Comparison of the anti-nociceptive effect of dexmedetomidine with that of clonidine immediately prior to propofol injection in alleviating propofol injection pain

Background: Propofol is the drug of choice for induction of anaesthesia because of its rapid onset and short duration of action, easy titration, and favourable profile for side effects. But three out of five patients experience pain on injection of propofol. Alleviation of Propofol injection pain (PIP) is thus a major concern and several interventions have been investigated to alleviate the pain associated with propofol injection. Clonidine was found to alleviate the pain of injected propofol effectively. Dexmedetomidine is also an alpha-2 adrenoceptor agonist but is more selective than clonidine and has analgesic and sedative properties. The aim of the study was to compare the anti-nociceptive effect of dexmedetomidine with that of clonidine immediately prior to propofol injection in alleviating propofol injection pain.Methods: A randomized controlled study was conducted on 60 patients admitted in Malla Reddy Institute of Medical Sciences, undergoing elective surgeries under general anaesthesia (GA) for 2 years from October 2015 to September 2017. The patients were randomly divided into two groups (30 each). Group A was administered intravenous injection clonidine 0.5 µg/kg. Group B was administered intravenous injection dexmedetomidine 0.5 µg/kg.Results: In the present study, difference between the study groups in their mean age, mean weight, gender, ASA grading was not found to be statistically significant. The difference between the groups in incidence of pain on propofol injection was found to be significant statistically. The mean baseline heart rate was declining and mean arterial blood pressure was increasing in both the groups but the difference was not found to be statistically significant.Conclusions: Pre-treatment with 0.5 µg/kg of IV dexmedetomidine is more effective as compared to IV clonidine in alleviating propofol injection pain.

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COMPARISON OF INDUCTION WITH PROPOFOLAND SEVOFLURANE FOR LARYNGEAL MASK AIRWAY INSERTION DURING ELECTIVE SURGERIES

10.36106/ijsr/6510048 ◽

2021 ◽

pp. 44-46

Author(s):

Anjani Sravanthi Kotturi ◽

Geetha Bhavani

Keyword(s):

Intravenous Injection ◽

Study Groups ◽

Laryngeal Mask ◽

Controlled Study ◽

Laryngeal Mask Airway Insertion ◽

Medical Sciences ◽

Elective Surgical Procedures ◽

Group A ◽

Group B

Background And Aims: Laryngeal mask airways are gaining popularity these days in airway management and can be used for various types of surgeries and also during resuscitation. The aim of the study is to compare the induction characteristics and hemodynamic changes associated with intravenous injection of Propofol or inhalational Sevourane induction for LMAinsertion during elective surgeries. Materials And Methods: It is a prospective, single blind, randomized controlled study that is conducted at Maharajah's Institute of Medical Sciences, Nellimarla,Vizianagaram from January 2019 to July 2019. The study consists of sixty patients belonging to ASA grade I & II, aged between 20-60 years of both sexes, undergoing elective surgical procedures, which were randomly divided into 2 groups of 30 each. Patients in Group-A were induced with intravenous injection of Propofol 2mg/kg and inhalation of 100% Oxygen whereas in Group-B were induced with inhalation of 8% Sevourane in 100% Oxygen. The data regarding time for induction, LMAinsertion and hemodynamic parameters were recorded and compared in both the study groups. Results: The mean time taken for induction and insertion of LMAwas less in Group A(100±13.6sec) compared to Group B(120±14.2sec) and this difference is statistically signicant. The fall in MAPand HR in group - Ais also signicant. Conclusion: The quality of anaesthesia provided by propofol is better when compared to Sevourane for LMAinsertion, even though Sevourane is associated with better haemodynamic stability.

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Comparing Efficacy and Safety of Oral Tranexamic Acid and 4% Topical Hydroquinone Cream in Melasma Treatment: A Randomized Controlled Clinical Trial and Review of Literature

Serbian Journal of Dermatology and Venerology ◽

10.2478/sjdv-2019-0017 ◽

2019 ◽

Vol 11 (4) ◽

pp. 119-128

Author(s):

Reza Yaghoobi ◽

Samin Vala ◽

Nader Pazyar ◽

Maryam Zeinali ◽

Saeed Hesam

Keyword(s):

Clinical Trial ◽

Tranexamic Acid ◽

Skin Pigmentation ◽

Severity Index ◽

Study Groups ◽

Controlled Clinical Trial ◽

Therapeutic Effects ◽

Common Skin ◽

The Difference ◽

Group B

AbstractIntroduction. Melasma is a common skin pigmentation disorder affecting a patient’s life psychologically and socially. Topical medications or lasers can have temporary and limited therapeutic effects on melasma. Material and Methods. This study is a prospective clinical trial comparing therapeutic effects of oral Tranexamic acid (TXA) and topical Hydroquinone (HQ) cream. A total number of 69 patients were examined. During the study, 10 patients failed to appear for the follow-up and 59 of them completed the trial. The patients were also divided randomly into two groups. Group A received TXA capsule 250 mg every 12 hours and group B received 4% topical HQ cream day and night. The patients from both groups were treated for 3 months. Melasma Area and Severity Index (MASI) scores were then calculated at the baseline, 4 weeks, and 12 weeks into the treatment and 3 months after the end of intervention. Results. MASI baseline, 4 weeks,12 weeks, and 24 weeks in TXA group were 21.66, 13.69, 9.10, 9.24; respectively. Reduction of MASI between baseline and 4 weeks was statistically significant. Such a decreasing trend in MASI scores between baseline and 12 weeks was also reported as statistically significant (p=0.001). In the HQ group, MASI baseline,4 weeks, 12 weeks, and 24 weeks were 21.46, 13.57, 10.93, 11.20; respectively. Reduction of MASI scores between baseline and 4 weeks was statistically significant. Moreover, a decline in MASI scores was observed between baseline and 12 weeks that was statistically significant (p=0.001). Considering both groups MASI scores were reduced but the difference between two study groups was not statistically significant (p=0.98). Conclusion. The efficacy of TXA and HQ was the same and both could significantly reduce MASI scores.

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Prospective Clinical Comparative Assessment of Intubating Conditions and Neuromuscular Blocking Effects of Two Different Doses of Cisatracurium.

Academia Anesthesiologica International ◽

10.21276/aan.2020.5.1.7 ◽

2020 ◽

Vol 5 (1) ◽

pp. 34-40

Author(s):

Kailash Prabhudev ◽

Channagouda Hadimani

Keyword(s):

Study Groups ◽

Neuromuscular Blocking ◽

Allergic Reactions ◽

Duration Of Action ◽

Intubating Conditions ◽

Elective Surgical Procedures ◽

Blocking Effects ◽

The Difference ◽

Clinically Significant ◽

Different Doses

Background: To study the effects of two different doses of cisatracurium 0.15mg/kg and 0.2mg/kg regarding intubating conditions, duration of action, hemodynamic stability and allergic reactions.Subjects and Methods:60 patients posted for elective surgical procedures under general anaesthesia in various surgical disciplines were enrolled into the study and alternatively allocated patients into one of the two study groups of 30 each to receive either 0.15mg/kg or 0.2mg/kg of cisatracurium. Intubating conditions assessed as excellent, good, poor or not possible and duration of action assessed and noted. PR and BP monitored at regular timed intervals following muscle relaxant and allergic reactions evaluated clinically.Results:4×ED 95 dose of cisatracurium had statistically significantly longer duration of action and had produced proportionately excellent intubating conditions as compared to its 3×ED 95 dose. The mean duration of action after 4×ED 95 loading dose was 53.03±5.75 minutes and 45.16±4.41 minutes after 3×ED 95 dose and the difference was statistically and clinically significant. Proportionately 4×ED 95 dose of Cisatracurium had produced excellent intubating conditions as compared to its 3×ED 95 dose (90% vs 70%). Differences in hemodynamic changes (pulse rate and blood pressure) after the above doses were clinically insignificant. And none of the patients after either dose showed allergic reactions.Conclusion:Cisatracurium at a higher dose 0.2mg/kg (4×ED 95) as compared to its lower dose 0.15mg/kg (3×ED 95) provides longer duration of action and proportionately excellent intubating conditions. Both doses produced stable hemodynamic status without clinically significant changes in PR and BP. No allergic reactions were noted at both the doses.

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Multiple-dose tranexamic acid for perioperative blood loss in total knee arthroplasty in patients with rheumatoid arthritis：a single-blinded, randomised, parallel-controlled study protocol in China

BMJ Open ◽

10.1136/bmjopen-2019-034431 ◽

2020 ◽

Vol 10 (8) ◽

pp. e034431

Author(s):

Bing-Xin Kang ◽

Hui Xu ◽

Chen-Xin Gao ◽

Sheng Zhong ◽

Jing Zhang ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Blood Loss ◽

Tranexamic Acid ◽

Intravenous Injection ◽

Knee Arthroplasty ◽

Multiple Dose ◽

Controlled Study ◽

Group A ◽

Total Knee ◽

Group B

IntroductionThis clinical trial is designed to evaluate the effect of multiple-dose tranexamic acid (TXA) on perioperative blood loss in patients with rheumatoid arthritis (RA).Methods and analysisA randomised, single-blinded, parallel-controlled study will be designed. Patients with RA (age 50–75 years) undergoing unilateral primary end-stage total knee arthroplasty will be randomly divided into group A or group B. Group A will be treated with one dose of TXA (1 g; intravenous injection 3 hours postsurgery) and group B with three doses (1 g; intravenous injection at 3, 6 and 12 hours postsurgery) after surgery. The primary outcomes will be evaluated with blood loss, maximum haemoglobin drop and transfusion rate. The secondary outcomes will be evaluated with knee function and complications.Ethics and disseminationThe Shanghai Guanghua Hospital of Integrated Traditional Chinese Medicine and Western Medicine Ethics Committee approved in this study in July 2019. Informed consent will be obtained from all participants. Results of the trial will be published in the Dryad and repository in a peer-reviewed journal. Additionally, deidentified data collected and analysed for this study will be available for review from the corresponding author on reasonable request.Trial registration numberChiCTR1900025013.

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EFFICACY OF PHENYLEPHRINE AND EPHEDRINE IN MAINTAINING MATERNAL BLOOD PRESSURE INTRA OPERATIVELY DURING SPINAL ANESTHESIA FOR CAESAREAN SECTION

10.36106/6529615 ◽

2021 ◽

pp. 25-28

Author(s):

Anant Prakash ◽

Rahul Kumar ◽

Chandeshwar Choudhary ◽

Debarshi Jana

Keyword(s):

Blood Pressure ◽

Caesarean Section ◽

Spinal Anaesthesia ◽

Rapid Onset ◽

Maternal Blood ◽

Emergency Caesarean Section ◽

Singleton Pregnancy ◽

Duration Of Action ◽

Arterial Blood ◽

Maternal Blood Pressure

Introduction: Spinal anaesthesia has become a popular technique for caesarean section. It however has the potential to cause rapid onset of maternal hypotension which may have detrimental maternal and neonatal effects. Thus, a number of strategies for treating hypotension have been investigated. Careful positioning and volume preloading with crystalloid or colloids have been used to prevent it, but these are not complete measures and vasopressor is required to correct hypotension quickly . Methodology: 100 parturients ASA I and II scheduled for elective as well as emergency Caesarean section under sub arachnoid block (SAB) were studied. All parturients were at term, had uncomplicated singleton pregnancy with cephalic presentation. Results: Phenylephrine and Ephedrine are effective given prophylactically IV bolus followed by infusion in maintenance of arterial pressure within 15% limit of baseline. Phenylephrine has quicker and shorter duration of action effect in comparison to Ephedrine. Conclusion: Vasopressor drugs Phenylephreine and Ephedrine, effectively maintained arterial blood pressure during spinal anaesthesia for caesarean section

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Pain Perception following Administration of Propofol with 7.5 mg Ephedrine, 15 mg Ephedrine, or Lignocaine— A Comparative Study

Research & Innovation in Anesthesia ◽

10.5005/jp-journals-10049-0034 ◽

2017 ◽

Vol 2 (2) ◽

pp. 58-63

Author(s):

Harprit Kaur Madan ◽

Indrani H Chincholi ◽

Sonali D Patira

Keyword(s):

Statistical Analysis ◽

Comparative Study ◽

Repeated Measures ◽

Pain Perception ◽

Rating Scale ◽

Elective Surgery ◽

Rapid Onset ◽

Injection Pain ◽

P Value ◽

Duration Of Action

ABSTRACT Introduction Propofol is the drug of choice for induction of anesthesia because of its rapid onset, easy titration, and short duration of action. However, pain on propofol injection is an unpleasant experience felt by many of our patients. Many factors have been investigated to decrease the pain on propofol injection but it is still a mystery. Aim To compare the effect of two doses of ephedrine (7.5 and 15 mg) and lignocaine on pain during injection of propofol and to compare their hemodynamic parameters and note for any complications. Materials and methods This study was a prospective, randomized, double-blinded, single-center study on 150 adult patients of both the sexes belonging to American Society of Anesthesiologists (ASA) grades I and II for elective surgery under general anesthesia. The aim was to compare the analgesic effect of lignocaine, ephedrine 7.5 and 15 mg in ameliorating propofol injection pain. About 50 patients were allocated to each of the three groups receiving lignocaine 2% (1.5 mL), ephedrine 7.5 mg, and ephedrine 15 mg intravenously admixed with propofol. The intensity of pain at the time of propofol injection was assessed using verbal rating scale (VRS) 4-point scale before the patient lost consciousness. Statistical analysis Statistical analysis was done by using Statistical Package for the Social Sciences (SPSS) version 22.0 software. The qualitative data were summarized as frequency and percentages. The Fischer exact test was used to analyze the data. The continuous data were summarized as mean and standard deviation. The group and intergroup analyses were done using repeated measures analysis of variance (ANOVA) test. A p-value <0.05 was considered significant. Results Median (interquartile range) of the pain score was 1 (2) in group E-7.5 mg, 0 (1) in group E-15 mg, and 0(1) in group L. Results were statistically significant. Conclusion Adding 15 mg ephedrine was as effective as adding lignocaine for the prevention of propofol injection pain and ephedrine had a better and stable hemodynamic profile. How to cite this article Chincholi IH, Madan HK, Patira SD. Pain Perception following Administration of Propofol with 7.5 mg Ephedrine, 15 mg Ephedrine, or Lignocaine—A Comparative Study. Res Inno in Anesth 2017;2(2):58-63.

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EFFICACY OF ATRACURIUM VERSUS CISATRACURIUM IN PATIENTS UNDERGOING RETROGRADE CHOLANGIOPANCREATOGRAPHY PROCEDURE UNDER GENERAL ANAESTHESIA – A COMPARATIVE STUDY

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2020.v13i7.37824 ◽

2020 ◽

pp. 197-201

Author(s):

ALISHA SAHU ◽

SAMBEET SWAIN ◽

SOUMYA SAMAL ◽

SIBANARAYAN MOHANTY

Keyword(s):

Adverse Effects ◽

Rapid Onset ◽

Hemodynamic Parameters ◽

Onset Of Action ◽

Duration Of Action ◽

Group A ◽

American Society ◽

Group B ◽

Time Required ◽

American Society Of Anesthesiologists

Objectives: The objectives of the study were to compare the efficacy of injection atracurium 0.5 mg/kg intravenous (IV) versus injection cisatracurium 0.2 mg/kg IV for intubation in patients undergoing endoscopic retrograde cholangiopancreatography procedure (ERCP). Methods: Hundred adult patients of both sexes in the age group of 18–60 years belonging to the American Society of Anesthesiologists I/II category posted for ERCP procedures under general anesthesia were randomly allocated into two groups of 50 each. Group A received injection atracurium besylate 0.5 mg/kg intravenously and Group B received injection cisatracurium besylate 0.2 mg/kg intravenously. Parameters observed were time to the maximum blockade, intubating condition, time required for intubation, duration of action, hemodynamic parameters during intubation, and after 1, 2, 3, 5, and 15 min and any adverse effects. Results: Demographic profile was comparable between the groups. Intubating condition as per Cooper et al. score was excellent in 36 patients in cisatracurium group as compared to 19 patients in atracurium group. The overall intubating condition was found to be better in Group B (p=0.00001). Time to the maximum blockade was significantly high with atracurium as compared to cisatracurium. The mean of intubation time was less with cisatracurium (135±11.1) than that of atracurium (144±9.48) in seconds, which was statistically significant. Duration of neuromuscular blockade was found to be prolonged in Group B as compared to Group A (p=0.000). Hemodynamic parameters during intubation and after 1, 2, 3, 5, and 15 min were comparable between the groups. No adverse effect was seen in both groups. Conclusion: Cisatracurium 0.2 mg/kg provides excellent intubating conditions with rapid onset of action, longer duration of action, and no significant hemodynamic changes as compared with atracurium 0.5 mg/kg for ERCP procedures without any adverse effects.

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Complementary Therapies for Idiopathic Hirsutism: Topical Licorice as Promising Option

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2015/659041 ◽

2015 ◽

Vol 2015 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Gita Faghihi ◽

Fariba Iraji ◽

Bahareh Abtahi-Naeini ◽

Bahar Saffar ◽

Ali Saffaei ◽

...

Keyword(s):

Controlled Study ◽

Alexandrite Laser ◽

Double Blind ◽

Idiopathic Hirsutism ◽

The Face ◽

Group A ◽

The Mean ◽

The Difference ◽

Hair Removal Laser ◽

Group B

Hirsutism is one of the most prevalent health problems in women. The aim of the study was to compare the effect of 755 nm alexandrite hair removal laser with that of alexandrite laser plus topical licorice on the improvement of idiopathic hirsutism. A double-blind, randomized placebo-controlled study was performed on 90 female subjects. The patients were divided into two groups: alexandrite laser plus 15% licorice gel (group A) and placebo (group B). Each subject received one of both products over one side of the face, twice daily for 24 weeks on the hirsute locations. Each group underwent five sessions of alexandrite laser at 6-week intervals. To minimize the effects of confounding variables, the test was performed on two separate zones of patients’ skin. The mean ± SD numbers of terminal hairs in group A were 7.05 ± 4.55 for zone 1 and 6.06 ± 3.70 for zone 2. In group B, they were 3.18 ± 1.75 for zone 1 and 2.49 ± 1.63 for zone 2. The difference in the mean number of terminal hairs was statistically significant between the two groups (p<0.001), and there were no serious adverse reactions. The treatment of idiopathic hirsutism with 755 nm alexandrite laser plus topical licorice is more effective than alexandrite laser only.

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Motion Sifnos: A randomized, double-blind, placebo-controlled study demonstrating the effectiveness of tradipitant in the treatment of motion sickness

10.1101/2020.04.06.20055715 ◽

2020 ◽

Author(s):

Vasilios M. Polymeropoulos ◽

Mark É. Czeisler ◽

Mary M. Gibson ◽

Austin A. Anderson ◽

Jane Miglo ◽

...

Keyword(s):

Motion Sickness ◽

Study Groups ◽

Controlled Study ◽

Nk1 Receptor ◽

Double Blind ◽

The Pacific ◽

The Pacific Ocean ◽

The Difference ◽

Neurokinin 1 ◽

Nk1 Receptor Antagonists

AbstractBackgroundNovel therapies are needed for the treatment of motion sickness given the inadequate relief, and bothersome and dangerous adverse effects of currently approved therapies. Neurokinin-1 (NK1) receptor antagonists have the potential to be effective in improving the symptoms of motion sickness, given the involvement of Substance P in nauseogenic and emetic pathways and the expression of NK1 receptors in the gastrointestinal system. Here, we evaluated the efficacy of tradipitant, a novel NK1 receptor antagonist, in preventing motion sickness in variable sea conditions.MethodsA total of 126 adults participated in the Motion Sifnos Study. Groups of participants were assigned to one of seven boat trips lasting approximately four hours on the Pacific Ocean. Participants were randomized 1:1 to tradipitant 170 mg or placebo and completed the Motion Sickness Severity Scale (MSSS) every 30 minutes, in addition to other assessments. Severity of motion sickness was assessed with the incidence of vomiting and the MSSS.ResultsParticipants on tradipitant had a significantly lower incidence of vomiting as compared to those on placebo across all boat trips (tradipitant=17.5%, placebo=39.7%, p=0.0039). For trips exposed to rough sea conditions, the difference in the incidence of vomiting between the groups was more dramatic (tradipitant=15.79%, placebo=72.22%, p=0.0009). Across these trips, motion sickness symptoms were significantly lower in the tradipitant group compared to the placebo group (tradipitant=3.19, placebo=4.57, p=0.0235).DiscussionTradipitant has the potential to be an effective therapy for the prevention of vomiting and treatment of nausea in people with motion sickness.

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EFFECT OF YOGIC LIFESTYLE MODIFICATION ON ANGINAL EPISODES IN CAD PATIENTS

10.36106/ijsr/4607338 ◽

2021 ◽

pp. 50-52

Author(s):

Priyank Rastogi ◽

Tungvir Singh Arya ◽

Abha Gupta

Keyword(s):

Lifestyle Modification ◽

T Test ◽

Controlled Study ◽

Control Group ◽

P Value ◽

Conventional Drug ◽

Yoga Group ◽

The Difference ◽

Group B ◽

And Control

BACKGROUND: There has been an alarming increase in the prevalence of Coronary Artery Disease (CAD) worldwide and is a leading cause of mortality in India. Yoga is emerging as a signicant tool in managing the disease. OBJECTIVES:The study was conducted to nd out the effect of yogic lifestyle modication on anginal episodes in CAD patients. METHODS: This prospective, controlled study included the CAD patients between the ages 30 to 70 years who were randomised to yoga group (group A, n=51) and control group (group B, n=51). They were assessed clinically on the basis of number of anginal episodes per week. The yoga group patients were prescribed a family based yoga programme in addition to the conventional drug treatment for CAD. The control group received conventional drug therapy alone. The patients were assessed at baseline and thereafter, at the end of 6 months. RESULTS: The number of anginal episodes per week reduced signicantly by 25.40% in the yoga group vis-à-vis the control group at the end of six months (independent t-test p-value<0.01). It was also inferred from the study that while at baseline, there was no statistically signicant difference between the yoga and control groups (independent t-test p-value>0.05), the difference became signicant at the end of six months (independent t-test p-value<0.05). CONCLUSIONS: In the present study, we witnessed a substantial and signicant effect of yogic lifestyle intervention in decreasing the number of anginal episodes per week in CAD patients thereby reducing the morbidity associated with the disease considerably

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