scholarly journals Ketorolac or Pethidine for Analgesia after Elective Laparoscopic Sterilization

1995 ◽  
Vol 23 (2) ◽  
pp. 158-161 ◽  
Author(s):  
L. Cade ◽  
P. Kakulas
Keyword(s):  
Admission Rate ◽  
Day Surgery ◽  
Double Blind Study ◽  
Unplanned Admission ◽  
Double Blind ◽  
Analgesic Effects ◽  
Recovery Times ◽  
Laparoscopic Sterilization ◽  
Unplanned Admissions ◽  
Intramuscular Ketorolac

Laparoscopic sterilization is commonly performed as a day surgery procedure despite difficulties in providing adequate postoperative analgesia for all patients. We have examined the analgesic utility of intramuscular ketorolac in this setting by comparing it with intramuscular pethidine, both given after induction in a randomized, double-blind study in sixty such patients. Although the analgesic effects of the two drugs were comparable in the immediate postoperative period, ketorolac provided significantly better analgesia four hours after surgery (pain score of 2.7 v. 4.2, P=0.006). The recovery times taken to awake, to ambulate and for discharge were all significantly shorter after ketorolac (4.6 v. 8.8 min, P=0.01; 178 v. 260 min, P=0.0005; 242 v. 320 min, P=0.02), and the unplanned admission rate was also significantly less after ketorolac (7% v. 33%, P=0.01). Ketorolac appears to be a useful supplement for analgesia after laparoscopic sterilization, providing improved analgesia as well as decreased recovery time and fewer unplanned admissions.

Major ear surgery in a paediatric day care unit

2002 ◽  
Vol 116 (10) ◽  
pp. 791-793 ◽  
Author(s):  
R. G. Rowlands ◽  
R. Harris ◽  
J. Hern ◽  
J. R. Knight
Keyword(s):  
Outcome Measure ◽  
Admission Rate ◽  
Day Surgery ◽  
Unplanned Admission ◽  
Day Case ◽  
Ear Surgery ◽  
The Usa ◽  
Unplanned Admissions ◽  
Mastoid Surgery ◽  
Case Basis

Abstract Traditionally major ear surgery in children has been regarded as an in-patient procedure. Evidence from the USA for adults, however, concludes that it is both safe and effective to perform many major ear procedures as day cases. We have been carrying out major ear operations on children as day cases routinely for six years in a dedicated children’s day unit and examined our data to find out whether it was both safe and feasible to perform major ear surgery in children on a day-case basis. As our main outcome measure we used the rate of unplanned admissions.We found that the unplanned admission rate for surgery, excluding mastoid surgery, was 6.7 per cent and that procedures such as myringoplasty, ossiculoplasty, bilateral pinnaplasty, meatoplasty and tympanotomy with excision of cholesteatoma, were eminently suitable for day surgery.

scholarly journals Intra-articular morphine versus bupivacaine for knee motion among patients with osteoarthritis: randomized double-blind clinical trial

2008 ◽  
Vol 126 (6) ◽  
pp. 309-313 ◽  
Author(s):  
Miriam Bellini Gazi ◽  
Rioko Kimiko Sakata ◽  
Adriana Machado Issy
Keyword(s):  
Pain Clinic ◽  
Osteoarthritis Of The Knee ◽  
Double Blind Study ◽  
Double Blind ◽  
Analgesic Effects ◽  
Numerical Scale ◽  
Double Blind Clinical Trial ◽  
Significant Difference ◽  
Pain At Rest ◽  
Flexion And Extension

CONTEXT AND OBJECTIVE: Osteoarthritis causes pain and disability in a high percentage of elderly people. The aim of the present study was to assess the efficacy of intra-articular morphine and bupivacaine on the joint flexion and extension angles of patients with knee osteoarthritis. DESIGN AND SETTING: A randomized double-blind study was performed at a pain clinic of Universidade Federal de São Paulo. METHODS: Thirty-nine patients with pain for more than three months, of intensity greater than three on a numerical scale (zero to 10), were included. G1 patients received 1 mg (1 ml) of morphine diluted in 9 ml of saline, intra-articularly, and G2 patients received 25 mg (10 ml) of 0.25% bupivacaine without epinephrine. Pain was assessed on a numerical scale and knee flexion and extension angles were measured after administration of the drugs at rest and during movement. The total amount of analgesic supplementation using 500 mg doses of paracetamol was also determined. RESULTS: No significant difference in pain intensity was observed between G1 and G2. Significant decreases in pain at rest and during movement and significant increases in mean flexion and extension angles were observed in both groups, with no significant difference between the two groups. The mean total amount of paracetamol used over a seven-day period was 3578 mg in G1 and 5333 mg in G2 (P = 0.2355; Mann-Whitney test). CONCLUSION: The analgesic effects of 1 mg of morphine and 25 mg of 0.25% bupivacaine were similar among patients with osteoarthritis of the knee.

scholarly journals 262 Analysis of the Factors Contributing to Unplanned Admissions of Surgical Day Cases

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
R Al-Zubaidy ◽  
C Greaney ◽  
H Malik ◽  
F Awan
Keyword(s):  
Admission Rate ◽  
Incisional Hernia Repair ◽  
Cost Effective ◽  
Day Surgery ◽  
Root Cause ◽  
Background History ◽  
Unanticipated Admission ◽  
Almost All ◽  
Unplanned Admissions ◽  
Hospital Acquired

Abstract Introduction Day surgery has many benefits including a reduction in waiting lists, cancellations, hospital acquired infections and need for inpatient beds. It is also highly cost effective. The aim of this study is to identify which factors lead to the unanticipated admission of day cases, in order to adjust future patient selection, and retain efficiency Method A list of day cases that took place in 2017 was obtained from the HIPE department in St. Luke’s General Hospital. Day case patients who required admission were retrospectively analysed with the use of patient charts. Patient factors such as age, gender and co morbidities were recorded. The root cause of admission was identified, and the data collated. Results 457-day cases took place during 2017. 35/457 patients were admitted postoperatively (admission rate of 7.8%). The majority of patients were admitted post cholecystectomy (22) and incisional hernia repair (8). Surgical factors were responsible for almost all admissions. Conclusions Surgical factors/complications are not always predictable, but a thorough review of a patient’s background history and imaging can lead to the identification of patients, who should be directed away from day surgery, minimising the need for unexpected admissions, and maximising the efficiency of the unit.

Early analgesic effects of intravenous parecoxib and rectal diclofenac following laparoscopic sterilization: A double-blind, double-dummy randomized controlled trial

2018 ◽  
Vol 4 (1) ◽  
pp. 49
Author(s):  
Alexander Ng, MD, FRCA ◽  
Ajay Swami, FFARCSI ◽  
Graham Smith, MD, FRCA ◽  
Joe Emembolu, FRCOG
Keyword(s):  
Randomized Controlled Trial ◽  
Pain Intensity ◽  
Controlled Trial ◽  
Double Blind ◽  
Rescue Analgesia ◽  
Analgesic Effects ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Laparoscopic Sterilization ◽  
Rescue Antiemetic

The aim of this double-blind double-dummy randomized controlled trial was to investigate if there was any difference in analgesia between the maximum recommended doses of rectal diclofenac and iv parecoxib after laparoscopic sterilization. The authors studied 55 ASA I-II patients undergoing gynecological laparoscopy; each patient received either preoperative rectal diclofenac 100 mg and 2 mL of normal saline at induction of anesthesia, or preoperative placebo suppository and 2 mL of parecoxib 40 mg at induction. Pain intensity, sedation, and nausea were measured using a 100-mm visual analogue scale on awakening and at 1, 2, and 3 hour postoperatively. Median (interquartile range) pain intensity at rest on awakening and at 1, 2, and 3 hour postoperatively were 15 (0-40), 37 (10-56), 16 (6-29), and 13 (2-32) mm, respectively, in the parecoxib group, and 3 (0-34), 22 (5-45), 24 (6-37), and 10 (4-21) mm, respectively, in the diclofenac group. There was no significant difference in these scores. Furthermore, there was no significant difference between the two groups in sedation, nausea, rescue analgesia, or rescue antiemetic consumption. Preoperative rectal diclofenac 100 mg and parecoxib 40 mg iv at induction of anesthesia were found to have equianalgesic effects after laparoscopic sterilization. Both drugs appear to be useful after short anaesthetics.

The Early and Delayed Analgesic Effects of Ketamine After Total Hip Arthroplasty: A Prospective, Randomized, Controlled, Double-Blind Study

2009 ◽  
Vol 109 (6) ◽  
pp. 1963-1971 ◽  
Author(s):  
Francis Remérand ◽  
Charlotte Le Tendre ◽  
Annick Baud ◽  
Claude Couvret ◽  
Xavier Pourrat ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Blind Study ◽  
Double Blind Study ◽  
Double Blind ◽  
Total Hip ◽  
Analgesic Effects ◽  
Randomized Controlled
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