scholarly journals Efficacy of eutectic mixture of local anesthetics in alleviating pain associated with lumbar puncture in newborns: a placebo compared randomized controlled trial

2021 ◽  
Vol 8 (11) ◽  
pp. 1815
Author(s):  
Akshi Sharma ◽  
Rakesh Sharma ◽  
Mangla Sood ◽  
Pancham Kumar

Background: Lumbar puncture (LP) is one of the most commonly encountered painful procedure in paediatric medicine. Research has shown that neonates too experience pain from noxious stimuli that can be more intense than what is experienced by an adult, and so have the right to receive safe, efficient and effective pain management. Objective was to determine efficacy of topical eutectic mixture of local anesthetics (EMLA) in alleviating pain associated with lumbar puncture among newborns admitted to sick newborn care unit (SNCU).Methods: The study was a one-year tertiary care teaching hospital-based randomised comparative double blinded trial among 42 neonates aged 32 weeks or more admitted to SNCU and required a diagnostic lumbar puncture, randomly assigned to one of two groups. Half hour before the procedure, 1 g of topical EMLA cream was applied to LP site in intervention group versus placebo in other group. At different stages, the heart rate, transcutaneous oxygen saturation level, and total behaviour score were captured on a video camera and rated using the neonatal facial coding system.Results: EMLA dramatically lowers pain sensitivity when compared to placebo. Total behavioural score means±standard deviation (SD) at the moment of needle insertion (EMLA: 1.05±1.24; placebo: 2.71±1.76, p≤0.001) and post procedural 5 minute later was (EMLA: 0.05±0.22; placebo: 0.81±0.92, p≤0.01). Similarly, oxygen saturation level when needle was in spinal place (EMLA: 96.76±2.45; placebo: 94.29±3.62, p=0.01) and post procedural 1 hour later was (EMLA: 98.81±1.94; placebo: 97.48±2.18, p=0.04). The heart rate of all newborns in both groups was greater than it was at baseline, although the difference was not significant.Conclusions: EMLA is an effective agent in reducing pain associated with LP among newborns.

2019 ◽  
Vol 10 (4) ◽  
pp. 2800-2804 ◽  
Author(s):  
Alice Jeba J ◽  
Senthil Kumar S ◽  
Shivaprakash sosale

Preterm infants are babies who are delivered before the completion of 37 weeks gestation period. They are born with immature functioning of the brain. In  Neonatal Intensive Care Unit (NICU), these infants receives many environmental stimuli, and their comfort will be disturbed. These various sensory stimulus received in NICU influence the functional and neurodevelopmental outcome of these infants and also their quality of life. So this study was intended to evaluate the axillary temperature, heart rate, respiratory rate and oxygen saturation level of these infants prior to nesting and after nesting at the 60th minute. Forty preterm infants who fulfilled the criteria of selection were included in the study by simple random sampling and segregated into case and control groups by blocked randomization. Data was collected and recorded. The temperature was recorded by a digital thermometer, respiratory rate was counted by the number of times the infants' chest rises, heart rate and oxygen saturation readings from the pulse oximeter. The result of the study showed that there was statistically significant effect of nesting at 60th minute, temperature (t=5.03966,p<0.05), respiratory rate(t= -2.13,p<0.05) and heart rate (t=-2.59766,p<0.05). But the effect was not significant on oxygen saturation level (t=1.2,p=0.238).  Hence this study result supports the use of nesting in NICU.


2021 ◽  
Vol 4 (1) ◽  
pp. 32-38
Author(s):  
Muhammad Imran ◽  
Raisa Begum Gul ◽  
Shumaila Batool

Objective: The main objective of the study was to determine the effects of Surah Al-Rehman on post CABG patients’ pain level, oxygen saturation, and vital signs. Methodology: A quasi-experimental pre and post-test design was used with a sample size of 60 patients in two tertiary care Hospitals, from July 2018 to September 2018. A non-probability convenient sampling method was used to recruit the participants. Post CABG adult Muslim patients were the study participants. Surah Al-Rehman’s recitation in the voice of the Qari Abdul Basit was the intervention for the current study. At a significance level of p-value ≤ 0.05, a repeated measure ANOVA was applied to determine the effects of Surah Al-Rehman on the outcome variables, which were patient’s pain level, oxygen saturation level, and vital signs including heart rate [HR], respiratory rate [RR], systolic and diastolic blood pressure. Results: Overall, Surah Al Rehman had shown statistically significant effects on the participants’ pain level (p<0.001), oxygen saturation level (p=0.01), respiratory rate (p<0.001), and diastole blood pressure (DBP, p=0.04). A minimum change in the pre and post values of HR and systolic blood pressure (SBP) was also observed, but statistically, this change was insignificant (HR, p=0.13 & SBP, p=0.47). Conclusion: Findings of the current study demonstrated that listening to the recitation of Surah Al-Rehman could decrease pain level, RR, DBP and enhance oxygen-saturation in post CABG patients.


2021 ◽  
Vol 2 (1) ◽  
pp. 38-43
Author(s):  
Abdullajon Komilov ◽  
◽  
Madinabonu Sultonova ◽  
Durdona Orifjonova

Today, the COVID-19 pandemic is one of the most pressing problems facing humanity. Therefore, reducing the population's level of infection with this virus is one of our government's main tasks.Therefore, it is necessary to isolate patients with chronic diseases as much as possible. Clients are more likely to be infected with caronavirus due to their age and the presence of underlying medical conditions.Limiting direct contact between such patients and observing healthcare professionals significantly reduces the patient's chances of contracting caronavirus.The article proposes a device design that allows for remote automatic monitoring of patients' condition being treated at home by an observing medical professional.With the proposed device's help, the patient's blood oxygen saturation level is automatically and remotely controlled. The device is built on an Arduino board.The use of the device greatly reduces the likelihood of contracting caronavirus in patients receiving home treatment.This could be one of the most important decisions in maintaining the health of the population today.


2010 ◽  
Vol 4 (2) ◽  
Author(s):  
Thao P. Do ◽  
Lindsey J. Eubank ◽  
Devin S. Coulter ◽  
John M. Freihaut ◽  
Carlos E. Guevara ◽  
...  

When an infant is born prematurely, there are a number of health risks. Among these are underdeveloped lungs, which can lead to abnormal gas exchange of oxygen or hypoxemia. Hypoxemia is treated through oxygen therapy, which involves the delivery of supplemental oxygen to the patient but there are risks associated with this method. Risks include retinopathy, which can cause eye damage when oxygen concentration is too high, and brain damage, when the concentration is too low [1]. Supplemental oxygen concentration must be controlled rigorously. Currently healthcare staff monitors infants’ blood oxygen saturation level using a pulse oximeter. They manually adjust the oxygen concentration using an air-oxygen blender. Inconsistent manual adjustments can produce excessive fluctuations and cause the actual oxygen saturation level to deviate from the target value. Precision and accuracy are compromised. This project develops an automatic oxygen delivery system that regulates the supplemental oxygen concentration to obtain a target blood oxygen saturation level. A microprocessor uses a LABVIEW® program to analyze pulse oximeter and analyzer readings and control electronic valves in a redesigned air-oxygen blender. A user panel receives a target saturation level, displays patient data, and signals alarms when necessary. The prototype construction and testing began February 2010.


PEDIATRICS ◽  
1991 ◽  
Vol 88 (4) ◽  
pp. 663-669 ◽  
Author(s):  
Fran L. Porter ◽  
J. Philip Miller ◽  
F. Sessions Cole ◽  
Richard E. Marshall

To evaluate the efficacy of subcutaneous administration of lidocaine for reducing physiologic instability in acutely ill newborns during clinically required procedures, 81 neonates who required lumbar punctures within the first month of life were stratified by birth weight and respiratory support and randomly assigned to an experimental or a control group. The experimental group received an injection of 0.1 mL/kg of 1% lidocaine prior to the lumbar puncture. The control group received a nonanesthetized lumbar puncture without placebo. Changes in heart rate, respiratory rate, transcutaneous oxygen and carbon dioxide tensions, and heart rate variability from baseline, preparatory (positioning/handling), lumbar puncture, and recovery periods were measured. The administration of lidocaine did not minimize physiologic instability in response to the lumbar puncture nor was it associated with any detectable adverse effects other than prolonging the duration of the lumbar puncture. Although significant physiologic changes were observed in response to preparatory procedures, few additional changes beyond those occurred in response to lumbar punctures in either the experimental or control group. It is concluded that local anesthesia failed to influence manifestations of physiologic instability during neonatal lumbar punctures and that preparatory procedures were more destabilizing than either the administration of lidocaine or the lumbar puncture itself. The results suggest that the management of newborns requires emphasis on minimizing the destabilizing effects of required and frequent handling procedures.


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