scholarly journals Analgesic efficacy of ultrasound guided paravertebral block in percutaneous nephrolithotomy patients: a randomized controlled clinical study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ferda Yaman ◽  
Devrim Tuglu
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Statistical Significance ◽  
Intervention Group ◽  
Analgesic Efficacy ◽  
Paravertebral Block ◽  
Visual Analogue Scale Pain ◽  
Control Group ◽  
Opioid Use ◽  
Ultrasound Guided ◽  
Post Surgery

Abstract Background Paravertabral blocks (PVB) are in use to adequately manage pain arising from a variety of operations on the thorax, abdomen or pelvis. PVB is straightforward, efficacious in operations performed. This study was undertaken to evaluate how efficacious ultrasound-guided thoracic paravertebral block is when used in patients undergoing percutaneous nephrolithotomy (PCN). Methods A total of 44 patients, falling in categories I to III of the American Society of Anesthesiologists, and aged between 18 and 65 years, who were scheduled for PCN, were randomly distributed into two groups. The anaesthetic intervention group (PVB) contained 22 individuals, who were injected at level T8-T9 with 20 mL 0.25% bupivacaine as a single administration. In the control group C, also containing 22 individuals, the intervention was not carried out. The groups were compared after PCN in terms of opioid use, pain score, opioid adverse effects profile and the need for supplemental analgesia. Results Visual analogue scale pain scores whilst at rest or moving were lower at the level of statistical significance in the PVB group compared to controls at 2 and 4 h post-surgery. At 6 and 8 h post-surgery, the control group had a lower VAS score when moving, and this result reached statistical significance (p < 0.05). The controls used more opioid relief than the PVB group and had lower scores for satisfaction (p < 0.05). Conclusion Ultrasound-guided PVB using bupivacaine and an in-plane technique provides effective analgesia in PNL. It is associated with high scores on patient satisfaction and minimal complications. Trial registration ClinicalTrials.gov, NCT04406012. Registered retrospectively, on 27 May 2020.

scholarly journals Analgesic Efficacy of Ultrasound-Guided Paravertebral Block in Patients Undergoing Percutaneous Nephrolithotomy: A Randomised, Controlled Clinical Study

2020 ◽  
Author(s):  
Ferda Yaman ◽  
Devrim Tuglu
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Statistical Significance ◽  
Intervention Group ◽  
Analgesic Efficacy ◽  
Paravertebral Block ◽  
Visual Analogue Scale Pain ◽  
Control Group ◽  
Opioid Use ◽  
Ultrasound Guided ◽  
Post Surgery

Abstract Background: Paravertabral blocks (PVB) are in use to adequately manage pain arising from a variety of operations on the thorax, abdomen or pelvis. PVB is straightforward, efficacious in operations performed. This study was undertaken to evaluate how efficacious ultrasound-guided thoracic paravertebral block is when used in patients undergoing percutaneous nephrolithotomy (PCN). Methods: A total of forty-four patients, falling in categories I to III of the American Society of Anesthesiologists, and aged between 18 and 65 years, who were scheduled for PCN, were randomly distributed into two groups. The anaesthetic intervention group (PVB) contained 22 individuals, who were injected at level T8-T9 with 20mL 0.25% bupivacaine as a single administration. In the control group C, also containing 22 individuals, the intervention was not carried out. The groups were compared after PCN in terms of opioid use, pain score, opioid adverse effects profile and the need for supplemental analgesia.Results: Visual analogue scale pain scores whilst at rest or moving were lower at the level of statistical significance in the PVB group compared to controls at 2 and 4 hours post-surgery. At 6 and 8 hours post-surgery, the control group had a lower VAS score when moving, and this result reached statistical significance (p<0.05). The controls used more opioid relief than the PVB group and had lower scores for satisfaction (p<0.05).Conclusion: Ultrasound-guided PVB using bupivacaine and an in-plane technique provides effective analgesia in PNL. It is associated with high scores on patient satisfaction and minimal complications.Trial registration: ClinicalTrials.gov, NCT04406012. Registered retrospectively, on 27 May 2020.

scholarly journals Analgesic Efficacy of Ultrasound-Guided Paravertebral Block in Patients Undergoing Percutaneous Nephrolithotomy: A Randomised, Controlled Clinical Study

2020 ◽  
Author(s):  
Ferda Yaman ◽  
Devrim Tuglu
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Statistical Significance ◽  
Intervention Group ◽  
Analgesic Efficacy ◽  
Paravertebral Block ◽  
Visual Analogue Scale Pain ◽  
Control Group ◽  
Opioid Use ◽  
Ultrasound Guided ◽  
Post Surgery

Abstract Background Paravertabral blocks (PVB) are in use to adequately manage pain arising from a variety of operations on the thorax, abdomen or pelvis. PVB is straightforward, efficacious in operations performed. This study was undertaken to evaluate how efficacious ultrasound-guided thoracic paravertebral block is when used in patients undergoing percutaneous nephrolithotomy (PCN).Methods A total of forty-four patients, falling in categories I to III of the American Society of Anesthesiologists, and aged between 18 and 65 years, who were scheduled for PCN, were randomly distributed into two groups. The anaesthetic intervention group (PVB) contained 22 individuals, who were injected at level T8-T9 with 20 mL 0.25% bupivacaine as a single administration. In the control group C, also containing 22 individuals, the intervention was not carried out. The groups were compared after PCN in terms of opioid use, pain score, opioid adverse effects profile and the need for supplemental analgesia.Results Visual analogue scale pain scores whilst at rest or moving were lower at the level of statistical significance in the PVB group compared to controls at 2 and 4 hours post-surgery. At 6 and 8 hours post-surgery, the control group had a lower VAS score when moving, and this result reached statistical significance (p < 0.05). The controls used more opioid relief than the PVB group and had lower scores for satisfaction (p < 0.05).Conclusion Ultrasound-guided PVB using bupivacaine and an in-plane technique provides effective analgesia in PNL. It is associated with high scores on patient satisfaction and minimal complications.Trial registration: ClinicalTrials.gov, NCT04406012. Registered retrospectively, on 27 May 2020.

Ultrasound-guided Fascia Iliaca Plane Block for the treatment of donor site pain in the burn injured patient: a randomized control trial

2021 ◽  
Author(s):  
C Town ◽  
H Strand ◽  
J Johnson ◽  
J Brown ◽  
A Pelecanos ◽  
...  
Keyword(s):  
Pain Score ◽  
Donor Site ◽  
Intervention Group ◽  
Skin Grafting ◽  
Control Group ◽  
Postoperative Phase ◽  
Ultrasound Guided ◽  
Post Surgery ◽  
Pain Scores ◽  
Donor Site Pain

Abstract Burn injuries requiring surgical intervention often result in split- thickness skin grafting procedures, with donor skin frequently harvested from the patient’s anterolateral thigh. The donor site is often reported as the primary site of post-operative pain due to the damage sustained to localised nociceptors.A randomised control trial was undertaken to evaluate the impact an ultrasound-guided regional nerve block would have on patient reported pain scores in donor site wounds, and associated rescue analgesia consumption. Twenty participants requiring split-skin grafting for burn injuries of &lt;15% total body surface area were enrolled from a tertiary burns unit and randomised to control (10 participants) or intervention group (10 participants). The intervention group received the addition of an ultrasound-guided facia iliaca plane block prior to their surgery. Primary outcome was pain score in the donor site during the postoperative phase; while secondary outcome was pain on day 1 post-surgery as measured by the numeric pain score (0-10). During the post-operative phase, the intervention group had a significantly lower median donor site pain score of 0 (interquartile range (IQR) 0 - 0), compared to the control group median 6 (IQR 4 - 7) (p &lt; 0.001). Day 1 post-surgery the intervention group had a median pain score of 0 (IQR 0 – 4) compared to control group median 4.5 (IQR 2 – 6) (p= 0.043).The study findings demonstrated that regional anaesthesia was an effective way to reduce pain scores and requirement for additional analgesics during the postoperative phase.

scholarly journals Assessment of pain levels in patients undergoing foot surgery

2018 ◽  
Vol 12 (3) ◽  
Author(s):  
Gabriel Souza De Albuquerque ◽  
Marcelo De Brito Teixeira ◽  
Miguel Lanzieri Juste ◽  
Daniel Gomes de Aguiar Melo ◽  
Lucas Jorge Santana de Castro Alves ◽  
...  
Keyword(s):  
Intervention Group ◽  
Control Group ◽  
Opioid Use ◽  
Foot Surgery ◽  
Level Of Evidence ◽  
Vas Score ◽  
Post Surgery ◽  
Randomized Clinical Study ◽  
The Mean

Objective: To analyze the use of an anesthetic ankle block in the immediate postoperative period in patients undergoing foot surgery to evaluate the quality of postoperative recovery and in-hospital opioid use. Methods: Presentation of the preliminary results of a randomized, placebo-controlled, double-blind trial conducted from May 2016 to January 2017, with 16 patients undergoing surgery to correct foot pathologies. The patients in the intervention group were treated with an additional ankle block and compared to a control group. Results: The intervention group included eleven patients, of whom ten had mild pain, with a mean visual analog pain scale (VAS) score of 3 and a mean quality of post-surgical recovery (QoR-40) of 194; none of these patients required the use of opioids. The control group included five patients. Of these, one patient had severe pain and two showed moderate pain. The mean VAS score in this group was 4, and the mean QoR-40 was 190. Three patients from this group required opioids. Conclusion: The use of an ankle block in the 24 h immediately post-surgery reduced pain scores and the need for opioid use and improvedpostoperative recovery. Level of Evidence I; Therapeutic Studies; Randomized Clinical Study. 

scholarly journals Assessment of the impact of an opioid-specific education series on rates of medication-assisted treatment for opioid use disorder in veterans

2020 ◽  
Author(s):  
Taylor Kirby ◽  
Robert Connell ◽  
Travis Linneman
Keyword(s):  
Multivariate Analysis ◽  
Hospital Admission ◽  
Intervention Group ◽  
Opioid Use Disorder ◽  
Control Group ◽  
Opioid Use ◽  
Motivation To Change ◽  
Heroin Use ◽  
Ed Visits ◽  
The Impact

Abstract Purpose The impact of a focused inpatient educational intervention on rates of medication-assisted therapy (MAT) for veterans with opioid use disorder (OUD) was evaluated. Methods A retrospective cohort analysis compared rates of MAT, along with rates of OUD-related emergency department (ED) visits and/or hospital admission within 1 year, between veterans with a diagnosis of OUD who completed inpatient rehabilitation prior to implementation of a series of group sessions designed to engage intrinsic motivation to change behavior surrounding opioid abuse and provide education about MAT (the control group) and those who completed rehabilitation after implementation of the education program (the intervention group). A post hoc, multivariate analysis was performed to evaluate possible predictors of MAT use and ED and/or hospital readmission, including completion of the opioid series, gender, age (&gt;45 years), race, and specific prior substance(s) of abuse. Results One hundred fifty-eight patients were included: 95 in the control group and 63 in the intervention group. Rates of MAT were 25% (24 of 95 veterans) and 75% (47 of 63 veterans) in control and intervention groups, respectively (P &lt; 0.01). Gender, completion of the opioid series, prior heroin use, and marijuana use met prespecified significance criteria for inclusion in multivariate regression modeling of association with MAT utilization, with participation in the opioid series (odds ratio [OR], 9.56; 95% confidence interval [CI], 4.36-20.96) and prior heroin use (OR, 3.26; 95% CI, 1.18-9.01) found to be significant predictors of MAT utilization on multivariate analysis. Opioid series participation and MAT use were independently associated with decreased rates of OUD-related ED visits and/or hospital admission (hazard ratios of 0.16 [95% CI, 0.06-0.44] and 0.32 [95% CI, 0.14-0.77], respectively) within 1 year after rehabilitation completion. Conclusion Focused OUD-related education in a substance abuse program for veterans with OUD increased rates of MAT and was associated with a decrease in OUD-related ED visits and/or hospital admission within 1 year.

scholarly journals Perioperative Gabapentin Does Not Reduce Postoperative Delirium in Older Surgical Patients

2017 ◽  
Vol 127 (4) ◽  
pp. 633-644 ◽  
Author(s):  
Keyword(s):  
Postoperative Pain ◽  
Postoperative Delirium ◽  
Intervention Group ◽  
Group Versus ◽  
Length Of Hospital Stay ◽  
Treated Group ◽  
Assessment Method ◽  
Hospital Length Of Stay ◽  
Control Group ◽  
Opioid Use

Abstract Background Postoperative pain and opioid use are associated with postoperative delirium. We designed a single-center, randomized, placebo-controlled, parallel-arm, double-blinded trial to determine whether perioperative administration of gabapentin reduced postoperative delirium after noncardiac surgery. Methods Patients were randomly assigned to receive placebo (N = 347) or gabapentin 900 mg (N = 350) administered preoperatively and for the first 3 postoperative days. The primary outcome was postoperative delirium as measured by the Confusion Assessment Method. Secondary outcomes were postoperative pain, opioid use, and length of hospital stay. Results Data for 697 patients were included, with a mean ± SD age of 72 ± 6 yr. The overall incidence of postoperative delirium in any of the first 3 days was 22.4% (24.0% in the gabapentin and 20.8% in the placebo groups; the difference was 3.20%; 95% CI, 3.22% to 9.72%; P = 0.30). The incidence of delirium did not differ between the two groups when stratified by surgery type, anesthesia type, or preoperative risk status. Gabapentin was shown to be opioid sparing, with lower doses for the intervention group versus the control group. For example, the morphine equivalents for the gabapentin-treated group, median 6.7 mg (25th, 75th quartiles: 1.3, 20.0 mg), versus control group, median 6.7 mg (25th, 75th quartiles: 2.7, 24.8 mg), differed on the first postoperative day (P = 0.04). Conclusions Although postoperative opioid use was reduced, perioperative administration of gabapentin did not result in a reduction of postoperative delirium or hospital length of stay.

scholarly journals Jacobson and Truax Method: evaluation of the clinical effectiveness of a home care program after prostatectomy

2018 ◽  
Vol 26 (0) ◽  
Author(s):  
Luciana Regina Ferreira Pereira da Mata ◽  
Mariana Ferreira Vaz Gontijo Bernardes ◽  
Cissa Azevedo ◽  
Tânia Couto Machado Chianca ◽  
Maria da Graça Pereira ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Home Care ◽  
Clinical Significance ◽  
Statistical Significance ◽  
Intervention Group ◽  
Nursing Intervention ◽  
Telephone Counseling ◽  
Control Group ◽  
Teaching Program ◽  
Knowledge Variable

ABSTRACT Objective: to exemplify the applicability of the Jacobson and Truax Method in a nursing intervention study that analyzed the effectiveness of a home care teaching program after radical prostatectomy. Method: this is a descriptive study concerning the applicability of the Jacobson and Truax Method in the data analysis of a clinical trial. The intervention consisted of a teaching program for hospital discharge after radical prostatectomy through oral guidance, writing, and telephonic reinforcement. Thirty-four men participated in the intervention group and 34 men participated in the control group. A reliable index of change and clinical significance was calculated for the knowledge variable in both groups. Scatterplots were presented to demonstrate the effectiveness of the method. Results: for 30 individuals in the intervention group, the intervention presented clinically relevant change than in knowledge. In the control group, none of the 34 individuals presented clinical significance of the results related to this variable, that is, the statistical significance identified by the inferential tests did not have clinically relevant changes in the knowledge variable. Conclusion: the educational intervention carried out through the combination of oral, written and telephone counseling was shown to be clinically effective in improving knowledge about home care.

Ultrasound-guided low thoracic paravertebral block versus peritubal infiltration for percutaneous nephrolithotomy: a prospective randomized study

Urolithiasis ◽  
2018 ◽  
Vol 48 (3) ◽  
pp. 235-244 ◽  
Author(s):  
Ahmet Murat Yayik ◽  
Ali Ahiskalioglu ◽  
Saban Oguz Demirdogen ◽  
Elif Oral Ahiskalioglu ◽  
Haci Ahmet Alici ◽  
...  
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Randomized Study ◽  
Paravertebral Block ◽  
Prospective Randomized Study ◽  
Ultrasound Guided ◽  
Thoracic Paravertebral Block

A Randomized Study to Assess the Impact of Pharmacist Counseling of Employer-Based Health Plan Beneficiaries With Diabetes

2011 ◽  
Vol 25 (2) ◽  
pp. 169-179 ◽  
Author(s):  
Dale F. Kraemer ◽  
Wayne A. Kradjan ◽  
Theresa M. Bianco ◽  
Judi A. Low
Keyword(s):  
Diabetes Management ◽  
Statistical Significance ◽  
Glycosylated Hemoglobin ◽  
Randomized Study ◽  
Intervention Group ◽  
Control Group ◽  
Counseling Intervention ◽  
Care Plans ◽  
Pharmacist Counseling ◽  
The Impact

Objective: To assess the impact of pharmacist counseling on empowering people with diabetes to better self-care. Introduction: Community-based pharmacists can play a key role in educating and empowering people in such programs. Methods: A randomized trial compared the effects of pharmacist counseling (intervention group) with printed materials (control group) in diabetic beneficiaries of several employer-based health care plans. All participants also received waiver of out-of-pocket expenses for diabetic-related medications and supplies. Clinical, humanistic, and claim outcomes were evaluated at baseline and at 1 year follow-up. Results: Sixty-seven beneficiaries participated in this study. The 0.50% decrease from baseline in glycosylated hemoglobin (A1c) was statistically significant ( P = .0008) in the intervention group and the difference between the groups approached statistical significance ( P = .076). Beneficiaries in both groups had greater claim costs for diabetic-related medications and supplies during the study year. Both groups also improved in ability to manage their diabetes with the counseling group showing a significantly better understanding of diabetes ( P = .0024). Conclusion: There was a trend toward improvement in A1c in patients counseled by pharmacist with an increased utilization of diabetes-related medications and supplies. Counseling also improved diabetes knowledge and empowered patients to better diabetes management.

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