Effect of tonsillar fossa cooling with cold saline on early post-tonsillectomy pain: A randomized, double-blind controlled study

2021 ◽  
Vol 8 (2) ◽  
pp. 243-249
Author(s):  
Joseph Abraham Poonuraparampil ◽  
Kusuma R Halemani ◽  
Habib M R Karim ◽  
Meryl R John ◽  
Tuhin Mistry
Keyword(s):  
Postoperative Pain ◽  
Sore Throat ◽  
Statistical Tests ◽  
Pain Scale ◽  
Controlled Study ◽  
Double Blind ◽  
Tonsillar Fossa ◽  
Pain Scores ◽  
Valuable Adjunct ◽  
American Society

Postoperative pain following tonsillectomy is troublesome, and non-pharmacological methods can be a valuable adjunct to reduce the intensity of pain. Cooling can attenuate the damage done to tissues by hot dissection techniques.Thestudy was aimed to assess the effect of tonsillar fossa cooling on post-tonsillectomy pain. Forty patients aged 8-18 years of American Society of Anaesthesiologists physical status I and II scheduled for elective bilateral tonsillectomy with bipolar electrocautery under general anaesthesia were recruited. After obtaining consent and approval from the institutional ethical committee, they were randomly assigned to one of the two groups. At the end of tonsillectomy, the tonsillar fossa was packed for 10 minutes using gauze soaked in ice-cold 0.9% saline (5–10 ºC) in group T (test) and saline at room temperature in group C (control). The postoperative pain scores using Faces Pain Scale-Revised (FPS–R) and sore throat were evaluated at 15 minutes, 1 hour, 6 hours and 12 hours. All the data were analyzed using appropriate statistical tests. P < 0.05 was considered significant.Pain scores were significantly lower in group T as compared to group C at all time points. (p<0.05) The rescue analgesic consumption was lower in group T.(p<0.05) There was no difference in of sore throat between two groups. Cooling of the tonsillar fossa with ice-cold 0.9% saline after hot dissection tonsillectomy is a useful adjunct in reducing postoperative pain without any significant complications.

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)

A COMPARATIVE STUDY BETWEEN LIGNOCAINE NEBULISATION AND MAGNESIUM SULPHATE NEBULISATION FOR ATTENUATION OF POSTOPERATIVE SORE THROAT

2021 ◽  
pp. 9-11
Author(s):  
Dhiman Neogi ◽  
Sudeshna Bhar Kundu ◽  
Chaitali Biswas ◽  
Anisha Ghosh ◽  
Sourav Das
Keyword(s):  
Sore Throat ◽  
Postoperative Period ◽  
Magnesium Sulphate ◽  
Severity Score ◽  
Elective Surgery ◽  
Statistical Tests ◽  
Orotracheal Intubation ◽  
Controlled Study ◽  
Postoperative Sore Throat ◽  
Double Blind

BACKGROUND: Postoperative sore throat (POST) is a common complication following general anaesthesia (GA) with orotracheal intubation. Both magnesium sulphate nebulisation and lignocaine nebulisation have been reported to be used successfully to reduce the incidence and severity of POST. Till date, no study has been reported comparing the efcacy of these two drugs for attenuation of POST. Therefore, the aim of this study was to compare the efcacy of preoperative lignocaine nebulisation and magnesium sulphate nebulisation in reducing the incidence and severity of POSTin patients undergoing GAwith orotracheal intubation. METHODS:Aprospective, double blind, parallel group, randomised, controlled study was conducted on 96 patients, aged between 18-50 years, ASAphysical status I and II, undergoing elective surgery under GAwith orotracheal intubation. Patients were randomly allocated into two groups, group L and group M. The patients in group L (n=48) received 4% lignocaine nebulisation (3 ml) and those in group M (n=48) received isotonic magnesium sulphate nebulisation (3 ml) over 15 minutes ending 5 minutes prior to induction of GA. The patients were assessed for incidence and severity of POST, cough, hoarseness of voice and dysphagia at 5 minutes and thereafter at 1, 4, 12, 24 and 48 hours in the postoperative period. All data were compared using appropriate statistical tests. RESULTS: POST four-point scale was found to be signicantly lower in group M in comparison to group L at 5 minutes and 1 hour in the postoperative period. Hoarseness severity score and dysphagia severity score were also signicantly lower in group M at 1 hour postoperatively. CONCLUSION: In comparison to lignocaine nebulisation; magnesium sulphate nebulisation was found to be more effective to reduce the incidence and severity of POST, hoarseness of voice, and dysphagia particularly in the early postoperative period.

Prospective, Double-blind Evaluation of Perioperative Intravenous Acetaminophen and Ketorolac for Postoperative Pain and Opioid Consumption After Endoscopic Carpal Tunnel Release

Hand ◽  
2020 ◽  
pp. 155894472090650
Author(s):  
Elizabeth C. Truelove ◽  
Eva Urrechaga ◽  
Carmella Fernandez ◽  
John R. Fowler
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Opioid Consumption ◽  
Controlled Study ◽  
Opioid Use ◽  
Double Blind ◽  
Pain Scores ◽  
Endoscopic Carpal Tunnel Release

Background: The current opioid epidemic highlights the need for pain management strategies to decrease or eliminate postoperative use of opioid medications. The purpose of this study was to determine if perioperative administration of intravenous (IV) acetaminophen and/or IV ketorolac decreases postoperative pain and opioid consumption after endoscopic carpal tunnel release. Methods: In all, 44 subjects were enrolled in this randomized, double-blind, placebo-controlled study from October 2015 to April 2017 and divided into 4 treatment arms: placebo, IV acetaminophen, IV ketorolac, or both IV acetaminophen and IV ketorolac. Patients recorded pain at 8-hour intervals on an 11-point scale and daily opioid use for 7 days after surgery. Analysis of variance and Kruskal-Wallis tests were used to compare mean pain scores and opioid consumption. Results: Mean pain scores over the 7-day study period were lower in the placebo and IV acetaminophen groups. Patients in the placebo and acetaminophen groups reported less pain than those in the ketorolac and combination groups on postoperative days 6 and 7. Patients administered IV acetaminophen had lower daily mean opioid usage. In all, 50% of the patients did not take any opioids after surgery. Conclusions: There are small, statistically significant differences in postoperative pain and opioid consumption supporting the use of IV acetaminophen for pain control after endoscopic carpal tunnel release, though these results are likely not clinically relevant. We recommend continued investigation into multimodal pain management in upper extremity surgery as well as limiting the number and quantity of opioid prescriptions provided to patients postoperatively.

scholarly journals Preoperative Rectal Indomethacin for Analgesia after Laparoscopic Sterilisation

1992 ◽  
Vol 20 (3) ◽  
pp. 337-340 ◽  
Author(s):  
S. Crocker ◽  
M. Paech
Keyword(s):  
Postoperative Pain ◽  
Controlled Study ◽  
Day Case ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Pain Scores ◽  
Preoperative Administration ◽  
Subjective Pain ◽  
Clinical Benefits ◽  
Rectal Indomethacin

A randomised, double-blind, placebo-controlled study was conducted among 56 day-case patients to determine the effect of the preoperative administration of rectal indomethacin on postoperative pain and opioid requirements after laparoscopic sterilisation. Outcome in women receiving indomethacin did not differ significantly from the placebo group, but there was a trend to lower subjective pain scores, reduction in early postoperative pain assessed objectively and lower parenteral pethidine requirements in the first three hours postoperatively. Indomethacin did not appear either to cause side-effects or to significantly reduce morbidity from the other postoperative sequelae of laparoscopy. Despite evidence for postoperative analgesic effect, the clinical benefits of premedication with rectal indomethacin were minor.

scholarly journals Reliable and rapid smooth extubation after Ketofol for induction of general anesthesia in Laparoscopic Drilling of polycystic ovary: A randomized controlled trial

2020 ◽  
Author(s):  
Atef Mohamed Sayed Mahmoud ◽  
Joseph Makram Botros ◽  
Safaa Gaber Ragab
Keyword(s):  
General Anesthesia ◽  
Polycystic Ovary ◽  
Controlled Trial ◽  
Controlled Study ◽  
Double Blind ◽  
Randomized Controlled ◽  
Airway Response ◽  
American Society ◽  
American Society Of Anesthesiologists ◽  
Better Than

Abstract Background the outcome of ketofol on the hemodynamics and the airway response during induction of general anesthesia has been studied before. Its effect on smoothness of extubation has not been studied before. So, we aimed to assess the effect of ketofol on the smoothness of extubation and compare it with propofol only for induction of general anesthesia. Methods This double-blind, randomized, and controlled study was conducted on one hundred and six American Society of Anesthesiologists Physical status ''ASA PS'' class I and II female patients aged 18–40 years old and scheduled for laparoscopic drilling for polycystic ovary disease under general anesthesia. The patients were assigned into one of two groups (53) patients each; group KP = ketofol and group P = propofol. Results There was good sedation score during suction and extubation in the ketofol group. Airway response and smoothness of extubation were better in the ketofol group better than the propofol group. Conclusion Ketofol as an induction anesthetic agent was effective in attenuating the airway response during extubation more than profofol only. Trial registration: This trial was retrospectively registered at the Clinical Trial.gov with the Identification Number: NCT04365686.

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