scholarly journals Pain management and bupivacaine

Author(s):  
Anupam Nath Gupta ◽  
Paras Nath

Background: Pain is an unpleasant experience associated with tissue damage. Peripheral tissue injury results in functional disturbances in the nervous system. Modern anaesthesiologists are not only concerned about preoperative and intraoperative care of the patient but also with postoperative welfare of the patient.Methods: In present study we have compared the efficacy of injection bupivacaine 0.25% infiltration preoperatively versus postoperatively on duration of postoperative analgesia, VAS (visual analogue scale) at the onset of pain, total analgesia requirement in 24 hours. 150 patients belonging to ASA (American society of anesthesiologists) class I and II between the age of 15 and 75 who underwent lower abdominal surgeries belonging to either sex were included in the study. The patients were randomly allocated to three groups. Control group (C) received 20 ml normal saline, preoperative group (A) received 0.25% bupivacaine before incision, postoperative group (B) received 0.25% bupivacaine before closure.Results: Duration of analgesia, VAS score at the time of first request of analgesia and total doses of analgesia over 24 hours were recorded. The total analgesia requirement was reduced over 24 hours in the group B in which the infiltration was done postoperatively.Conclusions: The postoperative infiltration with 0.25% bupivacaine produces longer duration and better quality of analgesia as compared to preoperative infiltration.

2021 ◽  
Author(s):  
Waqar M. Naqvi

Abstract Entrepreneurs usually work for long hours resulting in exhaustion, stress, and burnout. The prevalent symptoms of burnout are reduced levels of physical and mental energy, reduced job efficiency and diminished productivity. Therefore, it is important to improve the health of entrepreneurs. Gamification has a positive relationship with improvements in health and well-being as it influences positive experiences and satisfaction. This trial aims to study how 30-minutes of virtual reality game use via Kinect Azure and Oculus platforms 3-times per week, for 4 weeks, relates to differences in entrepreneur stress, burnout, subjective life quality, and downstream firm performance. We will recruit entrepreneurs over the age of 18 for the gamification analysis. Analysis of previous power using G*Power will determine the sample size. We will divide the participants into 3 groups, wherein Group A will undergo gamification on the Kinect platform, Group B will undergo the Oculus Quest intervention, and Group C will be the control group. We will conduct the study at two sites, one at the HuMen research. The outcome measures include a five-point Likert scale for measuring entrepreneurial stress, burnout-measuring scale (BMS) for burnout, five-point Likert scale for performance and SF-12 for Quality of life. Since current strains pave ways to future accomplishment, entrepreneurs' eudemonic well-being might particularly relate to forward-looking challenge stressors and burnouts. The results will provide an insight into how gamification could help entrepreneurs to deal with work stress and maintain high well-being.


KYAMC Journal ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. 202-205
Author(s):  
Muhammad Sazzad Hossain ◽  
Mohammad Mamunur Rashid ◽  
Md Anisur Rahman Babu ◽  
Afsana Sultana ◽  
Md Sirajul Islam Mahfuz ◽  
...  

Background: Propofol is an intravenous (IV) anesthetic agent, can irritate the skin, mucous membrane and venous intima. The main drawback is the pain at injection site following its intravenous injection. Objectives: This study was performed to evaluate the effect of intravenous nitroglycerine on pain in patients following propofol injection. Materials and Methods: Eighty adult patients of both sexes, aged 20-50 years, according to American Society of Anesthesiologists (ASA) physical status were divided into two equal groups (n=40) to receive 200 mcg intravenous nitroglycerine diluted in 10 ml saline (group A) and 10 ml normal saline as placebo (group B) at an ambient operating room temperature in a randomized and double blinded fashion to compare the pain-relieving effects of the drugs during propofol injection before the patients lost consciousness. The pain on propofol injection was assessed according to the Mc Crirrick and Hunter scale. Results: The overall incidence and severity of pain were significantly less in Groups A (nitroglycerine group) than group B (placebo group) (p< 0.05). The incidence of mild and moderate pain in Group A versus group B was 25% vs 45% and 15% vs 30% respectively (p<0.05). The incidence of score '0' (no pain) was higher in Group A (60%) than Group B (25%) (p<0.05). Conclusion: Pretreatment with 200 mcg nitroglycerine with venous occlusion for one minute is effective pretreatment in alleviating propofol injection pain when compared to placebo. KYAMC Journal Vol. 10, No.-4, January 2020, Page 202-205


2017 ◽  
Vol 42 (6) ◽  
pp. 587-595 ◽  
Author(s):  
J Estay ◽  
J Martín ◽  
P Vildosola ◽  
IA Mjor ◽  
OB Oliveira ◽  
...  

SUMMARY Objectives: The aim of this study was to clinically evaluate posterior amalgam and resin composite restorations refurbished over a period of 12 years by investigating the influence of refurbishing on the survival of restorations and comparing their behaviors with respect to controls. Methods and Materials: Thirty-four patients were enrolled, ages 18 to 80 years, with 174 restorations, 48 restorations of resin composite (RC), and 126 restorations of amalgam (AM). Restorations with localized defects in anatomy, roughness, luster, or marginal staining that were clinically judged as suitable for refurbishing according to US Public Health Service (USPHS) Ryge criteria were assigned to group A—refurbishing (n=85; 67 AM, 18 RC)—or group B—control (n=89; 59 AM, 30 RC); the quality of the restorations was evaluated blindly according to the modified USPHS criteria. Two observers conducted evaluations at the initial state (k=0.74) and after one to five, 10, and 12 years (k=0.88). Wilcoxon, Friedman, and Mantel-Cox tests were performed to compare the groups, respectively. Results: After 12 years, both groups experienced a similar decline, except for an evidently better performance in marginal adaptation in RC control (p=0.043) and in anatomy in AM refurbished (p=0.032). Conclusions: After 12 years, no difference was found in the clinical condition and longevity of the refurbished restorations compared to the control group.


2011 ◽  
Vol 37 (2) ◽  
pp. 247-257 ◽  
Author(s):  
Amany A. El Hadary ◽  
Hala H. Yassin ◽  
Sameh T. Mekhemer ◽  
Julian C. Holmes ◽  
Martin Grootveld

Abstract Immunosuppressive agents have been recognized as factors that induce changes and modifications in bone metabolism. The purpose of this study was to evaluate the effect of ozonated plant extracts (herein termed ozonated oil) under the influence of Cyclosporin A (CsA) on osseointegration. A total of 20 dental implants were placed in 20 rabbit tibiae assigned to Group A or B. CsA was injected at an immunosuppressive dose in Groups A and B as a single-dose treatment. At the day of surgery, Group A received a single topical ozonated oil treatment (0.55 mL) around dental implants; Group B, the control group, received no ozonated oil. Animals were sacrificed after 8 weeks. Radiographs were obtained at implant surgery and on the day of sacrifice. Bone quality was compared between the 2 groups. Radiographically, osseointegration was microscopically evaluated using scanning electron and light microscopies. In ozonated Group A specimens, light microscopic examination demonstrated evidence of more organized mature bone compared with Group B. Within the limits of this study, the results suggest that short-term administration of CsA, when administered with topical ozonated oil, may influence bone density and the quality of dental implant osseointegration. Therefore, topically applied ozonated oil may influence bone density and the quality of osseointegration around dental implants.


Author(s):  
ALISHA SAHU ◽  
SAMBEET SWAIN ◽  
SOUMYA SAMAL ◽  
SIBANARAYAN MOHANTY

Objectives: The objectives of the study were to compare the efficacy of injection atracurium 0.5 mg/kg intravenous (IV) versus injection cisatracurium 0.2 mg/kg IV for intubation in patients undergoing endoscopic retrograde cholangiopancreatography procedure (ERCP). Methods: Hundred adult patients of both sexes in the age group of 18–60 years belonging to the American Society of Anesthesiologists I/II category posted for ERCP procedures under general anesthesia were randomly allocated into two groups of 50 each. Group A received injection atracurium besylate 0.5 mg/kg intravenously and Group B received injection cisatracurium besylate 0.2 mg/kg intravenously. Parameters observed were time to the maximum blockade, intubating condition, time required for intubation, duration of action, hemodynamic parameters during intubation, and after 1, 2, 3, 5, and 15 min and any adverse effects. Results: Demographic profile was comparable between the groups. Intubating condition as per Cooper et al. score was excellent in 36 patients in cisatracurium group as compared to 19 patients in atracurium group. The overall intubating condition was found to be better in Group B (p=0.00001). Time to the maximum blockade was significantly high with atracurium as compared to cisatracurium. The mean of intubation time was less with cisatracurium (135±11.1) than that of atracurium (144±9.48) in seconds, which was statistically significant. Duration of neuromuscular blockade was found to be prolonged in Group B as compared to Group A (p=0.000). Hemodynamic parameters during intubation and after 1, 2, 3, 5, and 15 min were comparable between the groups. No adverse effect was seen in both groups. Conclusion: Cisatracurium 0.2 mg/kg provides excellent intubating conditions with rapid onset of action, longer duration of action, and no significant hemodynamic changes as compared with atracurium 0.5 mg/kg for ERCP procedures without any adverse effects.


2013 ◽  
Vol 6 (1) ◽  
pp. 25
Author(s):  
Agreta Gecaj-Gashi ◽  
Hasime Terziqi ◽  
Tune Pervorfi ◽  
Arben Kryeziu

Introduction: The aim of this prospective, double-blinded studywas to investigate the effects of clonidine in co-administrationwith bupivacaine during spinal anesthesia, regarding the onset and regression of motor and sensory block, postoperative analgesia and possible side effects.Methods: We randomly selected 66 male patients (age 35 to 70), from the American Society of Anesthesiologists (ASA) class I-II; these patients were scheduled for transurethral surgical procedures. These patients were randomly allocated into two groups of 33 patients each: group B (bupivacaine) only received 0.5% isobaric bupivacaine 7.5 mg intrathecally and group BC (bupivacaine + clonidine) received bupivacaine 7.5 mg and clonidine 25 μg intrathecally. We performed the spinal anesthesia at a level of L3-L4 with a 25-gauge needle. We assessed the sensory block with a pinprick,the motor block using the Bromage scale, analgesia with thevisual analog scale and sedation with the modified Wilson scale.We also recorded the hemodynamic and respiratory parameters.Results: The groups were demographically similar. The mean time of achievement of moto block (Bromage 3) and sensory block at level T9 was significantly shorter in the BC group compared with B group (p = 0.002, p = 0.000, respeectively). The motor block regression time was not significantly different between the two groups (p = 0.237). The postoperative analgesia requirement was significantly longer in group BC compared with group B (p = 0.000). No neurological deficit, sedation or other significant adverse effects were recorded.Conclusion: The intrathecal application of clonidine in combination with bupivacaine improves the duration and quality of spinal anesthesia; it also provides longer duration of postoperative analgesia, without significant side effects.


2018 ◽  
Vol 16 ◽  
pp. 205873921877420
Author(s):  
Ke Zhang ◽  
Tianke Xiao ◽  
Zuqi Chen ◽  
Shuguang Xiong ◽  
Xiaohong Wang

The study was designed to understand the effects of oxycodone hydrochloride and sufentanil used in painless fiberoptic bronchoscopy. A total of 90 patients aged 3–84 years undergoing painless fiberoptic bronchoscopy were selected, American Society of Anesthesiologists (ASA): I–III criteria—the equal number of subjects were randomly divided into sufentanil group (group A) and oxycodone hydrochloride group (group B). The vital signs, surgical examination and anesthesia, the effect of anesthesia, and adverse reactions were compared between the two groups during the operation. The change of heart rate and changes of hemodynamics in group B were found to be lower than in group A. The number of breaths was significantly lower than group B. The decrease of SpO2 in group A was higher than in group B. Cases of SpO2 <90% was higher in group A than in group B. The dosage of propofol and the recovery time in group A was significantly higher than in group B. The incidence of nausea and vomiting in group A was higher than in group B. Oxycodone hydrochloride combined with propofol used in painless fiberoptic bronchoscopy could improve the safety and efficiency of analgesia compared to sufentanil combined with propofol. The effect was found to have stable hemodynamics and fewer adverse reactions.


2020 ◽  
Vol 8 (2) ◽  
pp. 256
Author(s):  
Dedy Hendra Gunawan

Cough after extubation not only causes patient discomfort, but can also cause hypertension, tachycardia, increased intracranial, intraocular, and intra-abdominal pressure, which can cause coronary ischemia, arrhythmia, or surgical difficulties. Cough after extubation can be prevented with several drugs. The purpose of this study is to compare the effects of lidocaine 2% 1.5 mg / kg intravenously compared to fentanyl 1 mcg / kg intravenously in reducing the incidence of cough during conscious extubation. Research conducted on 36 patients aged 18-65 years with the physical status of the American Society of Anesthesiologists (ASA) I and II who performed operations with general anesthesia using oral intubation in a position during supine surgery and correctly extubated. Patients were divided into 2 groups: group A received fentanyl 1 mcg / kg and group B received lidocaine 2% 1.5 mg / kg. The results of the study concluded that 2% lidocaine at a dose of 1.5 mg / kg better in coughing and rejected haemodynamics compared to fentanyl at a dose of 1 mcg / kg at the time of extubation was understood to be moderate.


2014 ◽  
Vol 24 (1) ◽  
pp. 3-7
Author(s):  
Nasir Uddin Ahmed ◽  
Mozaffor Hossain ◽  
AKM Akhtaruzzaman ◽  
Montosh Kumar Mondol ◽  
UH Shahera Khatun

Background The popularity of supraclavicular brachial plexus block in upper limb surgery in recent years are due to better understanding of using adjuvant to local anaesthetics, its advantages and in avoidance of the hazards of general anaesthesia. Objective To compare the quality of anaesthesia and duration of analgesia with clonidine-bupivacaine or fentanyl-bupivacaine in supraclavicular brachial plexus block. Method A total number of 60 patients (ASA class 1 and II) were selected randomly into two groups, thirty in each group. Group-A (control group) received fentanyl (100ìg) 2ml and bupivacaine (0.25%) 38ml, total of 40ml.Group-B (study group) received clonidine (150ìg) 2ml and bupivacaine (0.25%) 38ml, total of 40ml.The parameters including pulse rate, non-invasive systolic and diastolic blood pressure, respiratory rate, SpO2, onset and duration of motor and sensory block, post operative pain score in VAS, duration of analgesia, first analgesic demand, side effects were assessed and recorded. Result Onset and duration of sensory block were significantly higher in group-B than in group-A (P<0.001) and motor block were quite prolonged in group-B than group-A (p<0.001), prevalence of sedation in group-B slightly higher than group-A. But intensity of pain measured by VAS in group-A expressed highest at 8 hours of postoperative period and group-B shows highest VAS at 12 hours. Duration of effective analgesia (time from supraclavicular block to first analgesic demand) in study group-B had significantly longer mean duration than that produced by control group-A (14.4 ± 1.3 vs 10.9 ± 1.5 hours; P<0.001). Conclusion Clonidine and bupivacaine combination is a better alternative to fentanyl and bupivacaine in respect of quality of anaesthesia and duration of analgesia. DOI: http://dx.doi.org/10.3329/jbsa.v24i1.19792 Journal of Bangladesh Society of Anaesthesiologists 2011; 24(1): 3-7


2021 ◽  
pp. 59-61
Author(s):  
Gautam Piplai ◽  
Amrita Roy ◽  
Dipanjan Dutta ◽  
Sayantan Mukhopadhyay

The present study was undertaken to evaluate the efcacy of intravenous lignocaine versus topical lignocaine for attenuating haemodynamic response during laryngoscopy and intubation in patients undergoing surgery under general anaesthesia. This single blind randomized control study was done on sixty patients of either sex aged between 18 to 55 years, of American Society of Anesthesiologists (ASA) status class I undergoing elective surgery under general anesthesia with endotracheal intubation. Patients were randomly allocated into two groups (group A and group B). Group A and Group B received intravenous preservative free lignocaine hydrochloride 2% 2 mg/kg and topical (nebulized) lignocaine hydrochloride 4% at 2mg/kg. Heart rate, systolic, diastolic and mean blood pressure was documented before administering premedication (T0), at time of intubation (TI) and 1 min (T-1), 2 min (T-2) & 5 min (T- 5) after intubation. Attenuation in the HR , SBP, DBP, MBPwere found statistically signicant (P<0.05) in group B in comparison to the group A. So, to conclude, topical lignocaine 4% blunts haemodynamic response to laryngoscopy and intubation better than intravenous lignocaine 2% when other confounding factors are eliminated.


Sign in / Sign up

Export Citation Format

Share Document