scholarly journals Comparison of the effects of remifentanil and dexmedetomidine on surgeon satisfaction with surgical field visualization and intraoperative bleeding during rhinoplasty

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Reza Jouybar ◽  
Maryam Nemati ◽  
Naeimehossadat Asmarian
Keyword(s):  
Patient Satisfaction ◽  
Recovery Time ◽  
Controlled Trial ◽  
Anesthesia Induction ◽  
Double Blind ◽  
Intraoperative Bleeding ◽  
Surgical Field ◽  
Child Hospital ◽  
Surgeon Satisfaction ◽  
Remifentanil Group

Abstract Objective We aimed to compare the effect of dexmedetomidine with remifentanil on hemodynamic stability, surgical field quality, and surgeon satisfaction during rhinoplasty. Methods and materials In this double-blind randomized controlled-trial, 60 participants scheduled for rhinoplasty at the Mother and Child Hospital, Shiraz, Iran, was randomely divided into the dexmedetomidine group (IV infusion of 1 μg/kg dexmedetomidine over 20 min before induction of anesthesia then 0.6 μg/kg/hr. dexmedetomidine from the time of induction until the end of the operation) or in the the remifentanil group (an infusion rate of 0.25 μg/kg/min from the time of anesthesia induction until the end of the operation). Bleeding volume, surgeon satisfaction, postoperative pain (visual analog scale (VAS)), Level of sedation (Richmond Agitation Sedation Scale (RASS)), Patient satisfaction, Vital signs & recovery, and the Aldrete Score (used to discharge the patients from recovery) were measured for all participants. Results The patients in the dexmedetomidine group had less bleeding (p = 0.047) and shorter time to return of respiration, extubation, and the postoperative recovery time (p < 0.001). The surgeon satisfaction was higher in the dexmedetomidine group (p < 0.001). Patient satisfaction was significantly different between the two groups (p < 0.001). VAS scores, intaking paracetamol, and RASS score were significantly lower in the remifentanil group (p < 0.001). SBP, DBP, MAP, and heart rate were lower in dexmedetomidine group. Conclusion Dexmedetomidine was associated with relatively stable hemodynamics, leading to decreased intraoperative bleeding, recovery time, and greater surgeon satisfaction and the level of consciousness in the recovery ward. However, painlessness and patient satisfaction were greater with the use of remifentanil. Trial registration IRCT20141009019470N112.

scholarly journals The role of bovine colostrum on recovery time and length of hospital stay of acute diarrhea in infants and children: a double-blind randomized controlled trial

2016 ◽  
Vol 46 (3) ◽  
pp. 127
Author(s):  
IGN Suwarba ◽  
Sudaryat S ◽  
Hendra S ◽  
IKG Suandi ◽  
Raka Widiana
Keyword(s):  
Hospital Stay ◽  
Acute Diarrhea ◽  
Recovery Time ◽  
Controlled Trial ◽  
Length Of Hospital Stay ◽  
Bovine Colostrum ◽  
Mean Difference ◽  
Infants And Children ◽  
Double Blind ◽  
Defecation Frequency

Background WHO standard treatment for acute diarrhea remainsunsatisfying to the parents of acute diarrhea patients, particularlythe need of medical treatment. Bovine colostrum contains immuneand growth factors that is thought able to neutralize some agentscausing acute diarrhea in infants and children.Objective To evaluate the efficacy of bovine colostrum as adju-vant therapy on recovery time and length of hospital stay for acutediarrhea in infants and children.Methods A double-blind randomized controlled trial was conductedon infants and children with acute diarrhea admitted to SanglahHospital. Treatment group received standard therapy with bovinecolostrums and control group received standard therapy plus pla-cebo. The primary outcomes were achievement of recovery timeand length of hospital stay. Recovery time was determined by thenumber of days needed to achieve defecation frequency <3 times/day and needed to achieve normal stool consistency.Results Seventy infants and children were enrolled. The treatmentgroup significantly achieved recovery time earlier than the control groupin regard to the time of achieving defecation frequency to <3 times/day [2.31 (0.76) vs 3.34 (1.45); mean difference of -1.03; P= 0.001; CI95% -1.58;-0.48] and normal stool consistency [2.40 (0.77) vs 3.43(1.48); mean difference of -1.03; P = 0.001; CI 95% -1.59;-0.46]. Lengthof hospital stay was shorter in the treatment group than the controlgroup [2.89 (0.78) vs 3.94 (1.53); mean difference of -1.05; P= 0.001;CI 95% (-1.3;-0.7)]. No significant difference was found in mean ofbody weight recovery in two groups [0.47 (0.16) vs 0.49 (0.20); meandifference of -0.03; P=0.556; CI 95%: -0.11;0.06]. Age, nutritionalstatus, breastfeeding, and diarrhea before admission did not influ-ence the study outcome.Conclusion Bovine colostrums as an adjuvant in standard therapyfor acute diarrhea in infants and children is effective in regard toachieve earlier recovery time and shorter length of hospital stay

Comparison of ED95 of Butorphanol and Sufentanil for Gastrointestinal Endoscopy Sedation: a Randomized Controlled Trial

2020 ◽  
Author(s):  
Xiaona Zhu ◽  
Limei Chen ◽  
Shuang Zheng ◽  
Linmin Pan
Keyword(s):  
Recovery Time ◽  
Partial Agonist ◽  
Controlled Trial ◽  
Randomized Study ◽  
Sequential Method ◽  
Double Blind ◽  
Gi Endoscopy ◽  
Severity Scores ◽  
Clinical Trail ◽  
Group B

Abstract Background: Butorphanol, a synthetic opioid partial agonist analgesic, has been widely used to control perioperative pain. However, the ideal dose and availability of butorphanol for gastrointestinal (GI) endoscopy are not well known. The aim of this study was to evaluated the 95% effective dose (ED95) of butorphanol and sufentanil in GI endoscopy and compared their clinical efficacy, especially regarding the recovery time. Methods: The study was divided into two parts. For the first part, voluntary patients who needed GI endoscopy anesthesia were recruited to measure the ED95 of butorphanol and sufentanil needed to achieve successful sedation before GI endoscopy using the sequential method (the Dixon up-and-down method). The second part was a double-blind, randomized study. Two hundred cases of painless GI endoscopy patients were randomly divided into two groups (n= 100), including group B (butorphanol at the ED95 dose) and group S (sufentanil at the ED95 dose). Propofol was infused intravenously as the sedative in both groups. The recovery time, visual analogue scale (VAS) score, hand grip strength, fatigue severity scores, incidence of nausea and vomiting, and incidence of dizziness were recorded.Results: The ED95 of butorphanol for painless GI endoscopy was 9.07 μg/kg (95% confidence interval: 7.81-19.66 μg/kg). The ED95 of sufentanil was 0.1 μg/kg (95% CI, 0.079-0.422 μg/kg). Both butorphanol and sufentanil provided a good analgesic effect for GI endoscopy. However, the recovery time for butorphanol was significantly shorter than that for sufentanil (P < 0.05, group B vs. group S:21.26 ± 7.70 vs. 24.03 ± 7.80 min).Conclusions: Butorphanol at 9.07μg/kg was more effective than sufentanil for GI endoscopy sedation and notably reduced the recovery time.Trial registration: Chinese Clinical Trail Registry (Registration number # ChiCTR1900022780; Date of Registration on April 25rd, 2019) http://www.chictr.org.cn/showproj.aspx?proj= 37972.

scholarly journals A randomised double blind clinical trial to compare surgical field bleeding during endoscopic sinus surgery with clonidine-based or remifentanil-based hypotensive anaesthesia

2015 ◽  
Vol 53 (2) ◽  
pp. 107-115
Author(s):  
A. Cardesin ◽  
C. Pontes ◽  
R. Rosell ◽  
Y. Escamilla ◽  
J. Marco ◽  
...  
Keyword(s):  
Sinus Surgery ◽  
Double Blind ◽  
Intraoperative Bleeding ◽  
Hypotensive Anaesthesia ◽  
Video Recordings ◽  
Double Blind Clinical Trial ◽  
Duration Of Surgery ◽  
Vas Scores ◽  
Surgical Field ◽  
Operating Surgeon

Background: Significant bleeding during functional endoscopic naso-sinusal surgery (FESS) impairs recognition of anatomical references and may negatively affect surgical outcome. Anaesthesia including clonidine as an adjuntive hypotensive agent may reduce intraoperative bleeding. Methods: A randomised comparison of clonidine-based vs remifentanil-based hypotensive anaesthetic regimen was conducted in patients undergoing FESS. The main assessment was the proportion of subjects with Boezaart scores of surgical field bleeding, as blindly assessed from video recordings by a third surgeon not involved in patient care. Results: A total of 47 subjects underwent FESS and were randomised to clonidine or remifentanil. A significantly lower proportion of patients in the clonidine arm had blindly-assessed Boezaart scores higher than 2, with significantly lower mean blind Boezaart scores at 60 minutes and at 120 minutes. Similar findings were reported by the operating surgeon, and when Wormald and VAS scores were used. Objective estimates of bleeding and the duration of surgery and anaesthesia did not differ between groups. Conclusion: The use of clonidine- based controlled hypotensive anaesthesia achieves lower surgical field bleeding during FESS.

scholarly journals Liquid Formulation of AbobotulinumtoxinA: A 6-Month, Phase 3, Double-Blind, Randomized, Placebo-Controlled Study of a Single Treatment, Ready-to-Use Toxin for Moderate-to-Severe Glabellar Lines

2019 ◽  
Vol 40 (1) ◽  
pp. 93-104 ◽  
Author(s):  
Benjamin Ascher ◽  
Berthold Rzany ◽  
Philippe Kestemont ◽  
Said Hilton ◽  
Marc Heckmann ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Botulinum Toxin A ◽  
Controlled Trial ◽  
Placebo Patient ◽  
Controlled Study ◽  
Phase 3 ◽  
Double Blind ◽  
Duration Of Action ◽  
Appearance Time ◽  
Time Points

Abstract Background Safety and efficacy of botulinum toxin A for glabellar line (GL) treatment are well established. Currently approved formulations require reconstitution before injection. Objectives The authors sought to assess 6-month efficacy, safety, and patient satisfaction of new ready-to-use abobotulinumtoxinA solution for injection (ASI) in patients with moderate-to-severe GL at maximum frown. Methods The authors conducted a phase 3, double-blind, randomized, placebo-controlled trial (NCT02353871). Patients (N = 185) were randomized (2:1) to receive ASI 50 U or placebo. GL severity was evaluated at days 8, 15, 29, 57, 85, 113, 148, and 183 employing a 4-point scale for investigator’s live assessment (ILA) and subject's self-assessment (SSA). Primary endpoint was ILA of GL at maximum frown at day 29, and secondary endpoints were ILA and SSA of GL at maximum frown (all time points), patient satisfaction with GL appearance, time to onset, and duration of action. Results Responder rates were significantly higher for ASI vs placebo (88.3% vs 1.4%; P &lt; 0.0001) at day 29 by ILA and all time points by ILA (P &lt; 0.0001-0.0441) and SSA (P &lt; 0.0001-0.0036). Sixty percent of patients reported onset of treatment response on or before day 3 (P &lt; 0.0001 vs placebo), and in 5% of patients, efficacy by ILA lasted 6 months (day 183; P = 0.0441 vs placebo). Patient satisfaction rates were significantly higher for ASI vs placebo at all visits (P &lt; 0.0001). Safety was comparable with the known abobotulinumtoxinA profile. Conclusions ASI was significantly efficacious for improving moderate or severe GL vs placebo by investigator and patient assessment. ASI was associated with high patient satisfaction, a long duration of action, and comparable safety profile to abobotulinumtoxinA. Level of Evidence: 1

scholarly journals A small dose of remifentanil pretreatment suppresses sufentanil-induced cough during general anesthesia induction: a randomized, double-blind, placebo-controlled trial

2019 ◽  
Author(s):  
Wendong Lin ◽  
Jiehao Sun ◽  
Shuying Fu
Keyword(s):  
General Anesthesia ◽  
Small Dose ◽  
Elective Surgery ◽  
Controlled Trial ◽  
Inhibitory Effect ◽  
Control Group ◽  
Anesthesia Induction ◽  
Double Blind ◽  
Prospective Randomized Controlled Trial ◽  
Size Groups

Abstract Background: Intravenous use of sufentanil can elicit cough. This study aimed to evaluate the inhibitory effect of pre-injection of a mall dose of remifentanil on sufentanil-induced cough during the induction of general anesthesia. Methods: This prospective, randomized, controlled trial was conducted from January 10, 2019 to March 01, 2019. A total of 100 patients undergoing elective surgery under general anesthesia were enrolled, and at last 84 patients were included and randomly allocated into two equal size groups (n=42): Patients in the Remifentanil group (R group) received an intravenous infusion of remifentanil 0.3 µg/kg (diluted to 2 ml) 1 minute before sufentanil injection; patients in the Control group (C group) received 2 ml of normal saline (NS) at the same time point. Injections of patients in both groups were completed within 5 seconds. Then, sufentanil 0.5 µg/kg was injected within 5 seconds and the number of coughs that occurred within 1 minute after sufentanil injection were recorded. One minute after sufentanil injection, etomidate 0.3 mg/kg and cisatracurium 0.15 mg/kg were given for general anesthesia induction irrespective of the presence or absence of cough. The mean arterial pressure (MAP) and heart rate (HR) at time points just before remifentanil pretreatment administration (T0), 3 minutes after administration (T1), 1 minute after intubation (T2), and 3 minutes after intubation (T3) were recorded. Results: The incidence of cough in patients in the R group and C group was 4.8% and 31%, respectively. Compared with group C, the incidence and severity of cough in group R was significantly lower (P <0.01). No significant differences were observed in MAP and HR at the time of general anesthesia induction between the two groups (P> 0.05). Conclusion: Pretreatment with a small dose of remifentanil effectively and safely reduced the incidence and severity of cough induced by sufentanil during anesthesia induction and can be used as an alternative treatment to inhibit coughing caused by sufentanil.

scholarly journals Comparison of the combination of propofol and etomidate versus propofol or etomidate alone for induction of general anesthesia: a double-blind, randomized controlled trial

2021 ◽  
Author(s):  
Yun Li ◽  
Wenze Lu ◽  
David Li ◽  
Jon Zhou ◽  
Richard Applegate ◽  
...  
Keyword(s):  
Heart Rate ◽  
Randomized Controlled Trial ◽  
General Anesthesia ◽  
Controlled Trial ◽  
Anesthesia Induction ◽  
Double Blind ◽  
Randomized Controlled ◽  
Hemodynamic Variables ◽  
Processed Eeg ◽  
Induction Agents

IntroductionHemodynamic fluctuation during the induction of general anesthesia is a common event and adversely affect patients’ outcomes. The aim of this study is to investigate the impacts of different anesthesia induction agents: propofol, etomidate, and propofol-etomidate combination on patient hemodynamics and processed electroencephalography (EEG).Material and methodsSeventy-five patients undergoing elective non-cardiac surgery were randomly assigned to three groups of anesthesia induction agents: the group P received 2 mg/kg propofol, the group E received 0.3 mg/kg etomidate, and the group PE received the combination of 1mg/kg propofol plus 0.15mg/kg etomidate. Hemodynamic variables and processed EEG were measured during induction.ResultsHeart rate (HR) was significantly increased at intubation and 1 min after intubation compared with baseline in all three groups. Mean arterial pressure (MAP) decreased significantly after induction, at 5, and 10 min after intubation in group P (79.1±12.6, 77.0±14.2, 76.6±11.4 versus 93.2±9.9 mmHg; all P＜0.001). MAP increased significantly at intubation and 1 min after intubation in group E (104.7±13.0, 103.8±12.8 versus 92.9±10.2; P＜0.001, P=0.001 respectively). The incidence of myoclonus was lower in groups PE (4.0%) and P (4.0%) compared with that in group E (24.0%) (P=0.033). The incidence of pain at injection was higher in group P (28.0%) than that in groups PE and E (4.0% and 0.0%) (P=0.025).ConclusionsThe combination of propofol and etomidate used during induction of anesthesia provided a more stable BP profile, less pain at site of injection, and decreased myoclonic movements compared with propofol or etomidate alone.

scholarly journals Comparison of ED95 of Butorphanol with Sufentanil for Gastrointestinal Endoscopy Sedation: a randomized controlled trial

2020 ◽  
Author(s):  
Xiaona Zhu ◽  
Limei Chen ◽  
Shuang Zheng ◽  
Linmin Pan
Keyword(s):  
Recovery Time ◽  
Partial Agonist ◽  
Controlled Trial ◽  
Randomized Study ◽  
Sequential Method ◽  
Double Blind ◽  
Gi Endoscopy ◽  
Severity Scores ◽  
Fatigue Severity ◽  
Group B

Abstract Background: Butorphanol, a synthetic opioid partial agonist analgesic, has been widely used for the control of perioperative pain. However, the ideal dose and availability of butorphanol for gastrointestinal (GI) endoscopy are not well known. The aim of this study was to evaluated the 95% effective dose (ED95) of butorphanol and sufentanil in GI endoscopy and compared their clinical efficacy, especially the recovery time. Methods: The study was divided into two parts. For the first part, voluntary patients who needed GI endoscopy anesthesia were recruited to measure the ED95 of butorphanol and sufentanil when they reached successful sedation during GI endoscopy using the sequential method (the Dixon up-and-down method). In the second part, this was a double-blind, randomized study. Two hundred cases of painless GI endoscopy patients were randomly divided into two groups (n=100), including group B (butorphanol at the ED95 dose) and group S (sufentanil at the ED95 dose). Propofol was infused intravenously to both groups as the sedative. The recovery time, VAS (visual analogue scale) score, hand grip strength, fatigue severity scores, incidence of nausea and vomiting, and incidence of dizziness were recorded. Results: The ED95 of butorphanol in painless GI endoscopy was 9.07μg/kg (95% confidence interval: 7.81-19.66μg/kg). The ED95 of sufentanil was 0.1μg/kg (95% CI, 0.079-0.422μg/kg). Both butorphanol and sufentanil provided a good analgesic effect in GI endoscopy. However, the recovery time for butorphanol was significantly shorter than sufentanil (P<0.05, group B versus group S:21.26±7.70 vs. 24.03±7.80, min). Conclusions: Butorphanol at 9.07μg/kg showed a better effect compared with sufentanil in GI endoscopy sedation, notably reduced the recovery time.

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