Effectiveness of Antianxiety Drugs on Postoperative Pain Perception After Implant Placement: An In Vivo Study

2021 ◽  
Vol 12 (1) ◽  
pp. 144-152
Author(s):  
Minal Gopal Tulsani ◽  
Dhanraj Ganapathy ◽  
Divya Rupawat ◽  
Sanjana Devi
Keyword(s):  
Postoperative Pain ◽  
Analysis Of Variance ◽  
Pain Perception ◽  
Anxiety Level ◽  
In Vivo Study ◽  
Implant Placement ◽  
Significant Difference ◽  
Group A ◽  
Group B

Aim: To evaluate the effectiveness of midazolam and zolpidem on postoperative pain perception in patients undergoing implant placement. Materials and Methods: In the present in vivo study 60 patients undergoing implant placement were selected based on the inclusion criteria framed and were randomly allocated using sequentially numbered, opaque, and sealed envelope (SNOSE) method into 3 groups with 20 patients each after obtaining informed consent. Group A was the control group, Group B received midazolam 7.5 mg 30 minutes before the procedure. Group C received zolpidem 5 mg 30 minutes before the procedure. The anxiety level of patients was recorded using the Corah scale and postoperative pain was recorded after 2 hours of implant placement using the VAS scale. Statistical analysis was done using analysis of variance (ANOVA), one-way multivariate analysis of variance (one-way MANOVA), and then Tukey’s Honestly Significant Difference (HSD) test for comparison among groups at the 0.05 level of significance. Results: Group A had a mean anxiety level of 16 ± 1.451, Group B had a mean anxiety level of 11.2 ± 2.858, and Group C had a mean anxiety level of 13 ± 2.9019 and a statistically significant difference between the groups was observed ( P < .05). The mean for the postoperative pain perception for Group A was 6.8 ± 1.1965, for Group B was 3.8 ± 1.3611, and Group C was 5 ± 1.451 and a statistically significant difference between the groups was observed ( P < .05). Conclusion: This study concluded that both midazolam and zolpidem significantly reduced anxiety levels and postoperative pain in patients undergoing implant placement.

scholarly journals Comparison between scalpel incision and electrocautery incision in midline abdominal surgery: a comparative study

2021 ◽  
Vol 8 (5) ◽  
pp. 1507
Author(s):  
Amit Yadav ◽  
Lakshman Agarwal ◽  
Sumit A. Jain ◽  
Sanjay Kumawat ◽  
Sandeep Sharma
Keyword(s):  
Postoperative Pain ◽  
Blood Loss ◽  
Abdominal Surgery ◽  
Wound Infection ◽  
Skin Incision ◽  
P Value ◽  
Wound Area ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Fear of poor wound healing have curtailed the use of diathermy for making skin incision. Scalpel produces little damage to surrounding tissue but causing more blood loss. Our aim of study was to compare electrocautery incision with scalpel incision in terms of incision time, blood loss, postoperative pain and wound infection.Methods: Total of 104 patients were included in the study undergoing midline abdominal surgery. Patients were randomized into electrocautery (group A) and scalpel (group B). The incision dimension, incision time and blood loss were noted intraoperatively. Postoperative pain was noted on postoperative day 2 using visual analog scale. Wound complications were recorded on every postoperative day till the patient was discharged.Results: 52 patients in each of the two groups were analyzed. There was significant difference found between group A and group B in terms of mean incision time per unit wound area, 8.16±1.59 s\cm2 and 11.02±1.72 s\cm2 respectively (p value=0.0001). The mean blood loss per unit wound area was found to be significantly lower in group A (0.31±0.04 ml\cm2) as compared to group B (1.21±0.21), p value=0.0001. There was no significant difference noted in terms of postoperative pain and wound infection between both groups.Conclusions: Electrocautery can be considered safe in making skin incision in midline laparotomy compared to scalpel incision with comparable postoperative pain and wound infection with less intraoperative blood loss and less time consuming.

scholarly journals Preoperative Anxiety and Postoperative Pain in Patients With Laparoscopic Hysterectomy

2021 ◽  
Vol 12 ◽  
Author(s):  
Lin Zhang ◽  
Li-Jun Hao ◽  
Xiao-Lai Hou ◽  
Ya-Ling Wu ◽  
Lu-Shi Jing ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Postoperative Analgesia ◽  
Rating Scale ◽  
Laparoscopic Hysterectomy ◽  
Preoperative Anxiety ◽  
Chinese Patients ◽  
Average Score ◽  
Significant Difference ◽  
Group A ◽  
Group B

Objective: This study was designed to investigate preoperative anxiety situations and postoperative pain degree in Chinese patients undergoing laparoscopic hysterectomy and to analyze the related factors of preoperative anxiety and the correlation between preoperative anxiety and postoperative pain to provide a reference for effective postoperative analgesia management.Methods: A total of 100 female patients undergoing laparoscopic hysterectomy were enrolled in this study and randomly divided into two groups (n = 50, each). In group A, the patients were treated with dexmedetomidine and sufentanil for postoperative analgesia. In group B, the patients were treated with sufentanil alone for postoperative analgesia. All patients were evaluated with a self-rating anxiety scale (SAS) 1 day before the operation. The patients’ pain was evaluated using the numerical rating scale (NRS) 1 day after the operation, and data were recorded.Results: In these 100 patients, the highest preoperative SAS score was 48, and the average score was 40.99 ± 4.55 points, which is higher than the norm in China. There were significant differences in preoperative SAS scores among patients with different occupations and previous surgical experience (P &lt; 0.05). There was no significant difference in SAS scores among patients with different education levels (P &gt; 0.05). The postoperative NRS score of group A was significantly higher than that of group B, and the difference was statistically significant (P &lt; 0.05). The correlation coefficients between SAS scores and NRS scores in groups A and B were 0.836 and 0.870, respectively, presenting with a significantly positive correlation.Conclusion: Preoperative anxiety is an important predictor of postoperative pain. Patients undergoing laparoscopic hysterectomy have preoperative anxiety. The degree of anxiety is influenced by the occupation and previous operation experience of the patients, and patients with higher preoperative anxiety have greater postoperative pain. In addition, we should not neglect the management of postoperative pain because of the small trauma of laparoscopic surgery, and dexmedetomidine combined with sufentanil can improve the postoperative analgesic effect.

scholarly journals Comparative Evaluation of Pain Related Behavior During Administration of Local Anesthesia Using the Conventional Syringe and the Computerized Controlled Local Anesthetic Device in Children Exhibiting Different Levels of Anxiety: In vivo Study

2021 ◽  
pp. 285-294
Author(s):  
Pooja G. Muzumdar ◽  
Vikas Bendgude ◽  
Aditi Mathur
Keyword(s):  
Local Anesthesia ◽  
Pain Perception ◽  
Dental Anxiety ◽  
Negative Attitude ◽  
Pediatric Dentistry ◽  
In Vivo Study ◽  
Dental Procedures ◽  
Group B ◽  
Conventional Systems

Background: Pain experienced during dental procedures evolves into negative attitude towards dentistry, which is projected as anxiety and fear of the child. Administration of local anesthesia (L.A) although an intervention to render painless procedures, in itself causes pain by its conveyance. Wand® (Milestone Scientific, Livingston, NJ, USA) is a system introduced to decrease soreness in the course of anesthetic conveyance. Owing to the sparse information comparing conventional systems with those of Wand, the present study evaluated pain related behavior in children exhibiting pre-assessed variant levels of anxiety midst administration of local anesthesia. Aim: To correlate pain related behavior amidst delivery of local anesthesia using conventional syringe and the Wand® STA system in children exhibiting variant anxiety levels. Methodology: The In vivo study embodied 32 children aged between 6 to 8 years. The volunteered participants were pre-categorized into low and high anxiety using the Modified Child Dental Anxiety Scale. They were further divided using the SNOSE technique – receiving L.A the conventional syringe (group A) and those receiving L.A using the C.C.L.A.D (group B). Pain reactions and perceptions to the two delivery methods were calculated using subjective scales and objective physiological parameters. Results: Comparing pain perception in pre-assessed anxiety categories affirmed a remarkable difference with the use of C.C.L.A.D and appeared to bestow effortless, pain-free delivery over the traditional cartridge delivery. Conclusion: C.C.L.A.D builds a refined acclivity for dispersal of the solution, ergo an utilitarian tool in pediatric dentistry.

Association of bevacizumab-free interval with efficacy of anti-EGFR therapy in patients with metastatic colorectal cancer.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 610-610
Author(s):  
Azusa Komori ◽  
Hiroya Taniguchi ◽  
Yukiya Narita ◽  
Shiori Uegaki ◽  
Sohhei Nitta ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Metastatic Colorectal Cancer ◽  
Short Interval ◽  
Progression Free Survival ◽  
Patient Characteristics ◽  
Free Interval ◽  
Significant Difference ◽  
Group A ◽  
Group B

610 Background: Both bevacizumab (Bev) and anti-EGFR agents are sequentially used for metastatic colorectal cancer (mCRC). Some basic studies reported the interaction between Bev and anti-EGFR agents in vivo. Therefore we hypothesized the shorter Bev-free interval may lead to poor outcome of anti-EGFR therapy. The aim of this study is to examine the association of the interval between last Bev administration and initial anti-EGFR agents with efficacy of anti-EGFR therapy. Methods: We retrospectively reviewed consecutive mCRC patients who underwent combination therapy of anti-EGFR agents and irinotecan after failure of fluoropyrimidines, oxaliplatin, irinotecan, and Bev at a single institution. We divided patients in two groups (group A: the interval between Bev and anti-EGFR agents <6M, group B: ≥6M). Results: A total of 114 patients constituted the cohort of analysis. The median age was 63; 78 (68%) patients were male. Most patients (N=100, 88%) were treated with cetuximab, and 14 patients were panitumumab. Seventy-four patients were group A and 40 patients group B, respectively. There was no significant difference in patient characteristics. Response rate was 24.7% in group A, and 50.0% in group B (p=0.0072). The patients in group B have significantly longer progression free survival (4.2 vs. 6.6 M, HR 0.65, 95% CI 0.43- 0.98, p=0.042) and longer overall survival (11.6 vs. 14.3 M, HR 0.62, 95% CI 0.39- 0.97, p=0.038). Conclusions: The short interval (<6M) between last Bev and anti-EGFR agents may interfere with the efficacy of anti-EGFR therapy.

Clinical trial to assess role of ketamine in post operative analgesia after laparoscopic cholecystectomy

2021 ◽  
Vol 23 (05) ◽  
pp. 421-432
Author(s):  
Dr. Mohammad Kheiri Mahmod ◽  
◽  
Dr. Bashar Naser Hussein ◽  
Dr. Ammar Hamid Hanoosh ◽  
◽  
...  
Keyword(s):  
Clinical Trial ◽  
Laparoscopic Cholecystectomy ◽  
Postoperative Pain ◽  
Analgesic Effect ◽  
Analgesic Requirement ◽  
Pain Scores ◽  
Post Operative Pain ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: The physiological consequences of post-operative pain including Stress response to surgery, Respiratory complications, cardiovascular complications, Thromboembolic complications, Gastrointestinal complications, Musculoskeletal complications and Psychological complications, all of which could delay or impair postoperative recovery and increase the economic cost of surgery as a result of the longer period of hospitalization. Inadequate post-operative pain control may also lead to the development of chronic pain after surgery .Aim of This study: is to evaluate the preemptive analgesic effect of intravenous ketamine in laparoscopic cholecystectomy. Patients and Methods: double blinded randomized clinical trial conducted at Al-Yarmouk teaching hospital, over a period of one year from March 2013 to March 2014 on a total of 120 adult patients scheduled for elective laparoscopic cholecystectomy, Patients were divided in to three groups of 40 patients each, the study drug administered intravenously during induction. Groups A and B received ketamine in a dose of 1 and 0.5 mg/kg, respectively, whereas group C received isotonic saline. The degree of pain at rest and deep breathing postoperatively were estimated using VAS, time of first analgesic dose, total opioid consumption, nausea, vomiting and hallucination were recorded for 24 h postoperatively. Results: postoperative pain scores were significantly low in group A when compared with the other groups at most times in the first 24 hours. Highest pain score was in group C at 0 h. Postoperative analgesic consumption was minimum in group A then group B and highest in group C. There was little significant difference in the pain scores between groups B and C. Group A had a significantly higher blood MAP than group B at 0, 0.5 and 1 h. 7.5% incidence of hallucinations were in group A. Conclusion: According to this study we conclude that preemptive ketamine in a dose of 1 mg/kg has a definitive role in reducing postoperative pain and analgesic requirement in patients undergoing laparoscopic cholecystectomy. A low dose of 0.5 mg/kg had little significant in preemptive analgesic effect and in reducing analgesic requirement.

scholarly journals A randomised controlled trial of excision versus invagination in the management of indirect inguinal hernial sac

2019 ◽  
Vol 101 (2) ◽  
pp. 119-122
Author(s):  
M Sharma ◽  
OP Pathania ◽  
A Kapur ◽  
S Thomas ◽  
A Kumar
Keyword(s):  
Inguinal Hernia ◽  
Postoperative Pain ◽  
Testicular Atrophy ◽  
High Ligation ◽  
Indirect Inguinal Hernia ◽  
Tension Free ◽  
Hernial Sac ◽  
Significant Difference ◽  
Group A ◽  
Group B

Introduction Lichtenstein tension-free mesh hernioplasty of primary inguinal hernia is currently considered as the preferred method for the plastic reconstruction of inguinal hernia by the majority of surgeons. Several studies have examined the best way to manage the hernial sac in this surgery, but no consensus has been reached. This study was designed to compare the effects of excision of sac and invagination of sac on post-operative outcomes. Methods and methods This prospective randomised study included a total of 70 patients with primary unilateral uncomplicated indirect inguinal hernia. Group A (35 patients) underwent high dissection and invagination of the hernial sac and group B (35 patients) underwent high ligation and excision of the hernial sac. The repair of the posterior wall of the inguinal canal was done according to Lichtenstein tension-free technique. The primary outcome of this study was postoperative pain and secondary outcomes were wound infection, chronic sepsis, sinus formation, persistent pain, testicular atrophy and recurrence during the one-year follow-up period. Results There was a significant difference (P < 0.01) in pain experienced by the patients in the immediate post-operative period between the two groups; group A experienced less postoperative pain than group B. There was no significant difference in incidence of infection between the groups. Conclusions Invagination of the sac results in less postoperative pain compared with excision, with no significant difference in other postoperative outcomes.

Therapeutic Efficacy of Calcium Hydroxide as an Intra Canal Dressing on Postoperative Reaction of Patients with Residual Pulpitis

2013 ◽  
Vol 749 ◽  
pp. 211-214
Author(s):  
Hui Xiao Yang
Keyword(s):  
Postoperative Pain ◽  
Calcium Hydroxide ◽  
Therapeutic Efficacy ◽  
Treatment Session ◽  
Chi Square ◽  
Anterior Teeth ◽  
Significant Difference ◽  
Chi Square Test ◽  
Group A ◽  
Group B

To evaluate the therapeutic efficacy of calcium hydroxide as an intra canal dressing on controlling postoperative pain and swelling in patients suffering from residual pulpitis. 118 patients with residual pulpitis in their anterior teeth participated in this study. These patients were randomly divided into two groups (group A and group B) of fifty-nine. All teeth were treated with root canal therapy with a two-visit approach. The patients in group A were treated with calcium hydroxide as an intra canal dressing , and in group B using formocresol as an intra canal dressing. All of the patients were followed up for 72 h after each treatment session. The postoperative incidence and severity of pain and swelling were recorded. The data were analyzed by chi-square test and variance analysis. After the first visit, the incidence and severity of pain and swelling showed to be higher in group B and lower in group A. These differences were statistically significant. After the second visit, the incidence and severity of pain and swelling showed to be still higher in group B and lower in group A. But there were no significant difference. Conclusion It is concluded that calcium hydroxide as an intra canal dressing could be effective to decrease the postoperative pain and swelling. It is recommended to use calcium hydroxide as an inter-appointment dressing in teeth with residual pulpitis.

scholarly journals A comparative study of inguinal hernia repair: Shouldice versus Lichtenstein repair

2018 ◽  
Vol 5 (6) ◽  
pp. 2238
Author(s):  
Ram Sagar Shah ◽  
Ajay Kumar
Keyword(s):  
Inguinal Hernia ◽  
Postoperative Pain ◽  
Wound Infection ◽  
Operating Time ◽  
Cost Effective ◽  
Lichtenstein Repair ◽  
Shouldice Repair ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Inguinal hernia is a common problem and its repair is one of the most frequently performed operation in general surgical practice. There are appreciable advantages of Lichtenstein over Shouldice repair in terms of simplicity, less time consuming and postoperative pain; there in the context of less developed countries with limited economic resources, however Shouldice repair is more cost effective and there are no differences in recurrences and other complications which would be a better proposition. The present study aims at comparing the results of Shouldice versus Lichtenstein’s repair in inguinal hernia in adult male (≥18 years).Methods: Total of fifty cases was included in this study, were equally divided into 2 groups; Group A and Group B and subjected for Shouldice and Lichtenstein mesh repair respectively. Operating time, postoperative complications as Wound infection, Seroma, Hematoma, Postoperative pain, and days of hospital stay, total costs and time to return to usual activity was noted.Results: Out of 50 patients, 36 (72%) were had indirect hernia and most of them were in between 18-29.9 years of age. There were no difference between two groups with respect to postoperative pain, Wound infection 12% and 8%, Seroma  8% and 4% and Hematoma 4% and 4% in Group A and Group B respectively. However, there is significant difference noted in operating time period in which Shouldice repair took more time (Mean time in Shouldice 84.16 min and Lichtenstein 58.80 min). There were no recurrences in either group.Conclusions: So, comparing our results of both groups, Lichtenstein repair were found to be better as it is simple procedure and is less time consuming than Shouldice repair.  However, Shouldice repair was found to be cost effective which could be an important consideration in developing countries.

scholarly journals Comparison between the mean postoperative pain score with two different file systems in patients with irreversible pulpitis-a clinical study in Altamash Institute of Dental Medicine.

2019 ◽  
Vol 26 (08) ◽  
pp. 1359-1364
Author(s):  
Sara Jamil ◽  
Rizwan Jouhar ◽  
Dinaz Gandhi ◽  
Tayyaba Tahira ◽  
Jamshed Shaikh
Keyword(s):  
Stainless Steel ◽  
Postoperative Pain ◽  
Pain Score ◽  
T Test ◽  
Postoperative Pain Score ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Irreversible Pulpitis

Endodontic Pain if occurs after few hours or days after the treatment indicates a poor pathosis and a bad prognosis in long term, due to this a newer generation of instruments for canal treatment has been introduced from Ni-Ti alloy which has even better ability to shape narrow and curved root canals, without causing aberration. To compare the mean postoperative pain score after manual SS (stainless steel) K-files and mechanical Ni-Ti rotary path files in patients with irreversible pulpitis. Study Design: Randomized controlled trial. Setting: Department of Operative Dentistry, Altamash Institute of Dental Medicine, Karachi. Period: 6 months from 01-10-2017 to 30-03-2018. Materials and Methods: Total 60 patients of irreversible pulpitis with moderate pain score ≥5 were included and divided equally in manual stainless-steel k-files and mechanical Ni-Ti rotary path files groups. Treatment was started with local anesthesia. Patients were recalled after 24 hours and the level of postoperative pain was examined. T-test was applied to compare the outcome in both groups. Stratification was done using t-test and P value ≤0.05 was significantly considered. Results: The mean pre-treatment VAS in group-A and group-B was 7.16±1.44 and 7.86±1.38 respectively. Mean post-treatment VAS in group-A and group-B was 2.33±1.02 and 1.10±0.66 respectively. A significant difference between the pre and post op pain was noted between the two groups, when compared after 24hours by using VAS. Conclusion: Mean post-operative pain score was significantly less with NiTi rotary path files as compare to manual stainless steel K-files.

scholarly journals In vivo evaluation of the virucidal efficacy of Chlorhexidine and Povidone-iodine mouthwashes against salivary SARS-CoV-2.

2021 ◽  
Author(s):  
Rola ElZein ◽  
fadi Abdel Sater ◽  
Soha Fakhreddine ◽  
Pierre Abi Hanna ◽  
Rita Feghali ◽  
...  
Keyword(s):  
Povidone Iodine ◽  
T Test ◽  
Control Group ◽  
Distilled Water ◽  
Ct Value ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Virucidal Efficacy

Abstract Background. The oral cavity is potentially high-risk transmitter of COVID-19. Antimicrobial mouthrinses are used in many clinical pre procedural situations for prophylactic purposes. An evident-based investigation for an effective mouthwash solution against salivary SARS-CoV-2 is urgently required for the exposure reduction during dental procedures. Aims. This study aimed to evaluate in vivo virucidal efficacy of 2 mouthwashes: 1% Povidone-iodine and 0.2% Chlorhexidine as a dental preprocedural oral disinfection against salivary SARS-CoV-2. Materials and Methods. In this randomized-controlled clinical trial, studied group comprised laboratory-confirmed COVID-19 positive patients through nasopharyngeal swabs. Participants were divided into 3 groups. For 30 seconds, group A gargled with 1% Povidone-iodine, group B mouthrinsed with 0.2% Chlorhexidine and control group C mouthrinsed with distilled water. Saliva samples were collected before and 5 minutes after mouthwash. SARS-CoV-2 rRT-PCR was then performed for each sample. Evaluation of the efficacy was based on difference in Ct value. The analysis of data was carried out using GraphPad Prism version 5 for Windows. Paired t test and unpaired t test were used. A probability value of less than 0.05 was regarded as statistically significant. Results. Sixty-one compliant participants (36 female and 25 male) with a mean age 45.3 plusmn 16.7 years-old were enrolled. A significant mean Ct value difference (p < 0.0001) between the paired samples in group A (n = 25) and also in group B (n = 27) (p < 0.0001) was found. In contrast, no significant difference (p = 0.566) existed before and after the experiment in the control group C (n = 9). Moreover, a significant difference was noted between the delta Ct of distilled water wash and each of the 2 solutions 1 % Povidone-iodine (p = 0.012) and Chlorhexidine 0.2% (p = 0.0024). No significant difference was found between the delta Ct of patients using 1% Povidone-iodine and Chlorhexidine 0.2% solutions (p = 0.24). Conclusion. Chlorhexidine 0.2% and 1% Povidone-iodine oral solutions are effective preprocedural mouthwashes against salivary SARS-COV-2 in dental treatments. Their use as a preventive strategy to reduce the spread of COVID-19 during dental practice should be systematically implemented.

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