scholarly journals The influence of neuromuscular blockade on phase lag entropy and bispectral index: A randomized, controlled trial

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257467
Author(s):  
Sohee Jin ◽  
Hee Jung Baik ◽  
Sooyoung Cho ◽  
Rack Kyung Chung ◽  
Kyoung Ae Kong ◽  
...  
Keyword(s):  
Neuromuscular Blockade ◽  
Bispectral Index ◽  
Normal Saline ◽  
Controlled Trial ◽  
Power Spectra ◽  
Saline Group ◽  
Emg Activity ◽  
Phase Lag ◽  
Normal Saline Group ◽  
Awake State

The aim of this study is to compare the effects of neuromuscular blockade (NMB) on phase lag entropy (PLE) and the bispectral index (BIS). We recorded the BIS, electromyograph (EMG) activity on a BIS monitor (EMG_BIS), PLE, and EMG activity on a PLE monitor (EMG_PLE) in 40 patients receiving general anesthesia. During the awake state, we analyzed the changes in parameters before and 2 min after the eyes were closed. During sedation, we compared the changes in the parameters before and at 4 min after injecting rocuronium (group R) or normal saline (group C) between the two groups. During anesthesia, we compared the changes in parameters before and at 4 min after injecting sugammadex (group B) or normal saline (group D) between the two groups. During the awake state, the BIS, EMG_BIS, and EMG_PLE, but not PLE, decreased significantly with closed eyes. An effect of EMG on the BIS was evident, but not on PLE. During sedation, the BIS decreased with the decrease in EMG_BIS regardless of NMB caused by rocuronium, but NMB decreased PLE, although the degree of the decrease in EMG_PLE after NMB was similar to that after placebo. To determine the effect of NMB on electroencephalograms (EEGs) in groups R and C, we plotted the power spectra before and at 4 min after injecting rocuronium or normal saline. Changes in slow and delta frequency bands were observed at 4 min after injecting rocuronium relative to before injecting rocuronium. There was no effect of EMG on either the BIS or PLE during anesthesia. In conclusion, the effect of electromyograph activity and/or neuromuscular blockade on BIS or PLE depends on the level of consciousness.

Randomized Controlled Trial and Meta-analysis of Oral Decontamination with 2% Chlorhexidine Solution for the Prevention of Ventilator-Associated Pneumonia

2008 ◽  
Vol 29 (2) ◽  
pp. 131-136 ◽  
Author(s):  
Hutsaya Tantipong ◽  
Chantana Morkchareonpong ◽  
Songyod Jaiyindee ◽  
Visanu Thamlikitkul
Keyword(s):  
Randomized Controlled Trial ◽  
Normal Saline ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Saline Group ◽  
Ventilator Associated Pneumonia ◽  
Normal Saline Group ◽  
Randomized Controlled ◽  
Oral Decontamination ◽  
Chlorhexidine Solution

Objective.To determine the effectiveness of oral decontamination with 2% chlorhexidine solution for the prevention of ventilator-associated pneumonia (VAP).Design.Randomized controlled trial and meta-analysis.Setting.A tertiary care university hospital in Bangkok, Thailand.Participants.Adult patients who received mechanical ventilation and who were hospitalized in intensive care units and general medical wards.Methods.The patients were randomized to receive oral decontamination with 2% chlorhexidine solution or normal saline solution 4 times per day until their endotracheal tubes were removed. The outcome measures were the development of VAP and oropharyngeal colonization with gram-negative bacilli. Meta-analysis was performed by combining the results of the present study with those from another randomized controlled trial that also used a 2% chlorhexidine formulation for oral decontamination.Results.The characteristics of the patients in the chlorhexidine group (n= 102) and the normal saline group (n= 105) were not significantly different. The incidence of VAP in the chlorhexidine group was 4.9% (5 of 102), and the incidence in the normal saline group was 11.4% (12 of 105) (P= .08). The rate of VAP in the chlorhexidine group was 7 episodes per 1,000 ventilator-days, and the rate in the normal saline group was 21 episodes per 1,000 ventilator-days (P= .04). Irritation of the oral mucosa was observed in 10 (9.8%) of the patients in the chlorhexidine group and in 1 (0.9%) of the patients in the normal saline group (P= .001). Oropharyngeal colonization with gram-negative bacilli was either reduced or delayed in the chlorhexidine group. Overall mortality of the patients did not differ significantly between the groups. Meta-analysis of 2 randomized controlled trials revealed an overall relative risk of VAP for patients in the chlorhexidine group of 0.53 (95% confidence interval, 0.31-0.90;P= .02).Conclusion.Oral decontamination with 2% chlorhexidine solution is an effective and safe method for preventing VAP in patients who receive mechanical ventilation.

The Effect of Prophylactic Ephedrine on Systemic Hypotension Caused by Induction of Anaesthesia with Propofol and Sufentanil in Elderly Hypertensive Patients: A Prospective Randomized, Double-blind Placebo-controlled Clinical Trial

2020 ◽  
Keyword(s):  
Blood Pressure ◽  
General Anesthesia ◽  
Normal Saline ◽  
Saline Group ◽  
Normal Saline Group ◽  
Hypertensive Patients ◽  
Group A ◽  
Elderly Hypertensive ◽  
Elderly Hypertensive Patients ◽  
Group B

Objective: To study the effectiveness of prophylactic ephedrine to prevent hypotension caused by induction of anesthesia with propofol and sufentanil in elderly hypertensive patients. Methodology: 70 elderly ASA grade II-III hypertensive patients undergoing elective general anesthesia were randomized into two groups to receive either intravenous ephedrine,100 ug/kg in 5ml normal saline (Group B), or an equal volume of normal saline (Group A) before induction. Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP) and Heart Rate (HR) were recorded at T0 (after entry to the operating room), T1 (1 min after induction), T2 (2 min after induction), T3 ( 3 min after induction), T4 (4 min after induction), T5 (when intubated), T6 (2 min after intubation), and T7 (at the start of the procedure), as well as the incidence of hypotension and bradycardia. Results: SBP, DBP and HR were not significantly different at T0 and were significantly different at T1 to T7 after anesthesia induction. There were statistically significant effect on hypotension and bradycardia between the two groups and group B have a lower risk of hypotension and bradycardia relative to group A. SBP and DBP decreased significantly after induction in both groups. HR decreased significantly in group A while increased in group B. Conclusion: Ephedrine pretreatment can minimize hypotension and bradycardia caused by propofol and sufentanil during the induction of general anesthesia in elderly patients with hypertension.

scholarly journals Effect of 2% Lignocaine Solution in Pain During Removal of Nasal Pack

2019 ◽  
Vol 15 (2) ◽  
pp. 80-83
Author(s):  
Ashish Dhakal ◽  
Bikash Lal Shrestha ◽  
Monika Pokharel
Keyword(s):  
Normal Saline ◽  
Saline Group ◽  
Nasal Packing ◽  
Distilled Water ◽  
Left Nostril ◽  
Normal Saline Group ◽  
Nasal Pack ◽  
Control Side ◽  
Group 5

Background: Nasal packing is commonly done after septal surgeries. Nonabsorbable nasal pack is used to minimize bleeding from surgery site, support the mucoperichondrial flaps, and minimize the risk of formation of septal hematomas and adhesions. However, these materials cause pain and discomfort in-situ as well as during removal. This study was done to evaluate the effect of 2% lignocaine rehydration of nasal pack on pain during pack removal. Methods: This prospective study was conducted on 60 patients who had undergone septoplasty. The patients were divided into 2 groups: Lignocaine and Normal saline group, with 30 patients each. In the Lignocaine group, 2.5 ml of 2% of lignocaine was diluted with 2.5 ml of distilled water and was injected into the nasal pack; and in Normal saline group, 5 ml of normal saline was injected into the nasal pack. Nothing was injected to the left nostril, which acted as a control, in both groups. All patients were asked severity of pain during removal of nasal packing by VAS. Results: In lignocaine group, mean pain score was 3.73 ± 1.63 on lignocaine side and 6.23 ± 1.69 on control side (U=109.5, p<0.001). In Normal saline group, it was 6.5 ± 1.7 on normal saline side and 6.23 ± 1.96 on control side (U=425.5, p=0.711). On comparing VAS between lignocaine and normal saline group, pain was significantly lower in the lignocaine group (U=112.5, p<0.001) Conclusion: Rehydrating nasal pack with 2% topical lignocaine is a useful method to reduce pain during nasal pack removal.

scholarly journals Effects of prophylactic ketamine and pethidine to control postanesthetic shivering: A comparative study

2018 ◽  
Vol 5 (12) ◽  
pp. 2898-2903 ◽  
Author(s):  
Masoum Khoshfetrat ◽  
Ali Rosom Jalali ◽  
Gholamreza Komeili ◽  
Aliakbar Keykha
Keyword(s):  
Normal Saline ◽  
Pearson Correlation ◽  
Saline Group ◽  
Normal Saline Group ◽  
Chi Square ◽  
Double Blind ◽  
Postanesthetic Shivering ◽  
Significant Difference ◽  
The Mean ◽  
One Way Anova

Background: Shivering is an undesirable complication following general anesthesia and spinal anesthesia, whose early control can reduce postoperative metabolic and respiratory complications. Therefore, this study aims to compare the effects of prophylactic injection of ketamine and pethidine on postoperative shivering. Methods: This double-blind clinical trial was performed on 105 patients with short-term orthopedic and ENT surgery. The patients were randomly divided into three groups; 20 minutes before the end of the surgery, 0.4 mg/kg of pethidine was injected to the first group, 0.5 mg/kg of ketamine was injected to the second group, and normal saline was injected to the third group. After the surgery, the tympanic membrane temperature was measured at 0, 10, 20, and 30 minutes. The shivering was also measured by a four-point grading from zero (no shivering) to four (severe shivering). Data were analyzed by one-way ANOVA, Kruskal Wallis, Chi-square and Pearson correlation. Results: The mean age of patients was 35.8+/-11.45 years in the ketamine group, 34.8+/-11.64 years in the normal saline group, and 33.11+/-10.5 years in the pethidine group. The one-way ANOVA showed no significant difference in the mean age between the three groups (P=0.645). The incidence and intensity of shivering were significantly higher in the normal saline group than in the ketamine and pethidine groups (p=0.001). However, there was no significant difference in the incidence and the intensity of shivering between the ketamine and the pethidine groups (p=0.936). Conclusion: The results showed that the 0.5 mg/kg of ketamine could control the post-anesthetic shivering.  

scholarly journals Efficacy of Phenylephrine in Preventing Hemodynamic Responses of Oxytocin during Elective Cesarean Section: A Randomized, Double-Blind, Controlled Trial

2019 ◽  
Vol 55 (01) ◽  
pp. 048-053
Author(s):  
Medha Mohta ◽  
Vijay Kumar ◽  
Rachna Agarwal ◽  
Geetanjali T. Chilkoti ◽  
Sakshi Duggal
Keyword(s):  
Cesarean Section ◽  
Normal Saline ◽  
Controlled Trial ◽  
Saline Group ◽  
Elective Cesarean Section ◽  
Hemodynamic Changes ◽  
Singleton Pregnancy ◽  
Double Blind ◽  
Elective Cesarean ◽  
Better Than

AbstractThis study compared hemodynamic changes and occurrence of complications following oxytocin administration with a prior injection of phenylephrine 100 μg or normal saline during elective cesarean section. Sixty-six healthy term parturients with uncomplicated, singleton pregnancy undergoing elective cesarean section under spinal anesthesia were studied. They received either intravenous phenylephrine 100 μg or normal saline before oxytocin 3 IU was administered over 30 seconds. Oxytocin dose was repeated depending on the adequacy of uterine tone. There was no significant change in systolic, diastolic, and mean arterial pressures during the initial 3 minutes following oxytocin administration in the phenylephrine group but a significant fall in mean and diastolic pressures in the saline group. Heart rate did not change significantly, and no significant complications occurred in either of the groups. To conclude, phenylephrine 100 μg administered before oxytocin injection maintained hemodynamic parameters better than normal saline injection during elective cesarean section.

scholarly journals Comparison of Ketamine, Fentanyl and Clonidine as an Adjuvant During Bupivacaine Caudal Anaesthesia in Paediatric Patients

2013 ◽  
Vol 10 (3) ◽  
pp. 25-29
Author(s):  
Jeevan Singh ◽  
RS Shah ◽  
N Vaidya ◽  
PK Mahato ◽  
S Shrestha ◽  
...  
Keyword(s):  
Side Effects ◽  
Normal Saline ◽  
Saline Group ◽  
Single Shot ◽  
Normal Saline Group ◽  
Post Operative Pain ◽  
Caudal Anaesthesia ◽  
Caudal Analgesia ◽  
Lower Pain ◽  
Group B

Background Caudal epidural analgesia with bupivacaine is very popular in paediatric anaesthesia for providing intra- and postoperative analgesia. Several adjuvants have been used to prolong the action of bupivacaine. Objectives To compare the efficacy of ketamine, fentanyl and clonidine in terms of quality and duration of analgesia they produce when added with caudal bupivacaine by single shot technique in children. Methods Eighty children, age one to ten years, undergoing sub-umbilical surgery, were prospectively randomized to one of four groups: caudal analgesia with 0.75 ml/kg of 0.25% bupivacaine in normal saline (Group B) or caudal analgesia with 0.75 ml/kg of 0.25% bupivacaine with 1 μg/kg of clonidine in normal saline (Group BC) or caudal analgesia with 0.75ml/kg of 0.25% bupivacaine with ketamine 0.5mg/kg (Group BK) or caudal analgesia with 0.75ml/kg of 0.25% bupivacaine with fentanyl 1mcg/kg (Group BF). Post-operative pain was assessed for 24 hours using the FLACC scale. Results The mean duration of analgesia was significantly longer in Group BC (629.06 ± 286.32 min) than other three groups P < 0.05. The pain score assessed using FLACC scale was compared between the four groups, and children in Group BC had lower pain scores, which was statistically significant. The requirement of rescue medicine was lesser in Group BC. Clonidine in a dose of 1 μg/kg added to 0.25% bupivacaine for caudal analgesia, during sub-umbilical surgeries, prolongs the duration of analgesia of bupivacaine, without any side effects in compare to fentanyl or ketamine. Conclusion We conclude that clonidine in a dose of 1 μg/kg, added to 0.25% bupivacaine for caudal analgesia and administered as a 0.75 ml/kg mixture in children, for sub-umbilical surgery, significantly prolongs the duration of post-operative analgesia when compared to 0.75 ml/kg of 0.25% bupivacaine in normal saline than 0.75 ml/kg of 0.25% bupivacaine with ketamine 0.5 mg/kg or 0.75 ml/kg of 0.25% bupivacaine with fentanyl 1 mcg/kg or 0.75 ml/kg of 0.25% bupivacaine alone, without any side effects. Kathmandu University Medical Journal | VOL.10 | NO. 3 | ISSUE 39 | JUL- SEP 2012 | Page 25-29 DOI: http://dx.doi.org/10.3126/kumj.v10i3.8013

scholarly journals Effect of Non-Anticoagulant N-Desulfated Heparin on Basic Fibroblast Growth Factor Expression, Angiogenesis, and Metastasis of Gastric Carcinoma In Vitro and In Vivo

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Jin-Lian Chen ◽  
Jing Fan ◽  
Ming-Xiang Chen ◽  
Ying Dong ◽  
Jian-Zhong Gu
Keyword(s):  
Gastric Cancer ◽  
Growth Factor ◽  
Gastric Carcinoma ◽  
Normal Saline ◽  
Saline Group ◽  
Fibroblast Growth ◽  
Normal Saline Group ◽  
Heparin Group

Objective. The present study was performed to investigate the effect of N-desulfated heparin on basic fibroblast growth factor (bFGF) expression, tumor angiogenesis and metastasis of gastric carcinoma.Methods. Human gastric cancer SGC-7901 tissues were orthotopically implanted into the stomach of NOD SCID mice. Twenty mice were randomly divided into two groups which received either intravenous injection of 0.9% NaCl solution (normal saline group) or 10 mg/kg N-desulfated heparin (N-desulfated heparin group) twice weekly for three weeks. In vitro, human gastric carcinoma SGC-7901 cells were treated with N-desulfated heparin in different concentration (0.1 mg/mL, 1 mg/mL, N-desulfated heparin group), and treated with medium (control group).Results. In vivo, the tumor metastasis rates were 9/10 in normal saline group and 2/10 in N-desulfated heparin group (P<0.05). The intratumoral microvessel density was higher in normal saline group than in N-desulfated heparin group (P<0.05). bFGF expression in gastric tissue was inhibited by N-desulfated heparin (P<0.05). There was no bleeding in N-desulfated heparin group. In vitro, N-desulfated heparin inhibited significantly bFGF protein and mRNA expression of gastric carcinoma cells (P<0.05).Conclusions. N-desulfated heparin can inhibit the metastasis of gastric cancer through inhibiting tumor bFGF expression and tumor angiogenesis with no obvious anticoagulant activity.

scholarly journals Intraperitoneal Hydrocortisone plus Bupivacaine versus Bupivacaine alone for Pain Relief after Laparoscopic Cholecystectomy

2016 ◽  
Vol 3 (2) ◽  
pp. 41 ◽  
Author(s):  
Mahesh Sharma ◽  
Kalpana Kharbuja ◽  
Nil Raj Sharma
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Pain Relief ◽  
Normal Saline ◽  
Randomized Study ◽  
Saline Group ◽  
Normal Saline Group ◽  
Analgesic Requirement ◽  
Number Of Patients ◽  
Group A ◽  
Group B

Introduction: Laparoscopic cholecystectomy has been the gold standard in the treatment of gallstones since last decades. Beside several benefits of laparoscopic cholecystectomy compared with open surgery, postoperative pain is still a frequent melancholy.  Hence, pain management is utmost regarding patients' comfort. The main objective of the study was to compare the effect of intraperitoneal hydrocortisone plus bupivacaine with bupivacaine alone on pain relief following laparoscopic cholecystectomy.   Methods: A randomized study was conducted from December 2015 to August 2015 that included 100 patients aged 20 to 60 years of both genders who were found to have symptomatic gallstones and were scheduled for elective laparoscopic cholecystectomy at Lumbini Medical College. Patients randomly received 100 mg hydrocortisone plus 100 mg bupivacaine in 200 ml normal saline (group A) or 100 mg bupivacaine in 200 ml normal saline (group B) into the peritoneum. Post-operative abdominal and shoulder pain were evaluated using Visual Analog Score (VAS). The patients were also followed up for postoperative analgesic requirements, and recovery variables. Data were collected, tabulated and analyzed statistically using SPSS version 19.   Results: Total number of patients in this study were 100. Age and gender among both groups were comparable. VAS scores for pain was significantly lower for group A as compared to group B at 0, 2, 4, 6, 12, and 24 hours. Time of oral intake in hrs for liquids and solids was statistically significant in Group A compared to Group B. Rescue analgesic requirement was also significantly low in Group A compared to Group B. Hospital stay in both group were comparable.   Conclusion: Combination of hydrocortisone plus bupivacaine can relieve pain after laparoscopic cholecystectomy better compared to bupivacaine alone when administered intraperitoneally.

scholarly journals Study on antihyperglycemic effect of bromocriptine in dexamethasone induced hyperglycemic wistar rats

2021 ◽  
Vol 10 (6) ◽  
pp. 699
Author(s):  
Rekha M. B. ◽  
Basavaraj Bhandare ◽  
Satyanarayana V. ◽  
Hemamalini M. B.
Keyword(s):  
Diabetes Mellitus ◽  
Normal Saline ◽  
Wistar Rats ◽  
Saline Group ◽  
Control Group ◽  
Normal Saline Group ◽  
Male Wistar Rats ◽  
Group B ◽  
Control Group Group

Background: Diabetes mellitus is a chronic metabolic disorder that develops due to insulin deficiency or insulin resistance. Recent animal and human studies have reported bromocriptine to be effective in the management of type 2 diabetes mellitus. The present study was done to evaluate the antihyperglycemic effect of bromocriptine in dexamethasone induced hyperglycemic rats.Methods: Male wistar rats were used and divided into 5 groups. Dexamethosone was used to induce hyperglycemia in group B-E. Group A was the untreated control group, group B was the standard control group, group C was the oral 10 mg/kg of bromocriptine dissolved in 0.9% normal saline, group D was the oral 20 mg/kg metformin dissolved in 0.9% normal saline, group E was the oral 10 mg/kg bromocriptine+20 mg/kg metformin dissolved in 0.9% normal saline. Fasting blood glucose, post prandial blood glucose and body weight was estimated on day 1, 15, 30.Results: It was seen that dexamethasone induced hyperglycemia and increase in body weight in male wistar rats, which were significantly controlled by oral bromocriptine and bromocriptine with metformin combination.Conclusions: Results obtained from this study showed that bromocriptine can be a promising drug with novel mechanism to treat type 2 diabetes mellitus.

scholarly journals Effectiveness of Platelet Rich Plasma for the Management of Knee Osteoarthritis

2021 ◽  
Vol 15 (7) ◽  
pp. 1553-1556
Author(s):  
Adnan Qamar ◽  
Saima Naz Mohsin ◽  
Uzma Nasim Siddiqui ◽  
Sana Naz ◽  
Sana Danish
Keyword(s):  
Knee Osteoarthritis ◽  
Normal Saline ◽  
Platelet Rich Plasma ◽  
Controlled Trial ◽  
Saline Group ◽  
Control Group ◽  
Plasma Therapy ◽  
Vas Score ◽  
To Receive

Aim: To determine impact of platelet rich plasma therapy for the management of knee osteoarthritis. Study design: Prospective double-blinded, add –on randomized, placebo-controlled trial Place and duration of study: Department of Orthopedics, Shaikh Zayed Hospital Lahore from 1st January 2019 to 30th June 2019 Methodology: Fifty volunteer participants fulfilling inclusion criteria were enrolled. One hundred knees of patients were randomly allocated into two groups. Knees were assigned either of the two groups. Platelet rich plasma group which was assigned to receive 5ml of platelet rich plasma and normal saline (NS) group which was assigned to receive 5ml of NS labeled as control group. All patients given 3 successive intra-articular injections of 5 mL of autologous platelet rich plasma or 5ml of normal saline was given at weekly intervals. Patients were blinded and subjected to a standardized injection protocol and the intensity of pain was assessed on visual analog scale (VAS) for pain. Results: The VAS scores decreased from 50.9±14.7 at baseline assessment to 43.6±16.2 at 1-month follow-up after completion of therapy for PRP group (p<0.0203). The improvement was maintained from the end of the therapy to 3 and 6 months’ follow-up, as measure of VAS score as 30.54±11.8 and 20.2±8.6 respectively (p<0.0001). In normal saline group, there was very slight decrease in VAS score from baseline i.e. 49.8±19.5 to 48±22.7, 44±16.6, and 42±21.7 at 1, 3 and 6 months interval. Conclusion: Platelet rich plasma therapy can provide effective pain control up to 6 months post injection in knee osteoarthritis. Key words: Platelet rich plasma (PRP), Knee osteoarthritis (OA), Pain score

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