scholarly journals Intranasal midazolam versus intranasal dexmedetomidine as premedication in paediatric patients: A comparative study

2021 ◽  
Vol 8 (4) ◽  
pp. 532-536
Author(s):  
Vinayak Gour ◽  
Vimal Dangi ◽  
Sushil Chand Verma
Keyword(s):  
Separation Anxiety ◽  
Controlled Trial ◽  
Parental Separation ◽  
Paediatric Patients ◽  
Post Operative Pain ◽  
Significant Difference ◽  
Preanesthetic Medication ◽  
Baseline Values ◽  
Randomised Controlled ◽  
Parental Separation Anxiety

: Preanesthetic medication is important among the paediatric patients undergoing surgeries. A good preanesthetic medication reduces the anxiety and the post-operative pain among paediatric patients. A randomised controlled trial was done to compare the two groups of Dexmedetomidine, and Midazolam given as preanesthetic medication intranasally.: Both the groups had comparable baseline values before premedication but there was a significant difference in the vital parameters of heart rate and systolic blood pressure after medication. The mean Parental Separation Anxiety Scale was found to be 1.4 ± 0.85 and 2.5 ± 0.98 among Dexmedetomidine and Midazolam group respectively. This was found to be significant (p < 0.001). Dexmedetomidine when given as preanesthetic medication intranasally significantly controls the vitals within the normal range and produces better parental separation anxiety scores and mask acceptance scores as compared to Midazolam.

A randomised controlled trial comparing compression therapy after stripping for primary great saphenous vein incompetence

2019 ◽  
Vol 34 (10) ◽  
pp. 669-674 ◽  
Author(s):  
Attila G Krasznai ◽  
Tim A Sigterman ◽  
Janine P Houtermans-Auckel ◽  
Ed Eussen ◽  
Maarten Snoeijs ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Controlled Trial ◽  
Compression Therapy ◽  
Full Recovery ◽  
Control Group ◽  
Post Operative Pain ◽  
Significant Difference ◽  
Randomised Controlled

Background Venous insufficiency of the lower extremity affects up to 40–60% of general adult population in the Western population, of which around 25% has varicose veins mostly treated by ablation of the incompetent great saphenous vein. Although endovenous options are available, the majority is still treated with stripping of the great saphenous vein for which there is no consensus regarding postoperative compressive therapy. The objective of this prospective randomised controlled trial was to evaluate 4 h compared to 72 h of leg compression after great saphenous vein stripping. Method Patients in the Zuyderland Medical Centre with an indication for stripping of the great saphenous vein were eligible for inclusion in this study. Patients were randomised to 4 or 72 h of leg compression (standard elastic bandaging) after stripping of the great saphenous vein. Primary outcome was change in leg volume after 14 days. Secondary outcomes were post-operative pain scores, complications and time to full recovery. Results A total of 78 patients were randomised, 36 patients enrolled the intervention (4 h) group and 42 patients the control group (72 h). The intervention group (4 h) showed a 57 mL reduction in leg volume after 14 days, compared to 6 mL of the control group (72 h) ( p = 0.11). Post-operative pain, complications and time to full recovery did not statistically differ. Conclusion Wearing leg compression four hours after stripping is non-inferior in preventing leg oedema compared with 72 h compression therapy. No statistically significant difference in pain and time to full recovery was shown.

scholarly journals Guillotine versus dissection tonsillectomy: randomised, controlled trial

2012 ◽  
Vol 126 (11) ◽  
pp. 1142-1149 ◽  
Author(s):  
S J Frampton ◽  
M J A Ward ◽  
V S Sunkaraneni ◽  
H Ismail-Koch ◽  
Z A Sheppard ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Blood Loss ◽  
Operative Time ◽  
Controlled Trial ◽  
Operative Blood Loss ◽  
Post Operative Pain ◽  
Significant Difference ◽  
Secondary Haemorrhage ◽  
Randomised Controlled ◽  
Cold Steel Dissection

AbstractObjective:This trial aimed to compare the guillotine technique of tonsillectomy with ‘cold steel’ dissection, the current ‘gold standard’.Design:A single centre, randomised, controlled trial.Methods:One hundred children aged 3 to 11 years who were listed for bilateral tonsillectomy were recruited. Patients had one tonsil removed by each technique, and were blinded to the side. The operative time, intra-operative blood loss, haemostasis requirement and post-operative pain scores were recorded and compared.Results:Operative time and intra-operative blood loss were both significantly less for the guillotine technique (p < 0.001) and there was a significantly reduced haemostasis requirement (p < 0.001). Pain was also less on the guillotine side (p < 0.001). There were no tonsillar remnants or palatal trauma for either technique. There was no significant difference between techniques in the frequency of secondary haemorrhage.Conclusion:This study provides level Ib evidence that guillotine tonsillectomy in children with mobile tonsils is an effective and time-efficient procedure which produces less intra-operative blood loss and post-operative pain than cold steel dissection.

scholarly journals Comparison of Intranasal Dexmedetomidine and Oral Midazolam for Premedication in Pediatric Dental Patients under General Anesthesia: A Randomised Clinical Trial

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Li Wang ◽  
Lili Huang ◽  
Tiejun Zhang ◽  
Wei Peng
Keyword(s):  
Separation Anxiety ◽  
Pediatric Anesthesia ◽  
Pediatric Dentistry ◽  
Parental Separation ◽  
Hemodynamic Parameters ◽  
Emergence Delirium ◽  
Oral Midazolam ◽  
Significant Difference ◽  
Acceptance Scale ◽  
Parental Separation Anxiety

The aim of this study was to compare the effects of preoperative intranasal dexmedetomidine and oral midazolam on preoperative sedation and postoperative agitation in pediatric dentistry. A total of 60 children (ASA grade I, aged 3–6 years) scheduled for elective pediatric dental treatment were randomly divided into the dexmedetomidine (DEX) and midazolam (MID) groups. Ramsay sedation score, parental separation anxiety scale, mask acceptance scale, pediatric anesthesia emergence delirium scale, and hemodynamic parameters were recorded. The Ramsay sedation scale and hemodynamic parameters of the children were observed and recorded immediately before administration and 10, 20, and 30 min after administration. A satisfactory mask acceptance scale rate was 93.33% in both MID and DEX groups, and there was no significant difference between the two groups (p>0.05). The proportions of children that “successfully separated from their parents” were 93.33% (MID) and 96.67% (DEX). No significant difference was found between the two groups (p>0.05). The incidence of agitation was 20% in the MID group and 0% in the DEX group, and the difference was statistically significant (p<0.05). Intranasal dexmedetomidine and oral midazolam provided satisfactory sedation. No significant difference between the two groups was found in terms of parental separation anxiety and mask acceptance (p>0.05). The incidence of postoperative pediatrics emergence delirium was significantly lower in the DEX group (p<0.05).

Electroacupuncture Analgesia in Major Abdominal and Pelvic Surgery: A Randomised Study

1997 ◽  
Vol 15 (1) ◽  
pp. 10-13 ◽  
Author(s):  
P Poulain ◽  
E Pichard Léandri ◽  
A Laplanche ◽  
F Montange ◽  
J Bouzy ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Acupuncture Group ◽  
Pelvic Surgery ◽  
Spontaneous Respiration ◽  
Control Group ◽  
Narcotic Analgesics ◽  
Randomised Study ◽  
Post Operative Pain ◽  
Significant Difference ◽  
Randomised Controlled

Proponents of acupuncture anaesthesia have tended to look on it as a replacement for conventional anaesthesia. This randomised, controlled trial involving 250 cancer patients undergoing abdominal or pelvic surgery, has aimed to assess the use of electroacupuncture as the sole analgesic, but within a standard anaesthetic. It was found that while there was little difference between the per-operative requirement for anaesthetic drugs, all the non acupuncture group required fentanyl, compared to only 5% of the electroacupuncture group (P<0.001). Time to spontaneous respiration (P<0.02) and extubation (P<0.001) immediately post-operatively was reduced in the acupuncture group. Transcutaneous electrical nerve stimulation (TENS) was used for post-operative pain relief in the acupuncture group, while the control group received non-narcotic analgesics. There was no significant difference in the numbers of patients complaining of pain, but the requirement for additional analgesia was less when TENS was used (P<0.01). There was no difference in the period of post-operative ileus as measured by the return of normal bowel sounds. However the return to normal self caring was significantly improved in the acupuncture group (P<0.02). Both practically and economically this is probably the most important beneficial aspect of electroacupuncture demonstrated by this study.

Capsular closure versus unrepaired interportal capsulotomy after hip arthroscopy in patients with femoroacetabular impingement, results of a patient-blinded randomised controlled trial

2021 ◽  
pp. 112070002110057
Author(s):  
Niels H Bech ◽  
Inger N Sierevelt ◽  
Sheryl de Waard ◽  
Boudijn S H Joling ◽  
Gino M M J Kerkhoffs ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Femoroacetabular Impingement ◽  
Hip Arthroscopy ◽  
Controlled Trial ◽  
Poor Quality ◽  
Control Group ◽  
Treatment Groups ◽  
Significant Difference ◽  
Randomised Controlled

Background: Hip capsular management after hip arthroscopy remains a topic of debate. Most available current literature is of poor quality and are retrospective or cohort studies. As of today, no clear consensus exists on capsular management after hip arthroscopy. Purpose: To evaluate the effect of routine capsular closure versus unrepaired capsulotomy after interportal capsulotomy measured with NRS pain and the Copenhagen Hip and Groin Outcome Score (HAGOS). Materials and methods: All eligible patients with femoroacetabular impingement who opt for hip arthroscopy ( n = 116) were randomly assigned to one of both treatment groups and were operated by a single surgeon. Postoperative pain was measured with the NRS score weekly the first 12 weeks after surgery. The HAGOS questionnaire was measured at 12 and 52 weeks postoperatively. Results: Baseline characteristics and operation details were comparable between treatment groups. Regarding the NRS pain no significant difference was found between groups at any point the first 12 weeks after surgery ( p = 0.67). Both groups significantly improved after surgery ( p < 0.001). After 3 months follow-up there were no differences between groups for the HAGOS questionnaire except for the domain sport ( p = 0.02) in favour of the control group. After 12 months follow-up there were no differences between both treatment groups on all HAGOS domains ( p  > 0.05). Conclusions: The results of this randomised controlled trial show highest possible evidence that there is no reason for routinely capsular closure after interportal capsulotomy at the end of hip arthroscopy. Trial Registration: This trial was registered at the CCMO Dutch Trial Register: NL55669.048.15.

scholarly journals The Effects of Time-Restricted Eating versus Standard Dietary Advice on Weight, Metabolic Health and the Consumption of Processed Food: A Pragmatic Randomised Controlled Trial in Community-Based Adults

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 1042
Author(s):  
Nicholas Phillips ◽  
Julie Mareschal ◽  
Nathalie Schwab ◽  
Emily Manoogian ◽  
Sylvie Borloz ◽  
...  
Keyword(s):  
Weight Loss ◽  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Smartphone Application ◽  
Metabolic Health ◽  
Dietary Advice ◽  
Processed Food ◽  
Significant Difference ◽  
Randomised Controlled ◽  
Pragmatic Randomised Controlled Trial

Weight loss is key to controlling the increasing prevalence of metabolic syndrome (MS) and its components, i.e., central obesity, hypertension, prediabetes and dyslipidaemia. The goals of our study were two-fold. First, we characterised the relationships between eating duration, unprocessed and processed food consumption and metabolic health. During 4 weeks of observation, 213 adults used a smartphone application to record food and drink consumption, which was annotated for food processing levels following the NOVA classification. Low consumption of unprocessed food and low physical activity showed significant associations with multiple MS components. Second, in a pragmatic randomised controlled trial, we compared the metabolic benefits of 12 h time-restricted eating (TRE) to standard dietary advice (SDA) in 54 adults with an eating duration > 14 h and at least one MS component. After 6 months, those randomised to TRE lost 1.6% of initial body weight (SD 2.9, p = 0.01), compared to the absence of weight loss with SDA (−1.1%, SD 3.5, p = 0.19). There was no significant difference in weight loss between TRE and SDA (between-group difference −0.88%, 95% confidence interval −3.1 to 1.3, p = 0.43). Our results show the potential of smartphone records to predict metabolic health and highlight that further research is needed to improve individual responses to TRE such as a shorter eating window or its actual clock time.

scholarly journals Effect of Engaging Trainees by Assessing Peer Performance: A Randomised Controlled Trial Using Simulated Patient Scenarios

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Charlotte Loumann Krogh ◽  
Charlotte Ringsted ◽  
Charles B. Kromann ◽  
Maria Birkvad Rasmussen ◽  
Tobias Todsen ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Global Rating ◽  
Training Performance ◽  
Significant Difference ◽  
Training Format ◽  
Peer Performance ◽  
And Performance ◽  
Randomised Controlled

Introduction. The aim of this study was to explore the learning effect of engaging trainees by assessing peer performance during simulation-based training.Methods. Eighty-four final year medical students participated in the study. The intervention involved trainees assessing peer performance during training. Outcome measures were in-training performance and performance, both of which were measured two weeks after the course. Trainees’ performances were videotaped and assessed by two expert raters using a checklist that included a global rating. Trainees’ satisfaction with the training was also evaluated.Results. The intervention group obtained a significantly higher overall in-training performance score than the control group: mean checklist score 20.87 (SD 2.51) versus 19.14 (SD 2.65)P=0.003and mean global rating 3.25 SD (0.99) versus 2.95 (SD 1.09)P=0.014. Postcourse performance did not show any significant difference between the two groups. Trainees who assessed peer performance were more satisfied with the training than those who did not: mean 6.36 (SD 1.00) versus 5.74 (SD 1.33)P=0.025.Conclusion. Engaging trainees in the assessment of peer performance had an immediate effect on in-training performance, but not on the learning outcome measured two weeks later. Trainees had a positive attitude towards the training format.

Intranasal dexmedetomidine to facilitate mask induction and prevent emergence delirium.

2021 ◽  
Author(s):  
Michiel Denis ◽  
Hans Goethuys ◽  
Elly Vandermeulen ◽  
Dieter Mesotten ◽  
Joris Vundelinckx
Keyword(s):  
Day Care ◽  
Recovery Room ◽  
Controlled Trial ◽  
Perioperative Period ◽  
Control Group ◽  
Care Hospital ◽  
Implementation Study ◽  
Emergence Delirium ◽  
Paediatric Patients ◽  
Randomised Controlled

Abstract Background As children are exposed to stress and anxiety during the perioperative period, pre-anaesthetic medication to facilitate induction of anaesthesia without prolonging recovery is needed. Dexmedetomidine is increasingly being used for sedation in the intensive care units and for procedural anaesthesia outside the operating room. However, the effectiveness of pre-operative sedation with intranasal dexmedetomidine in paediatric patients undergoing ambulatory surgery has not yet been well characterised. Aims To identify the effectiveness of intranasal dexmedetomidine in facilitating mask induction and preventing emergence agitation. Methods In a single centre retrospective implementation study, we compared intranasal dexmedetomidine (2 µg/kg) administration, sequentially in all paediatric patients undergoing minor urological surgery between January 2019 and July 2019 with a period in which dexmedetomidine was not administered. The outcome measures were tolerance of mask induction, post-operative sedation and the Paediatric Anaesthesia Emergence Delirium scale (PAED) score. Results The 53 children in the control group were compared with 50 children in the dexmedetomidine group during implementation. The incidence of sedation on mask induction was greater in patients given dexmedetomidine compared to those who did not receive premedication (60% versus 0%, p<0.0001). The proportion of children who were asleep but easily arousable in the recovery room and in day-care hospital was greater in the dexmedetomidine group compared to the control group. (32% versus 7% in the recovery room; p=0.004, and 20% versus 2% in day-care hospital, p = 0.002). The PAED scores did not differ between the two groups, neither in the recovery room nor in day-care hospital. Conclusion In paediatric patients undergoing small urologic surgery, premedication with intranasal dexmedetomidine in a dose of 2µg/kg provides adequate sedation and anxiolysis on mask induction and in the postoperative period. These results from an implementation study need to be confirmed in a multicentre blinded randomised controlled trial.

scholarly journals The Effect of Glycomacropeptide versus Amino Acids on Phenylalanine and Tyrosine Variability over 24 Hours in Children with PKU: A Randomized Controlled Trial

Nutrients ◽  
2019 ◽  
Vol 11 (3) ◽  
pp. 520 ◽  
Author(s):  
Anne Daly ◽  
Sharon Evans ◽  
Satnam Chahal ◽  
Saikat Santra ◽  
Alex Pinto ◽  
...  
Keyword(s):  
Amino Acids ◽  
Controlled Trial ◽  
Target Range ◽  
Blood Spots ◽  
Meal Plan ◽  
Significant Difference ◽  
Randomised Controlled ◽  
Limiting Amino Acids ◽  
The Impact ◽  
Rate Limiting

Introduction: In phenylketonuria (PKU), evidence suggests that casein glycomacropeptide supplemented with rate-limiting amino acids (CGMP-AA) is associated with better protein utilisation and less blood phenylalanine (Phe) variability. Aim: To study the impact of CGMP-AA on blood Phe variability using 3 different dietary regimens in children with PKU. Methods: This was a 6-week randomised controlled cross-over study comparing CGMP-AA vs. Phe-free l-amino acids (l-AA) assessing blood Phe and tyrosine (Tyr) variability over 24 h in 19 children (7 boys) with PKU, with a median age of 10 years (6–16). Subjects were randomised to 3 dietary regimens: (1) R1, CGMP-AA and usual dietary Phe (CGMP + Phe); (2) R2, CGMP-AA − Phe content of CGMP-AA from usual diet (CGMP − Phe); and (3) R3, l-AA and usual dietary Phe. Each regimen was administered for 14 days. Over the last 48 h on days 13 and 14, blood spots were collected every 4 h at 08 h, 12 h, 16 h, 20 h, 24 h, and 04 h. Isocaloric intake and the same meal plan and protein substitute dosage at standardised times were maintained when blood spots were collected. Results: Eighteen children completed the study. Median Phe concentrations over 24 h for each group were (range) R1, 290 (30–580), R2, 220 (10–670), R3, 165 (10–640) μmol/L. R1 vs. R2 and R1 vs. R3 p < 0.0001; R2 vs. R3 p = 0.0009. There was a significant difference in median Phe at each time point between R1 vs. R2, p = 0.0027 and R1 vs. R3, p < 0.0001, but not between any time points for R2 vs. R3. Tyr was significantly higher in both R1 and R2 [70 (20–240 μmol/L] compared to R3 [60 (10–200) μmol/L]. In children < 12 years, blood Phe remained in the target range (120–360 μmol/L), over 24 h, for 75% of the time in R1, 72% in R2 and 64% in R3; for children aged ≥ 12 years, blood Phe was in target range (120–600 μmol/L) in R1 and R2 for 100% of the time, but 64% in R3. Conclusions: The residual Phe in CGMP-AA increased blood Phe concentration in children. CGMP-AA appears to give less blood Phe variability compared to l-AA, but this effect may be masked by the increased blood Phe concentrations associated with its Phe contribution. Reducing dietary Phe intake to compensate for CGMP-AA Phe content may help.

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