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

2018 ◽  
Vol 5 (9) ◽  
pp. 2646-2650 ◽  
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.

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.

Intravenous Ondansetron for Attenuation of Post Spinal Anesthesia Hypotension

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ahmed Saeed Mohamed Ibrahim ◽  
Rania Mahrous Aly Hussien ◽  
Hazem Mohamed Sabry Abdel Aziz Ahmed
Keyword(s):  
Spinal Anesthesia ◽  
Local Anesthetic ◽  
Normal Saline ◽  
Demographic Data ◽  
Randomized Study ◽  
P Value ◽  
Anthropometric Measures ◽  
Double Blind ◽  
Induced Hypotension ◽  
Significant Difference

Abstract Background Spinal Anesthesia is a common type of anesthesia used during many surgical procedures. This regional technique can be accomplished by administering an intrathecal dose of hyperbaric local anesthetic solution. The local anesthetic within the subarachnoid space can block sensory, motor and sympathetic pathways. Objectives The Purpose of this study was to find out the effectiveness of prophylactic administration of intravenous ondansetron for attenuation of spinal anesthesia induced hypotension in non-obstetric spinal anesthesia surgeries. Patients and Methods Therefore, A prospective double-blind, placebo-controlled, randomized study was found to be the most suitable design in order to achieve the study objectives. A total of 90 patients males & females included in the study, aged 20-40 years, and were divided equally into two groups: Group A received 8 mg ondansetron diluted in volume of 10 cm normal saline 5 minutes prior to spinal anesthesia. Group B received a placebo of 10 cm normal saline 5 minutes prior to spinal anesthesia. Results There was no statistically significant difference found between the two studied groups regarding demographic data, anthropometric measures, ASA score and total time of surgery. There was statistically significant increase in the incidence of hypotension immediately after spinal and at 5 min in placebo group than ondansetron group with p-value = 0.026 and 0.014 respectively. Conclusion The present study demonstrated that, among patients who received spinal anesthesia with bupivacaine for elective for surgeries below umbilicus, prophylactic intravenous ondansetron 8mg iv 5 mins prior to spinal anesthesia reduced spinal anesthesia induced hypotension decreases in SBP, MAP, and heart rate. Ondansetron did not have a significant effect on DBP. Ondansetron did not have a significant effect on DBP. The incidence of nausea and vomiting was lower following the administration of ondansetron, and vasopressor use and dosages were reduced.

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

QJM ◽  
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.

scholarly journals Perbandingan Efektivitas Anestesi Spinal Menggunakan Bupivakain 0,5% Hiperbarik Dosis 7,5 Mg dengan 5 Mg pada Seksio Sesarea

2020 ◽  
Vol 3 (1) ◽  
pp. 1-8
Author(s):  
Muh. Zulkifli ◽  
Andi Salahuddin ◽  
Muh. Ramli Ahmad
Keyword(s):  
Clinical Trial ◽  
Caesarean Section ◽  
Spinal Anesthesia ◽  
T Test ◽  
Double Blind ◽  
Double Blind Clinical Trial

Latar Belakang: Teknik anestesi yang efektif adalah tujuan utama dari teknik anestesi spinal, yang bertujuan meminimalkan efek samping pada ibu dan bayi baru lahir. Tujuan: Membandingkan ketinggian blok, onset dan durasi, efek samping antara Bupivakain 0,5% Hiperbarik dosis 7,5 Mg + Fentanyl 25 Mcg dan dosis 5 Mg + Fentanyl 25 Mcg pada seksio sesarea.Metode: Penelitian ini menggunakan pendekatan uji klinis acak tersamar ganda (Randomized double blind clinical trial). Sampel terdiri atas 2 kelompok yakni LD (Kelompok yang mendapatkan anestesi spinal bupivakain 0,5% hiperbarik 5 mg + fentanil 25 μg ) dan CD (Kelompok yang mendapatkan anestesi spinal bupivakain 0,5% hiperbarik 7,5 mg + fentanil 25 μg) dengan jumlah sampel masing-masing 20 orang. Data dianalisis menggunakan uji statistik Independen Sample T Test dengan tingkat kemaknaan α=0.05. Hasil: Ada perbedaan onset blok motorik (p=0,004), durasi motorik (p=0,000), durasi blok sensoris (p=0,000) antara kelompok LD dan kelompok CD. Sedangkan durasi operasi (p= 0,769), selisih perubahan TD Sistole (p> 0,05), selisih perubahan TD Diatole (p> 0,05), selisih perubahan nadi (p> 0,05), selisih perubahan MAP (p> 0,05), efek samping mual/muntah (p> 0,05) dan rescue (p> 0,05) menunjukkan tidak ada perbedaan.Simpulan: Onset blok sensorik lebih lama, dan durasi blok sensoris dan motorik lebih singkat pada kelompok LD dibanding CD sehingga ada perbedaan efektifitas bupivakain antara kedua kelompok. Tidak perbedaan yang bermakna untuk efek samping dan perubahan hemodinamik pada kedua kelompok. The Effectiveness of Spinal Anesthesia Using Bupivacaine 0.5% Hyperbaric Dosage 7.5 Mg with 5 Mg in Caesarean Section Surgery Abstract Latar Belakang: Teknik anestesi yang efektif adalah tujuan utama dari teknik anestesi spinal, yang bertujuan meminimalkan efek samping pada ibu dan bayi baru lahir. Tujuan: Membandingkan ketinggian blok, onset dan durasi, efek samping antara Bupivakain 0,5% Hiperbarik dosis 7,5 Mg + Fentanyl 25 Mcg dan dosis 5 Mg + Fentanyl 25 Mcg pada seksio sesarea.Metode: Penelitian ini menggunakan pendekatan uji klinis acak tersamar ganda (Randomized double blind clinical trial). Sampel terdiri atas 2 kelompok yakni LD (Kelompok yang mendapatkan anestesi spinal bupivakain 0,5% hiperbarik 5 mg + fentanil 25 μg ) dan CD (Kelompok yang mendapatkan anestesi spinal bupivakain 0,5% hiperbarik 7,5 mg + fentanil 25 μg) dengan jumlah sampel masing-masing 20 orang. Data dianalisis menggunakan uji statistik Independen Sample T Test dengan tingkat kemaknaan α=0.05. Hasil: Ada perbedaan onset blok motorik (p=0,004), durasi motorik (p=0,000), durasi blok sensoris (p=0,000) antara kelompok LD dan kelompok CD. Sedangkan durasi operasi (p= 0,769), selisih perubahan TD Sistole (p> 0,05), selisih perubahan TD Diatole (p> 0,05), selisih perubahan nadi (p> 0,05), selisih perubahan MAP (p> 0,05), efek samping mual/muntah (p> 0,05) dan rescue (p> 0,05) menunjukkan tidak ada perbedaan.Simpulan: Onset blok sensorik lebih lama, dan durasi blok sensoris dan motorik lebih singkat pada kelompok LD dibanding CD sehingga ada perbedaan efektifitas bupivakain antara kedua kelompok. Tidak perbedaan yang bermakna untuk efek samping dan perubahan hemodinamik pada kedua kelompok.

scholarly journals Maternal and Neonatal Effects of Vasopressors Used for Treating Hypotension after Spinal Anesthesia for Caesarean Section: A Randomized Controlled Study

2015 ◽  
Vol 4 (1) ◽  
pp. 54-58 ◽  
Author(s):  
Alma Soxhuku-Isufi ◽  
Vjollca Shpata ◽  
Hektor Sula
Keyword(s):  
Caesarean Section ◽  
Pregnant Women ◽  
Spinal Anesthesia ◽  
Apgar Score ◽  
Randomized Controlled Study ◽  
Controlled Study ◽  
Double Blind ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Acid Base Status

AIM: The aim of the study was to examine whether ephedrine and phenylephrine were different in their efficacy for managing maternal hypotension and their effect of adverse maternal and neonatal outcome.METHODS: A double-blind randomized controlled study in healthy pregnant women ASA physical status 2, which underwent elective caesarian delivery under spinal anesthesia. Patients were randomized to receive an intravenous bolus of either phenylephrine (Ph group) or ephedrine (E group) immediately after the episode of hypotension after spinal anesthesia. Maternal and neonatal outcomes were recorded.RESULTS: Two hundred and two (202) pregnant women at term were entered in this study. There were no differences between group E and group Ph regarding the incidence of hypotension after vasopressor therapy, and the incidence of nausea and vomiting. There was no significant difference between groups in the first-minute and the 5th minute Apgar score, none of the neonates had the true fetal acidosis.CONCLUSIONS: Ephedrine and phenylephrine have the same efficacy in treating hypotension after spinal anesthesia for caesarean section. The use of Phenylephrine was associated with better fetal acid-base status, and there were no differences on Apgar score values and on the incidence of maternal bradycardia and hypotension.

scholarly journals The Effect of Local Injections of Bupivacaine Plus Ketamine, Bupivacaine Alone, and Placebo on Reducing Postoperative Anal Fistula Pain: A Randomized Clinical Trial

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Alireza Kazemeini ◽  
Mojgan Rahimi ◽  
Mohammad Sadegh Fazeli ◽  
Seyedeh Adeleh Mirjafari ◽  
Hamid Ghaderi ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Postoperative Pain ◽  
Spinal Anesthesia ◽  
Normal Saline ◽  
Adult Patients ◽  
Time Interval ◽  
Random Allocation ◽  
Anal Surgery ◽  
Significant Difference ◽  
Group 3

Background and Objective. This study aimed to compare the effects of different local anesthetic solutions on postoperative pain of anal surgery in adult patients.Method. In this randomized double-blind prospective clinical trial, 60 adult patients (18 to 60 years old) with physical status class I and class II that had been brought to a university hospital operating room for fistula anal surgery with spinal anesthesia were selected. Patients were randomly divided into 4 equal groups according to table of random numbers (created by Random Allocation Software 1). Group 1 received 3 mL of normal saline, group 2, 1 mL of normal saline plus 2 mL of bupivacaine 0.5%, group 3, 1 mL of ketamine plus 2 mL of bupivacaine 0.5%, and group 4, no infiltration. Intensity of pain in patients was measured using visual analogue scale (VAS) at 0 (transfer to ward), 2, 6, 12, and 24 hours after surgery. Time interval to administration of drugs and overall dose of drugs were measured in 4 groups.Results. Mean level of pain was the lowest in group 3 at all occasions with a significant difference, followed by groups 2, 4, and lastly 1 (P<0.001). Furthermore, groups 2 and 3 compared to groups 1 and 4 had the least overall dose of analgesics and requested them the latest, with a significant difference (P<0.05).Conclusion. Local anesthesia (1 mL of ketamine plus 2 mL of bupivacaine 0.5% or 1 mL of normal saline plus 2 mL of bupivacaine 0.5%) combined with spinal anesthesia reduces postoperative pain and leads to greater comfort in recovering patients.

scholarly journals An Investigation Into the Effects of Magnesium Sulfate on the Complications of Succinylcholine Administration in Nulliparous Women Undergoing Elective Cesarean Section: A Double-Blind Clinical Trial

2019 ◽  
Vol 7 (4) ◽  
pp. 520-525
Author(s):  
Davoud Aghamohamadi ◽  
Mehdi Khanbabayi Gol
Keyword(s):  
Clinical Trial ◽  
Cesarean Section ◽  
Magnesium Sulfate ◽  
Statistical Tests ◽  
Elective Cesarean Section ◽  
Double Blind ◽  
Nulliparous Women ◽  
Double Blind Clinical Trial ◽  
Significant Difference ◽  
Elective Cesarean

Objectives: Controlling the complications of anesthetics (e.g., succinylcholine) seems necessary since they are greater for nulliparous women who undergo elective cesarean section (C-section). The present study aimed to investigate the effects of magnesium sulfate on the complications of succinylcholine administration in nulliparous women undergoing elective C-section. Materials and Methods: This double-blind clinical trial was conducted on 60 nulliparous women during 2012-2013. The women were randomly assigned to A and B groups. Before inducing the rapid anesthesia with succinylcholine, patients in the intervention group received 30 mg/kg of magnesium sulfate within 10 minutes and then the hemodynamic status and the side effects of succinylcholine were recorded in a special form. Statistical tests were performed using repeated-measures ANOVA, chi-square test, and one-way ANOVA tests and the level of significance was determined to be P<0.05. Results: There was no significant difference between the two groups in terms of demographic data (P>0.059). However, the results indicated that there was a significant difference between the 2 groups regarding the myoglobin level (P=0.010). Contrarily, the results showed that most patients in the intervention (n=23) and control (n=15) groups experienced no or mild and severe fasciculation, respectively (P<0.001). Conclusions: In general, magnesium sulfate can greatly control and reduce the complications of succinylcholine administration, including fasciculation.

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