scholarly journals Spinal and intravenous midazolan anesthetic effects on fentanyl/ ligdocaine regional anesthesia following back minor orthopedic surgery

2010 ◽  
Vol 9 (1) ◽  
pp. 30-34
Author(s):  
Gabriela Rocha Lauretti ◽  
Anita L. Mattos
Keyword(s):  
Orthopedic Surgery ◽  
Concentration Level ◽  
Statistical Significance ◽  
Intrathecal Injection ◽  
Control Group ◽  
Sensory Level ◽  
Double Blind Study ◽  
Double Blind ◽  
Effective Analgesia ◽  
Group 1

OBJECTIVES: the present study was designed to evaluate the usefulness of intravenous and intrathecal midazolan as an adjunct to intrathecal ligdocaine, with or without intrathecal fentanyl. METHODS: double-blind study, institutional approval and informed consent; 40 patients scheduled for minor lumbar orthopedic surgery were randomly assigned to one of five groups (n=8). Patients were premedicated with a 4 mL final intravenous volume (saline or midazolan). Spinal anaesthesia was administered to a 3 mL final volume - 75 mg of lidocaina plus either 33 mg fentanyl or 500 mg midazolan diluted in saline (0,9%) - with the patient in sitting position. The latency time for onset of the block (LT), time to progress to T10 sensory level (TT10), duration of the block (Bl), duration of effective analgesia (An), the subjective degree of intraoperative sedation, level of alertness, concentration level and degree of anxiety were specifically measured. P<0.05 was considered significant. RESULTS: the addition of midazolan to the intrathecal injection in the absence of fentanyl was the only procedure which caused a statistically significant reduction in LT (p<0.002) and TT10 (p<0.001). Intrathecal midazolan increased the blockade time both with (p<0.05) and without (p<0.02) intrathecal fentanyl, but, when given intravenously, this effect failed to reach statistical significance (p>0,05). Both intrathecal fentanyl and midazolan increased the duration of analgesia (p<0.01). With respect to the subjective measures, group 1 served as the control group, demonstrating an alert, fully awake patient who was able to concentrate but showed some anxiety. CONCLUSIONS: while all additional treatments resulted in a relaxed patient, only those given intrathecal midazolan remained fully awake, alert and able to concentrate. Intrathecal fentanyl with saline premedication or intravenous midazolan premedication resulted in decreased alertness and inability to concentrate, as well as sleepiness, which was more extreme in the case of those patients given intravenous midazolan.

Addition of Epinephrine to Intrathecal Bupivacaine and Sufentanil for Ambulatory Labor Analgesia

1997 ◽  
Vol 86 (3) ◽  
pp. 525-531 ◽  
Author(s):  
David C. Campbell ◽  
Robert Banner ◽  
Lesley-Ann Crone ◽  
Wendy Gore-Hickman ◽  
Ray W. Yip
Keyword(s):  
Labor Analgesia ◽  
Saline Control ◽  
Control Group ◽  
Double Blind Study ◽  
Saline Control Group ◽  
Double Blind ◽  
Prolonged Labor ◽  
Intrathecal Analgesia ◽  
Limited Duration ◽  
Effective Analgesia

Background The intrathecal combination of sufentanil and bupivacaine provides rapid, effective analgesia for labor with a limited duration. Many anesthesiologists have concerns that the use of intrathecal local anesthetics precludes maternal ambulation. This prospective, randomized, double-blind study was designed to determine whether the addition of epinephrine to the combination of sufentanil and bupivacaine would prolong intrathecal analgesia for labor. Patients' ability to ambulate was also assessed. Methods Thirty-nine patients received either an intrathecal control dose of 10 micrograms sufentanil plus 2.5 mg bupivacaine plus 0.2 ml normal saline (control group); or 10 micrograms sufentanil plus 2.5 mg bupivacaine plus 0.2 ml (0.2 mg) of epinephrine (EPI group). Results Seven patients (3 control, 4 EPI) delivered vaginally and two (1 control, 1 EPI) required cesarean delivery before requesting epidural analgesia. The duration (mean +/- SD) of intrathecal labor analgesia was prolonged significantly by the addition of epinephrine: control (n = 15): 145 +/- 23 min; EPI (n = 15): 188 +/- 25 min (P &lt; 0.0001). Maternal ambulation was demonstrated in 100% (19 of 19) of the control group and in 80% (16 of 20) of the EPI group (P = NS). Conclusions The addition of 0.2 mg epinephrine to the intrathecal combination of sufentanil and bupivacaine significantly prolonged labor analgesia without causing adverse effects to the mother or fetus. The intrathecal combination of sufentanil and bupivacaine, with or without epinephrine, provided rapid, profound labor analgesia and allowed most patients to ambulate.

scholarly journals One-Abutment One-Time Effect on Peri-Implant Marginal Bone: A Prospective, Controlled, Randomized, Double-Blind Study

Materials ◽  
2021 ◽  
Vol 14 (15) ◽  
pp. 4179
Author(s):  
Filipe Moreira ◽  
Salomão Rocha ◽  
Francisco Caramelo ◽  
João P. Tondela
Keyword(s):  
Bone Loss ◽  
Statistical Significance ◽  
Test Group ◽  
Primary Stability ◽  
Control Group ◽  
Double Blind Study ◽  
Double Blind ◽  
Implant Placement ◽  
Bone Level ◽  
The Mean

Objective: To evaluate the peri-implant hard tissue change at 6 and 12 months after implant placement between definitive abutment placed at the same time of implant surgery, never removing it, and healing abutment disconnected and reconnected three times until the placement of the final rehabilitation. Material and methods: Each partial edentulous patient could receive between 1 and 4 platform-switched implants in the posterior regions. If the implants had primary stability—implant stability quotient (ISQ) equal to or greater than 50, they were randomized to the test group with the abutment inserted at the same time of implant placement (DA) or to the control group, receiving a healing abutment (PA). At 6 and 12 months after surgery, data related with vertical bone level changes (primary outcome) and other clinical parameters (implant mobility, bleeding on probing, probing depth, plaque index) were assessed. Results: 53 implants were included in the trial and completed 12 months follow-up (overall survival rate: 100%). All implants achieved primary stability, with an average ISQ value of 80.9 on the day of surgery. From surgery to 6 months, the mean bone loss was 0.14 ± 0.18 mm for the DA group and 0.23 ± 0.29 mm for the PA group, without statistical significance difference. Between 6 and 12 months, the mean bone loss was 0.14 ± 0.21 mm for the DA group and 0.21 ± 0.27 mm for the PA group, also without statistical significance between the two groups. There were no statistically significant differences (p = 0.330) in total bone loss after 12 months between the control and the study groups. Conclusions: The one abutment one time protocol has at least an equivalent effect on the peri-implant bone level changes when compared with the use of healing abutments that are disconnected and reconnected at least three times.

OCT as a monitoring tool for assessment of the stage and severity of multiple sclerosis

2020 ◽  
Vol 1 (3) ◽  
pp. 179-182
Author(s):  
Yoav Yechezkel Pikkel ◽  
◽  
Vadim Igal ◽  
Yael Sara Pikkel Igal ◽  
Adi Nov-Sharabi ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Statistical Significance ◽  
Control Group ◽  
Double Blind Study ◽  
Monitoring Tool ◽  
Fiber Layer ◽  
Double Blind ◽  
Rnfl Thickness ◽  
Disability Status ◽  
The Mean

AIM: To identify a link between optical coherence tomography (OCT), length of multiple sclerosis (MS) and the expanded disability status scale (EDSS). METHODS: In a prospective double blind study, 29 patients with a diagnosis of MS were compared with 29 healthy patients, matched by age and sex. All participants underwent an OCT study and neurological EDSS test on the same day. RESULTS: The mean EDSS score was 3.2 in the MS group vs 0.03 in the control group, and the duration of MS is 11.7y. The mean retinal nerve fiber layer (RNFL) thickness was significantly thinner in those with MS (P<0.001). Correlation was found between duration of MS and RNFL thinning. EDSS and thinning of RNFL showed a tendency to correlate but without statistical significance.

scholarly journals Effectiveness of Traditional Japanese Herbal (Kampo) Medicine, Daiobotanpito, in Combination with Antibiotic Therapy in the Treatment of Acute Diverticulitis: A Preliminary Study

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Keiko Ogawa ◽  
Koji Nishijima ◽  
Fumio Futagami ◽  
Takashi Nakamura ◽  
Genichi Nishimura
Keyword(s):  
Acute Diverticulitis ◽  
Statistical Significance ◽  
Kampo Medicine ◽  
Double Blind Study ◽  
Open Label ◽  
Double Blind ◽  
Patient Demographics ◽  
Intravenous Antibiotics ◽  
Group 2 ◽  
Group 1

In traditional Japanese herbal (Kampo) medicine, daiobotanpito (DBT) or Da Huang Mu Dan Tang in Chinese has been used in medical treatment of acute diverticulitis for many years based on the experience. Our aim was to investigate whether the treatment of acute diverticulitis can be treated with intravenous antibiotics plus orally administrated DBT than intravenous antibiotics alone. A retrospective nonrandomized open-label trial was established to compare patients with acute diverticulitis who received oral DBT associated with intravenous antibiotics with those who received intravenous antibiotic alone. We included 34 patients, eleven patients in group 1 with DBT and 23 patients in group 2 without DBT. Both groups were comparable in patient demographics and clinical characteristics. There was a significantly better outcome in the group treated with DBT than in the group without DBT when comparing duration of fever, abdominal pain, and antibiotics administration. A trend toward a day shorter mean hospital stay and fasting was seen in group 1, although this did not reach statistical significance. In conclusion, most patients with acute diverticulitis can be managed safely with oral DBT. Although randomized, double-blind study must be done, we could show the possibility to use daiobotanpito as an additional option in treating acute diverticulitis.

Comparative Evaluation of 0.1% Octenidine Mouthwash with 0.2% Chlorhexidine Mouthwash in Prevention of Plaque and Gingivitis – A Clinicomicrobiological Study

2021 ◽  
Vol 13 (3) ◽  
pp. 202-210
Author(s):  
Sowmya Sadanandan ◽  
Suhas S ◽  
Sanjay Venugopal ◽  
Kavitha Karur
Keyword(s):  
Antibacterial Properties ◽  
Chlorhexidine Gluconate ◽  
Control Group ◽  
Double Blind Study ◽  
Gingival Inflammation ◽  
Patient Acceptability ◽  
Double Blind ◽  
Microbiological Parameters ◽  
Group B ◽  
The Impact

Background: Our study aimed to assess the efficacy of 0.1% Octenidine mouthwash as an anti-plaque agent and to assess its effect on gingival inflammation and staining of teeth when compared to 0.2% chlorhexidine gluconate by evaluating the impact on plaque and gingival inflammation as well as on microbial load. Materials and Methods: A three week double blind study was conducted on 69 subjects, aged 20-50 years, with moderate to severe gingivitis. The study population was divided into three groups with 23 subjects in each group: Group A - control subjects received only scaling, Group B received 0.2% chlorhexidine gluconate in addition to scaling and Group C received 0.1% Octenidine mouthwash along with scaling. Clinical and microbiological parameters were recorded at baseline, on 14th day and on 21st day. Subjective and objective criteria were assessed on the 14th day and 21st day. Results: There was a statistically significant reduction in all the tested parameters within all the three groups and between the groups from baseline to 21st day. The highest mean reduction in all the parameters was seen in subjects using 0.1% Octenidine. On comparison with the control group, subjects using the mouthwashes (Group B and Group C) had better improvement in clinical and microbiological parameters from baseline to 21st day. On comparison with chlorhexidine, Octenidine mouthwash significantly reduced plaque (p<0.05) and showed better patient acceptability. However, it was comparable to chlorhexidine in other two tested parameters. Conclusion: Owing to Octenidine’s pronounced and comparable antibacterial properties, it can be a promising candidate for the use in antiseptic mouthwashes.

The Effectiveness of Group Acceptance and Commitment Therapy and Cognitive Therapy on Alexithymia and Marital Boredom, Case study: Women Affected by Marital Infidelity in Mashhad, Iran

2022 ◽  
Author(s):  
Maryam Sadeghi ◽  
Naeimeh Moheb ◽  
Marziyeh Alivandi Vafa
Keyword(s):  
Cognitive Therapy ◽  
Analysis Of Covariance ◽  
Control Group ◽  
Double Blind Study ◽  
University Counseling Center ◽  
Double Blind ◽  
University Counseling ◽  
Acceptance And Commitment ◽  
Marital Infidelity ◽  
The Mean

Introduction: The aim of current paper was to compare the effectiveness of acceptance and commitment group therapy (ACT) and group cognitive therapy (GCT) on Alexithymia and marital boredom (MB) among women affected by marital infidelity in Mashhad. Method: This clinical trial was a double- blind study with a pretest-posttest design in which two intervention groups and one control group were investigated. The study performed on women who realized their spouse infidelity and referred to Azad University Counseling Center in Mashhad in 2018. The sample consisted of 30 women who were selected by purposive sampling and were randomly assigned to two intervention groups and a control group (n=10 per group). The intervention groups were put under ACT training (twelve 90-minute sessions) and GCT training (twelve 90-minute sessions), but the control group did not receive any intervention. Data was obtained by the Toronto Alexithymia Scale-20 and Pines Marital Boredom Scale and was analyzed by multivariate analysis of covariance with SPSS (version 22) software. Results: The results showed a significant reduction in the mean score of MB in the ACT group, also there was a significant reduction in the mean score of Alexithymia in the GCT group (P <0.05). So comparing both therapies, ACT was more influential on reducing marital boredom whereas GCT was more effective on reducing alexithymia. Conclusion: Although both intervention methods were effective on Alexithymia and Marital Boredom in women affected by marital infidelity, it was demonstrated that ACT and GCT have more effect on Marital Boredom and Alexithymia, respectively.

A Parallel-Group Comparison of Astemizole and Loratadine for the Treatment of Perennial Allergic Rhinitis

1997 ◽  
Vol 25 (4) ◽  
pp. 175-181 ◽  
Author(s):  
H Al-Muhaimeed
Keyword(s):  
Allergic Rhinitis ◽  
Statistical Significance ◽  
Double Blind Study ◽  
Perennial Allergic Rhinitis ◽  
Double Blind ◽  
Once Daily ◽  
Runny Nose ◽  
Parallel Group ◽  
The Mean ◽  
To Receive

The efficacy and safety of the two antihistamines, astemizole and loratadine, were compared in a double-blind study of 84 patients with perennial allergic rhinitis. Patients were randomized to receive orally either astemizole 10 mg once daily ( n = 40) or loratadine 10 mg once daily ( n = 44) for 1 week. No other antirhinitis medication was allowed during the study. By day 7 the mean daily symptom scores, recorded on diary cards, were lower in patients receiving astemizole than in those receiving loratadine for runny nose, itchy nose and sneezing, although not for blocked nose, and treatment differences only reached statistical significance for runny nose. After 7 days, 53.75% of patients on astemizole and 38.6% on loratadine were free of symptoms, and 87% of patients on astemizole described the treatment as good or excellent compared with 62% on loratadine. The present results suggest that astemizole may be more effective than loratadine in controlling symptoms of perennial allergic rhinitis.

Sulfinpyrazone And Prevention Of Postoperative Deep Venous Thrombosis(DVT)

1981 ◽  
Author(s):  
G Arapakis ◽  
A Trovas ◽  
G Orphanoudakis ◽  
P Vassilikos
Keyword(s):  
Arterial Thrombosis ◽  
Statistical Significance ◽  
Group Analysis ◽  
Control Group ◽  
Placebo Control ◽  
Double Blind Trial ◽  
Double Blind ◽  
Placebo Control Group ◽  
Postoperative Deep Venous Thrombosis ◽  
Surgical Operations

Though the antithrombotic properties of sulfinpyrazone (SP) in arterial thrombosis have been documented, its value in phlebothrombosis remains uncertain. In this randomized double-blind trial, the effect of SP (500mg I.M. twice daily for the first 10 postoperative days) on postoperative DVT was compared with a placebo control group. 96 (65 male and 31 female) patients 41 to 83 years of age undergoing major surgical operations were included in the trial. The composition of the two groups (treated and placebo) were homogenious regarding age, sex and type of operation (0,30<p<0,50). The incidence of DVT was estimated clinically and isotopically by the 125I-labelled figrinogen test.No clinical phlebothrombosis was observed in either group but DVT was detected isotopically in 4 (8,3%) out of 48 in the placebo and in 7 (14,5%) of the 48 in the SP group. Analysis by the x2 showed no statistical significance in the prevalence of postoperative DVT between the two groups (x2<x20,30/1). These results suggest that SP has no place in the prevention of postoperative DVT.

scholarly journals Prophylactic Intramuscular Ephedrine Prior to Caesarean Section

1992 ◽  
Vol 20 (4) ◽  
pp. 448-452 ◽  
Author(s):  
C. C. Rout ◽  
D. A. Rocke ◽  
R. Brijball ◽  
R. V. Koovarjee
Keyword(s):  
Caesarean Section ◽  
General Anaesthesia ◽  
Control Group ◽  
Double Blind Study ◽  
Double Blind ◽  
Maximum Increase ◽  
Arterial Ph ◽  
Maternal Hypertension ◽  
Acid Base Status ◽  
Umbilical Arterial Ph

Thirty healthy parturients, having given informed consent, were randomly allocated in a double-blind study to receive an intramuscular injection of either 0.9% sodium chloride (control), ephedrine 25 mg, or ephedrine 50 mg, 30 minutes prior to general anaesthesia for caesarean section. Nine patients (90%) in the 50 mg group and five patients (50%) in the 25 mg group demonstrated reactive hypertension of 20% or greater from control. The mean maximum increase in the 50 mg group was 28.2% (range 4.4–38.3%). Maternal pH was significantly lower (P = 0.03) in the ephedrine 50 mg group. Neonatal acid base status was significantly impaired in the ephedrine 50 mg group with umbilical venous pH (P = 0.0001) and umbilical arterial pH (P = 0.001) being significantly lower than the control group. The associated increase in umbilical arterial base deficit suggests a metabolic component due to fetal asphyxia related to decreased uterine blood flow. We conclude that the prophylactic administration of intramuscular ephedrine prior to spinal anaesthesia is associated with an unacceptably high incidence of maternal hypertension, and should the spinal fail and general anaesthesia be required, also results in adverse neonatal biochemical changes. The technique is therefore not to be recommended.

Adding herbal extracts to silicone gel on post-sternotomy scar: a prospective randomised double-blind study

2020 ◽  
Vol 29 (Sup4) ◽  
pp. S36-S42
Author(s):  
Palakorn Surakunprapha ◽  
Kengkart Winaikosol ◽  
Bowornsilp Chowchuen ◽  
Kriangsak Jenwitheesuk ◽  
Kamonwan Jenwitheesuk
Keyword(s):  
Aloe Vera ◽  
Median Sternotomy ◽  
Centella Asiatica ◽  
Herbal Extract ◽  
Double Blind Study ◽  
Herbal Extracts ◽  
Double Blind ◽  
Silicone Gel ◽  
Group 2 ◽  
Group 1

Objective: Silicone gel has been shown effective in improving healing post-sternotomy scars. It remains to be determined whether adding herbal extracts to the gel would augment the healing effect. Method: After median sternotomy, patients were randomised into two groups. Group 1: topical silicone gel plus herbal extract gel (Allium cepa, Centella Asiatica, Aloe vera and Paper Mulberry) and Group 2: silicone gel. Patients were treated for six months. The postoperative scars were assessed at three and six months by plastic surgeons using the Vancouver Scar Scale (VSS) and the patient assessment scar scale. Results: Each group comprised 23 patients (n=46 in total). The VSS was significantly lower in Group 1 than in Group 2 (p=0.018 and p=0.051, respectively). In Group 1, the four differences from baseline were vascularity scores at three and six months (–0.391, p=0.025; –0.435, p=0.013, respectively), and pigmentation scores at three and six months (–0.391, p=0.019; –0.609, p=0.000, respectively). In Group 2, differences from baseline were the pigmentation and vascularity score at six months (–0.6609, p=0.000; –0.348, p=0.046, respectively). Conclusion: Our results suggest, post-sternotomy scars trend to have better vascularity and pigmentation when treated with silicone gel plus herbal extracts.

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