Effect of Nebulized Morphine vs. Intravenous Morphine in Decreased Pain in Renal Colic Patient

Introduction: Renal colic refers to one or more acute and painful short-term attacks due to the movement and excretion of kidney stones. The aim of this study was to determine the effect of intravenous morphine and inhaled morphine on pain relief in renal colic patients. Methods: This clinical trial study was performed on 50 patients of Shahid Sadoghi Hospital and Shahid Rahnemoon Hospital with renal colic symptoms who were randomly divided into two groups. The first group received 5 mg intravenous morphine and 5 cc normal saline (placebo) and the second group received 10 mg inhaled morphine and 5 cc normal saline. Severity of pain was assessed at the time of emergency and onset of Visual Analog Scale and then questionnaires were completed at 10, 20 and 30 minutes intervals. The data through SPSS Inc., Chicago, IL; Version 16 and the Friedman, Mann-Whitney, and Chi-square tests were analyzed. Results: Our study showed the mean intensity of pain was 9.52±1.12 (nebulized) and 9.24±1.51 (intravenous) on admission without significant difference (p=0.46). After 10 minutes, mean pain intensity in both nebulized and intravenous groups was 7.76±1.3 and 6.68±2.03, respectively. There was a significant difference between the two groups (p=0.03). After 20 minutes, the mean pain intensity was 5.68±1.72 and 4.32±2.17, respectively, and the difference between the two groups was significant. After 30 minutes, the mean intensity of pain in two groups of nebulized and intravenous was 3.88±3.14 and 3.36±3.34, respectively. The difference between the two groups was not significant (p = 0.57).The mean pain intensity in the intravenous method was lower than the nebulized, but in the nebulized method it was showed a decreasing trend. Conclusion: Nebulized morphine relieves pain in the patients with renal colic, but pain relief is faster by intravenous morphine. Accordingly, this method is more preferred in renal colic patients.

Download Full-text

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.

Download Full-text

The effect of Quercus infectoria pair cream on the severity of episiotomy pain in nulliparous women

Journal of Herbmed Pharmacology ◽

10.34172/jhp.2021.47 ◽

2021 ◽

Vol 10 (4) ◽

pp. 401-407

Author(s):

Roza Soltanifard ◽

Fatemeh Nahidi ◽

Faraz Mojab ◽

Mehdi Birjandi

Keyword(s):

Pain Intensity ◽

Normal Saline ◽

Pain Intensity Score ◽

Chi Square ◽

Double Blind ◽

Second Stage Of Labor ◽

Nulliparous Women ◽

Significant Difference ◽

Important Health ◽

Quercus Infectoria

Introduction: Episiotomy is an incision in the perineal area during the second stage of labor to facilitate delivery. Complications of perineal injuries are one of the most important health issues. Oak pair has long been used experimentally to heal wounds and reduce pain. The present study was performed to investigate the effect of oak pair (Quercus infectoria) cream on pain due to episiotomy in nulliparous women. Methods: This double-blind clinical trial experimental study was performed on 120 nulliparous women in Asali hospital in 2018. Individuals were randomly divided into oak pair cream, placebo, and normal saline groups. Data were collected by demographic and midwifery information questionnaires and numerical pain scales. The creams were used by the participants every 12 hours for 10 days, and the pain intensity was evaluated before the intervention and on days 1, 5, and 10. Data analysis was performed by SPSS using chi-square, Kruskal-Wallis, and one-way analysis of variance (ANOVA) tests. Results: There was no statistically significant difference in pain intensity scores among the three groups of oak pair, placebo, and normal saline before the intervention (P = 0.20). Pain intensity on days 1, 5, and 10 after the intervention showed a significant difference between the three groups in favor of oak cream (P < 0.001). The results showed that there was a significant decrease in the mean pain intensity score of the oak pair receiving group over time (P < 0.001).Conclusion: Oak cream might be effective in reducing pain caused by episiotomy due to analgesic properties.

Download Full-text

Comparison of the Analgesic Effect of Intravenous Ketamine versus Intravenous Morphine in Reducing Pain of Renal Colic Patients: Double-Blind Clinical Trial Study

Reviews on Recent Clinical Trials ◽

10.2174/1574887114666190705122727 ◽

2019 ◽

Vol 14 (4) ◽

pp. 280-285 ◽

Cited By ~ 2

Author(s):

Arash Forouzan ◽

Kambiz Masoumi ◽

Hassan Motamed ◽

Seyed Reza Naji Esfahani ◽

Ali Delirrooyfard

Keyword(s):

Clinical Trial ◽

Renal Colic ◽

Initial Result ◽

Double Blind ◽

Double Blind Clinical Trial ◽

Significant Difference ◽

Intravenous Morphine ◽

Hospital Patients ◽

The Mean ◽

Intravenous Ketamine

Background: The effective relief of renal colic patients with low complications is one of the important concerns of emergency physicians. The aim of this study was to investigate the use of injectable ketamine as an alternative to routine drugs in the relief of pain in patients with renal colic. Methods: This double-blind clinical trial was conducted on patients who had suffered kidney pain due to kidney stones in 2017, referred to Ahvaz Imam Khomeini Hospital. Patients were divided into 2 groups: the first group received intravenous ketamine (0.3 mg/kg) and the second group received intravenous morphine (0.1 mg/kg) in a double-blind form. Finally, the mean pain was evaluated before injection, after 10, 20, 30, and 60 minutes as the initial result while the side effects were considered as secondary results. Results: In this study, 135 patients with renal colic participate in this study. The mean pain at the time of referral to the hospital in the group receiving morphine and ketamine was 9.2 and 9.2, respectively, which did not show any significant difference. Based on these findings, there was no significant difference between the factors evaluated during the study of the two groups. Only in the ketamine group, there were 3 cases of nausea and 1 of vomiting. However, there was a significant increase in the need for additional doses of fentanyl in the morphine recipient group (p = 0.02). Conclusion: The findings suggest that the use of ketamine can produce a more rapid relief effect, and decrease the use of opioids which create various complications, including nausea and vomiting in patients, especially patients with renal colic.

Download Full-text

Effect of topical bupivacaine on post-tonsillectomy pain relief in children

Pyramid Journal of Medicine ◽

10.4081/pjm.2020.64 ◽

2021 ◽

Vol 3 (2) ◽

Author(s):

Musa Kallamu Suleiman ◽

Abdulkarim Aitek Abdullahi ◽

Alhassan Datti Mohammed ◽

Kufre Robert Iseh ◽

Abdulrahman Aliyu ◽

...

Keyword(s):

Postoperative Pain ◽

Pain Relief ◽

Pain Intensity ◽

Normal Saline ◽

Pain Scale ◽

Inclusion Criteria ◽

Tonsillar Fossa ◽

The Difference ◽

Group B

Tonsillectomy is a common surgery performed in paediatric otorhinolaryngology and is usually accompanied by considerable postoperative pain. Earlier literature has shown the use of topical bupivacaine for post-tonsillectomy pain relief to be promising. This study was conducted to evaluate the efficacy of topical bupivacaine application on post-tonsillectomy pain relief. Fifty consenting patients scheduled for tonsillectomy that met the inclusion criteria were enrolled in the study and assigned into two groups of 25 patients each. Group B had their tonsillar fossa packed with 0.5% bupivacaine soaked gauze for 5 minutes while Group S had normal saline. Pain intensity was measured at 1, 2, 4, 12 and 24 hours postoperatively, using the Faces Pain Scale- Revised (FPS-R). Mean scores for groups B and S at 1, 2, 4, 8, 12, 24 hours were 1.96±1.17, 2.40±0.82, 2.8±1.0, 2.88±1.17, 3.08±0.99, and 3.04±1.02 and 3.36±1.38, 4.72±1.62, 3.92±1.35, 3.76±1.45, 4.00±1.41, 3.38±0.98 respectively. The difference was significant at 1 and 2 hours only (P≤0.05). Post-tonsillectomy pain was reduced in the first two hours by application of bupivacaine soaked gauze.

Download Full-text

Differences of young adult smokers and non-smokers saliva reviewed by salivary pH, viscosity, and volume

Padjadjaran Journal of Dentistry ◽

10.24198/pjd.vol31no2.22863 ◽

2019 ◽

Vol 31 (2) ◽

pp. 142

Author(s):

Dias Mareta Kusumaningrum ◽

Sri Tjahajawati ◽

Ervin Rizali

Keyword(s):

Young Adult ◽

Mean Value ◽

P Value ◽

Chi Square ◽

Tissue Integrity ◽

Significant Difference ◽

Salivary Ph ◽

Oral Tissue ◽

The Mean ◽

The Difference

Introduction: Salivary pH, viscosity and volume play an important role in maintaining tooth and oral tissue integrity. The purpose of this research was to evaluate the difference of young adult smokers and non-smokers saliva reviewed by its pH, viscosity and volume. Methods: The research sample of 28 smokers and 24 non-smokers. Saliva was collected by spitting method then the pH, viscosity and volume was measured. The data was analyze using independent sample t-test and chi-square. Results: The result indicated that there was a significant difference in the mean value of salivary pH on smokers and non-smokers with p-value 0.000 (p < 0.05). There was a significant difference in the mean value of salivary viscosity on smokers and non-smokers with p-value 0.000 (p < 0.05.) There was a significant difference in the mean value of salivary volume on smokers and non-smokers with p-value 0.000 (p < 0.05). Conclusion: The conclusion of the research showed that salivary pH of smokers was lower than non-smokers, salivary viscosity of smokers was higher than non-smokers and salivary volume of smokers was fewer than non-smokers.Keywords: Young adult, smokers, non-smokers, saliva, salivary pH, salivary viscosity, salivary volume

Download Full-text

Thyroid Dysfunction and its Effect on Red Blood Cell Parameters

Journal of Nobel Medical College ◽

10.3126/jonmc.v10i2.41777 ◽

2021 ◽

Vol 10 (2) ◽

pp. 54-57

Author(s):

Samir Singh

Keyword(s):

Blood Cell ◽

Red Blood Cell ◽

Metabolic Regulation ◽

Thyroid Dysfunction ◽

Hematological Parameters ◽

Chi Square ◽

Cell Parameters ◽

Significant Difference ◽

The Mean ◽

The Difference

Background: Thyroid hormones are necessary for the growth and development, cellular differentiation, physiological function and metabolic regulation of almost all tissues in our body. Thyroid disorders are accompanied by alteration in hematological profile. This study aims to evaluate the effect of thyroid dysfunction on red blood cell parameters. Materials and Methods: This case-control observational study was conducted in the Department of Clinical Biochemistry, KIST Medical College and Teaching Hospital (KISTMCTH), Lalitpur, Nepal from January 2021 to June 2021.Total number of recruited subjects was 248, out of which 67 were labeled as hypothyroid, 7 were hyperthyroid and 174 were euthyroid as control. Subjects for all three groups were between 16-93 years old. Thyroid hormone profile of patients was determined by Siemens ADVIA Centaur CP immunoassay analyzer and hematological parameters by automated hematology analyzer Sysmex XN-550. Results were analyzed by SPSS 21 software and a chi-square test was applied to see significant differences among the groups. Results: The mean age of all study participants was 42.08±17.27 years and female constituted 74.6% of total subjects. Analysis of the data obtained a statistically significant difference in the mean hemoglobin (p<0.001) between hypothyroid and euthyroid groups. The difference was not significant for hemoglobin (p=0.252) among hyperthyroid and euthyroid groups. There was no statistical significant difference between thyroid cases and control for MCV, MCH and MCHC. Conclusion: The current study concluded that thyroid dysfunction have a significant effect on red blood cell parameters. Hematological parameters should be evaluated in patient with thyroid dysfunction.

Download Full-text

Comparing the efficacy of nebulized morphine with intravenous morphine in traumatic musculoskeletal pain management

Journal of Research in Clinical Medicine ◽

10.34172/jrcm.2020.021 ◽

2020 ◽

Vol 8 (1) ◽

pp. 21-21

Author(s):

Mani Mofidi ◽

Ali Dashti ◽

Mahdi Rezai ◽

Niloufar Ghodrati ◽

Hoorolnesa Ameli ◽

...

Keyword(s):

Pain Management ◽

Pain Relief ◽

Musculoskeletal Pain ◽

Normal Saline ◽

Rating Scale ◽

Numerical Rating Scale ◽

Vital Signs ◽

Categorical Variables ◽

Intravenous Morphine ◽

Numerical Rating

Introduction: This study was designed to compare the effectiveness of intravenous morphine with nebulized morphine in pain relief of patients referring to the emergency setting with traumatic musculoskeletal pain. Methods: This randomized, placebo-controlled and double-blind clinical study evaluated 160 patients 18 to 65 years of age with acute traumatic pain, who attended the emergency department during 2019. Subjects were assessed with Numerical Rating Scale based on inclusion and exclusion criteria and randomly divided into two groups. In one group, 80 patients received IV morphine (0.1 mg/kg+5 mL normal saline) plus an equivalent volume of IV placebo. In the second group, 80 patients received nebulized morphine (0.2 mg/kg+5 mL normal saline) plus nebulized placebo. Pain score was monitored in all patients with Numerical Rating Scale before and after intervention at baseline, 15, 30, 45, and 60-minute intervals. Patients’ vital signs and possible adverse events were evaluated in each observation time points. Finally, all participants were assessed for their satisfaction with pain management. Data were analyzed using repeated measure analysis for continuous variables and Binomial test for categorical variables Results: There was no significant difference between the demographic characteristics of patients in study groups. Pain relief between the two groups was similar during the observation (0, 15, 30, 45, 60 min) (P>0.05). There were no changes in vital signs between two groups, although the nebulized group had lower systolic blood pressure at the time-point of 15 minutes after the treatment initiation (P=0.03). Conclusion: Although Nebulized morphine has similar efficacy in comparison with IV route, nebulization might be considered as the clinically efficacious route of morphine administration with minimal side effects, providing optimal pain relief in patients.

Download Full-text

Comparative Analysis of Different Local Anesthetic Solutions Available in Market: An In Vitro and Clinical Study

European Journal of Dentistry ◽

10.1055/s-0041-1727553 ◽

2021 ◽

Author(s):

Eisha Imran ◽

Faisal Moeen ◽

Beenish Abbas ◽

Bakhtawar Yaqoob ◽

Mehreen Wajahat ◽

...

Keyword(s):

Comparative Analysis ◽

Local Anesthetic ◽

Compositional Analysis ◽

Bacterial Activity ◽

Similar Composition ◽

Ph Values ◽

Significant Difference ◽

The Mean ◽

The Difference

Abstract Objectives The study aimed to evaluate and compare various commercially available local anesthetic solutions. Materials and Methods A total of 150 commercially available local anesthetic cartridges of similar composition (2% lidocaine with epinephrine 1:100,000) were randomly collected and divided into 3 groups. The designations of groups were selected from their product names such that each group consisted of 60 cartridges. Group S (Septodont, France) Group M (Medicaine, Korea) and Group H (HD-Caine, Pakistan). The samples were divided into five sub-groups, each consisting of 10 cartridges from each group to investigate each parameter. Results The acquired data was statistically analyzed and compared (using SPSS version 12). Compositional analysis revealed a non-significant (P>0.05) difference when the three Groups were compared with standard lidocaine and epinephrine solutions. The mean pH values of samples from group S, M and H respectively fell within the range of pH values of commercially available solutions. Non-significant difference in EPT values of Group S and H was found when efficacy was compared (p = 0.3), however a significant difference (p < 0.01) was observed in contrast to Group M. Anti-bacterial activity was observed in all the group and a non-significant difference in cell viability values of Group S and M was found (p = 0.6), while the difference was significant in comparison to Group H. Conclusion Within the limitations of these investigations, it appears that the properties of different manufacturers fall within the recommended ranges as mentioned in literature and do not appear to be statistically different in the variables we have tested.

Download Full-text

Reported and unreported potentially important incidental findings in urgent nonenhanced abdominal CT for renal colic

Medical Principles and Practice ◽

10.1159/000515852 ◽

2021 ◽

Author(s):

Elena Belloni ◽

Stefania Tentoni ◽

Ilaria Fiorina ◽

Chandra Bortolotto ◽

Olivia Bottinelli ◽

...

Keyword(s):

Emergency Department ◽

Health Status ◽

Pleural Effusion ◽

Incidental Findings ◽

Renal Colic ◽

Legal Issues ◽

Abdominal Ct ◽

Significant Difference ◽

Original Report ◽

The Difference

PURPOSE: To retrospectively evaluate the prevalence of reported and unreported potentially important incidental findings in consecutive nonenhanced abdominal CTs performed specifically for renal colic in the urgent setting. METHOD: One radiologist, blinded to the finalized report, retrospectively re-evaluated nonenhanced abdominal CTs performed from January through December 2017 on adult patients from the Emergency Department with the specific request of urgent evaluation for renal colic, searching for potentially important incidental findings. RESULTS: The CTs of 312 patients were included in the study. Thirty-eight findings were reported in 38 different CTs, whereas the re-evaluation added 47 unreported findings in 47 different CTs, adding to total of 85 findings (27%). The difference in the proportion of reported and unreported potentially important incidental findings between the original report and re-evaluation was significant (P<.001). No significant difference was found between the age of patients with and without reported findings. The proportion of potentially important findings did not vary significantly among the three shifts neither in the original report nor in the re-evaluation. The most frequent findings, both reported and unreported, were pleural effusion, lymphadenopaties and liver nodules. CONCLUSIONS: Potentially important additional findings are frequently present in urgent nonenhanced abdominal CTs performed for renal colic, and many are not described in the finalized reports. Radiologists should take care not to under report potentially important incidental findings even in the urgent setting because of the possible consequences on the patient’s health status and in order to avoid legal issues, while satisfying the need for timely and efficient reporting.

Download Full-text

386 An Exploratory Study of Bedtime Procrastination and Emotional Regulation Strategies in Insomnia compared to healthy individuals

SLEEP ◽

10.1093/sleep/zsab072.385 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A153-A153

Author(s):

Goeun Kim ◽

Hyojin Nam ◽

Huisu Jeon ◽

Sooyeon Suh

Keyword(s):

Emotional Regulation ◽

Severity Index ◽

Ministry Of Education ◽

Chi Square ◽

Healthy Group ◽

Significant Difference ◽

Regulation Strategies ◽

The Difference ◽

The Republic ◽

Bedtime Procrastination

Abstract Introduction Bedtime Procrastination (BP) is defined as the behavior of voluntarily delaying going to bed, without having external reasons for doing so. Recent research on procrastination behavior suggests that when negative emotions are elevated, procrastination behaviors can be triggered in order to find pleasure to avoid and alleviate them. Procrastination can also occur when there is difficulty regulating emotions. In addition, the reason for bedtime procrastination may be different depending on whether the individuals present with insomnia. According to previous studies, patients with insomnia may exhibit more pronounced negative avoidance of bedtime due to prolonged sleeplessness. Therefore, this study compared the difference between of the bedtime procrastination and the emotional regulation strategies between the insomnia group and the healthy group. Methods This study was conducted in 582 adults (mean age 23.06 ±2.16 years), 81.6% females. Individuals scoring higher than 15 on the Insomnia Severity Index (ISI) were classified into the insomnia group (n=375), and those less than 15 were classified into the healthy group (n=207). Participants completed the Bedtime Procrastination Scale (BPS), Emotional Regulation Strategies Checklist. Data was analyzed using descriptive statistics, chi square test, and independent t tests. Results The insomnia group had significantly higher bedtime procrastination scores than the healthy group (t=-6.241, p<.001), and also the avoidant/distractive regulation style score was significantly higher (t=-1.969, p<.05). In addition, the score of active regulation style was significantly lower in the insomnia group than in the healthy group (t=3.050, p<.01). There was no significant difference between the two groups in the support-seeking regulation style. Conclusion Based on these results, it was confirmed that there was a difference in the bedtime procrastination and the emotional regulation strategies between the insomnia group and the healthy group. Support (if any) This work was supported by the Ministry of Education of the Republic of Korea and the National Research Foundation of Korea(NRF-2018S1A5A8026807)

Download Full-text