surgery – A Prospective, Randomized, Double-Blind Study

Neurosurgery ◽  
2019 ◽  
Vol 85 (2) ◽  
pp. E233-E239
Author(s):  
Lauren K Dunn ◽  
Robert H Thiele ◽  
Michelle C Lin ◽  
Edward C Nemergut ◽  
Marcel E Durieux ◽  
...  
Keyword(s):  
Spine Surgery ◽  
Bowel Movement ◽  
Bowel Function ◽  
Blind Study ◽  
Double Blind Study ◽  
Opioid Use ◽  
Double Blind ◽  
Pain Scores ◽  
Significant Difference ◽  
The Impact

Abstract BACKGROUND Pain management following major spine surgery requires high doses of opioids and is associated with a risk of opioid-induced constipation. Peripheral mu-receptor antagonists decrease the gastrointestinal complications of perioperative systemic opioid administration without antagonizing the analgesic benefits of these drugs. OBJECTIVE To investigate the impact of alvimopan in opioid-naive patients undergoing major spine surgery. METHODS Patients undergoing >3 levels of thoracic and/or lumbar spine surgery were enrolled in this prospective, randomized, double-blind study to receive either alvimopan or placebo prior to and following surgery. Opioid consumption; pain scores; and time of first oral intake, flatus, and bowel movement were recorded. RESULTS A total of 24 patients were assigned to the active group and 25 were assigned to the placebo group. There was no significant difference in demographics between the groups. Postoperatively, the alvimopan group reported earlier time to first solid intake [median (range): alvimopan: 15 h (3-25) vs placebo: 17 h (3-46), P < .001], passing of flatus [median (range): alvimopan: 22 h (7-63) vs placebo: 28 h (10-58), P < .001], and first bowel movement [median (range): alvimopan: 50 h (22-80) vs placebo: 64 h (40-114), P < .001]. The alvimopan group had higher pain scores (maximum, minimum, and median); however, there was no significant difference between the groups with postoperative opioid use. CONCLUSION This study shows that the perioperative use of alvimopan significantly reduced the time to return of bowel function with no increase in postoperative opioid use despite a slight increase in pain scores.

scholarly journals Is Skin-Touch Sham Needle Not Placebo? A Double-Blind Crossover Study on Pain Alleviation

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Miho Takayama ◽  
Hiroyoshi Yajima ◽  
Akiko Kawase ◽  
Ikuo Homma ◽  
Masahiko Izumizaki ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Analogue Scale ◽  
Sham Acupuncture ◽  
Treatment Control ◽  
Double Blind ◽  
Analgesic Effects ◽  
Significant Difference ◽  
Open Question ◽  
Blind Crossover Study ◽  
Double Blind Crossover Study

It remains an open question whether placebo/sham acupuncture, in which the needle tip presses the skin, can be used as a placebo device for research on pain. We compare the analgesic effect of the skin-touch placebo needle with that of the no-touch placebo needle, in which the needle tip does not touch the skin, in a double-blind crossover manner including no-treatment control in 23 healthy volunteers. The subjects received painful electrical stimulation in the forearm before and during needle retention to the LI 4 acupoint and after the removal of the needle and rated pain intensity using a visual analogue scale. We found no significant difference in analgesic effects among the skin-touch placebo needle, no-touch placebo needle, and no-treatment control at every point before, during, and after the treatments (p>0.05). The results indicate that the skin-touch placebo needle can be used as a placebo device in clinical studies on pain.

scholarly journals An investigation into the effect of evening primrose in dilatation of cervix and pain during and after hysterosalpingography

2019 ◽  
Vol 12 (3) ◽  
pp. 284-289
Author(s):  
Shahrzad Shahnam Nia ◽  
◽  
Fatemeh Safi ◽  
Maryam Shoukrpour ◽  
Alireza Kamali ◽  
...  
Keyword(s):  
Contrast Medium ◽  
Analogue Scale ◽  
Cervical Length ◽  
Diagnostic Methods ◽  
Control Group ◽  
Double Blind ◽  
Evening Primrose ◽  
Double Blind Clinical Trial ◽  
Significant Difference ◽  
Contrast Medium Injection

Hysterosalpingography is one of the essential diagnostic methods for examining women who have difficulty becoming pregnant. This procedure is somehow invasive and is associated with numerous complications such as allergic sensitivity, pain, abdominal cramps and shock. Therefore, this study aimed to investigate the effect of evening primrose on cervical length and pain during and after hysterosalpingography. In this double-blind clinical trial, 66 candidates for hysterosalpingography were randomly divided into two groups. A group received 1000 mg of evening primrose orally for two days prior to hysterosalpingography, while the control group received a placebo drug similar in size to evening primrose three days prior to hysterosalpingography. The pain level was recorded based on the Visual Analogue Scale (VAS), during tenaculum placement but also immediately and four hours after hysterosalpingography. Finally, the data were analyzed using SPSS (version 20). There was a significant difference between the two groups in terms of pain during insertion of speculum and injection of the contrast medium (p <0.05). Less pain was reported in the evening primrose group compared to placebo. There was no significant difference between the two groups in terms of the length and diameter of the cervix (p <0.05). Given the fact that it is a medicinal plant with no complications and can reduce pain during speculum insertion and during contrast medium injection, evening primrose seems to be a good drug for managing pain during hysterosalpingography.

Randomized double-blind placebo-controlled trial of celecoxib for radiation-induced oral mucositis.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 9620-9620
Author(s):  
Rajesh V. Lalla ◽  
Linda E. Choquette ◽  
Kathleen F. Curley ◽  
Robert J. Dowsett ◽  
Richard S. Feinn ◽  
...  
Keyword(s):  
Oral Mucositis ◽  
Fixed Effects ◽  
Controlled Trial ◽  
Opioid Analgesics ◽  
T Test ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Pain Scores ◽  
Significant Difference ◽  
Cox 2

9620 Background: Oral mucositis (OM) is a painful complication of radiation therapy (RT) for head and neck (H&N) cancer. OM can compromise nutrition, require opioid analgesics and hospitalization for pain control, and lead to treatment interruptions. Due to the role of inflammatory pathways in the pathogenesis of OM, this study investigated the effect of inhibition of cyclooxygenase-2 (COX-2) on severity and morbidity of OM. Methods: In this randomized double-blind placebo-controlled trial,40 H&N cancer patients were randomized to daily use of 200 mg celecoxib or matched placebo, for the duration of RT. Eligibility criteria included planned RT dose of ≥ 5000 cGy to 2+ areas of the mouth and no contraindication for celecoxib use. The planned sample size of 20 per arm provided 80% power to detect a 1 point difference in mean Oral Mucositis Assessment Scale (OMAS) score (range 0-5) at 5000 cGy RT (primary endpoint), applying a two-tailed, two-sample t-test at the 5% level of significance. Clinical OM, normalcy of diet, pain scores and analgesic use were assessed 2-3 times a week by blinded investigators during the 6-7 week period of RT, using validated scales. Results: Twenty subjects were randomized to each arm, which were similar with respect to tumor location, radiation dose, and concomitant chemotherapy. In both arms, mucositis and pain scores increased over the course of RT. Intent-to-treat analyses demonstrated no significant difference in mean (SD) OMAS scores at 5000 cGy [celecoxib 1.32 (0.71), placebo 1.27 (0.86), p = 0.83, two sample t-test]. There was also no difference between the celecoxib and placebo arms respectively, in mean OMAS scores over the period of RT (SD) [0.98(0.77) & 0.97 (0.86), p = 0.84], mean worst pain scores [3.38 (3.07) & 3.31 (3.32), p = 0.83], mean normalcy of diet scores [5.43 (3.86) & 5.11(3.94), p = 0.65], or mean daily opioid medication use in IV morphine equivalents [19.08 (16.57) & 20.48 (19.07), p = 0.48], all by linear mixed model fixed effects regression analysis. There were no SAEs attributed to celecoxib use. Conclusions: Daily use of a selective COX-2 inhibitor, during the period of RT for H&N cancer, did not reduce the severity of clinical OM, pain, dietary compromise or use of opioid analgesics. Clinical trial information: NCT00698204.

scholarly journals The prevalence of ovine herpesvirus-2 in 4 sheep breeds from different regions in South Africa

2010 ◽  
Vol 81 (2) ◽  
Author(s):  
C.W. Bremer
Keyword(s):  
South Africa ◽  
Nested Pcr ◽  
Lower Incidence ◽  
The Other ◽  
Malignant Catarrhal Fever ◽  
Single Tube ◽  
Sheep Breeds ◽  
Significant Difference ◽  
Herpesvirus 1 ◽  
Low Incidence

About 90% of bovine malignant catarrhal fever (BMCF) PCR-positive cases in South Africa are caused by alcelaphine herpesvirus-1 (AlHV-1) and the other 10 % by ovine herpesvirus-2 (OvHV-2). The prevalence of OvHV-2 in different sheep breeds in South Africa was determined in order to investigate whether the lower incidence of BMCF caused by OvHV-2 in comparison with AlHV-1 can be ascribed to a low incidence of the virus in sheep. A single-tube hemi-nested PCR was developed, evaluated and applied to detect OvHV-2 DNA. The prevalence of the virus in 4 sheep breeds from various regions in South Africa was shown to be 77 %. No statistically significant difference was found amongst the sheep breeds tested.

Effect of diathermy on pain and healing in tonsillectomy, compared with other methods of haemostasis: a randomised study

2008 ◽  
Vol 123 (6) ◽  
pp. 648-655 ◽  
Author(s):  
C H Hahn ◽  
J A Rungby ◽  
T Overgaard ◽  
H Møller ◽  
P Schultz ◽  
...  
Keyword(s):  
Clinical Study ◽  
Outcome Measures ◽  
Local Anaesthesia ◽  
Analogue Scale ◽  
The Other ◽  
Bipolar Diathermy ◽  
Consultation Rate ◽  
Randomised Study ◽  
Pain Scores ◽  
Controlled Clinical Study

AbstractObjective:To compare three methods of haemostasis used for ‘cold steel’ tonsillectomy, in terms of pain scores and morbidity.Method and material:Prospective, randomised, single-blinded, controlled clinical study. Three haemostasis methods were compared: compression of the tonsillar fossae with gauze packs; bipolar diathermy; and local anaesthesia then pack compression. The outcome measures were pain scores (derived from a visual analogue scale), peri-operative bleeding, and post-operative episodes of blood-stained saliva, consultation rate, tonsillar bed healing and days before return to regular diet. One hundred and five patients were included.Results:Peri-operative bleeding was significantly reduced in the local anaesthesia group compared with the other two groups. Delayed post-operative tonsillar bed healing was noted in the diathermy group. No other significant differences were found between the three haemostasis groups, for any other outcome measures. The presence of blood-stained saliva was associated with higher pain scores.Conclusion:Diathermy and compression were associated with similar post-tonsillectomy morbidity.

scholarly journals The Efficacy of Adding a Continuous Intravenous Morphine Infusion to Patient-Controlled Analgesia (PCA) in Abdominal Surgery

1995 ◽  
Vol 23 (4) ◽  
pp. 453-458 ◽  
Author(s):  
P. J. Dawson ◽  
F. C. Libreri ◽  
D. J. Jones ◽  
G. Libreri ◽  
A. R. Bjorkstein ◽  
...  
Keyword(s):  
Abdominal Surgery ◽  
Continuous Infusion ◽  
Delivery Ratio ◽  
Double Blind ◽  
Morphine Infusion ◽  
Pain Scores ◽  
Significant Difference ◽  
Intravenous Morphine ◽  
Lower Pain ◽  
Intravenous Analgesia

The effect of adding a continuous infusion of morphine 1 mg/hr to patient-controlled intravenous analgesia was studied in a randomized double-blind trial. Ninety-six patients scheduled for abdominal surgery were enrolled; 38 received PCA and continuous infusion (PCA + C), 45 received PCA alone and 13 were excluded because of protocol violations. PCA was delivered via an ABBOTT 4200 pump with settings of morphine 1 mg bolus and five-minute lockout in both groups. A separate pump delivered a continuous infusion of morphine 1 mg/ml (PCA + C) or 9% normal saline (PCA) at 1 ml/hr for three postoperative days. Pain was assessed by hourly verbal pain scores (VPS) and daily visual analog pain scores at rest and on movement (VASrest, VASmove). PCA delivered morphine and the demand to delivery ratio (D/D ratio) were used as indirect indicators of pain. These were assessed during daytime (0800–2200 hours), sleep (2200–0500 hours) and on first waking (0500–0800 hours). Patient demographics were similar. Patients receiving a continuous infusion had lower pain scores during the first 24 hours but not thereafter (VPS P=0.04, VASmove P=0.02). The PCA group delivered more PCA morphine during 0500–0800 hours and 0800–2200 hours on the first day only. There was no significant difference in the D/D ratio for any time period during the three days. Total morphine delivery was greater in the PCA + C group on the second and third postoperative days (P= 0.009 and P=0.0001 respectively). The incidence of respiratory depression and the total number of complications were significantly higher in those receiving continuous infusion (P=0.04 and P=0.011 respectively.) Adding a continuous morphine infusion of 1 mg/hr to the described PCA settings for three days following abdominal surgery improved analgesia during the first 24 hours but was associated with a greater incidence of complications.

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