scholarly journals A Comparison of the Efficacy of Ketorolac and Indomethacin for Postoperative Analgesia following Laparoscopic Surgery in Day Patients

1996 ◽  
Vol 24 (2) ◽  
pp. 237-240 ◽  
Author(s):  
G. C. Murrell ◽  
T. Leake ◽  
P. J. Hughes
Keyword(s):  
Case Reports ◽  
Double Blind Study ◽  
Random Allocation ◽  
Day Case ◽  
Double Blind ◽  
Group I ◽  
Rectal Suppository ◽  
Analgesic Supplement ◽  
Visual Analog Pain Score ◽  
Postoperative Renal Failure

The analgesia provided in the postoperative period by three regimens commonly used in our private anaesthetic practice were compared in a double-blind study of one hundred and thirty-seven women presenting for day-case laparoscopic procedures. After random allocation into three groups, all patients were similarly anaesthetized and then received both a rectal suppository and an IM injection. Group P received two placebos, Group I had an indomethacin suppository 100 mg, and Group K an IM injection of ketorolac 30 mg. The trial showed a statistically significant reduction in pain at 180 minutes postoperatively in the group receiving ketorolac (visual analog pain score of 13.8 v 21.7). The parenterally administered ketorolac may be a useful analgesic supplement in these patients. However the trial was aborted following the appearance in the literature of case reports of postoperative renal failure. Further investigation of the efficacy and side-effect profile of reduced doses may be warranted.

scholarly journals Comparative evaluation of Myolaxin and EM LA cream for attenuation of venous cannulation pain: A prospective, randomised, double blind study

2007 ◽  
Vol 35 (5) ◽  
pp. 726-729 ◽  
Author(s):  
A. Agarwal ◽  
G. Yadav ◽  
D. Gupta ◽  
M. Tandon ◽  
S. Dhiraaj ◽  
...  
Keyword(s):  
Eutectic Mixture ◽  
Similar Efficacy ◽  
Blind Study ◽  
Double Blind Study ◽  
Dominant Hand ◽  
Venous Cannulation ◽  
Double Blind ◽  
Suitable Alternative ◽  
Group I ◽  
Cannulation Site

We evaluated the efficacy of topical Myolaxin (capsaican ointment, Geno, Mumbai) ointment over EMLA (eutectic mixture of lignocaine, prilocaine; Neon, Goa) cream for attenuating venous cannulation pain in this prospective, randomised, double blind study. Sixty adult patients undergoing elective laparoscopic cholecystectomy were randomly assigned into two equal groups. Group I (EMLA) received EMLA cream, whereas Group II (Myolaxin) received Myolaxin ointment. For both groups the cream was applied at the venous cannulation site (dorsum of the non-dominant hand) one hour prior to venous cannulation and was covered with an occlusive dressing. Following venous cannulation patients were asked if they felt pain during venous cannulation. If the answer was yes, they were asked to rate the severity of venous cannulation pain using a Visual Analogue Scale (VAS) of O-10. The incidence of venous cannulation pain was similar between groups: in the EMLA group 65% (18/28) compared to 67% (20/30) in the Myolaxin group (P=0.19). The severity of pain (median VAS with inter quartile range) was also similar between the groups: in the EMLA group 1.5 (3) compared to 1.5 (2) in the Myolaxin group (P=0.46). As the topical application of Myolaxin ointment is cheaper than EMLA and has similar efficacy, it may be a suitable alternative for reducing the incidence and severity of venous cannulation pain.

ULTRASONOGRAPHY AS A DIAGNOSTIC MODALITY OF TIBIAL STRESS FRACTURES

2008 ◽  
Vol 11 (02) ◽  
pp. 55-61 ◽  
Author(s):  
Uri Farkash ◽  
Javier Naftal ◽  
Estela Deranze ◽  
Alexander Blankstein
Keyword(s):  
Bone Scan ◽  
Imaging Modality ◽  
Case Reports ◽  
Stress Fractures ◽  
Surface Irregularity ◽  
Double Blind Study ◽  
Basic Training ◽  
Double Blind ◽  
Diagnostic Modality ◽  
Medicine Service

Tibial stress fractures (SFs) are a common orthopedic problem during military basic training. Bone scan is considered the gold standard for diagnosing this condition. Several case reports have described sonographic features of stress fractures. This is a prospective, double-blind study to compare diagnostic ultrasound (US) examination with isotope bone scan in diagnosing SF. Thirty-one soldiers who were referred to the nuclear medicine service for a bone scan to rule out tibial SF participated in this study. The SF lesions of the lower extremities were classified according to the classification criteria introduced by Zwas et al.20 US examination was performed on the same day. Areas of cortical thickening and other pathologies like bone surface irregularity and bone discontinuity were recorded. Each examination was graded as either normal or suggestive of representing a SF. Thirty of 62 tibiae were diagnosed as having SF according to bone scan, whereas US examination suggested SF in 35 tibiae. US examination was positive in 20 of 30 tibiae with SF (67% sensitivity, 53% specificity). Although US correctly diagnosed SF in 20 tibiae, bone scan remains the chosen imaging modality to detect SF in soldiers. US was not found to be a reliable modality to diagnose SF.

scholarly journals Oral midazolam versus oral triclofos for sedation of children for computed tomography scan - a randomized clinical trial

2015 ◽  
Vol 2 (2) ◽  
pp. 41-45
Author(s):  
Anushu Gupta ◽  
Maitree Pandey ◽  
Lalita Choudhry ◽  
Aruna Jain ◽  
Harish Pemde
Keyword(s):  
Computed Tomography ◽  
Double Blind Study ◽  
Computed Tomography Scan ◽  
Double Blind ◽  
Comparable Rate ◽  
Group I ◽  
Oral Midazolam ◽  
Group Ii ◽  
Student’S T ◽  
Tomography Scan

Background: Effective and safe pediatric procedural sedation is still a concern especially in areas outside operation theatres. The aim of the study was to compare the efficacy and safety of oral triclofos and oral midazolam in children undergoing computed tomography.Methods: A prospective randomized double blind study was conducted in 100 children aged one to five years. Group-I (n=50) received oral triclofos 100 mg/kg and Group-II (n=50) oral midazolam 0.75 mg/kg. Both groups were given oral atropine 0.03 mg/kg and supplemented with intravenous midazolam upto 0.1 mg/kg in case of inadequate effect. Onset and duration of sedation, success for completion of procedure and time to recovery were noted. Student’s t test and Z test of proportions were used for statistical analysis.Results Majority of children 36(72%) in Group-I achieved Ramsay Sedation Score >4 as compared to 25(50%) in Group-II. Computed tomography scan could be successfully completed at comparable rate (52% vs 56%). Success rate improved to 96% vs 80% after supplementing intravenous midazolam in Group I & II respectively (p< 0.05). Onset (37.91minutes ± 7.96 vs 26 ± 10), duration of sedation ( 117.91minutes ± 72.41 vs 66.2minutes ± 33) were significantly shorter and recovery (98.19minutes ± 72.58 vs 47.4minutes ± 31.42) in Group I & II respectively was faster in children who received oral midazolam (p< 0.05).Conclusion We conclude that both drugs were equally effective and safe for computed tomography scan in children. However better recovery profile of midazolam makes it more suitable for day care procedures.Journal of Society of Anesthesiologists of Nepal 2015; 2(2): 41-45

scholarly journals PREVENTION OF SHIVERING DURING LOWER SEGMENT CESAREAN SECTION;

2013 ◽  
Vol 20 (03) ◽  
pp. 409-415
Author(s):  
ASHFAQ AHMED ◽  
MOHAMMAD ASLAM
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Carbon Dioxide Production ◽  
Double Blind Study ◽  
Lower Segment ◽  
Chi Square ◽  
Double Blind ◽  
Lower Segment Cesarean Section ◽  
Group I ◽  
Group Ii

Objectives: To compare the efficacy of low-dose prophylactic use of ketamine with ketamine plus midazolam for theprevention of shivering caused by spinal anesthesia, during lower segment cesarean section. Main Outcome Measures: Heamodynamicmonitoring, avoidance of lactic acidosis/ increased carbon dioxide production and patient satisfaction. Design: Prospective RandomizedControlled trial. Place: Department of Anesthesia and ICU PNS Shifa Karachi. Duration of study: March 2010 to June 2010. Patients andMethods: 100 ASA-I & II consecutive patients who reported for LSCS in PNS Shifa Hospital were studied. In this double-blind study,patients were randomly allocated to receive ketamine alone (Group I, n= 50), and ketamine plus midazolam (Group II, n = 50). Afterstandardized Spinal anesthesia, a shivering was recorded at 5 min intervals for 15 minutes. Results: Shivering was observed in 9/50(18%) patients of group I (Ketamine only) as compared to only 2/50 (4%) patients in Group II (ketamine + midazolam) (p=0.025) whichis statically significant. The two groups were comparable regarding distribution of age (p=0.37), BMI (p=0.27) and duration of surgery.Results were analyzed by using chi square test. Conclusions: The efficacy of i.v. ketamine plus midazolam is better as compared to lowdosei.v. ketamine alone in preventing shivering in lower segment Cesarean Section patients, during spinal anesthesia.

scholarly journals Comparison of intraperitoneal instillation of ropivacaine with normal saline in laparoscopic cholecystectomy

2017 ◽  
Vol 5 (11) ◽  
pp. 4924 ◽  
Author(s):  
Tripat Kaur Bindra ◽  
Davinder Chawla ◽  
Parmod Kumar ◽  
. Parul
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Side Effects ◽  
Double Blind Study ◽  
Analgesic Requirement ◽  
Double Blind ◽  
Analgesic Consumption ◽  
Vas Score ◽  
Group I ◽  
Intraperitoneal Instillation ◽  
Group Ii

Background: Local anesthetics are now widely used, as they have a good safety profile and are available in long acting preparation. They provide the benefit of analgesia without systemic side effects that may result from use of enterally and parenterally administered drugs.Methods: This prospective randomized double-blind study was conducted on 100 patients with symptomatic gall stones disease undergoing laparoscopic cholecystectomy. Patients were randomized to receive either 0.5% of 3mg/kg of Ropivacaine diluted in 100 ml NS, instillation at intraperitoneal space before creation of pneumoperitoneum (group I) or 100 ml NS instillation at intra peritoneal space before creation of pneumoperitoneum (group II). VAS score for pain abdomen as well as shoulder were recorded postoperatively at various time intervals and compared in both the groups. Total analgesic consumption in 24hrs was also noted and compared.Results: The mean postoperative VAS score for abdomen and shoulder pain was significantly (p values<0.05) lower in group I than in group II till 24 hrs postoperatively. The latency time from end of operation to first analgesic requirement was significantly longer in group I than in group II.Conclusions: Intraperitoneal instillation of Ropivacaine before the creation of pneumoperitoneum significantly decreased the total abdominal pain, shoulder tip pain with lower analgesic consumption. As it is safe and without apparent side effects, we believe that intraperitoneal instillation of local anaesthetic in patients undergoing elective laparoscopic cholecystectomy is an effective modality for postoperative pain management.

Tacrolimus in Dermatology

2001 ◽  
Vol 5 (4) ◽  
pp. 329-335 ◽  
Author(s):  
Quang Hieu Dé Tran ◽  
Elizabeth Guay ◽  
Suzanne Chartier ◽  
Jacqueline Tousignant
Keyword(s):  
Animal Studies ◽  
Case Reports ◽  
Growth Disorders ◽  
Double Blind Study ◽  
Double Blind ◽  
Fk 506 ◽  
Topical Tacrolimus ◽  
Streptomyces Tsukubaensis ◽  
Gm Csf ◽  
Adults And Children

Background: Tacrolimus (FK 506), a metabolite of the fungus Streptomyces tsukubaensis, is an anti-T-cell drug. It acts by inhibiting the production of IL-2, IL-3, IL-4, TNFα, and GM-CSF. More potent and with slightly less secondary effects than cyclosporine, it has been the object of considerable interest, especially in conditions that could benefit from the latter. Objective: In psoriasis, a placebo-controlled double-blind study has shown oral tacrolimus at 0.1 mg/kg/day to be effective in controlling recalcitrant lesions. In human, small studies have reported tacrolimus ointment to be effective in controlling acute contact dermatitis. Short-term trials of topical tacrolimus in the treatment of atopic dermatitis have recently shown excellent results in both adults and children. In animal studies of hair growth disorders, topical tacrolimus induces anagen and protects from chemotherapy-induced alopecia. Animal studies with the ointment for the prevention of skin graft rejection, lupus dermatoses, and skin papilloma formation have also shown to be promising. Conclusions: There are case reports of pyoderma gangrenosum, Sezary's syndrome, and Behçet's disease successfully treated with oral tacrolimus but, because of their small number, they remain anecdotal at this point.

Quetiapine and Hypothyroidism: A Literature Review

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1 ◽  
Author(s):  
V. Kontaxakis ◽  
D. Karaiskos ◽  
B. Havaki-Kontaxaki ◽  
D. Skourides ◽  
P. Ferentinos ◽  
...  
Keyword(s):  
Observational Study ◽  
Thyroid Function ◽  
Case Reports ◽  
Double Blind Study ◽  
Double Blind ◽  
Medline Search ◽  
Replacement Treatment ◽  
Product Monograph ◽  
Open Question ◽  
Reversible Condition

Objective:Recently, there is an interest on the possible association between quetiapine and hypothyroidism. the aim of this study is to critically review all the reported cases in the international literature.Methods:A Medline search for all studies dealing with quetiapine induced hypothyroidism was carried out from January 1997 to June 2008.Results:Published literature on quetiapine's impact on thyroid function consists of 1 double-blind study, 1 observational study, 2 open studies, 3 case reports and data from the product monograph. A study on elderly psychotic patients revealed only small decreases in T4 levels, while another one in adolescents show trends for decrease in T4 and a marked increase in TSH. an observational study of thyroid function in patients treated with quetiapine and other antipsychotics, found a decrease in T4 with no changes in TSH and T3 and another one only slight increases in TSH. in the case reports all patients excibited clinical hypothyroidism. in one case there was a positive history for hypothyroidism, while in another one the patient had experienced lithium induced hypothyroidism in the past. According to quetiapine manufacturer 0.4% of the patients experienced TSH increases with half of them requiring thyroid replacement treatment. in studies, where quetiapine was adjunct to lithium or divalproate, 12% of patients had elevated TSH levels.Conclusion:We suggest a careful thyroid monitoring for patients initiating quetiapine, since hypothyroidism may emerge and masquerade psychopathologic manifestations. However, there is an open question whether thyroid dysfunction is a permanent or reversible condition.

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