scholarly journals Sedative and analgesic effects of propofol–ketamine versus propofol–fentanyl for emergency department procedures

2020 ◽  
pp. 102490791989346
Author(s):  
Shahrad Tajoddini ◽  
Mojdeh Motaghi

Background: To manage and reduce painful procedures in the emergency wards, procedural sedation as well as analgesia can be used. Propofol combinations are the most common short-acting intravenous sedative drugs in the field of emergency medicine. Objectives: This research aimed to compare the effectiveness, safety, and complications of intravenous infusion of ketofol with fentofol in painful emergency procedures. Methods: This study was a randomized, double-blind clinical trial. Sampling was simple and used random assignment; 196 participants were randomly assigned to two groups of 98 patients each. In each group, injection was done with fentanyl–propofol or ketamine–propofol. For data gathering, pre-procedure, and procedure, modified Aldrete’s scoring checklist was used. In order to determine the levels of sedation, we used the Ramsay Sedation Scale. Data analysis was performed via SPSS Version 20 using statistical tests such as mean ± standard division, t-test, chi-square test, and analysis of variance. Results: Among the participants in this study, shoulder procedure was performed more than other procedures (56.6%). The mean of recovery time was significantly different in the two groups (ketofol: 5.65 ± 0.35 vs fentofol: 9.33 ± 0.78); the recovery time in group B (fentofol) was longer than that in group A (ketofol) (p = 0.001). Drug complications were statistically significant in the two groups, and complications by ketofol were less than those by fentofol (p = 0.001). “Hypotension and bradycardia” were observed with fentofol and “tachycardia” was observed with ketofol. The performance of these two drugs was not the same when subject to various procedures. Conclusion: Results of this study revealed that ketofol provided better analgesia and sedation, faster recovery time, lesser complications and adverse events, and reduced bradycardia and hypotension.

2010 ◽  
Vol 17 (03) ◽  
pp. 400-404
Author(s):  
ALI MIR MANSOURI ◽  
FARNOUSH FARZI ◽  
SHIRIN KHALKHALIRAD ◽  
Katayoon Haryalchi ◽  
Abas Sediginejad

Introduction: There are many complications for patients with post cesarean section relative pain. So it delays in discharging or increasing in hospital stay. The objective of this study was a comparison between Tramadol and Meperidine according to pain relief or other possible complications in post cesarean section pain control. Materials and Methods: This study was a double blind clinical trial. It arranged for 240 parturients who scheduled for emergency cesarean section with pain after surgery in spite of spinal anesthesia. All patients were in ASA class I. They were divided randomly in two groups .Meperidine (M) and Tramadol (T) groups with 120 patients in each group. After beginning of pain in post anesthesia care unit (VAS> or = 4), in group (T) tramadol 1.5 mg/kg and in group (M) meperidine  .5 mg/kg were injected intravenously. Apart from pain, other drug complications such as shivering, blood pressure changes, itching, nausea and vomiting, drowsiness were recorded one and two hours after injection. Data were analyzed by chi-square test. Results: Relative frequency rate (RFR) of 50% decrease in pain score one hour after intravenous injection was 56.7% in group (T) and 69.2% in group (M) ( P = 0.054). RFR for respiratory depression after one hour was 5.8% in (M) group and 0 in (T) group (P = 0.007). RFR for nausea after one hour was 39.2% in (T) group and 23.3% in (M) group (P = 0.008). RFR for vomiting after one hour was 23.3% in (T) group and 13.3% in (M) group (P= 0.045). RFR for drowsiness after one hour was 25% in (M) group and 3.3% in (T) group (P=0.007). There was no statistically significant relationship after 2nd hour for pain relief, nausea, vomiting and drowsiness between two groups. There was no difference between two groups in RFR for shivering, blood pressurechanges and itching in both two groups. Conclusion: This study illustrates both remedies Meperidine and Tramadol which were effective for pain relief and shivering after cesarean section. But according to high incidence of nausea and vomiting with Tramadol and more analgesic effects of Meperidine than Tramadol, administration of Meperidine is better than Tramadol after cesarean section for pain control.


2020 ◽  
Vol 3 (1) ◽  
pp. 73-78
Author(s):  
Dinesh Sharma Bhusal ◽  
Bebina Shrestha

Introduction: Resting tongue position is of crucial importance in the stability and retention of complete denture, particularly of the mandible. The retracted position of the tongue has been found to be higher in edentulous subjects when compared to dentate subjects and highest in completely edentulous individuals. Objectives: To evaluate the resting tongue position in completely edentulous as well as partially edentulous patients. Methods: 50 edentulous and 50 partially edentulous (mandible) subjects were taken. The edentulous group was divided into two groups according to the duration of edentulousness. Group A: Recently extracted edentulous subjects (< 1 year), Group B: Long term edentulous subjects (> 1 years). The partially edentulous group was divided into 4 groups according to Kennedy classification. The resting tongue positions of all the individuals were determined. The data was analyzed using SPSS statistical tests like mean, standard deviation, proportion, Chi-square test and Independent T-test. Results: In complete edentulous group, the abnormal upper was the most frequent (38%). In partial edentulous group, the normal lower was the most frequently observed tongue position with 34%. The abnormal tongue position was found in 68% and 40% in completely edentulous and partially edentulous subjects respectively. Conclusion: Retracted resting tongue position is found to be higher in completely edentulous subjects than partially edentulous ones.


2020 ◽  
Vol 3 (2) ◽  
pp. 92-99
Author(s):  
Nganji Christian ◽  
Hossein Ghanaati ◽  
Vahid Changizi ◽  
Bahaadin Siroos ◽  
Farnoosh Mousavi

Purpose: The purpose of this study is to highlight the reliability of clinical DWI mismatch (CDM) in the identification of patients with large infarct growth. Methods: We prospectively reviewed 21 ischemic stroke patients who underwent DWI imaging within 72 hours from stroke symptoms onset. Description of images was made by experienced radiologists. Lesion volumes were assessed by manually outlining the DWI infarct lesions area. The percentage of infarct growth was calculated by dividing the difference between second and first infarct volume by the first infarct volume times 100. The NIHSS scores were assessed by an experienced neurologist. CDM was defined as NIHSS score ≥8 and initial infarct volume on DWI ≤ 25 mL. Statistical Tests: We assessed the relationships of variables within different groups of CDM using nonparametric tests—Kruskal-Wallis and chi-square test. Sensitivity and specificity of CDM to predict large infarct growth were tested by using crosstabs table. Results: CDM was present in 36.8% of our patients and was associated with the percentage of infarct growth ( P < .01). The mean percentage growth was high in patients with CDM (211.8%) while it was low in the group of patients without CDM (5.7%; group B and 10.7%; group C). The sensitivity and specificity of CDM to predict infarct growth was 77.8% vs 100% with a likelihood ratio of 15.4 ( P = .0004). Conclusion: The approach of comparing CDM and percentage of infarct growth proved that the concept of CDM can accurately indicate the existence of a large volume of tissue at risk of infarction—penumbra.


2018 ◽  
Vol 1 (1) ◽  
pp. 34
Author(s):  
Ni Nyoman Novita ◽  
Gusman Arsyad

Implementation of IMD in hospitals has decreased from the previous year and has not reached the target set by the government. Some IMD implementation processes have not been carried out according to applicable standards. So that babies do not get an IMD in accordance with existing SOPs. The purpose of this study was to determine the determinant factors associated with the implementation of the IMD by midwives in the Midwifery and Maternity Room Emergency Room (IGD) at the Anutapura General Hospital in Palu. This research method is analytical with cross sectional approach. The population of this study was that all midwives in the obstetrics emergency room and maternity room at Anutapura Palu Hospital were 37 respondents. The sample in this study is total sampling. The analysis used was univariate, and bivariate analysis using the chi square test with a confidence level of 95% (α = 0.05). The results of statistical tests on variable knowledge of midwives with the implementation of IMD p value: 0.018 (p value <0.05). APN training with the implementation of IMD p value: 0.697 (p value> 0.05). length of work with the implementation of IMD p value: 0.029 (p value <0.05). and peer support with the implementation of IMD p value: 0.007 (p value <0.05). Conclusions there is a relationship between knowledge, length of work, peer support with the implementation of the IMD, and training factors that have nothing to do with IMD implementation. The strongest factor in the relationship is peer support. It is recommended that the Anutarapura Palu Hospital be able to motivate midwives so that they can further enhance their role in the implementation and provide support to their colleagues so that the implementation of the IMD can be carried out in accordance with applicable standards.Keywords: Knowledge, APN Training, Duration of work, Implementation of IMD


2021 ◽  
Vol 45 (5) ◽  
pp. 312-316
Author(s):  
Mishra Neha Sanjeev ◽  
Harsimran Kaur ◽  
Sandeep Singh Mayall ◽  
Rishika ◽  
Ramakrishna Yeluri

Objective: To evaluate the effectiveness of placing a resorbable collagen barrier in impeding the extrusion of obturation material in primary molars undergoing resorption. Study design: All the 94 canals in 47 mandibular molars were allocated to 2 groups- Group ‘A’- 47 canals with collagen barrier (Test group) and Group ‘B’- 47 canals without collagen barrier (Control group) based on randomization protocol. Pulpectomy was performed and obturation of both test and control canals were radiographically assessed. Pearson’s chi – square test was applied to analyze the results. The significance level was predetermined at p &lt; 0.05. Results: Among the test group, 93.6% of the canals showed no extrusion while, 6.4% showed visible extrusion of the material outside the apex. In the control group, 83% showed no extrusion whereas 17% of the canals showed visible extrusion outside the apex. But no significant difference was noted (p&gt;0.05). Conclusion: The placement of resorbable collagen barrier in the apical third of the canal prevented the extrusion of obturating material beyond the apex in resorbing primary molars.


2015 ◽  
Vol 22 (74) ◽  
pp. 385-404
Author(s):  
Sérgio Fernando Loureiro Rezende ◽  
Ricardo Salera ◽  
José Márcio de Castro

This article aims to confront four theories of firm growth – Optimum Firm Size, Stage Theory of Growth, The Theory of the Growth of the Firm and Dynamic Capabilities – with empirical data derived from a backward-looking longitudinal qualitative case of the growth trajectory of a Brazilian capital goods firm. To do so, we employed Degree of Freedom-Analysis for data analysis. This technique aims to test the empirical strengths of competing theories using statistical tests, in particular Chi-square test. Our results suggest that none of the four theories fully explained the growth of the firm we chose as empirical case. Nevertheless, Dynamic Capabilities was regarded as providing a more satisfactory explanatory power.


2017 ◽  
Vol 21 (4) ◽  
Author(s):  
Deivid Ramos dos Santos ◽  
Laura Maria Vidal Nogueira ◽  
Bárbara Lopes Paiva ◽  
Ivaneide Leal Ataide Rodrigues ◽  
Lívia Félix de Oliveira ◽  
...  

Abstract Objective: To analyze the occurrence of Maternal Mortality in general and in the indigenous population in the state of Pará. Method: A quantitative, analytical and retrospective study was performed, covering a historical series from 2005 to 2014. For the analysis of the results, non-parametric statistical tests, the Chi-square test and the G test were processed in the BioStat 5.0 software program. Results: A total of 884 maternal deaths were reported in the state of Pará, corresponding to a Mortality Rate of 60.7 per 100,000 live births for non-indigenous women and 135.8 per 100,000 live births for indigenous women. Oedema, proteinuria and hypertensive disorders in pregnancy, childbirth and puerperium corresponded to 30.5% (n = 270). Conclusion and Implications for the Practice: Maternal mortality remains a serious public health problem in the state of Pará, clearly demonstrating that indigenous pregnant women require greater care, since they showed higher Maternal Mortality Rates when compared to non-indigenous women.


2021 ◽  
Vol 4 (1) ◽  
pp. 29-37
Author(s):  
Sitti Marya Ulva ◽  
Sinar Jannah

The percentage of families in Lapulu Village that had healthy latrines was 64,84% who met the health requirements and 35,16% who did not meet the health requirements in 2019. This shows that the ownership of healthy latrines is still lower than the national achievement. This study aims to determine the factors associated with low ownership of healthy latrines in the coastal areas of Lapulu Village, Kendari City. The research design was observational, with a cross-sectional approach. The population in this study was 437 respondents, while the study sample was 209 respondents. The sampling technique used was proportional random sampling technique. The analysis were performed using the Chi-Square test. The results of statistical tests with chi-square obtained the value of land availability (p-value=0,000), knowledge (p-value=0,031), and income (p-value=0,000). It can be concluded that there is a relationship between land availability, knowledge, and income levels associated with low ownership of healthy latrines in the tidal area of ​​Lapulu Village, Kendari City. Therefore, it is hoped that the community and local government will establish this inter sector collaboration with related agencies to increase community ownership of healthy latrines.


2019 ◽  
Vol 3 (9) ◽  
pp. 283-289
Author(s):  
Shuchi Sukul ◽  
Goldy Rathee ◽  
Parimal Anand ◽  
Sakshi Kataria ◽  
Pratibha Taneja

OBJECTIVES: The present research was conducted to assess incidences of root microcracks caused by hand and rotary file system at different lengths MATERIAL AND METHODS: This in-vitro study was undertaken to assess incidence of root microcracks caused by hand and rotary file system at different lengths In total, 100 the mandibular premolar with straight roots determined with intact, fully formed apices were taken. Samples were randomly distributed into 5 groups based on the file system used: a) Group A: Control, b) Group B: Reciproc, c) Group C: WaveOne, d) Group D: One Shape and e) Group E: ProTaper. Pearson Chi-square test was used to determine the differences between groups. The dentinal defects were expressed as percentage of samples with microcracks in each group. Level of statistical significance was set at p-value less than 0.05. RESULTS: The chi square test was used to compare the Distribution of the number of teeth in which cracks were observed on the horizontal sections. It was found to be significant with group ProTaper showing maximum cracks at 3,6,9 mm level as compared to other file systemCONCLUSION: Nickel-titanium instruments causes cracks on the apical root surface or in the root canal wall. ProTaper causes maximum dentinal cracks as compared to other file systems


Author(s):  
Aprilia Aprisanti Reyani

Latar Belakang :Kehangatan dada ibu dapat menghangatkan bayi, sehingga apabila bayi diletakan di dada ibunya segera setelah melahirkan atau dilakukan Inisiasi Menyusu Dini, dapat menurunkan resiko hipotermia dan menurunkan kematian bayi baru lahir akibat kedinginan atau hipotermia. Tujuan : Tujuan dari penelitian ini adalah untuk mengetahui perbedaan suhu tubuh bayi baru lahir antara bayi yang berhasil melakukan IMD dan bayi yang tidak berhasil melakukan IMD Metode  :Analitik,desain cross sectional,populasi semua bayi baru lahir, sampel bayi barulahir, teknik Non Random Sampling, pengumpulan data dengan menggunakan Lembar Observasi dengan menggunakan uji Chi-Square dengan nilai signifikan α = 0.05 yaitu bila hasil uji statistik menunjukan p ≤ α maka H0 ditolak. Hasil      :Suhu tubuh bayi baru lahir yang berhasil melakukan IMD sebagianbesardengansuhutubuhtidakhipotermisebanyak 20 bayi (87%) Suhu tubuh bayi baru lahir yang tidak berhasil melakukan IMD sebagianbesardengansuhutubuhhipotermisebanyak 8 bayi (66,7%). Dari hasil uji statistik diperoleh hasil nilai p = 0,005 < α = 0.05 maka H1 diterima, artinya ada Perbedaan suhu tubuh bayi baru lahir yang berhasil melakukan IMD dan yang tidak berhasil melakukan IMD Kesimpulan :Terdapat perbedaan suhu tubuh bayi baru lahir antara bayi yang berhasil melakukan IMD dan bayi yang tidak berhasil melakukan IMD.   Kata kunci : Inisiasi Menyusu Dini, Suhu Tubuh Bayi Baru Lahir                                                                                               THE DIFFERENCE BODY TEMPERATURE BETWEEN BABIES WHO SUCCESSFULLY INITIATE BREASTFEEDING EARLY AND BABIESWHO FAIL TO INITIATE EARLY BREASTFEEDING AT RSIA KIRANA SIDOARJO 2019  Background : The warmth of the mother’s chest can warm the baby, so that when the baby is in the mother’s breast immediately after birth or initiated early breastfeeding can reduce the mortality rate of newborns due to hypotermia.Purpose :the purpose of this study was to determine the difference in body temperature of newborns between infants who successfully initiated early breastfeeding and infants who did not succeed in initiating early breastfeedingMethods : analytical, cross sectional design, population 40 newborns, samples 35 newborns, Non Random Sampling techniques, the data accumulation using observation sheets and using chi-square test, with significant value α = 0.05 is when the statistical test results show p ≤ α then Ho is rejected.Result : The body temperature of the newborn who succeeded in initiating early breastfeeding was 36.78ºC with 23 (65.7%) of infants none having hypothermia, the newborn baby's body temperature that did not succeed in doing this early breastfeeding was 35.78ºC With 8 infants experiencing hypothermia, while 4 babies with normal temperature. From the results of statistical tests obtained results with the value p = 0,000 <α = 0.05 then H1 accepted, meaning there is a difference in body temperature of a newborn who successfully initiated early breastfeeding and who did not succeed in Early Breastfeeding Initiation. Conclusion : There is a difference in the body temperature of a newborn between infants who successfully initiated breastfeeding and infants who are not successful in initiating early breastfeeding....Keywords : Early breastfeedinginitiation, newborns temperature


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