scholarly journals A randomised controlled double blind study to assess the effect of oral tizanidine premedication on intraoperative isoflurane consumption in patients undergoing laparoscopic surgeries under general anaesthesia

2021 ◽  
Vol 8 (2) ◽  
pp. 214-220
Author(s):  
Samudyatha T J ◽  
Bhargavi Sanket ◽  
Nethra S Surhonne ◽  
Sudheesh Kannan ◽  
Swathi Nagaraj
Keyword(s):  
Significant Variation ◽  
Demographic Data ◽  
Study Drug ◽  
Double Blind Study ◽  
Double Blind ◽  
Group A ◽  
Group B ◽  
End Tidal ◽  
Randomised Controlled

Tizanidine is an α 2 receptor agonist derived from clonidine with primary central myotonolytic action along with antinociceptive and anticonvulsant action. Unlike clonidine, there are few studies evaluating the role of tizanidine as an effective anaesthetic premedication. Hence this study was undertaken to evaluate oral tizanidine [2 mg and 4 mg] administered preoperatively in decreasing the intraoperative consumption of isoflurane. This prospective, randomised, double blind control trial was undertaken in 75 adult patients scheduled for elective laparoscopic surgeries. The subjects were randomly allocated into 3 groups with Group A (2 mg tizanidine), Group B (4 mg tizanidine), Group C (sugar pellet). The study drug was administered orally 90 minutes preoperatively. Intraoperative isoflurane consumption and end tidal isoflurane was recorded. Demographic data was comparable between the 3 groups. We observed a significant fall in isoflurane consumption in the tizanidine groups [Total: group A = 10.24 (2.07) ml, group B = 8.09 (2.17) ml, group C = 15.43 (4.77), p < 0.001; at 30 min: group A = 6.86 (0.91), group B = 5.22 (0.67), group C = 8.10 (1.15), p < 0.001; at 60 min: group A = 9.29 (0.73), group B = 7.92 (1.31), group C = 12.88 (2.45), p < 0.001; at 90 min: group A = 11.13 (0.83), group B = 10.25 (2.63), group C = 17.25 (2.5), p <0.001]. End tidal isoflurane was also significantly low in the tizanidine groups. Intergroup analysis showed no significant variation between tizanidine 2mg and 4mg. Oral tizanidine [2mg and 4 mg] is as effective and safe anaesthetic premedication in decreasing isoflurane consumption.

The role of tolvaptan in prevention of hyponatremia in patients undergoing transurethral resection of prostate surgery- A randomized double blind study

2021 ◽  
Vol 8 (2) ◽  
pp. 321-325
Author(s):  
Dinesh Kumar Singh ◽  
B B Baj ◽  
Vipin Goyal
Keyword(s):  
Transurethral Resection ◽  
Blind Study ◽  
Transurethral Resection Of Prostate ◽  
Double Blind Study ◽  
Double Blind ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B

The aim of our study to determine the role of tolvaptan in prevention of hyponatremia in transurethral resection of prostate surgery. This is randomized double-blind study conducted in 60 ASA grade status 1 and 2 patients age group between 45-80 yrs undergoing TURP under spinal anaesthesia in urology operation theatre in Mahatma Gandhi hospital Jaipur after receiving permission from hospital ethical committee. A detailed history, complete physical examination and routine investigation were done for all patients followed by informed written consent was obtained. Patients are randomly divided into 2 groups. In group A -30 patients who received orally tab tolvaptan 15 mg and group B-30 patients who received orally tab multivitamin 2 hrs before surgery after doing electrolytes of the patients in the morning. In both groups age (in yrs), wt (in kg), ASA grade, volume of irrigating fluid (in litres), volume of prostate resected (in gm) and duration of surgery (in minutes) all demographic and surgical details data were compared. Electrolytes were compared in both groups pre and post-operatively and statistical analysis was done.There was significant difference in post-operative sodium level between the two groups (A and B). The mean level of sodium significantly reduced post-operatively in group –B (control grp). The mean level of sodium significantly increased post-operatively in group –A (tolvaptan grp). We conclude single dose of tolvaptan -15 mg found to effective in prevention of hyponatremia in patients undergoing TURP.

Comparison of the effects of Dexamethasone and Ondansetron on the Reduction of Postoperative Nausea and Vomiting following Cesarean Section under Spinal Anesthesia

2020 ◽  
Vol 15 ◽  
Author(s):  
Arash karimi ◽  
Jahanbakhsh Nejadi ◽  
Mahnaz Shamseh ◽  
Nooshin Ronasi ◽  
Mehdi Birjandi
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Postoperative Nausea ◽  
Demographic Data ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Elective Cesarean Section ◽  
Double Blind ◽  
Group A ◽  
Group B

Background: Postoperative nausea and vomiting (PONV) is a common complication associated with the use of anesthesia. Several antiemetics are used to reduce the incidence and severity of PONV. The aim of this study is to investigate the role of dexamethasone and ondansetron to treat PONV in patients undergoing cesarean section (c-section) under spinal anesthesia. Methods: This double-blind clinical trial study was performed on patients who were referred to the operating room of Haji Karim Asali Hospital of Khorramabad for elective cesarean section in 2016-17. Upon meeting the inclusion criteria, patients were allotted into two groups (n=60). Group A received 8mg of dexamethasone and group B received 4mg of ondansetron after spinal anesthesia. The Visual Analog Scale (VAS) questionnaire and Depression-Anxiety-Stress Scale (DASS) questionnaire was used for the analysis. Patients with mild to moderate stress, anxiety, and depression were included in the study. Data were analyzed using SPSS 16 software. Results: There was no difference in the demographic data of the two groups. The mean severity of nausea in group A was significantly higher than in group B. The frequency of vomiting in group A was 20 times higher than group B, which was found to be statistically significant, p = 0.018. Concerning the type of delivery with the frequency of nausea, the results showed that the frequency of nausea in group A was 3.24 times higher than group B, however, this difference was not statistically significant, p = 0.106. Conclusion: Based on the results of this study, ondansetron had a significant effect on the alleviation of postoperative nausea and vomiting, as compared to dexamethasone in c-section surgical candidates.

scholarly journals Use of Warm Local Anaesthetic Solution for Caudal Blocks

1992 ◽  
Vol 20 (4) ◽  
pp. 453-455 ◽  
Author(s):  
E. T. M. Lim ◽  
K. Y. Chong ◽  
B. Singh ◽  
W. Jong
Keyword(s):  
Adverse Effects ◽  
Local Anaesthetic ◽  
Room Temperature ◽  
Double Blind Study ◽  
Double Blind ◽  
Anaesthetic Solution ◽  
Group A ◽  
Group B ◽  
Local Anaesthetic Solution ◽  
Speed Of Onset

A double-blind study was undertaken to investigate the effect of prewarmed local anaesthetic solution on the latency of onset of caudal blocks. Forty-four (ASA I-II) patients were allocated into two equal groups. In Group A, the local anaesthetic solutions were injected at room temperature (25°C), while in Group B, they were injected at 37°C. All the caudal blocks were performed using 20 ml of lignocaine 1.5% with adrenaline 1:200,000. The speed of onset of perianal analgesia was found to be significantly faster (39%) with the prewarmed local anaesthetic solution (P < 0.05). No adverse effects were observed.

scholarly journals EMLA Cream Prior to Insertion of Elective Epidurals

1995 ◽  
Vol 23 (3) ◽  
pp. 339-341 ◽  
Author(s):  
J. A. Elson ◽  
M. J. Paech
Keyword(s):  
Elective Caesarean Section ◽  
Needle Insertion ◽  
Patient Comfort ◽  
Epidural Needle ◽  
Double Blind Study ◽  
Double Blind ◽  
Emla Cream ◽  
Skin Infiltration ◽  
Group A ◽  
Group B

A randomized double-blind study was conducted in 83 women scheduled for elective caesarean section to determine the efficacy of EMLA and lignocaine infiltration for epidural insertion. The patients were randomly allocated to one of three groups: Group A (EM/LIG) received EMLA and intradermal and subdermal 1% lignocaine infiltration, Group B (EM/SAL) EMLA and saline while Group C (PL/LIG) received placebo cream and 1% lignocaine. Assessments using a 100 mm pain score were performed on skin infiltration and after subsequent insertion of a 16 gauge Tuohy needle into the supraspinous ligament. Skin changes under the applied cream and nursing rating of patients’ response were also noted. Statistical analyses were performed using Kruskal-Wallis and Fisher's Exact Tests. Groups were comparable for age, weight, parity and EMLA application time (interquartile range 105-150 minutes) There were significantly higher pain scores for skin infiltration in Group C (PL/LIG) (P<0.01) and for epidural needle insertion in Group B (EM/SAL) (P<0.05). We concluded that in this patient population, the application of EMLA cream for at least 90 minutes plus 1% lignocaine infiltration optimized patient comfort for epidural insertion.

scholarly journals A Double-Blind Randomized Prospective Study Comparing Ondansetron with Droperidol in the Prevention of Emesis following Strabismus Surgery

1995 ◽  
Vol 23 (4) ◽  
pp. 438-443 ◽  
Author(s):  
A. Davis ◽  
S. Krige ◽  
D. Moyes
Keyword(s):  
Recovery Time ◽  
Strabismus Surgery ◽  
Double Blind Study ◽  
Double Blind ◽  
Oral Fluids ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
To Receive ◽  
Mean Time

A prospective double-blind study was conducted to compare the anti-emetic efficacy of ondansetron and droperidol in preventing postoperative emesis following strabismus surgery. A sample size of 213 patients was divided into three equal groups to receive ondansetron 150 μg/kg (Group A), ondansetron 75 μg/kg (Group B), or droperidol 75 fig/kg (Group C). All patients received a standardized anaesthetic technique. All episodes of emesis, recovery time, and time to tolerating oral fluids were recorded. The incidence of emesis during 24 hours was Groups A and B 19.7%, and Group C 28.2%. The lower incidence of emesis recorded by the ondansetron groups compared with the droperidol group was not statistically significant. Ondansetron at 75 μg/kg was as effective as 150 μg/kg in reducing emesis when compared with droperidol. Mean time to discharge from the recovery room was 75.3 minutes (Group A), 44.4 minutes (Group B), and 41.0 minutes (Group C). The mean time to tolerating oral fluids was 356.5 minutes (Group A), 402.8 minutes (Group B), and 378.1 minutes (Group C). There was no statistical difference in discharge times from recovery or time to tolerating oral fluids in any of the three groups.

scholarly journals A COMPARITIVE STUDY BETWEEN EPIDURAL BUTORPHANOL, NALBUPHINE AND FENTANYL FOR POSTOPERATIVE ANALGESIA IN LOWER ABDOMINAL SURGERIES

2017 ◽  
Vol 10 (5) ◽  
pp. 383
Author(s):  
Swarna Banerjee ◽  
Shaswat Kumar Pattnaik
Keyword(s):  
Side Effects ◽  
Demographic Data ◽  
Age Groups ◽  
Study Drug ◽  
Sensory Block ◽  
Lower Abdomen ◽  
Post Operative Pain ◽  
Catheter Group ◽  
Group A ◽  
Group B

Background: Achieving satisfactory post-operative analgesia with neuraxial administration of narcotics has been the subject of much research. The use of epidural opioids had become an increasingly popular technique for management of acute post-operative pain in recent times. This study evaluates post-operative analgesic benefits in patients administered epidural butorphanol, nalbuphine, and fentanyl as adjuvants with local anesthetics postoperatively for surgery under epidural anesthesia.Methods: A total of 75 patients belonging to age groups 18-60 years who were scheduled for surgeries of lower abdomen were randomly divided into groups of 25 each. Epidural technique was adopted for surgery of the lower abdomen for all patients with 0.5% bupivacaine. In the post-operative period, the study drug was given through epidural catheter. Group A received butorphanol 2 mg, Group B received fentanyl 100 μg, and Group C received nalbuphine 10 mg with 0.125% bupivacaine diluted to 10 ml in normal saline each. Onset, duration, quality of analgesia, hemodynamic changes, and side effects – such as sedation, pruritus, nausea, vomiting, respiratory depression, and urinary retention - were recorded and compared.Results: The demographic data were comparable in all three groups. The onset of sensory block was significantly earlier in Group B (fentanyl) than other two groups. Duration was significantly longer in Group A (butorphanol). No serious cardiorespiratory side effects were noted in any of groups.Conclusion: Fentanyl produces the faster onset of analgesia with adverse effects like pruritus. Butorphanol administered epidurally has the advantage of longer duration of analgesia than fentanyl or epidural nalbuphine with side effects such as nausea, vomiting, and sedation.Keywords: Epidural analgesia, Butorphanol, Fentanyl, Nalbuphine.

scholarly journals Role of Immediate Release and Delayed Release Omeprazole in Patients with Gastro Esophageal Reflux Disease

2017 ◽  
Vol 11 (2) ◽  
pp. 67-73
Author(s):  
Mahabub Rahman ◽  
Dewan Saifuddin Ahmed ◽  
Syeda Nur E Jannat ◽  
MM Shahin Ul Islam ◽  
Abu Ahmed Abdullah
Keyword(s):  
Reflux Disease ◽  
Immediate Release ◽  
Esophageal Reflux ◽  
Double Blind ◽  
Delayed Release ◽  
End Of Treatment ◽  
Significant Difference ◽  
Group A ◽  
Group B

Proton pump inhibitors are widely used for Gastro Esophageal Reflux Disease (GERD) treatment. This prospective double blind randomized cross over study was carried out in the Department of Gastroenterology, BSMMU from June 2007 to May 2008 to assess the efficacy of Immediate-release omeprazole (IR-OMEP) & Delayed-release Omeprazole (DR-OMEP) in relieving symptoms & healing of oesophagitis in GERD. All patients who fulfilled the inclusion criteria underwent upper gastrointestinal (UGI) endoscopy to be lebelled as nonerosive and erosive GERD. Among total 69 patients, 43 (62.3 %) had nonerosive and 26 (37.7 %) had erosive GERD. Patients were divided into group A (35) and group B (34) who received group A drugs (20 mg IR-OMEP bd) and group B drugs (20 mg DROMEP bd) from day 1-14 respectively. Then drugs were crossed over (group A: 20mg DR-OMEP bd; group B: 20 mg IR-OMEP bd) from day 15-28. Improvement of heartburn, regurgitation in each group were assessed in every week, during drug cross over and at the end and then compared between two groups. There was no significant difference in relieving heartburn and regurgitation between IR-OMEP and DR-OMEP either in erosive or nonerosive GERD (P>0.50). Patients with erosive GERD underwent UGI endoscopy at the end of treatment to see healing of esophagitis. Study showed significant healing of oesophagitis in group A after 4 weeks than group B (14%) (P<0.05) but there is no superiority of IR-OMEP over DR-OMEP in relieving symptoms of GERD.Faridpur Med. Coll. J. Jul 2016;11(2): 67-73

scholarly journals A PHYTOCHEMICAL STUDY OF ANUPA AND JANGALA DESHASTHA SHITIVARAKA (Celosia argentea Linn.).

2018 ◽  
Vol 6 (06) ◽  
Author(s):  
Nitin N Lavate
Keyword(s):  
Geographical Variation ◽  
Study Drug ◽  
Phytochemical Study ◽  
Ayurvedic Drugs ◽  
Celosia Argentea ◽  
Group A ◽  
Place Of Origin ◽  
The Subject ◽  
Group B

Since long the subject of standardization of Ayurvedic drugs is hot. Today it has become a must to give attention towards all the factors which affect the potency of the drug. After lot of observation it was found that the geographical variation and climate of the place of origin of the drug may be the major factor in influencing the potency of drug. Hence for current study drug Shitivaraka is collected from Anupa and Jangala regions; and this drug is well known for its Mootrala (diuretic) property, it is mentioned and utilized by the Brahtrayi physicians for the treatment. The role of research in Ayurveda is not only to elucidate the principles of Ayurveda but also, to explain them in terms of modern parameters. Group-A(anupa), Group-B (Jangala), powdered drug is used for phytochemical study.

scholarly journals The Effect of Use of Anidulafungin on Failure of Weaning Due to Ventilator-associated Pneumonia which Complicate Contused Lungs

2018 ◽  
Vol 12 (1) ◽  
pp. 73-84
Author(s):  
Mohamed Gaber Ibrahium Mostafa Allam
Keyword(s):  
Broad Spectrum ◽  
Antifungal Drugs ◽  
Lung Contusion ◽  
Prolonged Treatment ◽  
Double Blind Study ◽  
Ventilator Associated Pneumonia ◽  
Double Blind ◽  
Broad Spectrum Antibiotics ◽  
Group A ◽  
Group B

Introduction:Failure of weaning is considered one of the most difficult challenges facing any intensivist especially in the devitalized lung due to infected lung contusion. Unsatisfactory results with prolonged treatment with the proper broad-spectrum antibiotics raise the point of exclusion of candidemia or suspected pulmonary candidiasis which is considered a major problem not only because of increasing rate (2-10 per 1000 ICU admission) but also because of difficult diagnosis. Patients with failure of weaning due to unresolved VAP after receiving broad-spectrum antibiotics for more than 10 days especially in preexisting severe lung contusion should be put on empirical systemic antifungal. Echinocandins are a new class of antifungal drugs used as a reliable class for empirical systemic antifungal treatment.Aim of Work:The study aims to evaluate and compare the effect of the use of anidulafungin on weaning from the ventilator due VAP which complicates traumatized contused lungs after 2 weeks from ventilation.Patients and Methods:This was a prospective double-blind study done on 200 patients admitted to King Abdulaziz Specialized Hospital, Taif, KSA between March 2015 and August 2018 in surgical ICU with the failure of weaning due to Ventilator Associated Pneumonia (VAP) complicate contused lungs. Group (A) 100 patients started on antibiotics regimen according to qualitative culture for 2 weeks while group (B) 100 patients received anidulafungin with the antibiotics regimen.In this study, diagnosis of lung contusion was made by Computerized Axial Tomography (CT) chest while both VAP was diagnosed by a modified Clinical Pulmonary Infection Score (CPIS). A score of 6 or more was considered VAP.Results:Comparing the data of the patients in the 3 studied periods (1st5 days, 2nd5 days and last 4 days) controlled tracheal secretion was recorded in 15, 38 and 46 patients in group A respectively in the 3 studied periods compared to 28, 75 and 83 in group B. Less parenchymatous lung infiltration in the chest X-ray found was in 12, 40 and 48 patients in group A compared to 24, 88 and 91 patients in group B. Improvement of the hypoxic index in 48, 76 and 85 patients in group A was compared to 66, 90 and 98 patients in B. Normalization of temperature in 16, 36 and 54 patients in group A while 40, 76 and 90 patients in B and reduction of total leucocytic count in 18, 35 and 57 patients in group A while 38, 70 and 87 patients in group B were observed. There were 15 out of 98 patients in Group A not weaned while only 5 out of 100 patients in group B failed to be weaned from mechanical ventilation within the study period (2 weeks).Conclusion:The use of anidulafungin with proper antibiotics in patients with failure of weaning due to VAP complicate contused lung efficiently treated VAP and reduced the morbidity by accelerating the weaning from the ventilator compared to the use of proper antibiotics alone.

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