Topical anaesthesia as an adjuvant to local anaesthetic injection in open trigger digit release: a randomized controlled trial

2020 ◽  
Vol 45 (10) ◽  
pp. 1066-1070
Author(s):  
Panai Laohaprasitiporn ◽  
Yuwarat Monteerarat ◽  
Roongsak Limthongthang ◽  
Torpon Vathana ◽  
Vajara Wilairatana
Keyword(s):  
Randomized Controlled Trial ◽  
Local Anaesthetic ◽  
Controlled Trial ◽  
Drug Application ◽  
Anaesthetic Drug ◽  
Topical Anaesthetic ◽  
Randomized Controlled ◽  
Pain Scores ◽  
Anaesthetic Injection ◽  
Local Anaesthetic Injection

We conducted a randomized controlled trial to compare pain scores and patient satisfaction between topical anaesthetic cream (5% lidocaine-prilocaine cream) versus placebo cream, applied approximately 90 minutes before local anaesthetic injection for open trigger digit release. One hundred participants were enrolled and randomly allocated into the two groups between May 2019 and February 2020. The visual analogue pain scores and satisfaction scores were measured. Most participants were female with Quinnell Grade 2–3 trigger digits. The pain scores during needle injection, local anaesthetic infiltration, the overall pain and satisfaction scores had no statistically significant differences between groups. There was no correlation between duration of topical anaesthetic drug application and pain scores. Subgroup analysis did not show significant differences in pain scores between genders. No complications were found during the study period. The topical anaesthetic drug was ineffective to use on the palmar skin during open trigger digit release surgery. Level of evidence: II

scholarly journals “Enhanced recovery after surgery – ERAS in elective craniotomies-a non-randomized controlled trial”

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anirudh Elayat ◽  
Sritam S. Jena ◽  
Sukdev Nayak ◽  
R. N. Sahu ◽  
Swagata Tripathy
Keyword(s):  
Randomized Controlled Trial ◽  
Glycemic Control ◽  
Hospital Stay ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Controlled Trial ◽  
Early Recovery ◽  
Randomized Controlled ◽  
Pain Scores ◽  
High Dependency

Abstract Background Enhanced Recovery After Surgery (ERAS) is a multimodal perioperative care bundle aimed at the early recovery of patients. Well accepted in gastric and pelvic surgeries, there is minimal evidence in neurosurgery and neurocritical care barring spinal surgeries. We wished to compare the length of intensive care unit (ICU) or high dependency unit (HDU) stay of patients undergoing elective craniotomy for supratentorial neurosurgery: ERAS protocol versus routine care. The secondary objective was to compare the postoperative pain scores, opioid use, glycemic control, and the duration of postoperative hospital stay between the two groups. Methods In this pragmatic non-randomized controlled trial (CTRI/2017/07/015451), consenting adult patients scheduled for elective supratentorial intracranial tumor excision were enrolled prospectively after institutional ethical clearance and consent. Elements-of-care in the ERAS group were- Preoperative –family education, complex-carbohydrate drink, flupiritine; Intraoperative – scalp blocks, limited opioids, rigorous fluid and temperature regulation; Postoperative- flupiritine, early mobilization, removal of catheters, and initiation of feeds. Apart from these, all perioperative protocols and management strategies were similar between groups. The two groups were compared with regards to the length of ICU stay, pain scores in ICU, opioid requirement, glycemic control, and hospital stay duration. The decision for discharge from ICU and hospital, data collection, and analysis was by independent assessors blind to the patient group. Results Seventy patients were enrolled. Baseline demographics – age, sex, tumor volume, and comorbidities were comparable between the groups. The proportion of patients staying in the ICU for less than 48 h after surgery, the cumulative insulin requirement, and the episodes of VAS scores > 4 in the first 48 h after surgery was significantly less in the ERAS group – 40.6% vs. 65.7%, 0.6 (±2.5) units vs. 3.6 (±8.1) units, and one vs. ten episodes (p = 0.04, 0.001, 0.004 respectively). The total hospital stay was similar in both groups. Conclusion The study demonstrated a significant reduction in the proportion of patients requiring ICU/ HDU stay > 48 h. Better pain and glycemic control in the postoperative period may have contributed to a decreased stay. More extensive randomized studies may be designed to confirm these results. Trial registration Clinical Trial Registry of India (CTRI/2018/04/013247), registered retrospectively on April 2018.

scholarly journals Liposomal bupivacaine addition versus standard bupivacaine alone for colorectal surgery: a randomized controlled trial

2021 ◽  
Author(s):  
Yar L Yeap ◽  
John Wolfe ◽  
Jennifer Stewart ◽  
Amy McCutchan ◽  
Gulraj Chawla ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Colorectal Surgery ◽  
Laparoscopic Colorectal Surgery ◽  
Controlled Trial ◽  
Liposomal Bupivacaine ◽  
Randomized Controlled ◽  
Pain Scores ◽  
Quadratus Lumborum ◽  
Prospective Randomized Controlled Trial ◽  
Registration Number

Aim: This study evaluated use of liposomal bupivacaine (LB) versus standard bupivacaine (SB) alone in quadratus lumborum (QL) blocks for laparoscopic colorectal surgery. Materials & methods: In this prospective, randomized controlled trial, patients received QL1 blocks with either LB (40 ml 0.125% SB plus 20 ml of LB) or SB (60 ml of 0.25% SB) with 30 ml per side. Opioid usage, pain scores, side effects and other medications were recorded. Results: For 78 patients (38 LB; 40 SB), all parameters were similar between groups, except that the LB group had a higher 48 h need for metoclopramide. Conclusion: LB provided no analgesic benefit over SB alone for QL blocks. Clinical Trials registration number: NCT03702621

Pain and outcomes of carpal tunnel release under local anaesthetic with or without a tourniquet: a randomized controlled trial

2018 ◽  
Vol 43 (8) ◽  
pp. 808-812 ◽  
Author(s):  
Hafiz J. Iqbal ◽  
Ashtin Doorgakant ◽  
Nader N. T. Rehmatullah ◽  
Ashok L. Ramavath ◽  
Prasad Pidikiti ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Carpal Tunnel ◽  
Local Anaesthetic ◽  
Local Anaesthesia ◽  
Controlled Trial ◽  
Carpal Tunnel Release ◽  
Similar Degree ◽  
Level Of Evidence ◽  
Randomized Controlled ◽  
Anaesthetic Mixture

We conducted a prospective randomized controlled trial to investigate carpal tunnel decompression under local anaesthesia. Carpal tunnel decompression was performed in 37 wrists using local anaesthesia and an arm tourniquet and 36 without tourniquet but with a local anaesthetic mixture containing adrenaline. Patients who underwent carpal tunnel decompression using a tourniquet experienced a significantly greater degree of pain when compared with those who did not have a tourniquet. Pain and hand function improved to a similar degree in both groups. We conclude that carpal tunnel decompression performed with a tourniquet causes patients unnecessary pain with no additional benefit as compared with the wide-awake carpal tunnel decompression without use of a tourniquet. Level of evidence: I

Different pain scores in single transumbilical incision laparoscopic cholecystectomy versus classic laparoscopic cholecystectomy: a randomized controlled trial

2010 ◽  
Vol 24 (8) ◽  
pp. 1842-1848 ◽  
Author(s):  
Evangelos C. Tsimoyiannis ◽  
Konstantinos E. Tsimogiannis ◽  
George Pappas-Gogos ◽  
Charalampos Farantos ◽  
Nikolaos Benetatos ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Laparoscopic Cholecystectomy ◽  
Controlled Trial ◽  
Randomized Controlled ◽  
Pain Scores

A prospective double-blind randomized controlled trial of the effect of topical bupivacaine on post-operative pain in bilateral nasal surgery with bilateral nasal packs inserted

2005 ◽  
Vol 119 (4) ◽  
pp. 284-288 ◽  
Author(s):  
Malcolm A Buchanan ◽  
Graham R Dunn ◽  
Gillian M MacDougall
Keyword(s):  
Randomized Controlled Trial ◽  
Local Anaesthetic ◽  
Controlled Trial ◽  
Nasal Surgery ◽  
Double Blind ◽  
Control Power ◽  
Randomized Controlled ◽  
Post Operative Pain ◽  
Number Of Patients ◽  
Significant Difference

To ascertain whether local anaesthetic use is of clinical benefit in nasal surgery, a prospective double-blind randomized controlled trial of topical bupivacaine on post-operative pain in patients packed after bilateral nasal surgery was carried out. Each patient received a bupivacaine-soaked and a saline-soaked Merocel pack, thereby acting as their own control. Power analysis ascertained the number of patients required to enter the trial to detect a statistically significant difference in pain. Fifty-seven patients completed the trial. Visual analogue scales determined the level of post-operative pain at different time points in each nostril. Less pain was demonstrated in nostrils containing bupivacaine-soaked packs compared with saline-soaked packs at two hours (p < 0.0001), four hours (p = 0.0183) and six hours (p = 0.0476) post-operatively. Although not statistically significant, less pain was noted on pack removal on the local anaesthetic sides. These results provide clinical-based evidence for the use of bupivacaine as a local anaesthetic in reducing pain following nasal surgery with packing.

scholarly journals Enhanced Recovery After Surgery – ERAS in Elective Craniotomies-a Non-randomized Controlled Trial

2020 ◽  
Author(s):  
Anirudh Elayat ◽  
Sritam Swarup Jena ◽  
Rabi Narayan Sahu ◽  
Sukdev Nayak ◽  
Swagata Tripathy
Keyword(s):  
Randomized Controlled Trial ◽  
Glycemic Control ◽  
Hospital Stay ◽  
Perioperative Care ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Controlled Trial ◽  
Early Recovery ◽  
Randomized Controlled ◽  
Pain Scores

Abstract Background: Enhanced Recovery After Surgery (ERAS) is a multimodal perioperative care bundle aimed at early recovery of patients. Well accepted in gastric and pelvic surgeries, there is minimal evidence in neurosurgery and neurocritical care barring spinal surgeries. We wished to compare the length of intensive care unit (ICU) or high dependency unit (HDU) stay of patients undergoing elective craniotomy for supratentorial neurosurgery: ERAS protocol versus routine care. The secondary objective was to compare the postoperative pain scores, opioid use, glycemic control, and the duration of postoperative hospital stay between the two groups.Methods: This was a pragmatic non-randomized controlled trial (CTRI/2017/07/015451). Consenting adult patients scheduled for elective supratentorial intracranial tumor excision were enrolled prospectively after institutional ethical clearance and consent. Patients in the ERAS group received a fixed bundle of care. Pre-operative –family education,, complex-carbohydrate drink, scalp blocks, and flupiritine ; Intraoperative –limited opioids,fluid and temperature regulation; Post operative- early mobilization, removal of catheters and initiation of feeds. In the control group, standard practice and protocols of perioperative care were followed. The two groups were compared with regards to the length of ICU stay, pain scores in ICU, opioid requirement, glycemic control and the overall duration of stay in the hospital. Results: Seventy patients were enrolled. Baseline demographics – age, sex, tumor volume and comorbidities were comparable between the groups. The proportion of patients staying in the ICU for less than 48 hrs after surgery, the cumulative insulin requirement and the episodes of VAS scores > 4 in first 48 hours after surgery was significantly less in the ERAS group – 40.6% vs 65.7%, 0.6 (±2.5) units vs 3.6 (±8.1 ) units and 1 vs 10 episodes ( p= 0.04, 0.001, 0.004 respectively). The total hospital stay was similar in both groups.Conclusion: The study demonstrated a significant reduction in the proportion of patients requiring ICU/ HDU stay > 48 hrs. Better pain and glycemic control in the postoperative period may have contributed to a decreased stay. More extensive randomized studies may be designed to confirm these results.

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