scholarly journals A randomized controlled trial to compare effects of different volume and concentration of lidocaine for preventing propofol injection pain in adults

2019 ◽  
Vol 8 (3) ◽  
pp. 564
Author(s):  
Ashish Patyal ◽  
Anjana Verma ◽  
Madhavi Buddhi
Keyword(s):  
Rating Scale ◽  
Elective Surgery ◽  
Controlled Trial ◽  
Numeric Rating Scale ◽  
Injection Pain ◽  
Response Scale ◽  
Chi Square ◽  
Experienced Pain ◽  
Group A ◽  
Group B

Background: Pain on propofol injection is an unwanted effect which can lead to decreased patient satisfaction. Although many studies have shown that pre-treatment with lidocaine injection is effective in this pain, nevertheless, very few studies have been done  on different concentration and volume of lidocaine, effective of reducing pain significantly. Objective of the current study was to assess and compare the efficacy of intravenous lidocaine with  0.4% and 2% concentration in reducing the incidence and severity of propofol injection pain.Methods: A total of 126 American Society of Anesthesiologist grade I and II patients with age ≥18 years, scheduled for an elective surgery, were enrolled in the study. Patients were randomized into two equal groups of 63 each. Group A (n = 63) received pretreatment with 0.4% lidocaine and group B (n = 63) received 2% lidocaine. Propofol injection pain was measured by using Numeric Rating Scale (NRS) and Withdrawl Response Scale (WRS). Unpaired t test, ANOVA and Chi square test were used for statistical analysis.Results: A statistically significant decrease in the pain was recorded in group A (0.4% lidocaine) as compared to group B (2% lidocaine). Using NRS scale, 12% of patients in group A as compared to 33% patients of group B, experienced pain (p =0.02); while using WRS, 8% patients of group A as compared to 27% group B patients experienced pain (p= 0.04).Conclusions: The pain on injection of propofol is significantly decreased by the use of 0.4% lidocaine in comparison with 2% Lidocaine.

scholarly journals Comparison of efficacy of internal sphincterotomy versus topical 0.2 % glyceryl trinitrate ointment after hemorrhoidectomy.

2020 ◽  
Vol 27 (12) ◽  
pp. 2541-2547
Author(s):  
Muhammad Arif ◽  
Sabih Nofal ◽  
Ahsan Khan ◽  
Mariam Tariq Awana ◽  
Anum Arif
Keyword(s):  
Glyceryl Trinitrate ◽  
Controlled Trial ◽  
P Value ◽  
Chi Square ◽  
Male Predominance ◽  
Internal Sphincterotomy ◽  
Open Hemorrhoidectomy ◽  
Group A ◽  
Group B ◽  
Glyceryl Trinitrate Ointment

Objectives: To compare the efficacy of 0.2% glyceryl trinitrate ointment versus internal sphincterotomy after hemorrhoidectomy. Study Design: Randomized Controlled Trial. Setting: Department of Surgery Unit III, at Lahore General Hospital, Lahore. Period: 6 months (August 2017 to February 2018). Material & Methods: The OPD of the Department of Surgery included 124 patients who satisfied the inclusion criteria. There were two groups of patients, Group A and Group B. Group-A was told to use gloved finger three times daily for 0.2 percent GTN ointment topically. For Group B, lateral internal sphincterotomy was performed as day care procedure. On visit, patients were assessed for pain relief by using VAS. All data was collected using a pre-designed (attached) proforma. In SPSS v23.0 the data were input and analyzed. It was stratified for age, sex, disease duration and hemorrhoid stage. The effectiveness of both groups was compared by using a p-value of 0.05 as significant for a chi-square test. Results: Male predominance; in group-A, 41(66.1%) patients were male and 21(33.9%) were female, while in group-B, 52(83.9%) patients were male and 10(16.1%) were females. Efficacy was found in 11(17.7%) patients in group-A (0.2% GTN) while in 25(40.3%) patients in group-B (Internal sphincterotomy) with p-value of 0.006 which is statistically significant. Conclusion: Open hemorrhoidectomy internal sphincterotomy is an effective method to reduce pain after hemorrhoidectomy in contrast to Glyceryl Trinitrate (GTN) topical cream of 0.2 percent.

scholarly journals A comparative evaluation of dexmedetomidine and fentanyl to attenuate hemodynamic response to laryngoscopy and intubation

2018 ◽  
Vol 9 (1) ◽  
pp. 65-72
Author(s):  
Erum Ozair ◽  
Qazi Ehsan Ali ◽  
Md Masood Husain Siddiqi ◽  
Syed Hussain Amir ◽  
Shagufta Naaz
Keyword(s):  
Elective Surgery ◽  
Pressor Response ◽  
Demographic Data ◽  
Hemodynamic Response ◽  
T Test ◽  
Chi Square ◽  
Demographic Profiles ◽  
Hemodynamic Variables ◽  
Group A ◽  
Group B

Background: Laryngoscopy and intubation are associated with a sympathetically mediated circulatory response due to irritation of respiratory tract which is associated with increase in pulse rate and blood pressure that may be dangerous.Aims and Objectives: The aim of the present study was to determine and compare the efficacy of dexmedetomidine and fentanyl in attenuating the hemodynamic response to laryngoscopy and intubation and to detect any complication or side effect as a result of these drugs.Materials and Methods: Following approval by ethical committee, 60 ASA grade I and II patients of either sex undergoing general anaesthesia for elective surgery were included in this study. Patients were randomly divided into two groups of 30 patients each. Dexmedetomidine in a dose of 1μg/kg was given to Group A patients and Fentanyl 2 μg/kg was given to Group B patients. Both the drugs were diluted with normal saline solution to make 10ml and were administered slow intravenous 10 min before induction.The hemodynamic parameters were recorded, demographic data was analyzed using unpaired t-test and hemodynamic variables were analyzed by using unpaired and paired t-test. Side effects were analyzed using chi square test.Result: The two groups were comparable in their demographic profiles. Dexmedetomidine proved itself to be an excellent drug when given intravenously as a premedicant in dose of 1μg/kg to attenuate hemodynamic response to laryngoscopy and intubation. It blunted the hemodynamic response to laryngoscopy and intubation to a greater magnitude than fentanylin a dose of 2μg/kg intravenously as a premedicant.Conclusion: We conclude that fentanyl 2μg/kg i.v. given ten minutes prior to airway instrumentation shows an inconsistent response to laryngoscopy and intubation. Between the two drugs under study, the use of dexmedetomidine 1μg/kg i.v. is satisfactory and produces a more favorable hemodynamic profile while fentanyl 2μg/kg is found to be non- dependable and less effective for the attenuation of the pressor response to laryngoscopy and endotracheal intubation. However, further larger studies are required to strengthen these conclusions.Asian Journal of Medical Sciences Vol.9(1) 2018 65-72

scholarly journals Open VS Closed Techniques for Laparoscopic Abdominal Surgeries

2021 ◽  
pp. 296-302
Author(s):  
Obaid Ul Haseeb ◽  
Haris Rashid ◽  
Afrin Ahmed ◽  
Mir Arsalan Ali ◽  
Shakil Alam ◽  
...  
Keyword(s):  
Controlled Trial ◽  
P Value ◽  
Open Approach ◽  
Chi Square ◽  
Closed Technique ◽  
Chi Square Test ◽  
Group A ◽  
Classic Technique ◽  
Group B ◽  
Surgery Department

Background: Laparoscopic surgery or "minimally invasive" surgery is a type of specialist surgery. The most crucial, demanding, and risky part of the laparoscopy is the creation of pneumoperitoneum. The two most prevalent methods for creating a pneumoperitoneum are the closed and open approaches. Despite the fact that there is no universal consensus on the best approach to gain access to the peritoneal cavity in order to create a pneumoperitoneum. The aim of present study was to compare the operative time and post-operative outcome associated with closed technique and open classic technique. Methods: This randomized controlled trial was carried out by recruiting patients presented in surgery department of Ziauddin Hospital North campus. The samples were divided into two equal groups A and B. Group A was operated for Laparascopic abdominal surgery by open technique while group B operated through closed technique. Effectiveness of procedures was measured by number of complications occurred during and after surgery. Chi-square test and independent T-test were applied for association. P-value of < 0.05 was considered as significant. Results: Mean age was found to be 45.5±16 years and mean weight was 68±10.5 kilograms. Mean time of operations was 84.5±18.5 minutes. 60 (69.8%) of patients included underwent the laparoscopic cholecystectomy while 15 (17.4%) patients had laparoscopic appendectomy. 13/86: 15.1% of patients had the minor complication including 12/43: 27.9% in group B and 1/43: 2.3% in group A. The comparative analysis between the two groups in terms of effectiveness of either method compared by means of development of the complications was found to be highly significant with p value 0.002. Conclusion: The open approach to laparoscopic entrance has been linked to fewer surgical problems than the closed approach.

scholarly journals ASTHMA;

2017 ◽  
Vol 24 (11) ◽  
pp. 1749-1754
Author(s):  
Muhammad Abdullah ◽  
Zaheer Ahmed ◽  
Hassan Fareed
Keyword(s):  
Controlled Trial ◽  
Response To Treatment ◽  
Smoking History ◽  
Chi Square ◽  
Oral Corticosteroids ◽  
Chi Square Test ◽  
History Of ◽  
Group A ◽  
Group B ◽  
Tract Infections

The aim on the study was to compare the efficancy of salmeterol and formoterolin persistent asthama. Study Design: Randomized-Controlled-Trial(RCT). Setting: Departmentof Medicine, Allied Hospital, Faisalabad. Period: June 2014 to December 2014. Methodology:Patients of both genders with ages between 18 and 70 years having persistent bronchial asthmawhile Pregnant or lactating mothers, patients with upper or lower respiratory tract infections,acute asthma exacerbations within 4 weeks of first visit, Oral corticosteroids within 4 weeks ordepot steroids within 12 weeks of first visit and Smoking history of more than 10 pack yearswere excluded from study. Patients were randomly divided into two groups (Group A & GroupB) using computer generated random number table. Salmeterol/Fluticasone combination wasgiven to group A with a dose of 50/250μg, 2 actuations with ABEL SPACER DEVICE twice aday for a period of 24 weeks. Formoterol/Budesonide combination was given to group B with adose of 400/6μg with Rotahaler twice a day. Follow up was done by patient’s outdoor visits at6th,12th,18h and 24th week. Results: 180 patients were enrolled in the study. 79 (44%) weremales and 101 (56%) were females. Mean age of study population was 45.25+13.382 years.Patients in Group B experienced lesser number of exacerbations than patients in Group B.Group B showed better response to treatment than Group A using chi square test. (P-Value0.001). Conclusion: It has been concluded that budesonide/Formoterol is more effective incontrolling asthma symptoms than fluticasone/Salmeterol.

scholarly journals The Impact of Ulipristal Acetate (UPA) versus Dienogest on Pain Related to Endometriomas Evaluated with Visual Analogue Scale (VAS)

2019 ◽  
Vol 70 (4) ◽  
pp. 1500-1506
Author(s):  
Romina Marina Sima ◽  
Dragos Albu ◽  
Antoniu Cringu Ionescu ◽  
Mihai Dimitriu ◽  
Mihai Popescu ◽  
...  
Keyword(s):  
Visual Analogue Scale ◽  
Analogue Scale ◽  
Rating Scale ◽  
Randomized Study ◽  
Good Method ◽  
Numeric Rating Scale ◽  
Ulipristal Acetate ◽  
Group A ◽  
Group B ◽  
The Impact

Visual analogue scale (VAS) is a psychometric scale applied to measure subjective characteristics. The purpose of our study was to evaluate the efficiency of Ulipristal acetate (UPA) compared with Dienogest for endometriomas related pain using VAS. We performed a randomized study on women with symptomatic endometriomas. The study was realized between January 2016�December 2018. The patients were randomized in two groups: Group A- that received UPA in doses of 5 mg daily for 12�13 weeks and Group B that received 2 mg Dienogest for 12�13 weeks. Each group received de VAS (Visual Analogue Scale) questionnaire before and after treatment. 70 women wereincluded in the study with 35 patients for each group. The age the mean age was 30.20 years. For Numeric Rating Scale before treatment in the group with UPA the median value was 6 (CI= 5.26, 6.51) and for group B the median was 5 (CI= 5.13, 5.66). After treatment for group A the median value was 4 (CI= 3.58, 4.29) and for group B the median value 4 (CI= 4.23, 4.6). For FRS before treatment in the group with UPA median value was 6 (CI= 5.87, 6.58) and for the group B median was 6 (CI= 6.16, 6.57). After treatment for group A the median value was 4 (CI= 4.12, 4.73) and for group B the median value 5 (CI= 4.9, 5.06). The pain significantly improved for group A. (p[ 0.05) VAS represent a good method to evaluate the quality of pain for patients with endometriomas. The UPA and Dienogest treatment improve the VAS parameters with better results for UPA in the present study.

scholarly journals Comparison of Blood Loss in Manual and Spontaneous Removal of Placenta in Caesarean Section

2020 ◽  
pp. 80-84
Author(s):  
Sabeen Ashraf ◽  
Azra Saeed Awan ◽  
Hina Tabassum ◽  
Omair Ashraf ◽  
Touseef Fatima ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Blood Loss ◽  
Cesarean Section ◽  
Controlled Trial ◽  
Analysis Data ◽  
Research Committee ◽  
Chi Square ◽  
Chi Square Test ◽  
Group A ◽  
Group B

Background: Efforts should be made to minimize the blood loss at the time of cesarean section. The techniques used to reduce the blood loss include finger splitting versus scissor cutting of incision, in situ stitching versus exteriorization and stitching of uterus and finally spontaneous or manual removal of the placenta. Objective: The main objective of this study is to correlate the frequency of loss of blood between the placenta removed manually and spontaneously during cesarean section. Methods: Randomized controlled trial in the department of Obstetrics and Gynecology, Fauji Foundation Hospital, Rawalpindi. The sample is collected through Consecutive (non- probability) sampling. The study was conducted after approval from the hospital ethical and research committee. Informed written consent was taken from all the patients. The patients were divided into two groups, group A and group B randomly by using random table numbers. Group A had spontaneous placental delivery. Group B had manual placental delivery. Each patient was examined thoroughly and detailed history was taken. Data Analysis: Data was analyzed using SPSS 20 for windows. The frequency and percentage of blood loss were measured. A chi-square test was applied to correlate the blood loss between the two groups. p values <0.05 were considered statistically significant. Effect modifiers like age, gestational age, parity were controlled by stratification. Results: The blood loss was compared between both groups using the chi-square test not assuming null-hypothesis. The blood loss was comparatively high in-group in which the placenta was removed manually (p=0.007). Keywords: Caesarean Section, Placenta removal, Spontaneous, Manual, Blood loss.

Accuracy of Paper Point Technique for Final Working Length Measurement after Canal Preparation

2021 ◽  
Vol 15 (10) ◽  
pp. 3359-3362
Author(s):  
Ambrin . ◽  
Farah Tasleem ◽  
Anum Saleem ◽  
Doua Tasleem ◽  
Talha Ahmed
Keyword(s):  
Controlled Trial ◽  
Length Measurement ◽  
Chi Square ◽  
Paper Point ◽  
Working Length ◽  
Significant Difference ◽  
Chi Square Test ◽  
Group A ◽  
Group B ◽  
Electronic Apex Locator

Objective: The aim this study was to check the accuracy of paper point technique for final working length measurement after canal preparation. Study Design: Randomized controlled trial Place and Duration: Study was performed in department of operative dentistry, Liaquat University of Medical & Health Sciences, Jamshoro for one year duration from January 2017 to December 2017. Methodology: This study was performed on 78 patients divided equally into two groups. In one group working length was established by using electronic apex locator while in second group working length was established by using electronic apex locator with paper point technique. To check the working length master apical gutta percha point (GP point) was inserted into canal and radiograph were taken by paralleling angle technique. Results: There were 34 (43.6%) males while 44 (56.4%) patients were females. Mean age of patients was 30.5±8.9 years. Mean tooth number was 28.8±11.0. Group A is concerned that was treated only with Electronic Apex Locator showed lesser number of acceptable length than group B. on the other hand, group B was treated with electronic apex locator and paper point technique showed higher acceptable length of respondents with a difference of 4 frequencies or 7% in excess. A less value of chi-square test showed relationship between observed and expected data; whereas, significance value indicated no significant difference between group A and B. Conclusion: Paper point technique is as reliable as other techniques for final working length measurement. Key Words: Electronic Apex Locator, Paper Point Technique, Endodontic Working Length

scholarly journals The role of glucomannan fiber in childhood functional constipation

2016 ◽  
Vol 56 (2) ◽  
pp. 95
Author(s):  
Indiana Aulia ◽  
Supriatmo Supriatmo ◽  
Emil Azlin ◽  
Atan Baas Sinuhaji
Keyword(s):  
Controlled Trial ◽  
Functional Constipation ◽  
Boarding School ◽  
Chi Square ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Rome Iii ◽  
Group A ◽  
Group B

its most common type is functional constipation. The dietary fiber may be useful in childhood functional constipation management, but unfortunately the role of fiber in functional constipation is still less developed.Objective To determine the role of glucomannan in treatment of childhood functional constipation.Methods A crossover randomized controlled trial (RCT) was done from May until July 2012 in a boarding school in Medan, North Sumatera. The subjects were children with functional constipation aged 7 to 12 years. Subjects were randomised into two group receiving glucomannan fiber as polysaccharide gel (group A) and maltodextrin as placebo (group B) with each dose of 100 mg/kg/day (maximum of 5 g/day) diluted in 50 ml water/500 mg for 4 weeks, then after a wash out period we did the crossover of the two groups. Frequency and consistency of stools were recorded into diary sheet for 4 and 8 weeks of treatment. Functional constipation has been diagnosed based on Rome III criteria. Data was analyzed using independent T-test and Chi-square test.Results A total of 36 subjects were eligible with each group consisting of 18 subjects and mean of weight of 25 kg. We found significant difference in stool frequency, treated on glucomannan with P= 0.002 before and P = 0.0001 after the wash out period. For stool consistency, we found difference while treated on glucomannan 9/18 (P= 0.034) in 4 weeks before and 11/18 (P = 0.008) in 4 weeks after the wash out period.Conclusion Glucomannan has significant effect to improve functional constipation especially in 4 weeks treatment.

scholarly journals Comparison of topical non-steroidal anti-inflammatory drugs and oil of evening primrose in management of mastalgias; A randomized controlled trial.

2020 ◽  
Vol 27 (10) ◽  
pp. 2062-2066
Author(s):  
Nausheen Hasham ◽  
Ahmed Raza ◽  
Tahira Hameed ◽  
Naveed Arshad ◽  
Syed Tatheer Abbas ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Chi Square ◽  
Evening Primrose ◽  
Patients Âgés ◽  
Randomized Controlled ◽  
Group A ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Group B ◽  
Topical Nsaids

Objectives: To compare the effects of topical non-steroidal anti-inflammatory drugs over oil of evening primrose in mastalgias in terms of frequency of pain. Study Design: Randomized Controlled Trail. Setting: Department of Surgical at Holy Family Hospital, Rawalpindi. Period: January 2016 to June 2016. Material & Methods: A total of 160 consecutive female patients, ages 17-45 years with history of breast pain for last 2-3 months (cyclic and noncyclic), were presenting in surgical OPD with symptoms of mastalgias between January 2016 to June 2016 included in the study. Patients allocated in two groups, Group A received topical NSAID in 0.5% Piroxicam gel for local application to affected area twice daily for three months and Group B was given oil of evening primrose (OEP) capsules (Efamol) 500mg twice daily for three months. Patients mastalgia pain was recorded by using VAS scale at baseline (1st day) and at end of treatment (3rd month). Pain calculated by compared in terms of mean, standard deviation between groups and independent sample T test was used. Percentage compare the efficacy of response of two therapies among group A and group B chi-square distribution was used. Results: One hundred and sixty (160) patients were recruited in this study. The mean ages of the patients were 27.54±7.53 years with minimum 17 and maximum 45 years. Out of 160 patients, 115 (71.9%) were younger than 30 years of age and 45 (28.1%) were between 30 and 45 years of age. Results showed significantly lower pain in patients using topical NSAIDs as compared to OEP capsules (p=0.000). Conclusion: Topical NSAIDs are more significant and show more improvement in reduction of pain in both cyclic and noncyclic mastalgia patients as compared to oil of evening primrose.

scholarly journals Perbandingan Insidensi Hipotensi Saat Induksi Intravena Propofol 2 Mg/Kg Bb Pada Posisi Supine dengan Perlakuan dan Tanpa Perlakuan Elevasi Tungkai

2016 ◽  
Vol 5 (1) ◽  
Author(s):  
Beni Indra ◽  
Untung Widodo ◽  
Yunita Widyastuti
Keyword(s):  
Randomized Control Trial ◽  
Elective Surgery ◽  
P Value ◽  
Chi Square ◽  
Parametric Data ◽  
Chi Square Test ◽  
Group A ◽  
Randomized Control ◽  
American Society ◽  
Group B

Abstrak          Penggunaan Propofol untuk induksi pada general anestesi dapat menyebabkan  hipotensi akibat vasodilatasi arteri dan vena terutama vena kapasitan ditungkai. Manuver elevasi tungkai dapat mempertahankan stabilitas hemodinamik dengan meningkatkan aliran balik vena ke jantung dan mengurangi penumpukan darah di vena kapasitan tungkai. Penelitian ini dirancang dengan menggunakan cara Open Randomized Control Trial. Subyek penelitian adalah 184 sampel pasien dewasa ASA I-II yang menjalani operasi elektif dengan menggunakan general anestesi dengan induksi propofol. Kelompok sampel penelitian dibagi dalam dua kelompok masing-masing berjumlah 92 orang. Setelah prabeban cairan RL 10 cc/kgbb dan pemberian fentanyl 2 mcg/kgbb dan midazolam 0,05 mg/kgbb maka kelompok A dilakukan elevasi tungkai 45º satu menit sebelum induksi propofol dan dipertahankan sampai penelitian selesai. Sedangkan kelompok B tidak dilakukan elevasi tungkai. Data yang dikumpulkan dianalisa dengan uji t tes. Untuk data proporsi dilakukan analisa dengan tes chi-square. Dari data demografi tidak didapatkan perbedaan yang bermakna secara statistik (p>0,05) antara kedua kelompok penelitian kecuali untuk BMI (p<0,05). Insidensi hipotensi  menit pertama pasca induksi propofol pada kelompok A (elevasi tungkai) secara signifikan lebih rendah (12%) dibanding kelompok kontrol B  (27,2%) (p=0,016; p < 0,05). Pada menit ketiga pasca induksi juga didapatkan insidensi hipotensi kelompok A  (15,2%) signifikan lebih rendah dibanding kelompok B (23,9%) (p= 0,014; p < 0,05). Elevasi tungkai 45 derajat efektif dalam menurunkan insidensi hipotensi pasca induksi propofol.  Kata kunci: propofol, hipotensi, elevasi tungkai AbstractThe induction of general anaesthesia with propofol may induce of considerable degree of hypotension that has been atributed to decrease in systemic vascular resistance  caused by combination of venous and arterial vasodilatation. It will produce a shifting  of blood to venous reservoir, especially capacitance venule of legs. Leg elevation can provide hemodynamic stability by increases cardiac preload and recruits blood contained in the venous reservoir. This is Open Randomized Control Trial include 184 elective surgery patients with American Society of Anaesthesiologist (ASA) physical status I and II. Anesthesia  was induced with propofol. Patients were randomly allocated into two groups with 92 patients in each. All the patients received Ringer’s Lactate (10 ml/kg) and premedicated with fentanyl (2 mcg/kg) and midazolam (0,05 mg/kg) before induction of anesthesia. Group A was performed passive leg raising 45 degree 1 minute before injection of propofol until  the end of study and group B (control) did not receive any maneuver. Parametric data were analyzed with t-test and categorical data was done by using Chi-square test. A p value of less than 0,05 was consider significant. Demografic characteristics (age, sex, body weight and height) and  baseline haemodynamic parameters of the patients were similar in two groups (p > 0.05) except for BMI (p < 0.05) . The incidence of hypotension was significantly lower in group A (12 %, ) than group  B (27,2%) at the first minute after propofol  injection, p value = 0.016 (p < 0,05). In the third minute, incidence of hypotension was also significantly lower in group A (15,2%) than group B (23,9%), p value = 0,014 (p < 0,05). Leg elevation maneuver 45º significantly decrease incidence of hypotension after propofol induction. Keywords: Propofol, hypotension, leg elevation

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