The randomised prospective comparative study to see the duration of analgesia following intravenous or rectal acetaminophen after adenotonsillectomy in children

Background: The greatest advance in pediatric pain medicine is the recognition that untreated pain is a significant cause of morbidity and even mortality after surgical trauma. Author compared the analgesic efficacy and duration of analgesia of rectal acetaminophen and I.V. acetaminophen.Methods: A total of 80 children in the age group of 2-5 years were randomly selected and divided into 2 groups. Group I received 15 mg/kg I.V. paracetamol and group II received 40 mg/kg rectal acetaminophen. Post-operative pain scores were measured using Face, Legs, Activity, Cry and Consolability scale and duration of analgesia were recorded and compared.Results: The pain scores in group I was lower immediately after extubation and at 30 minutes post extubations but at one, two and four hours the pains score were comparable in both the groups. At 6 hours, the pain score was significantly more in I.V. group and also the duration of analgesia was 9-10 hours in rectal acetaminophen group where as in I.V. group, it was 5-6 hours.Conclusions: Rectal acetaminophen 40 mg/kg produces prolonged analgesia as compared to I.V. paracetamol 15 mg/kg and also is more convenient and cost effective and is devoid of side effects of I.V. cannulation.

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Comparison of analgesic efficacy between TAP block and local site infiltration post operatively in caesarean section

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20181305 ◽

2018 ◽

Vol 6 (4) ◽

pp. 1407 ◽

Cited By ~ 2

Author(s):

Nabanita Das ◽

Usha Shukla ◽

Dheer Singh ◽

Urvashi Yadav

Keyword(s):

Caesarean Section ◽

Postoperative Analgesia ◽

Analgesic Efficacy ◽

Tap Block ◽

Local Site ◽

Pain Scores ◽

Group I ◽

Significant Difference ◽

Patient Pain ◽

Study Population

Background: Patients undergoing caesarean section need to be alert, comfortable and mobile in order to take care of their babies, for which they must be pain free in post operative period. The aim of present study is to compare the analgesic efficacy of TAP block with local anaesthetic infiltration specifically in LSCS patients in reducing patient pain postoperatively, as well as to decrease the analgesic requirements.Methods: The study population consisted of 60 patients posted for elective and emergency caesarean section. They were blindly divided into two groups of 30 patients each. Group T received 40ml 0.25% Ropivacaine in Transverses abdominis plane (TAP) block for postoperative analgesia and group I received 40ml 0.25% ropivacaine as infiltration at incision site for postoperative analgesia. Patients were observed for numeric pain score NPS, analgesic requirements, total analgesic consumption and adverse effects if any.Results: There was highly significant difference in numeric pain scores at 2nd, 6th, 12th and 24th hours (p<0.0001). Both the time for first rescue analgesic and total amount of analgesic consumed are statistically significant (p<0.0001).Conclusions: TAP block is an effective postoperative analgesic procedure for post caesarean section patients.

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Pre-Emptive Analgesic Effect of Intravenous Paracetamol in Modified radical mastectomy

Nepalese Journal of Cancer ◽

10.3126/njc.v2i1.25646 ◽

2018 ◽

Vol 2 (1) ◽

pp. 22-26

Author(s):

Bhawana Wagle ◽

Yogesh Regmi ◽

Sudhir Shrestha ◽

Pradeep Thapa ◽

Suraj VishowKarma ◽

...

Keyword(s):

Radical Mastectomy ◽

Analgesic Efficacy ◽

Modified Radical Mastectomy ◽

Analgesic Requirement ◽

Analgesic Effects ◽

Institutional Ethics ◽

Pain Scores ◽

Group I ◽

Group Ii ◽

American Society

Background: Modified radical mastectomy (MRM) is associated with significant post-operative pain. Intravenous (iv) paracetamol provides pain relief in most patients who have undergone MRM. It has been observed from previous studies conducted on patients undergoing other surgeries like abdominal surgeries that the analgesic efficacy of iv paracetamol improves when used Pre-emptively. There are no studies done previously on use of iv paracetamol Pre-emptively in MRM. Objective: The purpose of the study was to determine the post-operative analgesic effects of Pre-emptive intravenous (iv) paracetamol in MRM. Materials and Methods: Following institutional ethics committee approval, fourty American Society of Anesthesiology (ASA) physical status I-II patients were assigned in a randomized manner into two groups: Group I received iv paracetamol 1g, in 100mL, 15 minutes before induction and Group II received iv paracetamol 1g, in 100 mL, at the end of the surgery. The time to first analgesic use and the total analgesic consumed in 24 hours was recorded. Visual Analog Scale (VAS) pain scores were obtained from all patients at 0, 30 minutes, 1, 2, 6, 12 and 24 hours after the end of the Surgery. Results: Time to first analgesic requirement was significantly longer in Group I compared to Group II (p = 0.0329). Rescue analgesic consumption and post-operative VAS pain scores recorded were significantly lower in Group I compared to Group II (p < 0.05) until 24 after surgery. Conclusion: Pre-emptive iv paracetamol in comparison to intra- operative paracetamol, provided effective and reliable post- operative analgesia after modified radical mastectomy.

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Comparative evaluation of caudal tramadol and fentanyl when mixed with bupivacaine in paediatric age group

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20201340 ◽

2020 ◽

Vol 8 (4) ◽

pp. 1445

Author(s):

Abhinav Tewari ◽

Ajit Kumar Singh

Keyword(s):

Postoperative Analgesia ◽

Comparative Evaluation ◽

Pediatric Patients ◽

Analgesic Efficacy ◽

Age Group ◽

Caudal Block ◽

Pain Scores ◽

Haemodynamic Changes ◽

Paediatric Age ◽

The Mean

Background: A caudal block is commonly performed block for postoperative analgesia pediatric surgeries. Duration can be enhanced by addition drugs like fentanyl, tramadol, clonidine midazolam etc to local anesthetics helps in decreasing the requirement of postoperative analgesics. This study was conducted to assess the analgesic efficacy of tramadol or fentanyl when mixed with bupivacaine in pediatric patients for surgeries below the umbilicus.Methods: Fifty children of ASA I and ASA status, between 2 to 12 years of age, of both sexes underwent elective surgeries below umbilicus were selected and randomly divided into groups of 25 each. One Group, T (n = 25) received 0.75 ml/kg of 0.25% bupivacaine with tramadol 1mg/ kg and other Group F (n = 25) received 0.75 ml/kg of 0.25% bupivacaine with Inj fentanyl 1μg/kg. Assessment of analgesia and any side effects after caudal injection to the first administration of analgesia were recorded for both the groups in next 24 hours following objective pain scores. Duration of analgesia and requirement of additional rescue analgesics was noted.Results: The Mean duration of analgesia recorded longer in Group T (18.26±6.1 hours) as compared to Group F (10.0+/- 2.68 hrs.) and no significant haemodynamic changes or adverse effect noted between 2 groups.Conclusions: Addition of tramadol, 1mg/kg to bupivacaine 0.25% for caudal anesthesia in children undergoing surgeries below umbilicus, enhances and prolongs postoperative analgesia compared to caudal fentanyl 1μg/kg and bupivacaine 0.25% alone.

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Effect of laser assisted local anesthesia in single-visit root canal treatment for mandibular molar teeth with acute irreversible pulpitis

10.1101/2021.08.03.21261519 ◽

2021 ◽

Author(s):

Subashri V ◽

Nivedha V ◽

Anand Sherwood ◽

Paul Abbott ◽

James L Gutmann ◽

...

Keyword(s):

Laser Irradiation ◽

Nerve Block ◽

Inferior Alveolar Nerve ◽

Inferior Alveolar Nerve Block ◽

Pulp Tissue ◽

Pain Scores ◽

Group I ◽

Post Operative Pain ◽

Mandibular Molar ◽

Molar Teeth

Present study evaluated the efficacy of laser activation to control intra- and post-operative pain in single-visit root treatment for mandibular molar teeth with acute irreversible pulpitis following 2% lignocaine inferior alveolar nerve block. Ninety-eight patients presenting with pain were randomly divided into two anesthetic groups. Group-I inferior alveolar nerve block plus buccal infiltration and intra-ligamentary injections, Group-II inferior alveolar nerve block followed by laser irradiation focused directly on the pulp tissue. Intra- and post-operative pain intensities were assessed on a 10-point scale. The mean intra-operative pain scores in group-I was 6.62 and in group-II before and after laser irradiation pain scores was 6.94 and 1.3, respectively. Post-operative pain scores at 24-hrs in the laser group were significantly higher. Laser irradiation applied directly on pulp tissue for control of intra-operative pain was effective, thereby negating the need for additional local anesthesia.

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Effect of radiofrequency vs other surgeries in the management of obstructive sleep apnoea

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20192069 ◽

2019 ◽

Vol 5 (4) ◽

pp. 893

Author(s):

Atul M. Bage ◽

Lakshman Bhaskar Muthuvel ◽

Pradheep Kalatharan

Keyword(s):

Upper Airway ◽

Cost Effective ◽

Sleep Apnoea ◽

Age Group ◽

Voice Change ◽

Radiofrequency Surgery ◽

Airway Collapse ◽

Upper Airway Collapse ◽

Post Operative Pain ◽

Obstructive Sleep

Background: Snoring is an important social problem seen in both men and women. Snoring occurs as a result of soft tissue vibration caused by a partial upper airway collapse during sleep. The aim of the study was to analyse the morbidity and efficacy of radiofrequency thermal ablation of upper airway in patients suffering from OSA.Methods: In the Department of ENT, Pondicherry, 40 patients between the age group of 20 to 60 years who were diagnosed to have OSA were operated according to the site of obstruction including RFVTR. Various parameters including ESS, partner scores, post-op pain, bleeding, pharyngeal dryness voice change were measured accordingly on the 1st day, 45th day, 90th day and 180th day postoperatively for the efficacy of treatment and also for assessing the morbidity of treatment provided. Results: There is a statistically significant reduction in ESS scores and partner scores between pre-operative period and post operatively on the 45th day, 90th day and 180th day. Post-operative pain assessment also showed that patients who underwent RFVTR had lesser pain when compared to other surgeries like zetaplasty, LAUP, etc.Conclusions: Radiofrequency surgery should be considered as the treatment of choice for mild OSA and hypopneic snorers. The important advantage of these procedures is technically simple and minimally invasive. RFTA of the soft palate leaves the mucosa intact contrary to LAUP, hence the pain comparably less. Relatively cost effective when compared to LASER and Coblator.

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