A comparative study on the effectiveness of budesonide nasal irrigation versus normal saline nasal irrigation in post endoscopic sinus surgery patients

: Comparative studies evaluating budesonide and saline nasal irrigations for patients with polyposis/ rhinosinusitis are deficient in the current literature. This study aimed to evaluate the effectiveness of budesonide nasal irrigations compared with saline irrigations during postoperative care of patients with rhinosinusitis.: A total of 100 patients who underwent functional Endoscopic Sinus SurgeryESS) were randomly divided into two groups (A and B) of 50 participants each (normal saline [NS] + budesonide irrigation and NS irrigation alone, respectively). Pre- and post operative evaluation was done with a 22-item sinonasal outcomes test (SNOT-22), and Lund Kennedy endoscopic (LKE scores) in second and sixth week. : The condition of the patients significantly improved in both intervention arms related to SNOT-22 and LKE score at each postoperative visit (Group A: p<0.001, Group B: p<0.001). The reduction of SNOT 22 score was higher in budesonide group by 10% (mean SNOT 22 score from 33.31 to 15.84) compared to normal saline group (mean SNOT 22 score from 37.49 to 22.24). The reduction of LKEscore was higher in budesonide group by 18.69% (mean LKE score from 4.49 to 2.71) compared to normal saline group (mean LKE score from 5.02 to 4). : Steroid nasal irrigation is a good option in postoperative EES patients. The difference of reduction of both SNOT 22 score and LKEscore was statistically significant (p <0.05 and p<0.01 respectively) by repeated contrast test. This study is one of the few comparative studies evaluating budesonide and saline nasal irrigations in post-ESS patients.

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The Effect of Prophylactic Ephedrine on Systemic Hypotension Caused by Induction of Anaesthesia with Propofol and Sufentanil in Elderly Hypertensive Patients: A Prospective Randomized, Double-blind Placebo-controlled Clinical Trial

10.22514/sv.2020.16.0081 ◽

2020 ◽

Keyword(s):

Blood Pressure ◽

General Anesthesia ◽

Normal Saline ◽

Saline Group ◽

Normal Saline Group ◽

Hypertensive Patients ◽

Group A ◽

Elderly Hypertensive ◽

Elderly Hypertensive Patients ◽

Group B

Objective: To study the effectiveness of prophylactic ephedrine to prevent hypotension caused by induction of anesthesia with propofol and sufentanil in elderly hypertensive patients. Methodology: 70 elderly ASA grade II-III hypertensive patients undergoing elective general anesthesia were randomized into two groups to receive either intravenous ephedrine,100 ug/kg in 5ml normal saline (Group B), or an equal volume of normal saline (Group A) before induction. Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP) and Heart Rate (HR) were recorded at T0 (after entry to the operating room), T1 (1 min after induction), T2 (2 min after induction), T3 ( 3 min after induction), T4 (4 min after induction), T5 (when intubated), T6 (2 min after intubation), and T7 (at the start of the procedure), as well as the incidence of hypotension and bradycardia. Results: SBP, DBP and HR were not significantly different at T0 and were significantly different at T1 to T7 after anesthesia induction. There were statistically significant effect on hypotension and bradycardia between the two groups and group B have a lower risk of hypotension and bradycardia relative to group A. SBP and DBP decreased significantly after induction in both groups. HR decreased significantly in group A while increased in group B. Conclusion: Ephedrine pretreatment can minimize hypotension and bradycardia caused by propofol and sufentanil during the induction of general anesthesia in elderly patients with hypertension.

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Comparison of Ketamine, Fentanyl and Clonidine as an Adjuvant During Bupivacaine Caudal Anaesthesia in Paediatric Patients

Kathmandu University Medical Journal ◽

10.3126/kumj.v10i3.8013 ◽

2013 ◽

Vol 10 (3) ◽

pp. 25-29

Author(s):

Jeevan Singh ◽

RS Shah ◽

N Vaidya ◽

PK Mahato ◽

S Shrestha ◽

...

Keyword(s):

Side Effects ◽

Normal Saline ◽

Saline Group ◽

Single Shot ◽

Normal Saline Group ◽

Post Operative Pain ◽

Caudal Anaesthesia ◽

Caudal Analgesia ◽

Lower Pain ◽

Group B

Background Caudal epidural analgesia with bupivacaine is very popular in paediatric anaesthesia for providing intra- and postoperative analgesia. Several adjuvants have been used to prolong the action of bupivacaine. Objectives To compare the efficacy of ketamine, fentanyl and clonidine in terms of quality and duration of analgesia they produce when added with caudal bupivacaine by single shot technique in children. Methods Eighty children, age one to ten years, undergoing sub-umbilical surgery, were prospectively randomized to one of four groups: caudal analgesia with 0.75 ml/kg of 0.25% bupivacaine in normal saline (Group B) or caudal analgesia with 0.75 ml/kg of 0.25% bupivacaine with 1 μg/kg of clonidine in normal saline (Group BC) or caudal analgesia with 0.75ml/kg of 0.25% bupivacaine with ketamine 0.5mg/kg (Group BK) or caudal analgesia with 0.75ml/kg of 0.25% bupivacaine with fentanyl 1mcg/kg (Group BF). Post-operative pain was assessed for 24 hours using the FLACC scale. Results The mean duration of analgesia was significantly longer in Group BC (629.06 ± 286.32 min) than other three groups P < 0.05. The pain score assessed using FLACC scale was compared between the four groups, and children in Group BC had lower pain scores, which was statistically significant. The requirement of rescue medicine was lesser in Group BC. Clonidine in a dose of 1 μg/kg added to 0.25% bupivacaine for caudal analgesia, during sub-umbilical surgeries, prolongs the duration of analgesia of bupivacaine, without any side effects in compare to fentanyl or ketamine. Conclusion We conclude that clonidine in a dose of 1 μg/kg, added to 0.25% bupivacaine for caudal analgesia and administered as a 0.75 ml/kg mixture in children, for sub-umbilical surgery, significantly prolongs the duration of post-operative analgesia when compared to 0.75 ml/kg of 0.25% bupivacaine in normal saline than 0.75 ml/kg of 0.25% bupivacaine with ketamine 0.5 mg/kg or 0.75 ml/kg of 0.25% bupivacaine with fentanyl 1 mcg/kg or 0.75 ml/kg of 0.25% bupivacaine alone, without any side effects. Kathmandu University Medical Journal | VOL.10 | NO. 3 | ISSUE 39 | JUL- SEP 2012 | Page 25-29 DOI: http://dx.doi.org/10.3126/kumj.v10i3.8013

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Intraperitoneal Hydrocortisone plus Bupivacaine versus Bupivacaine alone for Pain Relief after Laparoscopic Cholecystectomy

Journal of Lumbini Medical College ◽

10.22502/jlmc.v3i2.71 ◽

2016 ◽

Vol 3 (2) ◽

pp. 41 ◽

Cited By ~ 1

Author(s):

Mahesh Sharma ◽

Kalpana Kharbuja ◽

Nil Raj Sharma

Keyword(s):

Laparoscopic Cholecystectomy ◽

Pain Relief ◽

Normal Saline ◽

Randomized Study ◽

Saline Group ◽

Normal Saline Group ◽

Analgesic Requirement ◽

Number Of Patients ◽

Group A ◽

Group B

Introduction: Laparoscopic cholecystectomy has been the gold standard in the treatment of gallstones since last decades. Beside several benefits of laparoscopic cholecystectomy compared with open surgery, postoperative pain is still a frequent melancholy. Hence, pain management is utmost regarding patients' comfort. The main objective of the study was to compare the effect of intraperitoneal hydrocortisone plus bupivacaine with bupivacaine alone on pain relief following laparoscopic cholecystectomy. Methods: A randomized study was conducted from December 2015 to August 2015 that included 100 patients aged 20 to 60 years of both genders who were found to have symptomatic gallstones and were scheduled for elective laparoscopic cholecystectomy at Lumbini Medical College. Patients randomly received 100 mg hydrocortisone plus 100 mg bupivacaine in 200 ml normal saline (group A) or 100 mg bupivacaine in 200 ml normal saline (group B) into the peritoneum. Post-operative abdominal and shoulder pain were evaluated using Visual Analog Score (VAS). The patients were also followed up for postoperative analgesic requirements, and recovery variables. Data were collected, tabulated and analyzed statistically using SPSS version 19. Results: Total number of patients in this study were 100. Age and gender among both groups were comparable. VAS scores for pain was significantly lower for group A as compared to group B at 0, 2, 4, 6, 12, and 24 hours. Time of oral intake in hrs for liquids and solids was statistically significant in Group A compared to Group B. Rescue analgesic requirement was also significantly low in Group A compared to Group B. Hospital stay in both group were comparable. Conclusion: Combination of hydrocortisone plus bupivacaine can relieve pain after laparoscopic cholecystectomy better compared to bupivacaine alone when administered intraperitoneally.

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Study on antihyperglycemic effect of bromocriptine in dexamethasone induced hyperglycemic wistar rats

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20212081 ◽

2021 ◽

Vol 10 (6) ◽

pp. 699

Author(s):

Rekha M. B. ◽

Basavaraj Bhandare ◽

Satyanarayana V. ◽

Hemamalini M. B.

Keyword(s):

Diabetes Mellitus ◽

Normal Saline ◽

Wistar Rats ◽

Saline Group ◽

Control Group ◽

Normal Saline Group ◽

Male Wistar Rats ◽

Group B ◽

Control Group Group

Background: Diabetes mellitus is a chronic metabolic disorder that develops due to insulin deficiency or insulin resistance. Recent animal and human studies have reported bromocriptine to be effective in the management of type 2 diabetes mellitus. The present study was done to evaluate the antihyperglycemic effect of bromocriptine in dexamethasone induced hyperglycemic rats.Methods: Male wistar rats were used and divided into 5 groups. Dexamethosone was used to induce hyperglycemia in group B-E. Group A was the untreated control group, group B was the standard control group, group C was the oral 10 mg/kg of bromocriptine dissolved in 0.9% normal saline, group D was the oral 20 mg/kg metformin dissolved in 0.9% normal saline, group E was the oral 10 mg/kg bromocriptine+20 mg/kg metformin dissolved in 0.9% normal saline. Fasting blood glucose, post prandial blood glucose and body weight was estimated on day 1, 15, 30.Results: It was seen that dexamethasone induced hyperglycemia and increase in body weight in male wistar rats, which were significantly controlled by oral bromocriptine and bromocriptine with metformin combination.Conclusions: Results obtained from this study showed that bromocriptine can be a promising drug with novel mechanism to treat type 2 diabetes mellitus.

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Clinical evaluation of general anaesthesia in pigeons using a combination of ketamine and diazepam

Journal of the South African Veterinary Association ◽

10.4102/jsava.v83i1.12 ◽

2012 ◽

Vol 83 (1) ◽

Cited By ~ 3

Author(s):

Aidin Azizpour ◽

Yashar Hassani

Keyword(s):

General Anaesthesia ◽

Normal Saline ◽

Muscle Relaxation ◽

Saline Group ◽

Clinical Effects ◽

Normal Saline Group ◽

Rapid Induction ◽

The Difference ◽

Induction Of Anaesthesia ◽

Group D

This study was undertaken to investigate the clinical effects of ketamine, diazepam and a ketamine and diazepam combination in the general anaesthesia of pigeons. Thirty-two pigeons of both sexes with body weights ranging from 280 g to 300 g were allocated randomly to four groups comprising eight birds each. Group D received a 0.5 mL mixture of diazepam (0.2 mg/kg) and normal saline, group K a 0.5 mL mixture of ketamine 5% (30 mg/kg) and normal saline, group D, group KD a 0.5 mL mixture of ketamine 5% (10 mg/kg), diazepam (0.2 mg/kg) and normal saline, whilst group C (control) received 0.5 mL of normal saline only. Each mixture was administered intramuscularly.Under standard operating room conditions, general anaesthesia was not observed in group C (normal saline alone). In group D, sedation and muscle relaxation without complete loss of consciousness was observed. Induction time of anaesthesia in group KD was significantly quicker than group K (p < 0.05). Duration of anaesthesia in group KD was significantly longer than group K (p < 0.05). Recovery took longer in group KD in comparison with group K, but the difference was not statistically significant (p > 0.05). The birds in group KD were calm and sedated, with good muscle relaxation, whilst in group K the birds were excited and showed a drop in body temperature.According to the results of this study, the combination of low dose ketamine hydrochloride (HCL) and diazepam overcame the adverse effects of ketamine alone. This combination produced a more rapid induction of anaesthesia, as well as an increase in anaesthesia duration, with good muscle relaxation and a smooth and slow recovery. Use of a combination of ketamine HCL given at 10 mg/kg and diazepam given at 0.2 mg/kg for anaesthesia in pigeons is therefore recommended.

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A comparative study of dexmedetomidine versus clonidine in epidural anaesthesia to assess the level of sedation in patients undergoing lower abdominal and lower limb surgery

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20181756 ◽

2018 ◽

Vol 6 (5) ◽

pp. 1666

Author(s):

Vinay Pathak ◽

B. B. Kushwaha ◽

Girish Chandra ◽

V. K. Bhatia ◽

Akash Gupta ◽

...

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Normal Saline ◽

Lower Limb ◽

Saline Group ◽

Hemodynamic Parameters ◽

Normal Saline Group ◽

Time Intervals ◽

Group A ◽

Group B

Background: To compare study of dexmedetomidine versus clonidine in epidural anesthesia to assess the level of sedation in patients undergoing lower abdominal and lower limb surgery.Methods: This was a comparative study conducted on admitted ASA grade I and II patients undergoing lower abdominal and lower limb surgeries. The patients were divided into three groups of 30 patients each, according to the epidural medication they received:-Group A-received 15ml of bupivacaine (0.5%) and dexmedetomidine (1.0µg/kg body weight) in 1ml of normal saline; Group B-received 15ml of bupivacaine (0.5%) and clonidine (2.0µg/kg body weight) in 1ml of normal saline; Group C-received 15ml of bupivacaine (0.5%) with 1ml of normal saline. The heart rate, blood pressure, sensory dermatome level, Motor blocked level, pain and VAS were recorded at different time intervals. The side effects were also noted.Results: The baseline parameters were comparable among the groups. All the hemodynamic parameters and other study parameters were similar at Min. 0. All the hemodynamic parameters such as heart rate, blood pressure and SpO2 were variable at different time intervals. Motor block level was significantly (p<0.05) lower in Group C than Group A and Group B from Min 50 to Min 90. The sedation score was observed to be nil in Group C. The post-op pain score became higher in Group C than Group A and Group B at subsequent time intervals. A 3 (10%) of the rescue agents was observed in Group C. Atropine (30%) and mephenteramine (10%) were common rescue agents in Group B. The bradycardia was observed in 30% patients of Group B and in 40% of Group A.Conclusions: On addition of dexmedetomidine as adjuvant to bupivacaine in epidural anesthesia provides better anesthesia and sedation than clonidine as adjuvant to bupivacaine or bupivacaine alone with mild hemodynamic changes which are easily manageable.

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Effect of topical furosemide on sinonasal polyposis relapse after endoscopic sinus surgery

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20205628 ◽

2020 ◽

Vol 7 (1) ◽

pp. 101

Author(s):

Souvagini Acharya ◽

Alka Kapil ◽

Kamalini Bepari ◽

Sandrendu Rajan ◽

Prachi Mohapatra ◽

...

Keyword(s):

Normal Saline ◽

Endoscopic Sinus Surgery ◽

Nasal Polyposis ◽

Statistical Significance ◽

Saline Group ◽

Sinus Surgery ◽

Randomised Control Trial ◽

Normal Saline Group ◽

Sinonasal Polyposis

Background: Chronic rhinosinusitis with nasal polyposis (CRSwNP) relapse is commonly seen during follow up period after endoscopic sinus surgery. Some studies claim the credibility of topical furosemide in preventing the polyposis recurrence after surgery. This randomised control trial was done to check the effectiveness of topical furosemide on sinonasal polyposis relapse after the endoscopic sinus surgery.Methods: In the current study, 44 patients, attending ENT department, VSSIMSAR, for follow up after endoscopic sinus surgery, were evaluated clinically and endoscopically to demonstrate the prevalence and severity of polyposis relapse using Visual analogue scale (VAS) and meltzer endoscopic grading, before initiating the intervention. Patients were then randomised in two groups- one receiving topical furosemide nebulization and other intranasal normal saline spray, respectively. All patients were evaluated again at 1st, 2nd, 4th and 6th month follow-ups by VAS and MEG, setting statistical significance at p<0.05.Results: The MEG was grade 0 in 77% (17) patients of furosemide group and 32% (7) of normal saline group (p=0.0147). Statistically significant improvement was also observed in VAS for nasal symptoms in former group (p=0.028) than latter. The rate of relapse was less (23.81%) in furosemide group as compared to normal saline group (65%) but result not statistically significant at p<0.05.Conclusions: Topical furosemide can be used as a valid therapeutic approach for reducing the severity of sinonasal polyposis relapse after endoscopic sinus surgery with no known side effects of furosemide when administered topically.

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Effect of 2% Lignocaine Solution in Pain During Removal of Nasal Pack

Journal of College of Medical Sciences-Nepal ◽

10.3126/jcmsn.v15i2.22629 ◽

2019 ◽

Vol 15 (2) ◽

pp. 80-83

Author(s):

Ashish Dhakal ◽

Bikash Lal Shrestha ◽

Monika Pokharel

Keyword(s):

Normal Saline ◽

Saline Group ◽

Nasal Packing ◽

Distilled Water ◽

Left Nostril ◽

Normal Saline Group ◽

Nasal Pack ◽

Control Side ◽

Group 5

Background: Nasal packing is commonly done after septal surgeries. Nonabsorbable nasal pack is used to minimize bleeding from surgery site, support the mucoperichondrial flaps, and minimize the risk of formation of septal hematomas and adhesions. However, these materials cause pain and discomfort in-situ as well as during removal. This study was done to evaluate the effect of 2% lignocaine rehydration of nasal pack on pain during pack removal. Methods: This prospective study was conducted on 60 patients who had undergone septoplasty. The patients were divided into 2 groups: Lignocaine and Normal saline group, with 30 patients each. In the Lignocaine group, 2.5 ml of 2% of lignocaine was diluted with 2.5 ml of distilled water and was injected into the nasal pack; and in Normal saline group, 5 ml of normal saline was injected into the nasal pack. Nothing was injected to the left nostril, which acted as a control, in both groups. All patients were asked severity of pain during removal of nasal packing by VAS. Results: In lignocaine group, mean pain score was 3.73 ± 1.63 on lignocaine side and 6.23 ± 1.69 on control side (U=109.5, p<0.001). In Normal saline group, it was 6.5 ± 1.7 on normal saline side and 6.23 ± 1.96 on control side (U=425.5, p=0.711). On comparing VAS between lignocaine and normal saline group, pain was significantly lower in the lignocaine group (U=112.5, p<0.001) Conclusion: Rehydrating nasal pack with 2% topical lignocaine is a useful method to reduce pain during nasal pack removal.

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Effects of prophylactic ketamine and pethidine to control postanesthetic shivering: A comparative study

Biomedical Research and Therapy ◽

10.15419/bmrat.v5i12.508 ◽

2018 ◽

Vol 5 (12) ◽

pp. 2898-2903 ◽

Cited By ~ 1

Author(s):

Masoum Khoshfetrat ◽

Ali Rosom Jalali ◽

Gholamreza Komeili ◽

Aliakbar Keykha

Keyword(s):

Normal Saline ◽

Pearson Correlation ◽

Saline Group ◽

Normal Saline Group ◽

Chi Square ◽

Double Blind ◽

Postanesthetic Shivering ◽

Significant Difference ◽

The Mean ◽

One Way Anova

Background: Shivering is an undesirable complication following general anesthesia and spinal anesthesia, whose early control can reduce postoperative metabolic and respiratory complications. Therefore, this study aims to compare the effects of prophylactic injection of ketamine and pethidine on postoperative shivering. Methods: This double-blind clinical trial was performed on 105 patients with short-term orthopedic and ENT surgery. The patients were randomly divided into three groups; 20 minutes before the end of the surgery, 0.4 mg/kg of pethidine was injected to the first group, 0.5 mg/kg of ketamine was injected to the second group, and normal saline was injected to the third group. After the surgery, the tympanic membrane temperature was measured at 0, 10, 20, and 30 minutes. The shivering was also measured by a four-point grading from zero (no shivering) to four (severe shivering). Data were analyzed by one-way ANOVA, Kruskal Wallis, Chi-square and Pearson correlation. Results: The mean age of patients was 35.8+/-11.45 years in the ketamine group, 34.8+/-11.64 years in the normal saline group, and 33.11+/-10.5 years in the pethidine group. The one-way ANOVA showed no significant difference in the mean age between the three groups (P=0.645). The incidence and intensity of shivering were significantly higher in the normal saline group than in the ketamine and pethidine groups (p=0.001). However, there was no significant difference in the incidence and the intensity of shivering between the ketamine and the pethidine groups (p=0.936). Conclusion: The results showed that the 0.5 mg/kg of ketamine could control the post-anesthetic shivering.

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Improved Preservation of Saphenous Venous Conduits by the Use of Papaverine mixed heparinized blood Solution during Harvesting

Cardiovascular Journal ◽

10.3329/cardio.v4i1.9382 ◽

1970 ◽

Vol 4 (1) ◽

pp. 3-7

Author(s):

MMF Maruf ◽

SAMA Sabur ◽

T Akter ◽

E Hakim ◽

NAK Ahsan

Keyword(s):

High Pressure ◽

Normal Saline ◽

Histological Study ◽

Artery Bypass ◽

Bypass Graft ◽

Saline Group ◽

Venous Grafts ◽

Mixed Blood ◽

Group B ◽

Peak Pressures

Background: High-pressure distension during harvesting damages the saphenous vein (SV) and may contribute to subsequent coronary artery bypass graft (CABG) occlusion. Application of vasodilator agents to the SV during harvesting may reduce the need for high-pressure distension and improve graft quality. We tested the effects of a vasodilator solution containing the conventional agent papaverine (Pap) mixed with heparinized blood on the pressure necessary to overcome SV spasm and on the structure. Methods: 150 patients undergoing CABG were nonrandomly allocated to receive an application of either intraluminal papaverine (Pap) mixed with heparinized blood(Group-A), or intraluminal heparin mixed normal saline(group-B) to the SV for distension during harvesting. The peak pressures required to distend the vein were recorded. Samples of SV were taken for microscopical analysis just before we performed the anastomosis. Results: The results for mean peak pressures (mm Hg) were: Normal saline 131.77±20.6 (range 85 to199 mmHg); and Papaverine mixed blood solution, 56.4±2.1 (range 40 to 90 mmHg); P<0.001, (Pap mixed blood solution versus normal saline); The results of histological study for endothelial injury were: Normal saline, 52.5 %; Papaverine mixed blood solution , 20%; (P<.02, untreated versus Pap mixed blood solution). Conclusions: Intraluminal use of Papaverine mixed heparinized blood solution during vein harvesting requires low distension pressure and improves endothelial coverage compared with the use of heparin mixed normal saline. Key Words: Venous Grafts; CABG; Papaverine DOI: http://dx.doi.org/10.3329/cardio.v4i1.9382 Cardiovasc. J. 2011; 4(1): 3-7

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