Clonidine as an Adjuvant to Bupivacaine for Suprazygomatic Maxillary Nerve Blocks in Cleft lip and Palate Repair: A Randomized, Prospective, Double-Blind Study

2020 ◽  
pp. 105566562096414
Author(s):  
Gaston Echaniz Barbero ◽  
Marcos de Miguel ◽  
Plinio Sierra ◽  
Glenn Merritt ◽  
Pranjal Bora ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Blind Study ◽  
Double Blind Study ◽  
Emergence Agitation ◽  
Nerve Blocks ◽  
Double Blind ◽  
Maxillary Nerve ◽  
Significant Difference

Objectives: Does clonidine, as adjuvant to bupivacaine for suprazygomatic maxillary nerve blocks, reduce emergence agitation in patients undergoing cleft lip and cleft palate surgery? Design: Randomized, controlled, and double-blind study. Setting: Guwahati Comprehensive Cleft Care Center, Guwahati (Assam, India). Participants: A total of 124 patients; with a median age of 5 years in the clonidine group (CLG) and 7 years in the control group (CG), who underwent cleft lip or cleft palate surgery were included. Exclusion criteria included lack of consent from patients or their guardians, allergy to local anesthetics, coagulation disorders, local infection at the puncture site before performing the block, and language difficulties or cognitive disorders. Interventions: Patients were randomized into 2 groups to receive bilateral suprazygomatic maxillary nerve blocks with either a bupivacaine/clonidine mixture for the CLG or bupivacaine alone in the CG. Main Outcome Measure: The primary end point was the incidence of emergence agitation. Results: There was a statistically significant difference in the incidence of emergence agitation (30.2% in the CG compared to 15.2% in the CLG; difference of incidences: 15%, 95% CI: 0.1-30.1). The percentage of patients requiring intraoperative Fentanyl was lower in the CLG (10.6% compared to 26.4%; difference of incidences: 15.8%, 95% CI: 1.8-29). No other differences were observed. Further research in a more typically aged children population undergoing cleft surgery is needed. Conclusions: The use of clonidine as an adjuvant to bupivacaine in maxillary nerve block reduces the incidence of emergence agitation and intraoperative opioid consumption without hemodynamic or sedative side effects in patients undergoing cleft lip and palate surgery.

scholarly journals Role of pre–extubation fentanyl in mastectomy: a randomized, controlled, double–blind study

2021 ◽  
Vol 25 (2) ◽  
Author(s):  
Ahmed Salman ◽  
Norma Osama Zayed ◽  
Ahmed Mansour ◽  
Ramy Howaidi ◽  
Ahmed Gamaleldin Foly ◽  
...  
Keyword(s):  
Short Form ◽  
Cardiovascular Responses ◽  
Blind Study ◽  
Double Blind Study ◽  
Double Blind ◽  
Randomized Controlled ◽  
Arterial Blood ◽  
Extubation Time ◽  
Significant Difference

Background: Both tracheal intubation and extubation are associated with dangerous consequences such as tachycardia, hypertension, myocardial ischemia and arrhythmias. The aim was to evaluate pre–extubation two different doses of fentanyl on hemodynamic stabilization and delayed recovery in mastectomy. Methodology: The randomized controlled double–blind study was conducted on 126 patients aged 16–60 years, with controlled hypertension, receiving chemotherapy before surgery and underwent mastectomy for breast cancer. Patients were randomly allocated into 3 equal groups. Before extubation, patients received 10 ml saline in group (C), 1 µg/kg fentanyl in Group–F1: and 2 µg/kg fentanyl in Group–F2. Mean arterial blood pressure (MAP) and heart rate (HR) were recorded at T1 (after maintenance of anesthesia), T2 (after giving the test drug), T3 (immediately after extubation), T4 (5 min. after extubation) and T5 (15 min after extubation). Results: MAP was significantly lower in fentanyl groups compared to Group–C at T2 and T3 without significant deference between fentanyl groups. HR was significantly lower in fentanyl groups compared to Group–C and in Group–F2 compared to Group–F1 at T3, T4 and T5. Time of extubation was significantly prolonged in Group–F2 compared to Group–F1 and Group–C without a significant difference between Group–F1 and Group–C. Conclusions: Pre–extubation fentanyl 1 µg/kg blunted cardiovascular responses to extubation without respiratory depression or prolonged recovery. Pre–extubation fentanyl 2 µg/kg provide more control in HR but with delay in the extubation time compared to 1 µg/kg of fentanyl. Key words: Pre–Extubation, Fentanyl, Mastectomy, Hemodynamics, Recovery Preregistration: The study was registered in the Ethical Committee of Faculty of Medicine, Cairo University, Cairo, Egypt (approval number: 281) Citation: Salman A, Zayed NO, Mansour A, Howaidi R, Foly AG, ElSharkawy MS, Abdelgalil AS. Role of pre–extubation fentanyl in mastectomy: a randomized, controlled, double–blind study. Anaesth. pain intensive care 2021;25(2):143-149. DOI: 10.35975/apic.v25i2.1462. Abbreviations: CST=Craniosacral therapy; SMT=Sensorimotor training; NCLBP=Nonspecific chronic low back pain; VAS=Visual analogue scale; ODI=Oswestry disability index, BDI-II=Beck depression inventory-II, and SF-36=Short Form-36; CSF=cerebral spinal fluid; CSS=craniosacral system; PRM=primary respiratory movements Received: 27 June 2020, Reviewed: 24 July 2020, Accepted: 27 July 2020

The role of tolvaptan in prevention of hyponatremia in patients undergoing transurethral resection of prostate surgery- A randomized double blind study

2021 ◽  
Vol 8 (2) ◽  
pp. 321-325
Author(s):  
Dinesh Kumar Singh ◽  
B B Baj ◽  
Vipin Goyal
Keyword(s):  
Transurethral Resection ◽  
Blind Study ◽  
Transurethral Resection Of Prostate ◽  
Double Blind Study ◽  
Double Blind ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B

The aim of our study to determine the role of tolvaptan in prevention of hyponatremia in transurethral resection of prostate surgery. This is randomized double-blind study conducted in 60 ASA grade status 1 and 2 patients age group between 45-80 yrs undergoing TURP under spinal anaesthesia in urology operation theatre in Mahatma Gandhi hospital Jaipur after receiving permission from hospital ethical committee. A detailed history, complete physical examination and routine investigation were done for all patients followed by informed written consent was obtained. Patients are randomly divided into 2 groups. In group A -30 patients who received orally tab tolvaptan 15 mg and group B-30 patients who received orally tab multivitamin 2 hrs before surgery after doing electrolytes of the patients in the morning. In both groups age (in yrs), wt (in kg), ASA grade, volume of irrigating fluid (in litres), volume of prostate resected (in gm) and duration of surgery (in minutes) all demographic and surgical details data were compared. Electrolytes were compared in both groups pre and post-operatively and statistical analysis was done.There was significant difference in post-operative sodium level between the two groups (A and B). The mean level of sodium significantly reduced post-operatively in group –B (control grp). The mean level of sodium significantly increased post-operatively in group –A (tolvaptan grp). We conclude single dose of tolvaptan -15 mg found to effective in prevention of hyponatremia in patients undergoing TURP.

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.

A Double-Blind Out-Patient Trial of Indalpine vs Mianserin

1985 ◽  
Vol 147 (3) ◽  
pp. 306-309 ◽  
Author(s):  
G. J. Naylor ◽  
B. Martin
Keyword(s):  
Side Effects ◽  
Treated Group ◽  
Blind Study ◽  
Antidepressant Effect ◽  
Double Blind Study ◽  
Double Blind ◽  
Significant Difference

SummaryIndalpine 150 mg per day and mianserin 60 mg per day were compared in a double-blind study of 65 depressed out-patients: 52 patients completed the 4-week trial. At the end of four weeks there was no significant difference in antidepressant effect between the two drugs; but in the first two weeks, improvement in the mianserin-treated group was significantly greater than that in the indalpine group. The mianserin-treated group reported more side-effects of sedation (eg. drowsiness, clumsiness, heaviness of limbs etc.) and one patient on indalpine developed a mild leucopenia.

scholarly journals Ultrasound Guided Infraclavicular Block for Pain Control After Upper Extremity Surgery

2018 ◽  
Vol 3 (4) ◽  
pp. 108-112
Author(s):  
Derya Yalçın ◽  
Dilek Erdoğan Arı ◽  
Ceren Köksal ◽  
Cansu Akın ◽  
Sinan Karaca ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Recovery Room ◽  
Motor Block ◽  
Double Blind Study ◽  
Ultrasound Guided ◽  
Nerve Blocks ◽  
Double Blind ◽  
Significant Difference ◽  
Infraclavicular Block ◽  
Group 2

Background: Opioids added to local anesthetics for peripheral nerve blocks may intensify analgesia and prolong analgesic and sensorial block duration. These agents may also cause potentiation and prolongation of motor block. Objective: This study compared the postoperative effects of 30 mL of 0.25% bupivacaine +50 mcg fentanyl and 30 mL of 0.25% bupivacaine + 100 mcg fentanyl solutions for the ultrasound-guided infraclavicular block in patients undergoing elbow and forearm surgery. Methods: In this randomized double-blind study, thirty-six patients with risk of ASA class I-III were randomly allocated into 2 randomized groups. Ultrasound-guided infraclavicular blocks with 30 mL of 0.25% bupivacaine + 50 mcg fentanyl for group 1 and 30 mL of 0.25% bupivacaine + 100 mcg fentanyl for group 2 were performed before patients emerged from general anesthesia. After surgery, pain levels at rest and during movement were evaluated using the 10-cm visual analog scale (VAS) at recovery room admission, at the 15th and 30th minutes in the recovery room, and at the 2nd, 6th, 12th and 24th hours postoperatively. Both morphine and rescue analgesic requirements were recorded. Sensorial and motor block durations, patient satisfaction, and complications related to the infraclavicular block were recorded. Results: In both groups, no significant difference in VAS pain scores, total morphine and total rescue analgesic requirements, duration of sensorial and motor block, or patient satisfaction were observed. None of the patients experienced any complications. Conclusion: The mixtures of 0.25% bupivacaine + 50 mcg fentanyl and 0.25% bupivacaine + 100 mcg fentanyl showed similar postoperative effects.

scholarly journals Bilateral suprazygomatic maxillary nerve blocks vs. infraorbital and palatine nerve blocks in cleft lip and palate repair

2019 ◽  
Vol 36 (1) ◽  
pp. 40-47 ◽  
Author(s):  
Gaston Echaniz ◽  
Marcos De Miguel ◽  
Glenn Merritt ◽  
Plinio Sierra ◽  
Pranjal Bora ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Nerve Blocks ◽  
Maxillary Nerve ◽  
Palate Repair

Double-Blind Study of Dothiepin versus Placebo in the Treatment of Primary Fibromyalgia Syndrome

1987 ◽  
Vol 15 (3) ◽  
pp. 154-159 ◽  
Author(s):  
I. Caruso ◽  
P. C. Sarzi Puttini ◽  
L. Boccassini ◽  
S. Santandrea ◽  
M. Locati ◽  
...  
Keyword(s):  
Side Effects ◽  
Fibromyalgia Syndrome ◽  
Blind Study ◽  
Double Blind Study ◽  
Double Blind ◽  
Clinical Variables ◽  
Primary Fibromyalgia ◽  
Significant Difference ◽  
Primary Fibromyalgia Syndrome

A double-blind study comparing the efficacy and tolerability of dothiepin with that of placebo in the treatment of primary fibromyalgia syndrome was carried out. Dothiepin was shown to improve significantly the condition of patients with primary fibromyalgia syndrome and there was a significant difference between dothiepin and placebo in all the clinical variables measured. Only mild and transient side-effects were reported. Further controlled studies are required to define the effects of dothiepin on fibromyalgia.

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