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

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.

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A comparison of the effect of dexamethasone and pethidine for prevention of shivering after spinal anesthesia in caesarean section: randomization clinical trial

Biomedical Research and Therapy ◽

10.15419/bmrat.v5i9.473 ◽

2018 ◽

Vol 5 (9) ◽

pp. 2646-2650 ◽

Cited By ~ 2

Author(s):

Hamideh Gholami ◽

Yousef Moradi ◽

Zaher Khazaei ◽

Shahrzad Tehrani

Keyword(s):

Clinical Trial ◽

Caesarean Section ◽

Spinal Anesthesia ◽

Normal Saline ◽

Saline Group ◽

Elective Cesarean Section ◽

Double Blind ◽

Dexamethasone Group ◽

Postanesthetic Shivering ◽

Significant Difference

Background: Postanesthetic shivering is one of the most common complications and problems after operations. Medications and drugs can be used to prevent postanesthetic shivering. The aim of this study is to compare the effects of Dexamethasone and Pethidine in preventing postanesthetic shivering after spinal anesthesia in Iranian women undergoing caesarean section. Method: This double-blind randomized clinical trial was performed in 66 pregnant women who were referred to Ayatollah Moosavi Hospital in Zanjan, Iran for elective cesarean section, from December 2011 to November 2012. All participants who have ASA I-II were randomly classified into three groups: Dexamethasone receivers (Group A), Pethidine receivers (Group B), and Normal Saline receivers (Group C). Data were collected and analyzed using SPSS16 software. IRCT registration number of this study is IRCT201112198469N1. Conclusion: Although statistically there was no significant difference between the three groups of Dexamethasone, Pethidine and Normal Saline receivers regarding shivering reduction; clinical complication rate in Dexamethasone group was lower comparedto Pethidine and Normal Saline groups. Results: There was no significant difference between three groups regarding shivering reduction. There were 11 (72.5%) trembling cases in Normal Saline group, 6 cases (27.3%) in Dexamethasone group, and 12 cases (54.5%) in Pethidine group.

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The effect of Quercus infectoria pair cream on the severity of episiotomy pain in nulliparous women

Journal of Herbmed Pharmacology ◽

10.34172/jhp.2021.47 ◽

2021 ◽

Vol 10 (4) ◽

pp. 401-407

Author(s):

Roza Soltanifard ◽

Fatemeh Nahidi ◽

Faraz Mojab ◽

Mehdi Birjandi

Keyword(s):

Pain Intensity ◽

Normal Saline ◽

Pain Intensity Score ◽

Chi Square ◽

Double Blind ◽

Second Stage Of Labor ◽

Nulliparous Women ◽

Significant Difference ◽

Important Health ◽

Quercus Infectoria

Introduction: Episiotomy is an incision in the perineal area during the second stage of labor to facilitate delivery. Complications of perineal injuries are one of the most important health issues. Oak pair has long been used experimentally to heal wounds and reduce pain. The present study was performed to investigate the effect of oak pair (Quercus infectoria) cream on pain due to episiotomy in nulliparous women. Methods: This double-blind clinical trial experimental study was performed on 120 nulliparous women in Asali hospital in 2018. Individuals were randomly divided into oak pair cream, placebo, and normal saline groups. Data were collected by demographic and midwifery information questionnaires and numerical pain scales. The creams were used by the participants every 12 hours for 10 days, and the pain intensity was evaluated before the intervention and on days 1, 5, and 10. Data analysis was performed by SPSS using chi-square, Kruskal-Wallis, and one-way analysis of variance (ANOVA) tests. Results: There was no statistically significant difference in pain intensity scores among the three groups of oak pair, placebo, and normal saline before the intervention (P = 0.20). Pain intensity on days 1, 5, and 10 after the intervention showed a significant difference between the three groups in favor of oak cream (P < 0.001). The results showed that there was a significant decrease in the mean pain intensity score of the oak pair receiving group over time (P < 0.001).Conclusion: Oak cream might be effective in reducing pain caused by episiotomy due to analgesic properties.

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Alfentanil for Short Duration Laparoscopic Procedures

Anaesthesia and Intensive Care ◽

10.1177/0310057x8601400109 ◽

1986 ◽

Vol 14 (1) ◽

pp. 37-40

Author(s):

K. S. Lee ◽

G. J. Purcell ◽

B. R. Rae ◽

B. White

Keyword(s):

Nitrous Oxide ◽

Short Duration ◽

Normal Saline ◽

Saline Group ◽

Postoperative Recovery ◽

Normal Saline Group ◽

Analgesic Agent ◽

Double Blind ◽

Cardiovascular Depression ◽

Low Dosage

Alfentanil in low dosage (8 μg kg−1) as an analgesic agent for short duration surgery was evaluated. Forty-one women undergoing laparoscopy received double-blind either alfentanil 8 μg kg−1 or normal saline at induction, and all received thiopentone, alcuronium, enflurane, nitrous oxide and oxygen. The fall in mean arterial pressure (MAP) with induction was similar between groups. The MAP following intubation with alfentanil was unchanged, while with normal saline a mean rise of 23 (SD 15.2) mmHg occurred (P<0.001). The pulse rate following intubation showed a smaller rise (P<0.001) with alfentanil of 26 (SD 14.6) beats min−1, than the normal saline group of 46 (SD 13.3) beats min−1. Alfentanil was found to be a safe and effective analgesic agent in short duration surgery, by reducing sympathetic responses to intubation without cardiovascular depression or compromise of postoperative recovery.

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Efficacy of Prophylactic Clonidine in Preventing Postanesthetic Shivering in Laparoscopicassisted Vaginal Hysterectomy

Journal of SAFOG with DVD ◽

10.5005/jp-journals-10006-1242 ◽

2013 ◽

Vol 5 (3) ◽

pp. 120-123 ◽

Cited By ~ 1

Author(s):

Sebanti Goswami ◽

Suman Chattopadhyay ◽

Amitava Rudra

Keyword(s):

Heart Rate ◽

Normal Saline ◽

Vaginal Hysterectomy ◽

Recovery Time ◽

Core Body Temperature ◽

Saline Group ◽

Normal Saline Group ◽

Arterial Blood ◽

Laparoscopic Assisted Vaginal Hysterectomy ◽

Postanesthetic Shivering

ABSTRACT Objective Postanesthetic shivering occurs in up to 60% of patients following general anesthesia and is associated with deleterious consequences. Various drugs have been used to prevent or treat postanesthetic shivering, but the ideal one has not yet been found. In this study, we have studied the efficacy of prophylactic clonidine in preventing postanesthetic shivering. Meterials and methods Sixty ASA (American Society of Anesthesiologists) I and II patients scheduled for laparoscopicassisted vaginal hysterectomy (LAVH) were randomly allocated to receive either clonidine 2 μg.kg—1 (group C, n = 30) or normal saline (group S, n = 30) intravenously at the time of vault closure. Core body temperature (nasopharyngeal) along with NIBP, heart rate and ECG were monitored at regular intervals. The severity of shivering was assessed according to a five-point scale (0 to 4). Results Significantly less shivering occurred in clonidine group 5 (17%) compared to normal saline group 20 (67%). The recovery time (between end of anesthesia and extubation) was significantly longer in the clonidine group (12.5 ± 4.3 minutes) compared with normal saline group (8.0 ± 4.5 minutes). Mean arterial blood pressure and heart rate were significantly lower in the clonidine group compared with saline group. Conclusion Prophylactic clonidine is effective in the prevention of postanesthetic shivering. Following clonidine administration, the recovery time was prolonged and incidence of bradycardia and hypotension were more than placebo. How to cite this article Chattopadhyay S, Goswami S, Rudra A. Efficacy of Prophylactic Clonidine in Preventing Postanesthetic Shivering in Laparoscopic-assisted Vaginal Hysterectomy. J South Asian Feder Obst Gynae 2013;5(3): 120-123.

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The Influence of Adrenaline on Postoperative Analgesia after Subarachnoid Morphine

Anaesthesia and Intensive Care ◽

10.1177/0310057x9302100119 ◽

1993 ◽

Vol 21 (1) ◽

pp. 79-84 ◽

Cited By ~ 10

Author(s):

M. J. Paech

Keyword(s):

Side Effects ◽

Postoperative Analgesia ◽

Saline Group ◽

Control Group ◽

Double Blind Study ◽

Gynaecological Surgery ◽

Normal Saline Group ◽

Double Blind ◽

Significant Difference ◽

To Receive

A randomised, double-blind study was conducted to investigate the postoperative effects of subarachnoid morphine, with or without adrenaline, after major gynaecological surgery. Seventy-five women having spinal anaesthesia combined with either sedation or general anaesthesia were randomised to receive subarachnoid morphine 0.25 mg with (group MA) or without (group M) adrenaline 200 ūg; or normal saline (group C). Groups M (n=22) and MA (n=25) differed significantly from control (n=23) with respect to the quality and duration of postoperative analgesia (P<0.0002) and to a higher incidence of pruritus (P<0.02). Groups were similar with respect to the incidence of other postoperative side-effects and respiratory data, although the latter showed a trend to less hypoxaemia in the control group. There was no significant difference in any outcome between groups MA and M. It was concluded that, under the study conditions in a post-gynaecological surgery population, the addition of adrenaline to subarachnoid morphine was of no benefit.

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Overweightness and obesity prevalence among university students in 2015-2016 educational season

Journal of Human Sciences ◽

10.14687/jhs.v13i3.4293 ◽

2016 ◽

Vol 13 (3) ◽

pp. 5884 ◽

Cited By ~ 1

Author(s):

Eren Uluöz

Keyword(s):

University Students ◽

Normal Population ◽

Pearson Correlation ◽

Obesity Prevalence ◽

Chi Square ◽

Significance Level ◽

Significant Difference ◽

The Mean ◽

The Government ◽

The Individual

The main purpose of this study is to find out the obesity prevalence among university students. In addition to the main purpose, another aims of this study is to determine the individual features of participants related to obesity such as gender, age, being an obese in family and doing physical activity.This study was performed on university students from five different faculties of Çukurova University in 2015-2016 educational season. In this study, 894 volunteer students accepted for attending to the research. The mean age of female participants was 21.39±2.53 years. However, mean of males was 22.28±2.73 years. Descriptive study design and causal comparative methods were used. The individual information form created by the researcher was used to determine the demographic characteristics of the participants. BMI was analyzed both quantitative and categorical ways in this study. WHO’s classification method was used for categorizing of BMI. All findings in the study were summarized by descriptive statistical methods such as mean, standard deviation, frequency, percentage, etc. The independent sample T test, the ANOVA test, Pearson correlation test and chi-square test were used. In all analyzes, significance level was accepted as p <0.05.The mean of the BMI was calculated as 22.40±3.49 kg/m2. There was a statistically significant difference between the mean BMI of males (23.80±3.40 kg/m2) and female participants (21,01±2,99 kg/m2, t(-13,043)=892, p<0.05). Also, it was found statically significant difference among BMI classification groups for gender (obesity rate of male: 4.9% ; female:1.1%) , x2(df=3, n=894)=101.21, p<0.05. These results have indicated that the rate of obesity among university students is lower than normal population in Turkey. At the same time the findings of this study have shown similar characteristics with the university students’ of other countries reported by previous studies.In conclusion, it should be taken some measures for reducing overweightness and obesity such as increasing physical activity possibilities for people in all condition by local and central Governments, increasing the number of hours of physical education and sports lessons in schools as much as possible and the processing of these courses must be inspected strongly, more strict measures taken by the government to reduce obesity rates in society, informing and awareness of community on obesity, informing adequate and balanced nutrition by using the all media devices and facilities.

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Nimodipine reduces delayed cerebral vasospasm after intracranial tumor surgery: a retrospective study

10.21203/rs.3.rs-32931/v2 ◽

2020 ◽

Author(s):

Ying Yu ◽

Yunqian Li ◽

Zheng Jin ◽

Fan Chen

Keyword(s):

Retrospective Study ◽

Normal Saline ◽

Saline Group ◽

Intracranial Tumor ◽

Tumor Surgery ◽

Normal Saline Group ◽

Mortality And Morbidity ◽

Delayed Cerebral Vasospasm ◽

Significant Difference

Abstract Background：Cerebral vasospasm (CVS) is a serious neurosurgical complication. This retrospective study was performed to analyze if nimodipine can improve prognosis and reduces ischemia secondary to delayed CVS after intracranial tumor surgery.Methods：Retrospective analysis of 94 patients with an anterior cranial fossa tumor and underwent intracranial tumor surgery was performed, with 42 cases treated with normal saline and 52 cases treated with nimodipine solution. Transcranial Doppler ultrasonography was used to measure velocity in the middle cerebral artery (MCA) and the distal extracranial internal carotid artery (eICA). An examination was conducted 1 day before surgery and 1, 3, 5, 7, and 14 days after surgery. Follow-up was performed using the Glasgow Outcome Scale (GOS) 3 months after discharge.Results：We showed that in the nimodipine group, CVS occurred in 13 (25%) patients who did not have CVS in the first three days after operation; nine patients had CVS between 4 and 7 days, and 4 had CVS between 8 and 14 days. In the normal saline group, nineteen (45%) patients had CVS, 3 presented with CVS within 3 days, 11 between 4-7 days and 5 between 8-14 days. A significant difference in the occurrence of CVS was observed between the two groups. Preoperative and postoperative the MCA velocities were compared, revealing a significant change in the normal saline group (P < 0.05) but not in the nimodipine group. Furthermore, significant differences in the outcome were observed between the two groups at the 3-month follow-up (P < 0.05).Conclusions：Nimodipine markedly improves prognosis and significantly reduces ischemia secondary to delayed CVS after intracranial tumor surgery, as well as the risks of mortality and morbidity.

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Comparison between Nalbuphine and Ketamine as an adjuvant to Heavy Bupivacaine on Post Dural Puncture Headache

QJM ◽

10.1093/qjmed/hcab086.060 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Mohammad A El Gendy ◽

Gamal M Elewa ◽

Mina Z Wadea ◽

Ashraf M Hazem

Keyword(s):

Spinal Anesthesia ◽

Normal Saline ◽

Dural Puncture ◽

Sensory Block ◽

Saline Group ◽

Controlled Study ◽

Normal Saline Group ◽

Hyperbaric Bupivacaine ◽

Post Dural Puncture Headache ◽

Significant Difference

Abstract Background Incidence of post dural puncture headache (PDPH) is relatively high, and many methods have been tried to prevent or treat it, but results are not satisfactory. Both Nalbuphine and Ketamine have analgesic effects, and have been used intrathecally with local anesthetics, but their effects on PDPH were not studied. Objective To study the incidence and severity of PDPH when nalbuphine or ketamine was added as an adjuvant to hyperbaric bupivacaine in spinal anesthesia (primary outcome). Secondary outcomes were the effects of adding nalbuphine or ketamine as an adjuvant to hyperbaric bupivacaine on motor and sensory effects, duration of analgesia, hemodynamics and side effects of both of them. Patients and Methods This prospective double-blind, randomized controlled study was conducted on 320 patients, aged 21–60 years of both sexes, ASA physical status I and II, and allocated for lower abdominal, pelvic, or lower limb surgeries under spinal anesthesia, after approval from ethical committee (Assurance No. FWA 000017585) of Faculty of Medicine, Ain, Shams University, Cairo, Egypt. Contact with 17 patients was lost. So, 303 patients completed the study. Patients were divided into 3 equal groups (101 each) according to drugs injected intrayhecally. Group (N): 3 ml of 0.5% hyperbaric bupivacaine with 0.5 mg nalbuphine hydrochloride diluted in 0.5 ml normal saline. Group (K): 3 ml of 0.5% hyperbaric bupivacaine with 25 mg ketamine hydrochloride diluted in 0.5 ml normal saline. Group (C): 3 ml of 0.5% hyperbaric bupivacaine with 0.5 ml normal saline. Results Incidence of PDPH was statistically significantly less in group N in comparison to Groups K and C, in the first day. But, no statistically significant difference was found between the three groups at 2nd and 3rd days. There was no statistically significant difference between groups according to severity of PDPH by visual analog score (VAS). Group N has the most rapid onset and long duration of sensory block in comparison with groups K and C. There was no statistically significant difference between groups according to onset and duration of motor block and hemodynamic changes. Conclusion Adding nalbuphine, and not ketamine, with hyperbaric bupivacaine in spinal anesthesia decreased incidence of post dural puncture headache, and prolonged the duration of sensory block. Both groups provided adequate anesthesia and analgesia with good hemodynamic stability.

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The Effect of Preparing Dialysis Machine Using Normal Saline-Heparin on the Dialysis Adequacy of Hemodialysis Patients: A Crossover, Two-Group, and Randomized Clinical Trial

Nephro-Urology Monthly ◽

10.5812/numonthly.112475 ◽

2021 ◽

Vol 13 (1) ◽

Author(s):

Seyed Reza Borzou ◽

Hiva Azami ◽

Mahmood Gholyaf ◽

Leili Tapak ◽

Tayebeh Nazari Doust

Keyword(s):

Normal Saline ◽

Saline Group ◽

Hemodialysis Patients ◽

Normal Saline Group ◽

Heparin Group ◽

Dialysis Adequacy ◽

Significant Difference ◽

Before And After ◽

Stage Renal Disease ◽

Hemodialysis Machine

Background: Patients with end-stage renal disease (ESRD) need adequate dialysis. Thus, identification of the ways to enhance dialysis adequacy is very important. Objectives: The present study was conducted to examine the effect of preparing a dialysis machine using a normal saline heparin method on the dialysis adequacy of hemodialysis patients. Methods: This study was conducted in Hamadan in 2019. A total of 36 patients with hemodialysis were selected using convenience sampling who were assigned to the control and intervention groups. The hemodialysis machine was primed for one month using a routine method (control) and one month using a normal saline-heparin method (intervention). Urea reduction ratio (URR) and Kt/V indices were calculated at the beginning and end of each month in the intervention and control groups. Data were analyzed using paired and independent t-test. Results: In the normal saline-heparin group, KT/V showed a statistically significant difference before and after the treatment (P = 0.013), as well as an increase in the KT/V. The URR as the mean dialysis adequacy showed a statistically significant difference (P = 0.004) between the normal saline group and the normal saline-heparin group before and after the treatment. Moreover, URR in the normal saline-heparin group increased after the treatment. In the normal saline treatment group, KT/V and URR decreased after the treatment. In the normal saline group, URR decreased after the treatment. Conclusions: Applying the hemodialysis machine preparation with a normal saline-heparin method increased dialysis adequacy in the patients who underwent hemodialysis.

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Comparative Study of Children's' Blood Sugar in Fluid Therapy with Dextrose Saline, Ringer and Normal Saline 0.9% Serums and its Relationship with Depth of Anesthesia in Elective Surgery

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i40b32268 ◽

2021 ◽

pp. 91-102

Author(s):

Farhad Nanaei ◽

Morteza Habibi Moghadam ◽

Zahra Eslamifar ◽

Hadi Bahrami ◽

Mohammad Hasan Bigdeli ◽

...

Keyword(s):

Blood Sugar ◽

Fluid Therapy ◽

Normal Saline ◽

Elective Surgery ◽

Vital Signs ◽

Depth Of Anesthesia ◽

Double Blind ◽

Significant Difference ◽

The Mean ◽

Group B

Background: This study was aimed to determine the children's' blood sugar level in fluid therapy with DSS (dextrose saline serum), RS (ringer serum) and NS 0.9% serums (normal saline 0.9%) and its relationship with the depth of anesthesia in elective surgery. Method: This double-blind experimental study was performed with 90 children referred to the surgical ward, including: group A (receiving DSS), group B (receiving NS 0.9%) and group C (receiving RS) that the blood sugar of each group in 5 steps was measured: half an hour before induction of anesthesia, during induction of anesthesia, half and one hour after induction of anesthesia and after complete awakening in recovery. In addition, the monitoring the vital signs, measuring depth of anesthesia, pulse oximetry and electrocardiogram were performed for all groups. Results: The results showed that the mean blood sugar in the 5 steps measured had a significant difference in three groups under study (P <0.05). The mean blood sugar in the group receiving DSS was significantly higher than the two groups receiving RS and NS 0.9%. Also the mean depth of anesthesia in three groups did not show a significant difference. Conclusion: Finally, according to this study, the use of DSS from the beginning of anesthesia, RS half an hour after the start of anesthesia and NS 0.9% one hour after the start of anesthesia can increase blood sugar in children. Therefore, the use of DSS is not recommended due to the stressful nature of anesthesia and operating room and the possibility of hyperglycemia.

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