Effect of magnesium supplementation on emergence delirium and postoperative pain in children undergoing strabismus surgery: a prospective randomised controlled study

Abstract Background The benefits of intraoperative magnesium supplementation have been reported. In this prospective, randomized study, the effects of magnesium supplementation during general anaesthesia on emergence delirium and postoperative pain in children were evaluated. Methods A total of 66 children aged 2 to 5 years who underwent strabismus surgery were assigned to the magnesium or to the control group. Preoperative anxiety was assessed using the modified Yale Preoperative Anxiety Scale. After anaesthesia induction, the magnesium group received an initial loading dose of 30 mg/kg magnesium sulphate over 10 min and, then, continuous infusion of 10 mg/kg per h until 10 min before the end of the surgery. The control group received an equal volume of normal saline via the same regimen. The Paediatric Anaesthesia Emergence Delirium (PAED) score, pain score, and respiratory events were assessed at the postanaesthetic care unit. Results Data obtained from 65 children were analyzed. The PAED and pain scores of the two groups did not differ significantly. There were 26 of 33 (78.8%) and 27 of 32 (84.4%) children with emergence delirium in the control and the magnesium groups, respectively (odds ratio 0.69, 95% CI 0.19–2.44; p = 0.561). The preoperative anxiety score was not significantly correlated with the PAED score. The incidence of respiratory events during the emergence period did not differ significantly between the two groups. Conclusions Magnesium supplementation during anaesthesia had no significant effects on the incidence of emergence delirium or postoperative pain in children undergoing strabismus surgery. Trial registration ClinicalTrials.gov (NCT03132701). Prospectively registered May 8, 2017.

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Magnesium Supplementation and Postoperative Recovery Quality in Children Undergoing Strabismus Surgery: A Prospective, Randomised, Controlled Study

10.21203/rs.3.rs-63561/v1 ◽

2020 ◽

Author(s):

Ji-Hyun Lee ◽

Seungeun Choi ◽

Minkyoo Lee ◽

Young-Eun Jang ◽

Eun-Hee Kim ◽

...

Keyword(s):

Postoperative Pain ◽

Strabismus Surgery ◽

Preoperative Anxiety ◽

Controlled Study ◽

Control Group ◽

Anesthesia Induction ◽

Emergence Agitation ◽

Magnesium Supplementation ◽

Respiratory Events ◽

Postanesthetic Care Unit

Abstract Background: The benefits of intraoperative magnesium supplementation have been reported. In this prospective, randomized study, the effects of magnesium supplementation during general anesthesia on emergence agitation and postoperative pain in children were evaluated.Methods: A total of 66 children aged 2 to 5 years who underwent strabismus surgery were assigned to the magnesium or to the control group. Preoperative anxiety was assessed using the modified Yale Preoperative Anxiety Scale. After anesthesia induction, the magnesium group received an initial loading dose of 30 mg/kg magnesium sulphate over 10 min and, then, continuous infusion of 10 mg/kg per h until 10 min before the end of the surgery. The control group received an equal volume of normal saline via the same regimen. The Pediatric Anesthesia Emergence Delirium (PAED) score, pain score, and respiratory events were assessed at the postanesthetic care unit.Results: Data obtained from 65 children were analyzed. The PAED and pain scores of the two groups did not differ significantly. There were 26 of 33 (78.8%) and 27 of 32 (84.4%) children with emergence agitation in the control and the magnesium groups, respectively (odds ratio 0.69, 95% CI 0.19–2.44; p = 0.561). The preoperative anxiety score was not significantly correlated with the PAED score. The incidence of respiratory events during the emergence period did not differ significantly between the two groups. Conclusions: Magnesium supplementation during anesthesia had no significant effects on the incidence of emergence agitation or postoperative pain in children undergoing strabismus surgery.Clinical trial registry: ClinicalTrials.gov (NCT03132701)

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Effect of Pregabalin on Preoperative Anxiety and Postoperative Pain in Spine Surgery: A Randomized Controlled Study

Journal of Neuroanaesthesiology and Critical Care ◽

10.1055/s-0037-1616037 ◽

2018 ◽

Vol 05 (01) ◽

pp. 8-14

Author(s):

Rahul Yadav ◽

Rajeeb K. Mishra ◽

Arvind Chaturvedi ◽

Girija P. Rath

Keyword(s):

Side Effects ◽

Postoperative Pain ◽

Spine Surgery ◽

Postoperative Nausea And Vomiting ◽

Preoperative Anxiety ◽

Controlled Study ◽

Lumbar Spine Surgery ◽

Control Group ◽

Vas Score ◽

Fentanyl Consumption

Abstract Background Pregabalin is a gabapentinoid which has been shown to possess analgesic and anxiolytic properties. The present study aimed to assess the efficacy of a single dose of pregabalin on postoperative pain and preoperative anxiety in patients undergoing lumbar spine surgery. Materials and Methods Sixty adults posted for elective lumbar laminectomy and discectomy were randomly assigned to one of the three groups; Group C received placebo capsules, Group PI received pregabalin 150 mg, and Group P2 received pregabalin 300 mg capsules, 2 h prior to induction of anesthesia. The levels of anxiety and pain were assessed with respective 100 mm visual analog scale (VAS) score. Postoperative fentanyl consumption and occurrence of side effects were recorded. All patients were observed for 8 h, postoperatively. Results There was a significant reduction in preoperative anxiety in both pregabalin groups as compared to control group (p = 0.001). VAS score for pain (at rest and during movement) was significantly decreased at all time intervals in both PI and P2 groups as compared to control (p < 0.05). Fentanyl consumption in the postoperative period was significantly reduced in pregabalin groups as compared to control (p = 0.001). The level of sedation was higher in P2 group in the first 4 h (p < 0.05). The occurrence of postoperative nausea and vomiting was more in control group as compared to the pregabalin groups (p = 0.018). The incidence of dizziness and blurring of vision was significantly more in P2 group. Conclusion Single preoperative dose of pregabalin 150 or 300 mg was effective in reducing preoperative anxiety, postoperative pain and total fentanyl consumption in patients undergoing lumbar laminectomy and discectomy. However, the incidence of postoperative side effects such as sedation, dizziness and visual blurring was more in patients who received pregabalin 300 mg.

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Self-produced audio-visual animation introduction alleviates preoperative anxiety in pediatric strabismus surgery: a randomized controlled study

BMC Ophthalmology ◽

10.1186/s12886-021-01922-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yuexi Jin ◽

Aifen Jiang ◽

Wanna Jiang ◽

Wenxin Wu ◽

Lisha Ye ◽

...

Keyword(s):

Clinical Trial ◽

Randomized Study ◽

Strabismus Surgery ◽

Preoperative Anxiety ◽

Controlled Study ◽

Average Score ◽

Anesthesia Induction ◽

Emergence Agitation ◽

Clinical Trial Registry ◽

Group A

Abstract Background Hospital anxiety caused by strabismus surgery has an unpleasant and disturbing feeling for both children and their parents. This study aimed to determine the effect of viewing a self-produced audio-visual animation introduction on preoperative anxiety and emergence agitation of pediatric patients undergoing strabismus surgery. Methods In this prospective randomized study, 1 hundred children scheduled for strabismus surgery with aged 3 ~ 6 years. The children were randomly divided into 2 groups (n = 50 for each), Group A: using a self-produced audio-visual animation introduction; Group C: controlled group without audio-visual animation introduction. Children’s preoperative anxiety was determined by the modified Yale Preoperative Anxiety Scale (mYPAS) at different time points: the night before surgery(T1), at pre-anesthetic holding room(T2), and just before anesthesia induction(T3). The Spielberger State-Trait Anxiety Inventory (STAI) was used to record the anxiety of parents at T1,T2 and T3. The incidence and the degree of emergence agitation were recorded. Results The mYPAS scores at T2 and T3 were higher than T1(p < 0.05) in both groups. The average score of mYPAS in Group A was significantly lower than in Group C at T2 and T3(p < 0.05). The STAI scores in Group A at T2 and T3 were significantly lower than in Group C(p < 0.05). The incidence of agitation in Group A was lower than that in Group C(p < 0.05). Conclusions Based on the findings, viewing a self-produced audio-visual animation can effectively alleviate the preoperative anxiety for both children and their parents in pediatric strabismus surgery, and it was effective for reducing emergence agitation as well. Trial registration The trial was prospectively registered before patient enrollment at Chinese Clinical Trial Registry (Clinical Trial Number: ChiCTR1900025116, Date: 08/12/2019).

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Postoperative analgesia by adding acupuncture to conventional therapy, a non-randomized controlled trial

Journal of Complementary and Integrative Medicine ◽

10.1515/jcim-2018-0028 ◽

2018 ◽

Vol 16 (2) ◽

Cited By ~ 2

Author(s):

Ilana Levy ◽

Samuel Attias ◽

Lior Cohen ◽

Nadav Stoppelmann ◽

Dan Steinberger ◽

...

Keyword(s):

Side Effects ◽

Postoperative Pain ◽

Analgesic Effect ◽

Pain Treatment ◽

Standard Of Care ◽

Acupuncture Group ◽

Controlled Study ◽

Control Group ◽

Pain Level ◽

Randomized Controlled

Abstract Background Postoperative pain is common in patients hospitalized in surgical departments, yet it is currently not sufficiently controlled by analgesics. Acupuncture, a complementary medical practice, has been evaluated for its benefits in postoperative pain with heterogeneous results. We tested the feasibility of a controlled study comparing the postoperative analgesic effect of acupuncture together with standard-of-care to standard-of-care only. Methods In this pilot non-randomized controlled study conducted at a tertiary medical center in Israel, patients received either acupuncture with standard-of-care pain treatment (acupuncture group) or standard-of-care treatment only (control group) following surgery. Visual Analogue Scale (VAS) ratings for pain level at rest and in motion were evaluated both at recruitment and two hours after treatment. Acupuncture-related side effects were reported as well. Results We recruited 425 patients; 336 were assigned to the acupuncture group and 89 to the control group. The acupuncture group exhibited a decrease of at least 40% in average level of pain both at rest (1.8±2.4, p<0.0001) and in motion (2.1±2.8, p<0.0001) following acupuncture, whereas the control group exhibited no significant decrease (p=0.92 at rest, p=0.98 in motion). Acupuncture's analgesic effect was even more prominent in reducing moderate to severe pain at baseline (VAS ≥4), with a decrease of 49% and 45% of pain level at rest and in motion respectively (p<0.001), compared with no significant amelioration in the control group (p=0.20 at rest, p=0.12 in motion). No major side effects were reported. Conclusion Integrating acupuncture with standard care may improve pain control in the postoperative setting.

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Perioperative pregabalin for reducing pain, analgesic consumption, and anxiety and enhancing sleep quality in elective neurosurgical patients: a prospective, randomized, double-blind, and controlled clinical study

Journal of Neurosurgery ◽

10.3171/2015.10.jns151516 ◽

2016 ◽

Vol 125 (6) ◽

pp. 1513-1522 ◽

Cited By ~ 22

Author(s):

Nir Shimony ◽

Uri Amit ◽

Bella Minz ◽

Rachel Grossman ◽

Marc A. Dany ◽

...

Keyword(s):

Postoperative Pain ◽

Sleep Quality ◽

Rating Scale ◽

Preoperative Anxiety ◽

Controlled Study ◽

Double Blind ◽

Analgesic Consumption ◽

Pain Scores ◽

Neurosurgical Patients ◽

Duration Of Surgery

OBJECTIVE The aim of this study was to assess in-hospital (immediate) postoperative pain scores and analgesic consumption (primary goals) and preoperative anxiety and sleep quality (secondary goals) in patients who underwent craniotomy and were treated with pregabalin (PGL). Whenever possible, out-of-hospital pain scores and analgesics usage data were obtained as well. METHODS This prospective, randomized, double-blind and controlled study was conducted in consenting patients who underwent elective craniotomy for brain tumor resection at Tel Aviv Medical Center between 2012 and 2014. Patients received either 150 mg PGL (n = 50) or 500 mg starch (placebo; n = 50) on the evening before surgery, 1.5 hours before surgery, and twice daily for 72 hours following surgery. All patients spent the night before surgery in the hospital, and no other premedication was administered. Opioids and nonsteroidal antiinflammatory drugs were used for pain, which was self-rated by means of a numerical rating scale (score range 0–10). RESULTS Eighty-eight patients completed the study. Data on the American Society of Anesthesiologists class, age, body weight, duration of surgery, and intraoperative drugs were similar for both groups. The pain scores during postoperative Days 0 to 2 were significantly lower in the PGL group than in the placebo group (p < 0.01). Analgesic consumption was also lower in the PGL group, both immediately and 1 month after surgery. There were fewer requests for antiemetics in the PGL group, and the rate of postoperative nausea and vomiting was lower. The preoperative anxiety level and the quality of sleep were significantly better in the PGL group (p < 0.01). There were no PGL-associated major adverse events. CONCLUSIONS Perioperative use of twice-daily 150 mg pregabalin attenuates preoperative anxiety, improves sleep quality, and reduces postoperative pain scores and analgesic usage without increasing the rate of adverse effects. Clinical trial registration no.: NCT01612832 (clinicaltrials.gov)

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Music to prevent deliriUm during neuroSurgerY (MUSYC) Clinical trial: a study protocol for a randomised controlled trial

BMJ Open ◽

10.1136/bmjopen-2020-048270 ◽

2021 ◽

Vol 11 (10) ◽

pp. e048270

Author(s):

Pablo Kappen ◽

Johannes Jeekel ◽

Clemens M F Dirven ◽

M Klimek ◽

Steven Kushner ◽

...

Keyword(s):

Postoperative Pain ◽

Randomised Controlled Trial ◽

Medical Center ◽

Controlled Trial ◽

Clinical Care ◽

Preoperative Anxiety ◽

Control Group ◽

Neurosurgical Procedures ◽

Depth Of Anaesthesia ◽

Randomised Controlled

IntroductionDelirium is a neurocognitive disorder characterised by an acute and temporary decline of mental status affecting attention, awareness, cognition, language and visuospatial ability. The underlying pathophysiology is driven by neuroinflammation and cellular oxidative stress.Delirium is a serious complication following neurosurgical procedures with a reported incidence varying between 4% and 44% and has been associated with increased length of hospital stay, increased amount of reoperations, increased costs and mortality.Perioperative music has been reported to reduce preoperative anxiety, postoperative pain and opioid usage, and attenuates stress response caused by surgery. We hypothesize that this beneficial effect of music on a combination of delirium eliciting factors might reduce delirium incidence following neurosurgery and subsequently improve clinical outcomes.MethodsThis protocol concerns a single-centred prospective randomised controlled trial with 6 months follow-up. All adult patients undergoing a craniotomy at the Erasmus Medical Center in Rotterdam are eligible. The music group will receive recorded music through an overear headphone before, during and after surgery until postoperative day 3. Patients can choose from music playlists, offered based on music importance questionnaires administered at baseline. The control group will receive standard of clinical careDelirium is assessed by the Delirium Observation Scale and confirmed by a delirium-expert psychiatrist according to the DSM-5 criteria. Risk factors correlated with the onset of delirium, such as cognitive function at baseline, preoperative anxiety, perioperative medication use, depth of anaesthesia and postoperative pain, and delirium-related health outcomes such as length of stay, daily function, quality of life (ie, EQ-5D, EORTC questionnaires), costs and cost-effectiveness are collected.Ethics and disseminationThis study is being conducted in accordance with the Declaration of Helsinki. The Medical Ethics Review Board of Erasmus University Medical Center Rotterdam, The Netherlands, approved this protocol. Results will be disseminated via peer-reviewed scientific journals and conference presentations.Trial registration numbersNL8503 and NCT04649450.

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Ultrasound-Guided Cannulation of the Great Saphenous Vein in Neonates: A Randomized Study

American Journal of Perinatology ◽

10.1055/s-0041-1733958 ◽

2021 ◽

Author(s):

Zhenzhen Tu ◽

Yanzhe Tan ◽

Lifei Liu ◽

Jia Xie ◽

Ying Xu ◽

...

Keyword(s):

Great Saphenous Vein ◽

Randomized Study ◽

Controlled Study ◽

Control Group ◽

Success Rates ◽

Procedure Time ◽

Ultrasound Guided ◽

Randomized Controlled ◽

Key Points ◽

Procedural Time

Objective This prospective randomized controlled study aimed to compare the ultrasound-guided (USG) technique with the standard single-wall puncture technique for epicutaneo-caval catheter (ECC) placement in neonates. Study Design A total of 100 neonates were included in this study. All enrolled neonates were randomly divided into two groups (n = 50): the USG group and the control group. The control group underwent standard single-wall puncture for ECC placement procedures, and the USG group underwent USG ECC placement procedures. Results The first attempt success rates (62 vs. 38%; p = 0.016) and the total success rates (92 vs. 74%; p = 0.017) were higher in the USG group than in the control group. The procedure time was shorter in the USG group than in the control group: 351.43 (112.95) versus 739.78 seconds (369.13), p < 0.001. The incidence of adverse events was not significantly different between the two groups. Conclusion Compared with the standard single-wall puncture method, USG cannulation is superior for neonatal ECC placement, with a higher success rate, and decreases the total procedural time. Key Points

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Efficacy of dexamethasone in reducing the incidence of postoperative sore throat: a double blind randomized study

Journal of Patan Academy of Health Sciences ◽

10.3126/jpahs.v5i1.24034 ◽

2018 ◽

Vol 5 (1) ◽

pp. 10-15 ◽

Cited By ~ 1

Author(s):

Sujita Manandhar ◽

Kishor Manandhar ◽

Sharad Khakrel

Keyword(s):

Endotracheal Tube ◽

Sore Throat ◽

Randomized Study ◽

Saline Group ◽

Controlled Study ◽

Control Group ◽

Lower Grade ◽

Postoperative Sore Throat ◽

Double Blind ◽

Dexamethasone Group

Introductions: Postoperative sore throat (POST) is a commonly seen adverse event after general anesthesia with endotracheal intubation. Dexamethasone, a potent corticosteroid with anti-inflammatory action is the most popular steroid studied in this regard with positive results. Methods: This randomized, prospective, double-blinded, placebo-controlled study was conducted on one hundred and ten adult patients of either sex, American Society of Anesthesiologists physical status I & II, undergoing elective surgeries requiring endotracheal tube intubation. After obtaining written informed consent, they were randomly divided into Control (A, n=55) and Dexamethasone (B, n=55) groups and received either an injection of Dexamethasone (Group B) 8 mg intravenously or an equivalent volume of Normal Saline (Group A) just before entering the operating theatre. All the patients received a similar anesthesia with endotracheal tube intubation and at the end of surgery, extubated and transferred to the post-anesthesia care unit. The incidence and severity of sore throat were assessed at 1, 6 and 24 hours post-extubation. Severity of sore throat were graded on a 4 point scale, p <0.05 was considered significant. Results: Incidence of POST in Dexamethasone group was found significantly low compared to the control group up to six hours (p<0.05) but was comparable at 24 hours post extubation. Severity of POST in the study group was of lower grade in compare to control group. Conclusions: Prophylactic intravenous Dexamethasone 8 mg administered to patients undergoing elective surgeries requiring endotracheal tube intubation significantly reduces the incidence and severity of POST up to six hours post-extubation.

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The effectiveness of preoperative individual information on reducing anxiety and pain after hysterectomy: A randomized controlled trial

Journal of Nursing Education and Practice ◽

10.5430/jnep.v10n1p67 ◽

2019 ◽

Vol 10 (1) ◽

pp. 67

Author(s):

Hrønn Thorn ◽

Lisbeth Uhrenfeldt

Keyword(s):

Randomized Controlled Trial ◽

Postoperative Pain ◽

Controlled Trial ◽

Anxiety Level ◽

Preoperative Anxiety ◽

Control Group ◽

Study Group ◽

Randomized Controlled ◽

Significant Difference ◽

Individual Information

Background and objective: Preoperative anxiety among gynecological patients is well-known and has a direct correlation with postoperative pain. By minimizing preoperative anxiety, the level of postoperative pain may decrease. The purpose of this study was to evaluate the effect of preoperative structured information and dialogue on patients' anxiety and postoperative pain.Methods: A single-center non-blinded randomized controlled trial. Forty-six women scheduled for hysterectomy were allocated either to the study group or the control group. The study group was given individual information at a preoperative consultation while the control group was given information at admittance. The main outcome was anxiety level and postoperative pain.Results: Forty participants (study group = 20; control group = 20) were analyzed. No statistically significant difference was found in anxiety level within the first 24 h postoperatively or in postoperative pain within four weeks between the groups.Conclusions: Preoperative individual information and dialogue did not result in significant effects in reducing anxiety level nor did it result in lower postoperative pain score.

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Role of Preoperative Pregabalin in Reducing Inhalational Anaesthetic Requirements in Abdominal Hysterectomy: Randomized Controlled Trial

10.21203/rs.2.183/v1 ◽

2019 ◽

Author(s):

Ahmed Abdalla Mohamed ◽

Gehan Helmy Ibrahim ◽

Nesrine Abd Elrahman El Refai ◽

Tamer Mousaad Abdelhamid Gamaleldin ◽

Reham Ali Abdelrahman Abdelrahman ◽

...

Keyword(s):

Postoperative Pain ◽

General Anaesthesia ◽

Bispectral Index ◽

Total Abdominal Hysterectomy ◽

Abdominal Hysterectomy ◽

Neurological Dysfunction ◽

Hypoglycemic Agents ◽

Controlled Study ◽

Control Group ◽

Rescue Analgesia

Abstract Background: preoperative oral pregabalin controls postoperative pain & decreases anesthetic requirements in total intravenous anaesthesia . In this study, we hypothesized that preoperative pregabalin reduces inhaled isoflurane requirements. Methods: Study was conducted in a university hospital, included 50 women (18-60 yrs.), ASA I or II, admitted to undergo elective abdominal hysterectomy under general anaesthesia. Time of study: June to September 2017. Exclusion criteria were allergy or hypersensitivity to pregabalin; patients on calcium channel blockers, antiepileptic drugs, antidepression drugs, any analgesics or sedatives, or oral hypoglycemic agents; and patients with severe cardiovascular, renal, hepatic or neurological dysfunction. Interventions: giving either oral pregabalin 150 mg or placebo to patients of both groups. Primary outcome measures: inhaled isoflurane requirements to maintain haemodynamics ± 20% of baseline& bispectral index (BIS) of 40 - 60, measured using MAQUET Flow-I anaesthetic machine. Secondary outcomes : attenuation of pressor response to intubation, postoperative pain, first time for rescue analgesia, total anaglesics and adverse effects. Results: Isoflurane consumption was significantly less in pregabalin group (7.80 ± 1.27ml h -1) versus (12.27 ± 2.49 ml h-1) in control group, (P= 0.00). Better haemodynamic stability was in pregabalin group after intubation. First postoperative hour :the mean VAS score was significantly higher in control group (7.10 ± 1.20) compared to pregabalin group (4.50 ± 1.70), P<0.001. All patients in control group received pethidine intramuscular. More patients in pregabalin group suffered dizziness. Conclusion: preoperative pregabalin 150 mg ,1 h before total abdominal hysterectomy has an inhaled anaesthetic-sparing effect, maintain haemodynamics and optimizes postoperative analgesia. Keywords: Gabapentinoids, Pregabalin; Inhalation Anaesthetics, Isoflurane; Monitoring, Bispectral Index; Surgery, Abdominal Hysterectomy Objectives: We aimed to investigate the effectiveness and safety of preoperative oral pregabalin 150 mg in women undergoing elective total abdominal hysterectomy under general anaesthesia. Design: A prospective, randomized, double-blind, controlled study. Trial Registry Number: ClinicalTrials.gov: NCT 03302208

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