scholarly journals A comparative study of granisetrone, dexamethasone and combination of granisetrone-dexamethasone as prophylaxis for postoperative nausea vomiting during laparoscopic surgeries

2019 ◽  
Vol 7 (4) ◽  
pp. 1200
Author(s):  
Deep Chilana ◽  
Bhawana Rastogi ◽  
Abhishake Kumar ◽  
Brig V.P. Singh ◽  
Richa Arora ◽  
...  
Keyword(s):  
Complete Response ◽  
Vagal Afferents ◽  
Combination Group ◽  
Double Blind Study ◽  
Physical Status ◽  
Double Blind ◽  
Group Iii ◽  
Group I ◽  
Induction Of Anaesthesia ◽  
Rescue Antiemetic

Background: In laparoscopic surgeries, insufflation with carbon dioxide triggers vagal afferents on the bowel and peritoneum which induces emesis by activating the vomiting center. It is hypothesized that combined antiemetics with different sites of activity would be more effective than one drug alone for the prophylaxis against PONV. So, the present study was planned to compare the efficacy of granisetron, dexamethasone and combination of granisetron with dexamethasone to prevent PONV.Methods: This randomized prospective double-blind study was performed on 120 patients, aged between 18 and 58 years of ASA physical status I and II of either sex undergoing laparoscopic surgeries under general anesthesia. Patients were randomized in three groups, group I (granisetrone 2 mg I.V.), group II (dexamethasone) 8 mg I.V., group III (granisetrone+dexamethasone) 2 mg+8 mg I.V. with 40 patients in each group. Complete response, incidence of nausea, vomiting, and rescue antiemetic were recorded at specified intervals.Results: A complete response (defined as no PONV and no need for another rescue antiemetic) was achieved in 75% of the patients given granisetron, 70% in dexamethasone and in 92.5% of the patients given granisetron plus dexamethasone (P <0.05). The overall cumulative incidences (0-24 hours) of PONV were 10 (25%) in the granisetron, 12 (30%) in the dexamethasone and 3 (7.5%) in the combination group. No difference in adverse events were observed in any of the groups.Conclusions: The prophylactic therapy of granisetron 2 mg plus dexamethasone 8 mg just before induction of anaesthesia is significantly effective in prevention of PONV in patients undergoing laparoscopic surgeries.

scholarly journals Comparison of Granisetron and Granisetron Plus Dexamethasone for the Prevention of Post-operative Nausea and Vomiting (PONV)

2007 ◽  
Vol 8 (Number 1) ◽  
pp. 21-27
Author(s):  
K S Islam ◽  
S M Bakhtiar ◽  
M A Mannan
Keyword(s):  
Postoperative Nausea And Vomiting ◽  
Complete Response ◽  
Nausea And Vomiting ◽  
Combination Group ◽  
Double Blind Study ◽  
Double Blind ◽  
Significant Difference ◽  
Group B ◽  
Post Operative Nausea ◽  
Induction Of Anaesthesia

77tere is a high incidence of postoperative nausea and vomiting (PONV) in patients undergoing surer, and anaesthesia. Many factors are claimed to be responsible for POW. This stad.v MU designed to compare the effectiveness of grornsetron pits desomethasone with gran isetron alone to prevent post-operative nausea and vomiting. In this randomised double blind study. sixty patients were divided into two egnal groups ( n=30 each ). Patients in Group A received granisetron 40 pion per kg before inductor of anaesthesia and those in Group B received gmnisetron 40 pp: per kg phis devamethasone 8 nog before induction of anaesthesia. All the patients were observed for post-opera tive nausea and vaniting for 24 hours (0-6 hours in the recovety room and 18 hours in ward or cabin). A significant difference was found in complete response, defined as no pos,opertalve nausea and vomiting. between patients of graniserron alone group and those of granisetron pins dexamethasone combination group. The combination of grontsoron plus de.tainethasone is considered to be more effective for prevention of post-operative nausea and vomiting.

scholarly journals Comparison of dexmedetomidine, midazolam, and propofol as an optimal sedative for upper gastrointestinal endoscopy: A randomized controlled trial

2014 ◽  
Vol 05 (02) ◽  
pp. 051-057 ◽  
Author(s):  
Sumanth Samson ◽  
Sagiev Koshy George ◽  
B. Vinoth ◽  
Mohd Saif Khan ◽  
Bridgitte Akila
Keyword(s):  
Gastrointestinal Endoscopy ◽  
Controlled Trial ◽  
Upper Gastrointestinal Endoscopy ◽  
Double Blind Study ◽  
Double Blind ◽  
Test Analysis ◽  
Group Iii ◽  
Group I ◽  
Midazolam Infusion ◽  
Upper Gastrointestinal

Abstract Context: Midazolam and propofol are effective sedatives for use in upper gastrointestinal endoscopy (UGIE); however, their utility is limited when used alone. In this regard, dexmedetomidine seems to be a promising sedative. Aims: The aim was to compare the hemodynamic effects and sedation efficacy of these drugs in patients undergoing elective diagnostic UGIE. Settings and Design: Randomized control double-blind study was conducted at a teaching hospital. Subjects and Methods: Patients belonging to ASA Grade I or II, undergoing diagnostic elective UGIE were enrolled in the study and randomized into three groups; Group I received midazolam infusion, Group II received propofol infusion and Group III received dexmedetomidine infusion. Hemodynamic parameters and adverse events were recorded during the procedure (intra-operative period [IOP]). Both patient and endoscopist satisfaction were rated on visual analog scale (0 = no pain/least difficulty to 10 = worst pain/maximum difficulty). Recovery was recorded as time to achieve modified Aldrete score of 10/10. Statistical Analysis: Parametric test analysis of variance was applied to compare the means of three groups of continuous data. Results: Ninety patients were analyzed. Mean arterial pressure was significantly lower in the propofol group at IOP2, IOP4, IOP8, and IOP10 compared with dexmedetomidine and midazolam group. The endoscopist satisfaction level was significantly higher in dexmedetomidine group as compared to propofol and midazolam (60%, 56.7%, 13.3%; P < 0.001). Significantly faster recovery was observed in dexmedetomidine group compared to midazolam and propofol group (7.7 ± 3.9, 18.3 ± 3.8, 12.7 ± 2.9 min; P = 0.001). Conclusions: Use of dexmedetomidine was associated with greater hemodynamic stability and faster recovery when compared to propofol and midazolam.

scholarly journals COMPARATIVE STUDY OF DIFFERENT DOSES OF DEXMEDETOMIDINE AS AN ADJUVANT TO INTRATHECAL HYPERBARIC BUPIVACAINE IN LOWER LIMB ORTHOPAEDIC SURGERIES

2021 ◽  
Vol 5 (8) ◽  
Author(s):  
Mukesh Choudhary ◽  
Neeti Mahla
Keyword(s):  
Lower Limb ◽  
Motor Block ◽  
Double Blind Study ◽  
Hyperbaric Bupivacaine ◽  
Analgesic Requirement ◽  
Double Blind ◽  
Group Iii ◽  
Group I ◽  
Dose Dependent ◽  
Different Doses

Background: This study is aimed to different doses of Dexmedetomidine as an adjuvant to Intrathecal hyperbaric bupivacaine in lower limb orthopaedic surgeries Methods: A prospective randomized double blind study was conducted with 90 consenting patients of ASA grade I and II, scheduled for lower limb Orthopaedic surgeries. Using the lottery method, the patients were randomly allotted into 3 groups, 30 patients in each group. Group I , Group II & Group III.  Results: Post-operative VAS and total analgesic requirement in 24 hours were minimal in group C as compare to B group. All the patients achieved Bromage scale 3 motor block and there was dose dependent prolongation of motor block in B and C groups. Conclusion: Supplementation of spinal Bupivacaine with Dexmedetomidine significantly prolonged both sensory and motor block compared with intrathecal Bupivacaine alone. Keywords: Bupivacaine, Dexmedetomidine, Motor block.

scholarly journals A comparative study for efficacy and safety of low doses of clonidine for hemodynamic stability in patients undergoing laparoscopic cholecystectomy

2019 ◽  
Vol 8 (9) ◽  
pp. 2102
Author(s):  
Ruchi Choudhary ◽  
Preeti Singh ◽  
Surabhi Gupta ◽  
P. P. Khosla ◽  
Prithpal S. Matreja ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Laparoscopic Cholecystectomy ◽  
Double Blind Study ◽  
Low Doses ◽  
Time Intervals ◽  
Hemodynamic Stability ◽  
Double Blind ◽  
Group Iii ◽  
Haemodynamic Stability ◽  
Group I

Background: This randomized prospective double-blind study was designed to evaluate the efficacy and side effects of low doses clonidine for perioperative haemodynamic stability and postoperative recovery.Methods: Patient’s with ASA grade I–II undergoing laparoscopic cholecystectomy were randomized into three groups of 30 patients each. All patients received either normal saline 10 ml (Group I) or 0.8 µg/kg (Group II) or 1 µg/kg (Group III) over duration of 180 seconds, 10 min prior to laryngoscopy and intubation. Anaesthesia was induced with 1% propofol (2 mg/kg) and maintained with nitrous oxide 60% in oxygen and isoflurane. The parameters assessed at various time intervals were heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure and sedation score.Results: Both doses of clonidine proved to be effective in perioperative haemodynamic stability. Clonidine 0.8 mcg/kg was as effectve and safer to Clonidine 1 mcg/kg for attenuatíon of the hemodynamíc responses to laparoscopy. There were no significant differences in the parameters of recovery between groups.Conclusions: Significant hemodynamic derangements can occur during laproscopic cholecystectomy at intubation, pneumoperitoneum and extubation. These were effectively attenuated by premedication with 0.8 mcg/kg and 1 mcg/kg of intravenous clonidine. Dose of 1 mcg/kg though found to be effective but produced adverse effects in form of hypotension and bradycardia.

The Quantitative Ultrastructure of the Heart Muscle of Japanese Quail by Hypergravitation, Hypodynamy and Combination

1990 ◽  
Vol 48 (3) ◽  
pp. 188-189
Author(s):  
Anton Bózner ◽  
Mikuláš Gažo ◽  
Jozef Dostál
Keyword(s):  
Japanese Quail ◽  
Heart Muscle ◽  
Relative Size ◽  
Combination Group ◽  
Control Group ◽  
Group V ◽  
Group Iii ◽  
Space Flights ◽  
Group I ◽  
Quantitative Ultrastructure

It is anticipated that Japanese quail /Coturnix coturnix japonica/ will provide animal proteins in long term space flights. Consequently this species of birds is of research interest of international space program INTERCOSMOS. In the year 1987 we reported on an experiment /2/ in which the effect of chronic acceleration of 2 G hypergravitation, the hypodynamy and the simultaneous effect of chronic acceleration and the location in the centre of the turntable of the centrifuge on the protein fractions in skeletal muscles was studied. The ultrastructure of the heart muscle was now in this experiments examined as well.Japanese quail cockerels, aged 48 days were exposed to 2 G hypergravitation /group IV/ in a 6,4 m diameter centrifuge, to hypodynamy /group III/ and their combination /group V/, respectively for 6 days / Fig.1/. The hypodynamy in group III was achieved by suspending the birds in jackets without contact the floor. The group II was located in the centre ofthe turntable of the centrifuge. The control group I. was kept under normal conditions. The quantitative ultrastructure of myocard was evaluated by the methods of Weibel/3/ - this enables to determine the number, relative size and volume of mitochondria volume of single mitochondria, defficiency of mitochondrial cristae and volume of myofibrils.

scholarly journals Comparative evaluation of Myolaxin and EM LA cream for attenuation of venous cannulation pain: A prospective, randomised, double blind study

2007 ◽  
Vol 35 (5) ◽  
pp. 726-729 ◽  
Author(s):  
A. Agarwal ◽  
G. Yadav ◽  
D. Gupta ◽  
M. Tandon ◽  
S. Dhiraaj ◽  
...  
Keyword(s):  
Eutectic Mixture ◽  
Similar Efficacy ◽  
Blind Study ◽  
Double Blind Study ◽  
Dominant Hand ◽  
Venous Cannulation ◽  
Double Blind ◽  
Suitable Alternative ◽  
Group I ◽  
Cannulation Site

We evaluated the efficacy of topical Myolaxin (capsaican ointment, Geno, Mumbai) ointment over EMLA (eutectic mixture of lignocaine, prilocaine; Neon, Goa) cream for attenuating venous cannulation pain in this prospective, randomised, double blind study. Sixty adult patients undergoing elective laparoscopic cholecystectomy were randomly assigned into two equal groups. Group I (EMLA) received EMLA cream, whereas Group II (Myolaxin) received Myolaxin ointment. For both groups the cream was applied at the venous cannulation site (dorsum of the non-dominant hand) one hour prior to venous cannulation and was covered with an occlusive dressing. Following venous cannulation patients were asked if they felt pain during venous cannulation. If the answer was yes, they were asked to rate the severity of venous cannulation pain using a Visual Analogue Scale (VAS) of O-10. The incidence of venous cannulation pain was similar between groups: in the EMLA group 65% (18/28) compared to 67% (20/30) in the Myolaxin group (P=0.19). The severity of pain (median VAS with inter quartile range) was also similar between the groups: in the EMLA group 1.5 (3) compared to 1.5 (2) in the Myolaxin group (P=0.46). As the topical application of Myolaxin ointment is cheaper than EMLA and has similar efficacy, it may be a suitable alternative for reducing the incidence and severity of venous cannulation pain.

scholarly journals A Comparison of the Efficacy of Ketorolac and Indomethacin for Postoperative Analgesia following Laparoscopic Surgery in Day Patients

1996 ◽  
Vol 24 (2) ◽  
pp. 237-240 ◽  
Author(s):  
G. C. Murrell ◽  
T. Leake ◽  
P. J. Hughes
Keyword(s):  
Case Reports ◽  
Double Blind Study ◽  
Random Allocation ◽  
Day Case ◽  
Double Blind ◽  
Group I ◽  
Rectal Suppository ◽  
Analgesic Supplement ◽  
Visual Analog Pain Score ◽  
Postoperative Renal Failure

The analgesia provided in the postoperative period by three regimens commonly used in our private anaesthetic practice were compared in a double-blind study of one hundred and thirty-seven women presenting for day-case laparoscopic procedures. After random allocation into three groups, all patients were similarly anaesthetized and then received both a rectal suppository and an IM injection. Group P received two placebos, Group I had an indomethacin suppository 100 mg, and Group K an IM injection of ketorolac 30 mg. The trial showed a statistically significant reduction in pain at 180 minutes postoperatively in the group receiving ketorolac (visual analog pain score of 13.8 v 21.7). The parenterally administered ketorolac may be a useful analgesic supplement in these patients. However the trial was aborted following the appearance in the literature of case reports of postoperative renal failure. Further investigation of the efficacy and side-effect profile of reduced doses may be warranted.

Studies On Coagulation Physiology In Perioperative Thromboembolism Prophylaxis In Surgery

1981 ◽  
Author(s):  
K Koppenhagen ◽  
A Häring ◽  
H Zühlke ◽  
A Wiechmann ◽  
M Matthes ◽  
...  
Keyword(s):  
Side Effects ◽  
Blood Coagulation ◽  
Low Dose ◽  
Combination Group ◽  
Double Blind Study ◽  
Thrombin Time ◽  
Thromboembolism Prophylaxis ◽  
Double Blind ◽  
Heparin Plasma ◽  
Low Dose Heparin

In a prospective and randomized double-blind study in 630 general surgery patients with different thromboembolism prophylaxis (130 patients with 5000 and 122 with 2500 I.U. of heparin, 128 with a fixed combination of 2500 I.U. of heparin and 0.5 mg dihydroergotamine ((2500-heparin-DHE)), 124 with 0.5 mg DHE and 126 with a placebo, 3 × daily) the influence of the medication on blood coagulation was examined by repeated pre-and post-operative determinations of blood-and coagulation parameters (activated partial thromboplastin time, heparin-plasma level, AT III, thromboplastin time, fibrinogen, thrombin time, thrombocyte aggregation test, β-thromboglobulin, Hb, erythrocytes, hematocrit, thrombocytes and differential blood picture). The frequency of postoperative thromboses and pulmonary embolisms was investigated by means of the radiofibrinogen test and lung scintigraphy. The results show that the lowest thromboembolism rate occurs in that patient collective in which there is in addition to the heparin application a simultaneous hemostatic effect of DHE. Side effects of the prophylaxis and influences on blood coagulation are dependent on the amount of heparin administered both in the single-drug low-dose treatment and in the combination therapy. The lowest rate of side effects was found in the group receiving 3×2500 I.U. of heparin and in the combination group 2500-heparin-DHE, but the combination treatment additionally affords the same thromboembolism protection as the routinely applied 3×5000 I.E. of low dose heparin.

Platelet Function Studies in Normal Volunteers and Patients with Angina Pectoris

1979 ◽  
Author(s):  
J.J.C. Jonker ◽  
den G.J.H. Ottolander
Keyword(s):  
Platelet Aggregation ◽  
Angina Pectoris ◽  
Platelet Function ◽  
Normal Range ◽  
Double Blind ◽  
Group Iii ◽  
Platelet Survival ◽  
Group I ◽  
Group Ii

In 30 normal subjects (group I) and in 89 patients with angina pectoris we studied: the platelet survival time (PST), the platelet aggregation test I (PAT I) acc. to Breddin, the platelet aggregation ratio (PAR) acc. to Wu and Hoak and the Filtragometer log TA acc. to Hornstra. The patients were divided in two groups: 46 patients had already been treated for 6 months with Clofibrate (group II) and 43 patients with placebo (group III) in a double blind trial. The average PST (T½) was within the normal range (group I 99 hrs. group II 105,7 hrs.; group III 102,0 hrs.). About 20% of patients of group II and III had abnormally shortened T½. The PAT I was on average abnormal in group II and III (PAT I in group II 2,3; group III 2,7), but group II normalized after 12 months treatment (PAT I 1,85). The PAR was abnormal in group III, while group II was within the normal range (group I 0,87; group II 0,82; group III 0,69). The log TA results were abnormal in group II and III (group I 2, 45, group II 2,1; group III 2, 1), after 12 months treatment the patient group remained abnormal (group II 2,2; group III 2,1). We failed to find a correlation between the four platelet function tests, nor with these tests and basic laboratory values. The PAT I, the PAR and the Filtragometer seems to be valuable in the detection of abnormal platelet behavior in vitro, but it does not mean than an abnormal platelet survival in vivo occurs in the same individuals.

scholarly journals Comparison of Ondansetron with Gabapentin for prevention of intrathecal morphine induced pruritus

2019 ◽  
Vol 2 (3) ◽  
pp. 142-148
Author(s):  
Rohini Sigdel ◽  
Anil Shrestha ◽  
Roshana Amatya
Keyword(s):  
Single Dose ◽  
Intrathecal Morphine ◽  
Double Blind Study ◽  
Physical Status ◽  
Hyperbaric Bupivacaine ◽  
Double Blind ◽  
Subarachnoid Block ◽  
Significant Difference ◽  
Group 2 ◽  
To Receive

Background: Ondansetron has been used successfully for prophylaxis and treatment of intrathecal morphine induced pruritus. Gabapentin has anxiolytic, antiemetic, antipruritic effects and has also been shown to potentiate the analgesic effect of intrathecally or epidurally administered opioids. Materials and method: We compared the effectiveness of oral gabapentin with intravenous ondansetron to prevent incidence of intrathecal morphine induced pruritus. In a prospective, double-blind study, sixty patients aged 18-65 years with ASA physical status I and II undergoing surgery under subarachnoid block were randomized to receive placebo tablets (ondansetron group) or gabapentin 1200 mg (gabapentin group) 2 hours before surgery. Patients receiving placebo tablets received 8 mg of intravenous ondansetron and those receiving gabapentin received 4 ml of intravenous normal saline just prior to subarachnoid block with 3 ml of 0.5% hyperbaric bupivacaine plus 0.2 mg morphine. The incidence, onset, severity, location of pruritus and incidence of side effects were studied for next 24 hours. Results: The overall incidence of pruritus was 48.3%. The incidence, severity, location of pruritus was comparable between the two groups. There was significant difference between the onset of pruritus between groups (p=0.009). The incidence and grade of nausea vomiting, requirement of intraoperative sedation was comparable between groups. The incidence of urinary retention was significantly high in gabapentin group (p=0.020). Respiratory depression was observed in one patient. Conclusion: A single dose of 1200 mg oral gabapentin 2 hours before, is as effective as prophylactic intravenous ondansetron 8 mg for prevention of intrathecal morphine induced pruritus.

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