scholarly journals Comparative study between levobupivacaine with clonidine and levobupivacaine with fentanyl in epidural labour analgesia in rural set up

2017 ◽  
Vol 5 (9) ◽  
pp. 4087
Author(s):  
Prashant K. Mishra ◽  
Anand K. Singh ◽  
Pragati Divedi
Keyword(s):  
Epidural Analgesia ◽  
Rating Scale ◽  
Breakthrough Pain ◽  
Numerical Rating Scale ◽  
Mode Of Delivery ◽  
Fetal Outcome ◽  
Labour Analgesia ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Background: Neuraxial techniques are the gold standard for intrapartum labour analgesia. Neuraxial labour analgesia using new local anaesthetics such as levobupivacaine has become very popular by virtue of the safety and lesser motor blockade caused by these agents. Multiple randomized controlled trials comparing epidural analgesia with systemic opioids, nitrous oxide or both have demonstrated lower internal pain scores and higher maternal satisfaction with neuraxial analgesia. The purpose of this study is to compare fentanyl and clonidine combination with levobupivacaine in terms of effect of epidural labour analgesia on fetal outcome and incidence of instrumental or caesarean delivery and duration of second stage of labour.Methods: A total of 50 primiparous with singleton pregnancy and vertex presentation and cervical dilatation of 3-5 cm were enrolled for the study in our hospital in department of obstetrics and gynecology. They were divided into group 1 and group 2 (25 patients in each group). Group 1 received 10 ml. of 0.125% isobaric levobupivacaine with 25µg fentanyl and group 2 received 10 ml of 0.125% isobaric levobupivacaine with 60 µg clonidine. Parturients were given epidural analgesia on numerical rating scale (NRS) Score >3. Breakthrough pain supplemented with 3-5 ml of 0.125% levobupivacaine. Data collected were demographic profile of the patients, analgesic qualities, 1st and 2nd stage labour duration, side effects and feto-maternal outcome.Results: Post treatment mean NRS were almost similar between two groups at all periods except at 15 minutes when it was significantly lower for group 2 (2.64±0.49). Onset of analgesia was earlier in group 2 (13.68±0.94) in comparison to group 1 (15.36±1.18) and was statistically significant.Conclusions: In conclusion Group 2 (levobupivacaine with clonidine) showed significant difference in early onset of analgesia but did not show any significant difference in duration of labour, maternal and fetal outcome and mode of delivery.

scholarly journals Epidural analgesia during labour: its influences on pain relief, progress of labour, mode of delivery, maternal and foetal

2020 ◽  
Vol 9 (2) ◽  
pp. 555
Author(s):  
M. Suneetha ◽  
A. Saritha
Keyword(s):  
Pain Relief ◽  
Epidural Analgesia ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Obstetric Care ◽  
Fetal Outcome ◽  
Control Group ◽  
Sitting Position ◽  
Tertiary Care Centre ◽  
Group 2

Background: Today, the availability of regional anaesthesia for labour is considered a reflection of standard obstetric care. This study is to be conducted in a tertiary care centre with all facilities available for proposed end of proving that epidural analgesia is a safe and effective method for both parturient and the foetus in abolishing pain during labour.Methods: A total of 60 parturients were studied. they were randomly divided into two groups Group 1 includes 30 parturients. In this group parturient received epidural analgesia. The loading dose consisted of 10 ml of Bupivacaine 0.1% and Fentanyl 0.0002% (20 mcg). The top up doses were 10 ml of 0.1% Bupivacaine and Fentanyl 0.0002%, administered whenever the parturient complained of pain. When parturients enters into second stage a further 12-15 ml was injected with parturient in sitting position or semi-sitting position. Group 2 - (control group) Includes 30 parturients. In this group parturient was monitored without any analgesia.Results: This prospective study was done to assess the effect of epidural analgesia on the progress of labour and its outcome, to evaluate its efficacy as an analgesic technique and to study the maternal and fetal outcome. The total number of 60 parturients were selected and randomly categorized into two groups. CASE-Those who received epidural analgesia, CONTROL-Those who did not receive any analgesia.Conclusions: Epidural analgesia provides a versatile method of administering effective and satisfactory pain relief to parturient women. The technique should not be considered as a single entity, because the type and the dose of epidural medication can be altered as needed.

scholarly journals A Comparative Study of the Effect of Sutureless Versus Multiple Sutures Technique on Complications following Third Molar Surgery in Nepalese Subpopulation

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Arun Kr. Mahat ◽  
Ram Yadav ◽  
Anjani Kr. Yadav ◽  
Pradeep Acharya ◽  
Ashok Dongol ◽  
...  
Keyword(s):  
Rating Scale ◽  
Numerical Rating Scale ◽  
Third Molar ◽  
Third Molar Surgery ◽  
Surgical Removal ◽  
Sutureless Technique ◽  
Lateral Canthus ◽  
Duration Of Surgery ◽  
Group 2 ◽  
Group 1

Objective. To compare the effect of sutureless versus multiple sutures technique on postoperative variables such as pain, swelling, and trismus after surgical removal of the third molar in Nepalese subpopulation. Materials and Methods. Forty-eight patients were equally grouped into multiple sutures (group 1) and sutureless (group 2) groups using a computer-generated random table. The same operator performed all the surgical procedures. Postoperative variables such as pain, swelling, and trismus were measured by a single concealed observer using a 10 cm Numerical Rating Scale (NRS), flexible plastic measuring tape, and vernier caliper preoperatively and on 1st, 2nd, and 7th postoperative days. Results. This study showed significantly more swelling measured from the gonion to lateral canthus in group 1 than in group 2 on all postoperative periods (P<0.05). The mean NRS score was significantly higher in group 1 on the 1st postoperative day (P=0.01). Though mean duration of surgery, swelling as measured from tragus to commissure, trismus, NRS score except on the 1st postoperative day, total number of analgesics consumed, and complications were noted more in the multiple sutures group, the difference was not statistically significant. Conclusion. Our results support the use of sutureless technique after third molar surgery to minimize postoperative morbidity and the overall operative time and reduce the cost within the Nepalese subpopulation.

scholarly journals Comparative study of maternal and fetal outcome in patients with Vaginal Birth after caesarean section and elective repeat caesarean section

2020 ◽  
Vol 11 (4) ◽  
pp. 5473-5480
Author(s):  
Poonam Kalburgi ◽  
Sanjaykumar Patil
Keyword(s):  
Caesarean Section ◽  
Prospective Observational Study ◽  
Institutional Delivery ◽  
Mode Of Delivery ◽  
Fetal Monitoring ◽  
Fetal Outcome ◽  
Vaginal Birth ◽  
Group 2 ◽  
Vaginal Birth After Caesarean ◽  
Group 1

Women after delivering her first baby by section have a choice about mode of delivery for her second baby. The study was planned to compare maternal and perinatal outcome between VBAC and repeat elective LSCS in patients with prior one LSCS and their complications. A prospective observational study was carried out in department of obstetrics and . Total 180 cases of previous LSCS who were eligible for vaginal delivery were recruited 90 in each group as per consent given by them. Group 1: Vaginal Birth after section Group 2: elective repeat section. It was observed that majority of the patients group 1(51.1%) and group 2 (47.8%) were in age group of 25 to 30 years. More than 25kg/m2 BMI was found in 18(20%) cases of VBAC group and 30(33.3%) cases of LSCS group pregnancy interval was significantly lower in LSCS group compared to VBAC group. Mean birth weight was 2.832 kg to 2.917kg in both group. with improved maternal care, close fetal monitoring and institutional delivery for a previous one section, VBAC is considered safer than repeat elective section in carefully selected patient.

scholarly journals Labour with low dose epidural analgesia: maternal perception and fetal outcome

2018 ◽  
Vol 7 (2) ◽  
pp. 689 ◽  
Author(s):  
Vasudha Sawant ◽  
Archana Kumbhar
Keyword(s):  
Epidural Analgesia ◽  
Apgar Score ◽  
Low Dose ◽  
Mode Of Delivery ◽  
Fetal Outcome ◽  
Natural Phenomenon ◽  
Second Stage ◽  
Second Stage Of Labour ◽  
Significant Difference ◽  
Vertex Presentation

Background: Experiencing labour pains and giving birth to infant is normal physiological process. Though it is a natural phenomenon, it produces severe pain which requires analgesia to relieve pain during labour. The objective of this study was to compare effects of low dose epidural analgesia verses no analgesia during labour on mother and fetus.Methods: Here in this study we have assessed effect of epidural analgesia on mother and fetus. Total we have taken 60 women in age group of 20-26 years with full term pregnancy (37-42 weeks). Those who have entered spontaneous labour with vertex presentation, without any previous uterine surgery, clinically adequate pelvis. We had divided these women in 2 groups, 30 were given epidural analgesia and 30 without any analgesia. Variables recorded were pain score during labour using VAS, duration of labour during each stage, mode of delivery, Apgar score of newborn at 1 minute and 5 minutes.Results: Present study shows that duration of first stage of labour in epidural and non-analgesia group are same. Second stage of labour is prolonged in epidural group than non-analgesia group. Both groups had normal APGAR score. Epidural analgesia is not associated with any change in mode of delivery. Visual analogue scale is good with epidural analgesia.Conclusions: There was no significant difference in first stage of labour in both group. Second stage of labour was slightly prolonged in EA group than control, but it was less than two hours. No harmful neonatal outcome in epidural analgesia.

scholarly journals Comparative study of efficacy of drotaverine hydrochloride and valethamate bromide with control in first stage of labour

2013 ◽  
Vol 11 (1) ◽  
pp. 38-42 ◽  
Author(s):  
P Dahal ◽  
B Banerjee ◽  
DK Uprety ◽  
BP Das ◽  
A Thakur ◽  
...  
Keyword(s):  
Side Effects ◽  
Mode Of Delivery ◽  
Active Phase ◽  
Fetal Outcome ◽  
Control Group ◽  
P Value ◽  
Drotaverine Hydrochloride ◽  
Group 2 ◽  
And Control ◽  
Group 1

Background: Labour is the most perilous journey a woman has to undertake. Painless and short labour is desired by every woman and is a constant aim for obstetrician.Objective: To analyze and compare the efficacy and safety of drotaverine and valethamate with control group on improving cervical dilatation and promoting progress of labour. Method: Three hundred demographically similar women, both primigravida and multigravida with a term pregnancy in established labour were randomly divided into three groups. One hundred women (group 1) were given injection valethamate intramuscularly,100 women (group 2) were given drotaverine and the rest 100 (group 3) were not given any drug. Comparative analysis was carried out as regards to duration of first stage of labour, mode of delivery, maternal side effects and fetal outcome. Results: The mean duration of active phase of labour in group 1, 2 and 3 was 254.29±96.621 min, 178.31±73.412 min and 346.31±123.351 min respectively. The duration of injection to end of first stage of labour in valethamate and Drotaverine group was 228.12±84.626min and 168.89±69.576min respectively (p value<0.0001). The duration of injection to delivery in Valethamate was 249.13± 88.321 min and in Drotaverine was 192.56±75.479min (p value<0.0001). There were no serious maternal and fetal adverse effects in any group but minor side effects were more common in valethamate group. Conclusion: The reduction of the duration of the first stage of labour was apparently more in drotaverine group as compared to valethamate and control group. Drotaverine was found to be safe with minimal or no adverse effect on the mother and the fetus. Health Renaissance, January-April 2013; Vol. 11 No.1; 38-42 DOI: http://dx.doi.org/10.3126/hren.v11i1.7600

scholarly journals LABOUR ANALGESIA BY NEUROAXIAL BLOCKADE TECHNIQUE AND ITS LABOUR OUTCOME

2021 ◽  
pp. 10-13
Author(s):  
R.Shanthi Malar ◽  
V. Vijayalakshmi ◽  
P. Thenmozhi
Keyword(s):  
Epidural Analgesia ◽  
Apgar Score ◽  
Mode Of Delivery ◽  
Fold Increase ◽  
Study Groups ◽  
Labour Analgesia ◽  
Control Group ◽  
Second Stage ◽  
Second Stage Of Labour ◽  
Significant Difference

BACKGROUND:Pain relief during labour is an important component of modern obstetric care and can be produced by neuraxial, systemic or inhalational analgesia. Recent meta-analyses have supported epidural analgesia as the most efficacious technique.A good labour analgesia should aim at good pain relief during delivery process,at the same time not causing foetal acidosis,ensures safe for both mother and the baby. AIM OF THE STUDY:To study the influence of epidural analgesia on maternal and neonatal outcome MATERIALS AND METHODS:The study was conducted in the depar tment of Obstet r ics and Gynecology,GOVT.Stanley Medical College,Govt.RSRM LYING IN HOSPITAL,CHENNAI over a period of eight months from July 2019 to February 2021. The study was performed in 120 selected subjects. The study subjects were divided based on intervention – labour analgesia into 2 study groups. In this study,change in vital parameters,fetal heart rate,assessment of pain score,Duration of first and second stage of labour,mode of delivery,APGAR score and the need for NICU admission were noted and recorded.Any complications during the course of labour were also recorded. RESULTS:In this study,there was no significant difference in the mean duration of first and second stage of labour in both the study and control groups.The mean Apgar score of babies at one minute was 7.02 and at 5 minutes was 8.07 in the labour analgesia group and showed no significance.Maternal satisfaction for the effect of epidural analgesia,60.00% of the patients of epidural analgesia, the incidence of satisfactory/very satisfactory experience was meaningfully and significantly more in labour analgesia group subjects compared to control group subjects by 30 % with a 2 fold increase. CONCLUSION: As per this study labour analgesia using neuroaxial blockade technique are more likely to encounter increasing maternal satisfaction and good quality labour pain reduction.

scholarly journals Comparison of anterior single- and standard two-portal techniques in arthroscopic Bankart repair

2021 ◽  
Vol 32 (2) ◽  
pp. 437-445
Author(s):  
Erdal Uzun ◽  
Fatih Doğar ◽  
Duran Topak ◽  
Ahmet Güney
Keyword(s):  
Functional Outcomes ◽  
Rating Scale ◽  
External Rotation ◽  
Bankart Repair ◽  
Sports Activity ◽  
Arthroscopic Bankart Repair ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Objectives: This study aims to compare the outcomes of patients undergoing a single anterior portal or a standard two-portal arthroscopic procedure for Bankart repair. Patients and methods: Between January 2015 and March 2018, a total of 71 consecutive patients (53 males and 18 females; mean age: 33.3±10.3 years; range, 17 to 56 years) who underwent arthroscopic Bankart repair with a minimum two-year follow-up period were included. The patients were divided into two groups according to the arthroscopic technique used: single anterior portal group (Group 1, n=32) and standard two-portal group (Group 2, n=39). Demographic and surgical characteristics of the patients were recorded. Pre- and postoperative clinical and functional outcomes were evaluated using the external rotation degree, as well as Visual Analog Scale (VAS), American Shoulder and Elbow Surgeons (ASES), University of California at Los Angeles (UCLA) Shoulder Rating Scale, Constant-Murley Score (CMS), Oxford Shoulder Instability Score (OSIS), and Rowe scores. The clinical and functional outcomes and revision rates were compared between the groups. Results: The mean follow-up was 32.0±7.4 months in Group 1 and 38.0±13.4 months in Group 2 (p=0.222). Good-to-excellent postoperative functional and clinical outcomes were achieved in both groups at the final follow-up, compared to baseline (p<0.001 for all). No significant difference was observed in the postoperative outcomes including daily sports activity, VAS, ASES, UCLA Shoulder Rating Scale, CMS, OSIS, and Rowe scores, and external rotation restriction degrees between the groups (p=0.270, p=0.190, p=0.313, p=0.248, p=0.125, p=0.203, p=0.318, p=0.083, respectively). The operative time in Group 1 was significantly lower than that in Group 2 (60.3±8.3 vs. 71.4±7.2, respectively; p=0.001). Four patients (5.6%) experienced recurrent dislocation with no significant difference between the groups (p=0.622). No significant complications occurred in the peri- or postoperative period. Fifty-eight (81.7%) patients returned to their preoperative sports activity level. The mean time to return to sports was 7.2±1.7 months. Conclusion: Good-to-excellent clinical and functional outcomes can be obtained after arthroscopic Bankart repair, regardless of the use of a single or two anterior working portals. However, the single-portal technique is associated with reduced the operative time, compared to two-portal technique.

scholarly journals A Comparative Study to Evaluate the Effect of Honey and Zinc Oxide Eugenol Dressing for the Treatment of Dry Socket: A Double-Blind Randomized Controlled Trial

2021 ◽  
Vol 12 (1) ◽  
pp. 6
Author(s):  
Zafar Ali Khan ◽  
Namdeo Prabhu ◽  
Naseer Ahmed ◽  
Abhishek Lal ◽  
Rakhi Issrani ◽  
...  
Keyword(s):  
Zinc Oxide ◽  
Rating Scale ◽  
Verbal Rating Scale ◽  
Dry Socket ◽  
Pain Scores ◽  
Zinc Oxide Eugenol ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Dry socket is a common postoperative complication secondary to any tooth extraction but is more commonly associated with mandibular third molars. Dry socket has been treated with various treatment modalities with different success rates. This study aimed to evaluate the effect of using honey and zinc oxide eugenol as an intra-socket medicament for the treatment of dry sockets. Ninety patients were divided into three groups as follows: Group 1 “honey”: 30 patients; Group 2 “zinc oxide eugenol”: 30 patients; and Group 3 “control”: 30 patients. Pre-medication and post-medication pain scores at different time intervals were measured on a verbal rating scale. The mean ages of the patients in each of the groups were as follows: Group 1: 44.26 ± 14.14; Group 2: 45.30 ± 18.08; and Group 3: 51.93 ± 9.75. As regards verbal rating scale pain scores, a significant difference was noted in patients that belonged to Groups 1 and 2, with an immediate reduction in post-medication pain scores. However, patients belonging to Group 3 reported pain and discomfort for over a week. The use of honey and zinc oxide eugenol resulted in significant immediate post-medication pain scores in patients as compared to the control group. Therefore, both honey and zinc oxide eugenol can be used as treatment options for dry socket patients.

scholarly journals Comparative study of mifepristone versus balloon catheter for cervical ripening and induction of labour in previous caesarean section

2020 ◽  
Vol 9 (6) ◽  
pp. 2504
Author(s):  
Krishna Dahiya ◽  
Nisha Yadav ◽  
Pushpa Dahiya ◽  
Isha Nandal
Keyword(s):  
Caesarean Section ◽  
Mode Of Delivery ◽  
Balloon Catheter ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Bishop Score ◽  
Catheter Group ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Background: The objective of this present study was to compare the efficacy of oral mifepristone and balloon catheter for cervical ripening and induction of labour in women with previous caesarean section.Methods: This prospective study was conducted on 130 pregnant women with previous 1 caesarean section and term singleton pregnancy admitted for induction of labour. Sixty-five patients were induced with oral mifepristone (Group 1) and in another 65 transcervical balloon catheter (Group 2) was inserted for induction of labour. Both groups were than compared with respect to change in bishop score, induction to active phase interval, induction to delivery interval, dose of oxytocin in milliunits, mode of delivery, maternal complication and fetal outcomes.Results: Change in bishop score after induction was more in mifepristone group than balloon catheter group (p=0.002). Favorable bishop score was more in Group 1 (83.07%) than Group 2 (66%), p=0.05. There was significant difference in mode of delivery between two groups, 61.53% in Group 1, and 32.3% in Group 2 delivered vaginally (p<0.001).Conclusions: Present study showed that mifepristone is an alternative to balloon catheter for induction of labour in women with previous one caesarean section with poor bishop score.

scholarly journals Itching Caused by TRPV3 (Transient Receptor Potential Vanilloid-3) Activator Application to Skin of Burn Patients

Medicina ◽  
2020 ◽  
Vol 56 (11) ◽  
pp. 560
Author(s):  
Hye One Kim ◽  
Kim Jin Cheol ◽  
Kong Yu Gyeong ◽  
Kwak In Suk
Keyword(s):  
Transient Receptor Potential ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Hospital Setting ◽  
Transient Receptor Potential Vanilloid ◽  
Investigational Drug ◽  
Burn Patients ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Background and objectives: Postburn pruritus is a common complication of scars in burn patients. In our previous study, we discovered increased expression of TRPV3, TRPV4, and TRPA1. Among them, TRPV3, in particular, is predominantly expressed in the epidermis of the tissue of pruritic burn scars. We sought to evaluate the correlation between the expression of TRPV3 activators and itching after application of TRPV3 activator carvacrol over burn scars. Materials and Methods: Design: This was a double-blind clinical trial with non-randomized distribution. Setting: This study was performed in a hospital setting. Patients or participants: Patients with itching of burn scars (numerical rating scale (NRS), <3; n = 8; Group 1 and NRS, ≥3; n = 16, Group 2) and healthy volunteers (n = 18, Group 3) were included. Interventions: The investigational drug carvacrol (100%, 75%, and 50%) and control drug (10% ethanol) were applied over the scars using IQ Ultimate™ 1 × 1 cm chamber sheets. Main variables of interest: The presence of pruritus, erythema, edema, and other skin lesions was evaluated. The verbal NRS scores were also compared. Results: Carvacrol induced more itching in Group 2 than in Groups 1 and 3. In Group 2, 100%, 75%, and 50% carvacrol caused significantly more itching (NRS score, 5.18 ± 3.04, 5.18 ± 3.04, and 4.93 ± 2.96, respectively) than that in Group 1 (NRS score, 1.00 ± 1.80, 1.00 ± 1.80, and 1.00 ± 1.80, respectively) and Group 3 (NRS score, 2.38 ± 1.94, 1.27 ± 1.32, respectively). Conclusions: The TRPV3 activator carvacrol can cause itching if applied over burn scars. This study can help understand the mechanism and prognosis of post-burn itching and contribute to the development of its treatment.

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