scholarly journals Intra-articular Administration of Tranexamic Acid Has No Effect in Reducing Intra-articular Hemarthrosis and Postoperative Pain After Primary ACL Reconstruction Using a Quadruple Hamstring Graft: A Randomized Controlled Trial

2020 ◽  
Vol 8 (7) ◽  
pp. 232596712093313
Author(s):  
Ja-Woon Lee ◽  
Sang-Gyun Kim ◽  
Su-Hyun Kim ◽  
Hyun-Woo Cho ◽  
Ji-Hoon Bae
Keyword(s):  
Randomized Controlled Trial ◽  
Postoperative Pain ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Acl Reconstruction ◽  
Controlled Trial ◽  
Cruciate Ligament ◽  
Control Group ◽  
Single Bundle ◽  
Randomized Controlled

Background: Insufficient data are available to support the routine use of tranexamic acid (TXA) in anterior cruciate ligament (ACL) surgeries with respect to administration method and frequency, exposure duration, dose, and adverse effects. Purpose: To investigate whether intra-articular (IA) administration of TXA could reduce hemarthrosis and postoperative pain in patients after ACL reconstruction. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A total of 47 patients were included in this study, which was performed between July 2017 and May 2019. Single-bundle reconstructions using autologous hamstring tendon grafts were performed in all patients. The patients were randomized into 2 groups: the TXA group (received the index procedure with 100-mL IA injection of TXA [30 mg/mL]) and a control group (did not receive IA injection of TXA). No patients received a drain. Blood loss was calculated on the basis of hemoglobin balance at postoperative day (PD) 2. The visual analog scale (VAS) for pain score was assessed at PD 3. The midpatellar circumference was measured at PD 2 and PD 5. Knee range of motion (ROM) was evaluated 6 weeks after surgery. Results: The mean ± SD blood loss was 467 ± 242 mL in the TXA group and 558 ± 236 mL in the control group. No significant differences were found for blood loss ( P = .20), VAS pain scores ( P = .28), ROM at postoperative week 6 ( P = .61), or patellar circumference at PD 2 ( P = .75) and PD 5 ( P = .84). Conclusion: This study showed that IA administration of 3.0 g of TXA had no effect in reducing blood loss and postoperative pain after primary anatomic single-bundle ACL reconstruction using quadruple hamstring autografts. Registration: NCT04042688 ( ClinicalTrials.gov identifier).

scholarly journals A randomized controlled trial comparing oxytocin administration before and after placental delivery in the prevention of postpartum haemorrhage in a tertiary care hospital in Bankura district of West Bengal, India

2020 ◽  
Vol 9 (5) ◽  
pp. 1976
Author(s):  
Rahul Kirtania ◽  
Jayita Pal ◽  
Sisir Biswas ◽  
Aditi Aich
Keyword(s):  
Randomized Controlled Trial ◽  
Blood Loss ◽  
Controlled Trial ◽  
Active Management ◽  
Control Group ◽  
Care Hospital ◽  
Normal Delivery ◽  
Randomized Controlled ◽  
Significant Difference ◽  
The Mean

Background: PPH is the prime cause of maternal mortality worldwide. The incidence of PPH can be drastically combatted by application of uterotonic in active management of third stage labour. Timing of its administration is a matter of concern. This study aimed to assess whether timing of administration of oxytocin would have any impact on incidence or mean blood loss of PPH.Methods: It was a single blinded randomized controlled trial conducted in the department of Obstetrics and Gynecology, Bankura Sammilani Medical College for 6 months where 100 antenatal mothers admitted for normal delivery in labour room were allocated randomly in study and control group considering inclusion and exclusion criteria. Incidence of PPH and mean blood loss had been identified clinically by following them for 24 hours.Results: Only 9% of study population had experienced PPH. There was no statistically significant difference in incidence of PPH with difference in timing of administration of oxytocin (p >0.05). But there was statistically significant decrease in mean blood loss if oxytocin was administered before the placental delivery. The mean blood loss with oxytocin administered before placental delivery was 296.8 ml (102.45) and after placental delivery was 452.0 (128.87) ml respectively.Conclusions: Policy makers should keep in mind not only the incidence of PPH, but the mean blood loss amount too in a setting where anaemia in pregnancy is quite prevalent.

scholarly journals A randomized controlled trial of cystoinflation to prevent bladder injury in the adhesive disease of multiple caesarean sections

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Shazia Saaqib ◽  
Ayesha Iqbal ◽  
Munazza Naheed ◽  
Tayyaba Saeed ◽  
Mohammad Khalid
Keyword(s):  
Randomized Controlled Trial ◽  
Blood Loss ◽  
Controlled Trial ◽  
Elective Caesarean Section ◽  
Injury Rate ◽  
Bladder Injury ◽  
Control Group ◽  
Randomized Controlled ◽  
Urological Complications ◽  
Micturition Problems

Abstract Caesarean sections carry the risk of urinary bladder injury due to formation of adhesions obscuring pelvic planes. Visualizing bladder during retro-fill (cystoinflation) makes it recognizable as it rises into the abdomen taking a tense rounded contour. We conducted a prospective randomized controlled trial to find out whether improved identification of bladder margins by cystoinflation could decrease bladder injury rate and blood loss without causing urological complications. This study included 214 healthy women with previous operative deliveries undergoing elective caesarean section and found to have dense pelvic adhesions. The subjects were randomly allocated into cystoinflation and control groups. Adhesiolysis was performed using bladder retro-fill with 300 cc saline in cystoinflation group, and without retro-fill in control. The bladder injury rate was significantly lower in cystoinflation group compared to control (2.8% vs 20.6%, P < .0001) with lesser blood loss in cystoinflation group (585.33 cc vs 797.10 cc, P < .0001). Mean operative time was similar in both groups. Urinary tract infection and micturition problems occurred more frequently in control group than cystoinflation group (16.8% vs 1.9%, P = .001 and .47 ± 1.63% vs 077 ± .633%, P = .021 respectively) with fistula in one subject compared to none in cystoinflation group. In this study, cystoinflation was effective to significantly reduce bladder injury rate and blood loss. This technique may also prove useful in the fields of surgery, urology and urogynecology.

Intra-Articular Tranexamic Acid Mitigates Blood Loss and Morphine Use After Total Knee Arthroplasty. A Randomized Controlled Trial

2019 ◽  
Vol 34 (5) ◽  
pp. 877-881 ◽  
Author(s):  
Artit Laoruengthana ◽  
Piti Rattanaprichavej ◽  
Supachok Rasamimongkol ◽  
Monton Galassi ◽  
Santi Weerakul ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Randomized Controlled Trial ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Knee Arthroplasty ◽  
Controlled Trial ◽  
Randomized Controlled ◽  
Total Knee

scholarly journals Does pregabalin effectively and safely relieve postoperative pain in patients undergoing pulmonary resections?

2019 ◽  
Vol 29 (4) ◽  
pp. 555-560 ◽  
Author(s):  
Shuangjiang Li ◽  
Wenbiao Zhang ◽  
Shan Cheng ◽  
Yongjiang Li
Keyword(s):  
Randomized Controlled Trial ◽  
Postoperative Pain ◽  
Randomized Controlled Trials ◽  
Controlled Trial ◽  
Perioperative Period ◽  
Control Group ◽  
Controlled Trials ◽  
Clinical Question ◽  
Randomized Controlled ◽  
Study Type

Summary A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was whether pregabalin could effectively and safely reduce postoperative pain in patients undergoing pulmonary resections. Altogether 23 papers were found using the reported search, of which 6 randomized controlled trials represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Five of 6 randomized controlled trials demonstrated that the application of oral pregabalin during the perioperative period could effectively reduce postoperative pain after pulmonary resections without compromising patients’ safety. One randomized controlled trial reported no difference in the postoperative pain levels between the pregabalin group and the control group. The rates of adverse effects were generally found to be decreased in patients who received pregabalin compared to the patients who received routine analgesia, although 2 studies reported significantly higher incidences of mild drowsiness and dizziness among the pregabalin-treated patients. Currently available evidence supports that the perioperative administration of pregabalin can effectively and safely relieve postoperative pain for patients undergoing pulmonary resections.

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