scholarly journals A prospective randomized controlled trial to study the effect of preoperative and intraoperative magnesium over postoperative ileus and postoperative pain in major non–laparoscopic abdominal surgeries

2019 ◽  
Vol 6 (9) ◽  
pp. 3182
Author(s):  
A. R. Vishal Varma Bathina ◽  
Rama Krishna Peetani ◽  
Viswa Teja Vaitla
Keyword(s):  
Postoperative Pain ◽  
Total Dose ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
Controlled Study ◽  
Control Group ◽  
Anesthetic Care ◽  
Analgesic Consumption ◽  
Randomized Controlled ◽  
Numeric Rating

Background: The objective of the study were postoperative pain on 1st postoperative hour and 2, 4, 12, 24th postoperative hour as per numeric rating scale (NRS); total dose of postoperative analgesic consumption; postoperatively time of first appearance of bowed sounds; postoperatively time of first passage of flatus.Methods: A randomized controlled study will be performed. Patients of ASA 1 and 2, scheduled for major abdominal (GI) surgery, were divided into magnesium group and control group. Serum magnesium levels are estimated in both groups. Magnesium group receives 40 mg/kg of magnesium sulfate in 100 cc NS 30 minutes before the induction* as Intravenous drip, followed by 10 mg/kg/hr during the intraoperative hours. Control group receives the same volume of isotonic saline solution. Intra-operative hemodynamic parameters are evaluated constantly by recording pulse rate, blood pressure and Spo2. Further, post- operative analgesic will be ensured by epidural top-up using bupivacaine and tramadol when patients complaints of pain or when monitored with numeric rating scale (NRS). Postoperative patient pain is going to be evaluated in post-anesthetic care unit (PACU)/ SICU by numeral rating scale (NRS) during 1st hour, 2nd hour, 4th hour, 12th hour and 1 day, total dose of post-operative analgesic consumption will be recorded.Results: Of the 60 patients studied, 30 belong to magnesium group for which pre-operative and intraoperative intravenous magnesium (cases). Remaining 30 were given equal amounts of preoperative and intraoperative normal saline given (controls).Conclusions: The results of present study suggests that pre and intra operative. Magnesium as an adjunct to epidural analgesia reduces postoperative pain pre-operative and intra operative IV mg reduces post-operative ileus duration.

scholarly journals Postoperative Drip-Infusion of Remifentanil Reduces Postoperative Pain—A Retrospective Observative Study

2021 ◽  
Vol 18 (17) ◽  
pp. 9225
Author(s):  
Yi-Hsuan Huang ◽  
Meei-Shyuan Lee ◽  
Yao-Tsung Lin ◽  
Nian-Cih Huang ◽  
Jing Kao ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Adverse Effects ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
Intravenous Anesthesia ◽  
Anesthetic Care ◽  
Drip Infusion ◽  
Pain Scores ◽  
Unpleasant Experience ◽  
Numeric Rating

Development of remifentanil-induced hyperalgesia (RIH) postoperatively is an unpleasant experience that requires further treatment. This study assessed the effects of gradual withdrawal combined with drip infusion of remifentanil on postoperative pain and the requirement for rescue analgesics. A total of 559 patients receiving total intravenous anesthesia with propofol and remifentanil were enrolled. All patients either underwent gradual withdrawal of remifentanil (GWR) or gradual withdrawal combined with drip infusion (GWDR) with a dose of 1 mcg·kg−1 for 30 min after extubation. The numeric rating scale (NRS) and the requirement of rescue analgesics were assessed. The requirement for rescue analgesics was significantly lower in the GWDR group than in the GWR group (13.2% vs. 35.7%; p < 0.001). At the post-anesthetic care unit (PACU), patients in the GWDR group had a lower NRS pain score (p < 0.001). In addition, in the postoperative 2nd hour, patients in the GWDR group had a significantly lower NRS than the GWR group (beta, −0.31; p = 0.003). No remifentanil-related adverse effects were observed. We found that gradual withdrawal combined with drip infusion of remifentanil required less rescue analgesics and reduced pain scores. The new way of remifentanil administration may be effective to prevent RIH.

Comparison of Frenotomy Techniques for the Treatment of Ankyloglossia in Children: A Systematic Review

2020 ◽  
Vol 163 (3) ◽  
pp. 428-443
Author(s):  
Usman Khan ◽  
Jake MacPherson ◽  
Michael Bezuhly ◽  
Paul Hong
Keyword(s):  
Rating Scale ◽  
Pediatric Population ◽  
Meta Analysis ◽  
Numeric Rating Scale ◽  
Assessment Tools ◽  
Future Research ◽  
Randomized Controlled ◽  
Comprehensive Search ◽  
High Level ◽  
Numeric Rating

Objective To compare the effectiveness of conventional (CF), laser (LF), and Z-plasty (ZF) frenotomies for the treatment of ankyloglossia in the pediatric population. Data Sources A comprehensive search of PUBMED, EMBASE, and COCHRANE databases was performed. Review Methods Relevant articles were independently assessed by 2 reviewers according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Results Thirty-five articles assessing CF (27 articles), LF (4 articles), ZF (3 articles), and/or rhomboid plasty frenotomy (1 article) were included. A high level of outcome heterogeneity prevented pooling of data. All 7 randomized controlled trials (RCTs) were of low quality. Both CF (5 articles with 589 patients) and LF (2 articles with 78 patients) were independently shown to reduce maternal nipple pain on a visual analog or numeric rating scale. There were reports of improvement with breastfeeding outcomes as assessed on validated assessment tools for 88% (7/8) of CF articles (588 patients) and 2 LF articles (78 patients). ZF improved breastfeeding outcomes on subjective maternal reports (1 article with 18 infants) only. One RCT with a high risk of bias concluded greater speech articulation improvements with ZF compared to CF. Only minor adverse events were reported for all frenotomy techniques. Conclusions Current literature does not demonstrate a clear advantage for one frenotomy technique when managing children with ankyloglossia. Recommendations for future research are provided to overcome the methodological shortcomings in the literature. We conclude that all frenotomy techniques are safe and effective for treating symptomatic ankyloglossia.

Postoperative analgesia by adding acupuncture to conventional therapy, a non-randomized controlled trial

2018 ◽  
Vol 16 (2) ◽  
Author(s):  
Ilana Levy ◽  
Samuel Attias ◽  
Lior Cohen ◽  
Nadav Stoppelmann ◽  
Dan Steinberger ◽  
...  
Keyword(s):  
Side Effects ◽  
Postoperative Pain ◽  
Analgesic Effect ◽  
Pain Treatment ◽  
Standard Of Care ◽  
Acupuncture Group ◽  
Controlled Study ◽  
Control Group ◽  
Pain Level ◽  
Randomized Controlled

Abstract Background Postoperative pain is common in patients hospitalized in surgical departments, yet it is currently not sufficiently controlled by analgesics. Acupuncture, a complementary medical practice, has been evaluated for its benefits in postoperative pain with heterogeneous results. We tested the feasibility of a controlled study comparing the postoperative analgesic effect of acupuncture together with standard-of-care to standard-of-care only. Methods In this pilot non-randomized controlled study conducted at a tertiary medical center in Israel, patients received either acupuncture with standard-of-care pain treatment (acupuncture group) or standard-of-care treatment only (control group) following surgery. Visual Analogue Scale (VAS) ratings for pain level at rest and in motion were evaluated both at recruitment and two hours after treatment. Acupuncture-related side effects were reported as well. Results We recruited 425 patients; 336 were assigned to the acupuncture group and 89 to the control group. The acupuncture group exhibited a decrease of at least 40% in average level of pain both at rest (1.8±2.4, p<0.0001) and in motion (2.1±2.8, p<0.0001) following acupuncture, whereas the control group exhibited no significant decrease (p=0.92 at rest, p=0.98 in motion). Acupuncture's analgesic effect was even more prominent in reducing moderate to severe pain at baseline (VAS ≥4), with a decrease of 49% and 45% of pain level at rest and in motion respectively (p<0.001), compared with no significant amelioration in the control group (p=0.20 at rest, p=0.12 in motion). No major side effects were reported. Conclusion Integrating acupuncture with standard care may improve pain control in the postoperative setting.

scholarly journals Perioperative pregabalin for reducing pain, analgesic consumption, and anxiety and enhancing sleep quality in elective neurosurgical patients: a prospective, randomized, double-blind, and controlled clinical study

2016 ◽  
Vol 125 (6) ◽  
pp. 1513-1522 ◽  
Author(s):  
Nir Shimony ◽  
Uri Amit ◽  
Bella Minz ◽  
Rachel Grossman ◽  
Marc A. Dany ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Sleep Quality ◽  
Rating Scale ◽  
Preoperative Anxiety ◽  
Controlled Study ◽  
Double Blind ◽  
Analgesic Consumption ◽  
Pain Scores ◽  
Neurosurgical Patients ◽  
Duration Of Surgery

OBJECTIVE The aim of this study was to assess in-hospital (immediate) postoperative pain scores and analgesic consumption (primary goals) and preoperative anxiety and sleep quality (secondary goals) in patients who underwent craniotomy and were treated with pregabalin (PGL). Whenever possible, out-of-hospital pain scores and analgesics usage data were obtained as well. METHODS This prospective, randomized, double-blind and controlled study was conducted in consenting patients who underwent elective craniotomy for brain tumor resection at Tel Aviv Medical Center between 2012 and 2014. Patients received either 150 mg PGL (n = 50) or 500 mg starch (placebo; n = 50) on the evening before surgery, 1.5 hours before surgery, and twice daily for 72 hours following surgery. All patients spent the night before surgery in the hospital, and no other premedication was administered. Opioids and nonsteroidal antiinflammatory drugs were used for pain, which was self-rated by means of a numerical rating scale (score range 0–10). RESULTS Eighty-eight patients completed the study. Data on the American Society of Anesthesiologists class, age, body weight, duration of surgery, and intraoperative drugs were similar for both groups. The pain scores during postoperative Days 0 to 2 were significantly lower in the PGL group than in the placebo group (p < 0.01). Analgesic consumption was also lower in the PGL group, both immediately and 1 month after surgery. There were fewer requests for antiemetics in the PGL group, and the rate of postoperative nausea and vomiting was lower. The preoperative anxiety level and the quality of sleep were significantly better in the PGL group (p < 0.01). There were no PGL-associated major adverse events. CONCLUSIONS Perioperative use of twice-daily 150 mg pregabalin attenuates preoperative anxiety, improves sleep quality, and reduces postoperative pain scores and analgesic usage without increasing the rate of adverse effects. Clinical trial registration no.: NCT01612832 (clinicaltrials.gov)

scholarly journals Spiritual relaxation to reduce dysmenorrhea: a quasy experimental

MEDISAINS ◽  
2020 ◽  
Vol 17 (3) ◽  
pp. 57
Author(s):  
Qurota A'yun ◽  
Mukhoirotin Mukhoirotin
Keyword(s):  
Rating Scale ◽  
Early Mobilization ◽  
Sampling Technique ◽  
Numeric Rating Scale ◽  
Control Group ◽  
Relaxation Techniques ◽  
Menstrual Pain ◽  
Control Group Design ◽  
And Control ◽  
Numeric Rating

Background: The dysmenorrhea prevalence is still reported high in the world. Several previous studies discovered that deep breathing relaxation effectively reduced dysmenorrhea. Other studies presented the combination of early mobilization and spiritual relaxation could reduce the level of client pain postoperative appendectomy, however the effectiveness of spiritual relaxation techniques to reduce dysmenorrhea is not yet tested.Objective: to determine the effect of spiritual relaxation to reduce dysmenorrhea.Method: The research design used was Quasi Experiment with the pretest-posttest Control Group Design approach. The populations were female students who experienced menstrual pain (dysmenorrhea) and met the inclusion and exclusion criteria. The variable in this study was dysmenorrhea. The sampling technique was simple ramdom sampling consisted of 44 respondents. The calculation instrument was NRS (Numeric Rating Scale) and data were analyzed through statistical test of Paired T-Test and Independent T-Test.Results: After spiritual relaxation treatment, the intensity of menstrual pain reduced significantly from 6.05 - 1.77, it proved that there was an effect of spiritual relaxation on dysmenorrhea with a significant value (ρ) of 0.000 (p ≤ 0.05). There were significant differences in the intensity of menstrual pain in the intervention and control groups (1.77 ± 1,109 vs 5.63 ± 0.445; p> 0.05).Conclusion: Spiritual relaxation effectively reduces dysmenorrhea

scholarly journals Effects of Intraoperative Nefopam on Catheter-Related Bladder Discomfort in Patients Undergoing Robotic Nephrectomy: A Randomized Double-Blind Study

2019 ◽  
Vol 8 (4) ◽  
pp. 519
Author(s):  
Chi-Bum In ◽  
Young-Tae Jeon ◽  
Ah-Young Oh ◽  
Se-Jong Jin ◽  
Byeong-Seon Park ◽  
...  
Keyword(s):  
Postoperative Period ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
Control Group ◽  
Double Blind Study ◽  
Analgesic Agent ◽  
Double Blind ◽  
Robotic Nephrectomy ◽  
Male Patients ◽  
Numeric Rating

Catheter-related bladder discomfort (CRBD) is one of the most difficult symptoms during the postoperative period. Nefopam is a non-narcotic analgesic agent, which also has anticholinergic action. This study was performed to evaluate the effects of nefopam on CRBD in male patients undergoing robotic nephrectomy. A total of 109 male patients were randomly divided into two groups: the control group (n = 55) received 20 mL of normal saline, and the nefopam group (n = 54) received 20 mg of nefopam 1 h before the end of the operation. At postoperative times of 20 min, 1 h, 2 h, and 6 h, the severity of CRBD was measured using an 11-point numeric rating scale, respectively. The severity of CRBD in the nefopam group was significantly lower than that in the control group at 20 min (4.8 ± 1.3 vs. 2.3 ± 1.0, respectively, p = 0.012) and at 1, 2, and 6 h (3.5 ± 1.2, 2.7 ± 0.9, and 2.5 ± 1.0 vs. 4.1 ± 0.8, 1.6 ± 0.8, and 1.3 ± 0.6, respectively, p < 0001). Intraoperative nefopam administration reduced the severity of CRBD in patients undergoing robotic nephrectomy.

Pre-emptive ice cube cryotherapy for reducing pain from local anaesthetic injections for simple lacerations: a randomised controlled trial

2017 ◽  
Vol 35 (2) ◽  
pp. 103-107 ◽  
Author(s):  
JaeWoo Song ◽  
HyukHoon Kim ◽  
EunJung Park ◽  
Jung Hwan Ahn ◽  
Eunhui Yoon ◽  
...  
Keyword(s):  
Injection Site ◽  
Local Anaesthetic ◽  
Rating Scale ◽  
Controlled Trial ◽  
Numeric Rating Scale ◽  
Control Group ◽  
Ice Cube ◽  
Perceived Pain ◽  
Randomised Controlled ◽  
Numeric Rating

ObjectiveSubcutaneous local anaesthetic injection can be painful to patients in the ED. We evaluated the effect of cryotherapy by application of an ice cube to the injection site prior to injection in patients with simple lacerations.MethodsWe conducted a prospective, randomised, controlled trial in consented patients with simple lacerations needing primary repair at a single emergency centre from April to July 2016. We randomly assigned patients undergoing repair for simple lacerations to either the cryotherapy group or the control group (standard care; no cryotherapy or other pretreatment of the injection site). In cryotherapy group subjects, we applied an ice cube (size: 1.5×1.5×1.5 cm) placed inside a sterile glove on the wound at the anticipated subcutaneous lidocaine injection site for 2 min prior to injection. The primary outcome was a subjective numeric rating (0–10 scale) of the perceived pain from the subcutaneous local anaesthetic injections. Secondary outcomes were (a) perceived pain on a numeric scale for cryotherapy itself, that is, pain from contact of the ice cube/glove with the skin and (b) the rate of complications after primary laceration repair.ResultsFifty patients were enrolled, consented and randomised, with 25 in the cryotherapy group and 25 in the control group. The numeric rating scale for subcutaneous anaesthetic injections was median, IQR, 95% CI 2.0 (1 to 3.5), 1.81 to 3.47, respectively, in the cryotherapy group and 5.0 (3 to 7), 3.91 to 6.05 in the control group (Mann-Whitney U=147.50, p=0.001). No wound complications occurred in either group. The numeric rating scale for cryotherapy itself was median, IQR, 95% CI: 2.0 (1 to 3.5), 1.90 to 3.70.ConclusionPre-emptive topical injection site cryotherapy lasting 2 min before subcutaneous local anaesthetic injections can significantly reduce perceived pain from subcutaneous local anaesthetic injections in patients presenting for simple laceration repair.Trial registration numberKCT0001990.

scholarly journals Effectiveness of Ketoprofen Suppositoria as Preemptive Analgesia for Postoperative Pain in Patients Undergoing Elective Surgery with General Anesthesia

2020 ◽  
Vol 2 (1) ◽  
pp. 20
Author(s):  
Lupi Lestari ◽  
Elizeus Hanindito ◽  
Arie Utariani
Keyword(s):  
Pain Management ◽  
Side Effects ◽  
Postoperative Pain ◽  
General Anesthesia ◽  
Rating Scale ◽  
Postoperative Pain Management ◽  
Numeric Rating Scale ◽  
Preemptive Analgesia ◽  
Acute Postoperative Pain ◽  
Numeric Rating

Introduction: Effective postoperative pain management provides improved patient comfort and satisfaction, earlier mobilization, fewer pulmonary and cardiac complications, reduced risk deep vein thrombosis, fast recovery, and reduced cost of care. Preemptive analgesia, initiated before the surgical procedure to prevent pain in the early postoperative period, has the potential to be more effective than a similar analgesic treatment initiated after surgery. As a part of multimodal analgesia, the use of NSAIDs should always be considered for acute postoperative pain management. NSAIDs can be used preoperatively as a part of the preemptive regimen and for postoperative pain control to increase the efficacy of opioids and reduce its side effects. Material and Method: This research was experimental research with a case-control design of the study. The samples separated into two groups, the first group got ketoprofen suppository before the induction, and the second group didn’t get the ketoprofen suppository The intensity of pain measured with the Numeric Rating Scale (NRS) or Wong-Baker Faces Pain Scale was the variable studied at different postoperative times (30 min, 60 min, 120 min, 2-6 hours, 6-12 hours). The total amount of rescue analgesics (fentanyl) and side effects were other variables of this study. Result and Discussion: The result is ketoprofen suppository as preemptive analgesia administrations can reduce postoperative pain. Numeric Rating Scale was significantly lower in the ketoprofen group compared to the control group (p < 0,05) at 30 min, 60 min, 230 min, 2-6 hours, 6-12 hours. The number of postoperative analgesics needed in the recovery room was significant differences among both groups (p < 0,05). Conclusion: Preemptive analgesia in patients who underwent an operation with general anesthesia with ketoprofen suppository was effectively in blocking noxious stimuli and central sensitization, with subsequent prevention of acute postoperative pain.

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