Effect of dexamethasone with granisetron or ondansetron for prevention of post-operative nausea vomiting in patients undergoing laparoscopic gynaecological surgery

Background: Post-operative nausea and vomiting (PONV) is generally self-limiting, associated with high level of patient dissatisfaction and may delay hospital discharge. The anaesthetist is usually blamed, despite evidence that PONV results from a variety of factors and variety of antiemetic drug available in market. With this issue we aim to compare the effectiveness of dexamethasone with granisetron or ondansetron in patients undergoing laparoscopic gynaecological surgery.Methods: 120 patients were registered in this prospective, randomized double blind study. Group I (n=60) received ondansetron 4 mg intravenously (IV)+dexamethasone 8mg I/V or II (n=60) received granisetron 1 mg IV+dexamethasone 8 mg I/V prior to anaesthesia. Post-operative data of PONV was recorded at pre-defined intervals.Results: The majority of the patients were of the age group 20-25 years (55.83%). The mean score of Group I subjects was 0.30±0.72 and that of Group II was 0.20±0.57 (p=0.43). There are 3.33% of patients in group-I having vomiting episodes, and 1.67% of patients in group-II having vomiting episodes, none of the patients developed 2nd episodes of vomiting in either group. Thus it appears that dexamethasone in combination with ondansetron and granisetron is effective in decreasing the number of episodes of PONV. The occurrence of sickness episodes within 24 hours of surgery revealed no significant different in both groups. Haemodynamic variables showed no significant difference recorded in postoperative care unit between the study groups. The most common complaint was headache 16.67% in both groups. Conclusions: Dexamethasone 8 mg with either granisetron 1 mg or ondansetron 4 mg showed no significant difference in antiemetic efficacy with minimal side effects and excellent patient satisfaction.

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Pretreatment with Magnesium Sulfate to Alleviate Pain on Propofol Injection: A Prospective Randomized Double Blind Study

Mediscope ◽

10.3329/mediscope.v6i2.43156 ◽

2019 ◽

Vol 6 (2) ◽

pp. 73-77

Author(s):

Muhammad Sazzad Hossain ◽

Md Mamunur Rashid ◽

Mohammad Mamunur Rashid ◽

Md Anisur Rahman Babu ◽

Afsana Sultana ◽

...

Keyword(s):

Magnesium Sulfate ◽

Statistical Tests ◽

Saline Group ◽

Sulfate Group ◽

Double Blind Study ◽

Double Blind ◽

Group I ◽

Significant Difference ◽

Elective Surgical Procedure ◽

Group Ii

Background and aim of study: Propofol is one of the most frequently used medications for inducing and maintaining anesthesia. However, propofol injection causes pain and discomfort in more than 70% of patients. This study was performed to determine the effect of magnesium sulfate on reducing pain at the onset of anesthesia induced by propofol injection. Materials and methods: A total of 80 healthy adult patients were selected in this study with either sex, scheduled for routine elective surgical procedure under general anesthesia. The patients enrolled were divided randomly into two groups of 40 patients each. Group I received 30 mg/kg of intravenous magnesium sulfate in 5 ml. Group II (placebo group) received 5ml of 0.9% intravenous normal saline 1 minute before propofol injection. The patients were asked to report their pain during injection of propofol. For all statistical tests, p<0.05 was taken to indicate a significant difference. Results: The incidence of pain experienced in magnesium sulfate group was 30% patients and in saline group was 60% patients, which is statistically significant p<0.05. The severity of POPI was also lower in magnesium sulfate group than the saline group (p<0.05). The incidence of mild and moderate pain in groups I versus group II was 22.5% versus 37.5% and 7.5% versus 22.5% respectively p<0.05. There was no severe pain recorded in any groups. Conclusion: Magnesium sulfate can be used before induction of anesthesia to reduce pain on propofol injection. Mediscope Vol. 6, No. 2: Jul 2019, Page 73-77

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Oral midazolam versus oral triclofos for sedation of children for computed tomography scan - a randomized clinical trial

Journal of Society of Anesthesiologists of Nepal ◽

10.3126/jsan.v2i2.13528 ◽

2015 ◽

Vol 2 (2) ◽

pp. 41-45

Author(s):

Anushu Gupta ◽

Maitree Pandey ◽

Lalita Choudhry ◽

Aruna Jain ◽

Harish Pemde

Keyword(s):

Computed Tomography ◽

Double Blind Study ◽

Computed Tomography Scan ◽

Double Blind ◽

Comparable Rate ◽

Group I ◽

Oral Midazolam ◽

Group Ii ◽

Student’S T ◽

Tomography Scan

Background: Effective and safe pediatric procedural sedation is still a concern especially in areas outside operation theatres. The aim of the study was to compare the efficacy and safety of oral triclofos and oral midazolam in children undergoing computed tomography.Methods: A prospective randomized double blind study was conducted in 100 children aged one to five years. Group-I (n=50) received oral triclofos 100 mg/kg and Group-II (n=50) oral midazolam 0.75 mg/kg. Both groups were given oral atropine 0.03 mg/kg and supplemented with intravenous midazolam upto 0.1 mg/kg in case of inadequate effect. Onset and duration of sedation, success for completion of procedure and time to recovery were noted. Student’s t test and Z test of proportions were used for statistical analysis.Results Majority of children 36(72%) in Group-I achieved Ramsay Sedation Score >4 as compared to 25(50%) in Group-II. Computed tomography scan could be successfully completed at comparable rate (52% vs 56%). Success rate improved to 96% vs 80% after supplementing intravenous midazolam in Group I & II respectively (p< 0.05). Onset (37.91minutes ± 7.96 vs 26 ± 10), duration of sedation ( 117.91minutes ± 72.41 vs 66.2minutes ± 33) were significantly shorter and recovery (98.19minutes ± 72.58 vs 47.4minutes ± 31.42) in Group I & II respectively was faster in children who received oral midazolam (p< 0.05).Conclusion We conclude that both drugs were equally effective and safe for computed tomography scan in children. However better recovery profile of midazolam makes it more suitable for day care procedures.Journal of Society of Anesthesiologists of Nepal 2015; 2(2): 41-45

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PREVENTION OF SHIVERING DURING LOWER SEGMENT CESAREAN SECTION;

The Professional Medical Journal ◽

10.29309/tpmj/2013.20.03.648 ◽

2013 ◽

Vol 20 (03) ◽

pp. 409-415

Author(s):

ASHFAQ AHMED ◽

MOHAMMAD ASLAM

Keyword(s):

Cesarean Section ◽

Spinal Anesthesia ◽

Carbon Dioxide Production ◽

Double Blind Study ◽

Lower Segment ◽

Chi Square ◽

Double Blind ◽

Lower Segment Cesarean Section ◽

Group I ◽

Group Ii

Objectives: To compare the efficacy of low-dose prophylactic use of ketamine with ketamine plus midazolam for theprevention of shivering caused by spinal anesthesia, during lower segment cesarean section. Main Outcome Measures: Heamodynamicmonitoring, avoidance of lactic acidosis/ increased carbon dioxide production and patient satisfaction. Design: Prospective RandomizedControlled trial. Place: Department of Anesthesia and ICU PNS Shifa Karachi. Duration of study: March 2010 to June 2010. Patients andMethods: 100 ASA-I & II consecutive patients who reported for LSCS in PNS Shifa Hospital were studied. In this double-blind study,patients were randomly allocated to receive ketamine alone (Group I, n= 50), and ketamine plus midazolam (Group II, n = 50). Afterstandardized Spinal anesthesia, a shivering was recorded at 5 min intervals for 15 minutes. Results: Shivering was observed in 9/50(18%) patients of group I (Ketamine only) as compared to only 2/50 (4%) patients in Group II (ketamine + midazolam) (p=0.025) whichis statically significant. The two groups were comparable regarding distribution of age (p=0.37), BMI (p=0.27) and duration of surgery.Results were analyzed by using chi square test. Conclusions: The efficacy of i.v. ketamine plus midazolam is better as compared to lowdosei.v. ketamine alone in preventing shivering in lower segment Cesarean Section patients, during spinal anesthesia.

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Managing irritable bowel syndrome: The impact of micro-physiotherapy

Journal of Complementary and Integrative Medicine ◽

10.1515/jcim-2015-0044 ◽

2017 ◽

Vol 14 (2) ◽

Cited By ~ 1

Author(s):

Daniel Grosjean ◽

Patrice Benini ◽

Pierre Carayon

Keyword(s):

Irritable Bowel Syndrome ◽

Holistic Approach ◽

Study Groups ◽

Control Group ◽

Double Blind Study ◽

Self Healing ◽

Double Blind ◽

Significant Difference ◽

Irritable Bowel ◽

The Impact

AbstractBackgroundIrritable bowel syndrome (IBS) has a complex pathology, high prevalence and large impact on patients’ quality of life. As conventional therapy may yield unsatisfactory results, a more holistic approach may be desirable. The current study assessed the effect of micro-physiotherapy on the severity of IBS symptoms.MethodsIn a double-blind study, 61 recurrent IBS patients were randomised to two sessions of micro-physiotherapy or sham micro-physiotherapy. Inclusion criteria were the presence of ≥1 IBS symptom from abdominal pain, constipation, diarrhoea or bloating. Exclusion criteria were previous major intestinal surgery and the presence of chronic diseases. The mean patient age was 53.5±15.3 years. Micro-physiotherapy consisted of micro-palpatory examination to identify osteopathic lesions, followed by micro-massage to stimulate self-healing. The control group underwent a sham procedure. The presence and severity of symptoms was assessed at baseline and at 1-month follow-up by the same gastroenterologist.ResultsTwo patients did not complete the study. There was a significant difference in percentage of patients that improved after the first session, at 74 % for the micro-physiotherapy group and 38 % for the sham group, respectively (p=0.005). After the second session, the initial improvement was maintained in both groups, although with no further gains, and the differences between the study groups remained significant (p=0.007).ConclusionsMicro-physiotherapy significantly improves IBS symptoms and should be explored further for use in mainstream healthcare.

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Effects of intrapolyp steroid injection on intraocular pressure and recurrent polyp treatment

Eye ◽

10.1038/s41433-021-01719-3 ◽

2021 ◽

Author(s):

Tae-Hoon Lee ◽

Jung-Gwon Nam ◽

Chang Kyu Lee

Keyword(s):

Intraocular Pressure ◽

Endoscopic Sinus Surgery ◽

Sinus Surgery ◽

Controlled Study ◽

Polyp Size ◽

Double Blind ◽

Injection Group ◽

Group I ◽

Significant Difference ◽

Group Ii

Abstract Purpose To examine the effects of intrapolyp triamcinolone acetonide (TA) injections on intraocular pressure (IOP) and recurrence of nasal polyps after endoscopic sinus surgery. Patients and methods This was a prospective, randomized, double-blind, placebo-controlled study. Patients were randomized into either the TA injection group (Group I, 20 mg/ml, 2 mL) or the placebo normal saline injection group (group II, 2 mL). There were a total of five study visits: one baseline visit and one at 2, 4, 8, and 12 w after the injection. The primary safe outcome was the change in IOP between two groups at 4 w. The secondary safe outcome was the IOP at each visit and proportion of patients having IOP above 21 mmHg at 4 and 8 w. Changes in the nasal polyp size were measured between two groups at each visit. Results A total of 43 consenting participants completed this study (22 in group I and 21 in group II). The mean IOP elevation in both eyes was not significantly different between the groups (p > 0.05) and was not over 2 mmHg at the 4-w mark. There was also no significant difference in the proportion of patients having IOP above 21 mmHg at 4 and 8 w between the groups (p > 0.05). However, there was a significant difference in the change in polyp size until 8 w between both groups (p < 0.01). Conclusions Intrapolyp TA injection is a safe and effective method for the management of recurrent polyps after endoscopic sinus surgery.

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Comparison of intraperitoneal instillation of ropivacaine with normal saline in laparoscopic cholecystectomy

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20174946 ◽

2017 ◽

Vol 5 (11) ◽

pp. 4924 ◽

Cited By ~ 1

Author(s):

Tripat Kaur Bindra ◽

Davinder Chawla ◽

Parmod Kumar ◽

. Parul

Keyword(s):

Laparoscopic Cholecystectomy ◽

Side Effects ◽

Double Blind Study ◽

Analgesic Requirement ◽

Double Blind ◽

Analgesic Consumption ◽

Vas Score ◽

Group I ◽

Intraperitoneal Instillation ◽

Group Ii

Background: Local anesthetics are now widely used, as they have a good safety profile and are available in long acting preparation. They provide the benefit of analgesia without systemic side effects that may result from use of enterally and parenterally administered drugs.Methods: This prospective randomized double-blind study was conducted on 100 patients with symptomatic gall stones disease undergoing laparoscopic cholecystectomy. Patients were randomized to receive either 0.5% of 3mg/kg of Ropivacaine diluted in 100 ml NS, instillation at intraperitoneal space before creation of pneumoperitoneum (group I) or 100 ml NS instillation at intra peritoneal space before creation of pneumoperitoneum (group II). VAS score for pain abdomen as well as shoulder were recorded postoperatively at various time intervals and compared in both the groups. Total analgesic consumption in 24hrs was also noted and compared.Results: The mean postoperative VAS score for abdomen and shoulder pain was significantly (p values<0.05) lower in group I than in group II till 24 hrs postoperatively. The latency time from end of operation to first analgesic requirement was significantly longer in group I than in group II.Conclusions: Intraperitoneal instillation of Ropivacaine before the creation of pneumoperitoneum significantly decreased the total abdominal pain, shoulder tip pain with lower analgesic consumption. As it is safe and without apparent side effects, we believe that intraperitoneal instillation of local anaesthetic in patients undergoing elective laparoscopic cholecystectomy is an effective modality for postoperative pain management.

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Effect of Intravenous Lignocaine in Attenuating Dexamethasone Induced Perineal Pruritus During Induction of Anesthesia

KYAMC Journal ◽

10.3329/kyamcj.v9i4.40142 ◽

2019 ◽

Vol 9 (4) ◽

pp. 144-147

Author(s):

Muhammad Sazzad Hossain ◽

Md Afzalur Rahman ◽

Mohammad Mamunur Rashid ◽

Mohammad Ifta Khairul Hasan ◽

Muhammad Alamgir Mandal ◽

...

Keyword(s):

Placebo Group ◽

General Anesthesia ◽

Normal Saline ◽

Sodium Phosphate ◽

Demographic Data ◽

Double Blind Study ◽

Analog Scale ◽

Double Blind ◽

Group I ◽

Significant Difference

Background: Intravenous dexamethasone may produce perineal pruritus in some patients when administered as premedicant before induction of anesthesia. Objectives of study: This randomized, double-blind study was done to evaluate the efficacy of pretreatment of lignocaine on the incidence and severity of dexamethasone-induced perineal pruritus. Materials and methods: 100 patients were enrolled in this study and allocated randomly into two equal groups. Then, patients received intravenous medications in the following sequence before induction of anesthesia: in group I, injection lignocaine 1mg/kg diluted in 5 ml normal saline and in group II, 5 ml normal saline (placebo group), then one minute later, intravenous dexamethasone sodium phosphate 10 mg was given in all groups in 3 seconds and was observed the patient's response about perineal pruritus. The severity of perineal pruritus was graded based on the visual analog scale (VAS) as none (VAS 0), mild (VAS 1-3), moderate (VAS 4-6), or severe (VAS 7-10), and recorded the incidence and severity of perineal pruritus. Then general anesthesia was induced and continued as usual. Results: In terms of demographic data, the results of this study showed that there was no significant difference between patients in both groups (P>0.05). Overall incidence and severity of perineal pruritus in lignocaine group was significantly less, when compared with placebo group (P<0.05). Conclusion: It can be concluded that pretreatment with 1mg/kg intravenous lignocaine may effectively reduce the incidence and severity of dexamethasone induced perineal pruritus. KYAMC Journal Vol. 9, No.-4, January 2019, Page 144-147

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The effect of Reiki on blood hypertension

Acta Paulista de Enfermagem ◽

10.1590/1982-0194201400078 ◽

2014 ◽

Vol 27 (5) ◽

pp. 479-484 ◽

Cited By ~ 3

Author(s):

Léia Fortes Salles ◽

Luciana Vannucci ◽

Amanda Salles ◽

Maria Júlia Paes da Silva

Keyword(s):

Blood Pressure ◽

Repeated Measures ◽

Study Groups ◽

Control Group ◽

Double Blind Study ◽

Double Blind ◽

Anova Model ◽

Significant Difference ◽

Before And After ◽

Experimental Group

Objective Determining the immediate effect of Reiki on abnormal blood pressure. Methods An experimental, double-blind study, in which were included 66 hypertensive patients, randomized to the three following study groups: control, placebo and experimental. The intervention lasted 20 minutes, the control group remained at rest, the placebo group received an imitation of the studied technique (mock Reiki) and the experimental group received the Reiki technique. Blood pressure was measured before and after the intervention by the same person with the same instrument. Results There was a decrease in blood pressure in the three groups and the reduction was greater in the experimental group, followed by the placebo and the control group. The ANOVA model for repeated measures showed a statistically significant difference among the groups (p <0.0001). Conclusion Reiki had a positive effect on reducing abnormal blood pressure, suggesting to be a complementary technique for the control of hypertension.

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Silodosin versus Tamsulosin as Medical Expulsive Therapy for Children with Lower-Third Ureteric Stones: Prospective Randomized Placebo-Controlled Study

Urologia Internationalis ◽

10.1159/000513074 ◽

2021 ◽

pp. 1-6

Author(s):

Mohamed G. Soliman ◽

Osama El-Gamal ◽

Samir El-Gamal ◽

Ali Abdel Raheem ◽

Ahmed Abou-Ramadan ◽

...

Keyword(s):

Randomized Study ◽

Study Groups ◽

Controlled Study ◽

Expulsion Rate ◽

Medical Expulsive Therapy ◽

Group Iii ◽

Group I ◽

Younger Age ◽

Significant Difference ◽

Group Ii

Aim: To compare the efficacy and safety of silodosin versus tamsulosin as medical expulsive therapy for stones of lower-third ureter in children. Patients and Methods: This prospective single-blind placebo-controlled randomized study included 167 pediatric patients who presented with distal ureteric stone (DUS) less than 1 cm. Patients were randomized into 3 groups; group I received silodosin 4 mg once daily, and group II received tamsulosin 0.4 mg while those in group III had placebo. The side effects of the used drugs, both rate and time of stone expulsion, and number of pain episodes were compared among the study groups for a maximum of 4 weeks. Results: Follow-up data of our patients after treatment revealed that the stone expulsion rate was significantly higher and the time to stone expulsion was significantly shorter in group I (89.3%, 12.4 ± 2.3 days) and group II (74.5%, 16.2 ± 4.2 days) compared to group III (51.8%, 21.2 ± 5.6). However, a statistically significant difference between silodosin and tamsulosin groups in favor of the former one was reported regarding the 2 studied items. Meanwhile, pain episodes requiring analgesia were statistically fewer in group I and II in contrast to placebo group. Adverse events were comparable among all groups. Conclusion: Silodosin provides significantly better stone expulsion rate and shorter expulsion time than tamsulosin for treatment of DUS. Both medications showed good safety profiles in children. However, further studies are required on a larger scale to confirm our results. Assessment of drug safety on younger age-group is still needed.

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

Journal of Medical Science & Research ◽

10.47648/jmsr.2007.v0801.04 ◽

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.

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