Effect of caudal ketamine on minimum local anesthetic concentration of ropivacaine in children: A prospective randomized trial

Abstract Background Caudal ketamine has been shown to provide an effective and prolonged post-operative analgesia with few adverse effects. However, the effect of caudal ketamine on the efficacy of ropivacaine for intra-operative analgesia is unclear. Methods One hundred and sixty-nine children were randomized to five groups: Group C (caudal ropivacaine only), Group K0.25 (caudal ropivacaine plus 0.25 mg/kg ketamine), Group K0.5 (caudal ropivacaine plus 0.5 mg/kg ketamine), Group K0.75 (caudal ropivacaine plus 0.75 mg/kg ketamine), and Group K1.0 (caudal ropivacaine plus 1.0 mg/kg ketamine). The primary outcome was the minimum local anesthetic concentration (MLAC) of ropivacaine with/without ketamine for caudal block. Results The MLAC values of ropivacaine were 0.128% (0.028%) in the control group, 0.112% (0.021%) in Group K0.25, 0.112% (0.018%) in Group K0.5, 0.110% (0.019%) in Group K0.75, and 0.110% (0.020%) in Group K1.0. There were no significant differences among the five groups for the MLAC values (p=0.11). During the post-operative period the mean durations of analgesia were 270, 381, 430, 494, and 591 min in the control, K0.25, K0. 5, K0.75, and K1.0 groups respectively, which shown significant differences among the five groups (p<0.05). Conclusions Adding caudal ketamine to ropivacaine prolong the duration of post-operative analgesia; however, it does not decrease the MLAC of caudal ropivacaine for intra-operative analgesia in children.

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Effect of caudal ketamine on minimum local anesthetic concentration of ropivacaine in children: A prospective randomized trial

10.21203/rs.2.11369/v2 ◽

2020 ◽

Author(s):

Huai-Zhen Wang ◽

Ling-Yu Wang ◽

Hui-Hong Liang ◽

Yan-Ting Fan ◽

Xing-Rong Song ◽

...

Keyword(s):

Adverse Effects ◽

Randomized Trial ◽

Local Anesthetic ◽

Primary Outcome ◽

Prospective Randomized Trial ◽

Control Group ◽

Caudal Block ◽

Post Operative Period ◽

Anesthetic Concentration ◽

The Mean

Abstract Background: Caudal ketamine has been shown to provide an effective and prolonged post-operative analgesia with few adverse effects. However, the effect of caudal ketamine on the minimum local anesthetic concentration (MLAC) of ropivacaine for intra-operative analgesia is unclear. Methods: One hundred and sixty-nine children were randomized to five groups: Group C (caudal ropivacaine only), Group K 0.25 (caudal ropivacaine plus 0.25 mg/kg ketamine), Group K 0.5 (caudal ropivacaine plus 0.5 mg/kg ketamine), Group K 0.75 (caudal ropivacaine plus 0.75 mg/kg ketamine), and Group K 1.0 (caudal ropivacaine plus 1.0 mg/kg ketamine). The primary outcome was the MLAC values of ropivacaine with/without ketamine for caudal block. Results: The MLAC values of ropivacaine were 0.128% (0.028%) in the control group, 0.112% (0.021%) in Group K 0.25 , 0.112% (0.018%) in Group K 0.5 , 0.110% (0.019%) in Group K 0.75 , and 0.110% (0.020%) in Group K 1.0 . There were no significant differences among the five groups for the MLAC values (p=0.11). During the post-operative period the mean durations of analgesia were 270, 381, 430, 494, and 591 min in the control, K 0.25 , K 0. 5 , K 0.75 , and K 1.0 groups respectively, which shown significant differences among the five groups (p<0.05). Conclusions: Adding caudal ketamine to ropivacaine prolong the duration of post-operative analgesia; however, it does not decrease the MLAC of caudal ropivacaine for intra-operative analgesia in children.

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Effect of caudal ketamine on minimum local anesthetic concentration of ropivacaine in children: a prospective randomized trial

BMC Anesthesiology ◽

10.1186/s12871-020-01058-y ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Huai-Zhen Wang ◽

Ling-Yu Wang ◽

Hui-Hong Liang ◽

Yan-Ting Fan ◽

Xing-Rong Song ◽

...

Keyword(s):

Randomized Trial ◽

Local Anesthetic ◽

Prospective Randomized Trial ◽

Anesthetic Concentration

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Vitamin C ameliorates the adverse effects of dexamethasone on sperm motility, testosterone level, and spermatogenesis indexes in mice

Human & Experimental Toxicology ◽

10.1177/0960327118816137 ◽

2018 ◽

Vol 38 (4) ◽

pp. 409-418 ◽

Cited By ~ 4

Author(s):

F Sadeghzadeh ◽

MS Mehranjani ◽

M Mahmoodi

Keyword(s):

Adverse Effects ◽

Vitamin C ◽

Sperm Motility ◽

Testosterone Level ◽

Leydig Cells ◽

Serum Testosterone ◽

Serum Testosterone Level ◽

Control Group ◽

The Mean ◽

Vit C

Background: Dexamethasone (DEX) is a common medicine that is capable of causing malformation in the male reproductive system. The aim of this study was to investigate the effect of vitamin C (Vit-C) on spermatogenesis indexes and daily sperm production (DSP) in adult mice treated with DEX. Methods: Male Naval Medical Research Institute (NMRI) mice were divided into four groups: Control, DEX (7 mg/kg/day), Vit-C (100 mg/kg/day), and DEX +Vit-C and treated for 7 days with intraperitoneal injection. Results: A significant increase in the mean levels of serum and tissue malondialdehyde (MDA) and apoptosis of Leydig cells was found in the DEX group compared to the control group. Sperm motility, DSP, tubular differentiation index, meiotic index, spermatogenesis index, the mean number of spermatocytes, round and long spermatids, and Leydig cells, and also serum testosterone level decreased in the DEX group compared to the control group. The results of this study indicate that Vit-C can significantly prevent the adverse effects of DEX on the mean number of spermatocyte, spermatid, and Leydig cells, tubular differentiation, meiotic and spermatogenesis index, DSP, sperm motility, and the mean levels of serum MDA. Conclusion: In conclusion, our results showed that coadministration of Vit-C and DEX prevents the adverse effects of DEX on the spermatogenesis indexes and DSP.

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Effect of KAP Intervention Model on Resilience and Cancer-related Fatigue in Patients with Colorectal Cancer Undergoing Chemotherapy

Journal of Clinical and Nursing Research ◽

10.26689/jcnr.v5i1.1779 ◽

2021 ◽

Vol 5 (1) ◽

Author(s):

Hui Zhang

Keyword(s):

Colorectal Cancer ◽

Randomized Trial ◽

Cancer Chemotherapy ◽

Prospective Randomized Trial ◽

Control Group ◽

Observation Group ◽

Intervention Model ◽

Cancer Related Fatigue ◽

Resilience Scale ◽

The Difference

Objective: To explore the effect of KAP intervention mode on resilience and cancer-related fatigue in patients with colorectal cancer undergoing chemotherapy. Methods: A prospective randomized trial was conducted. 55 patients with colorectal cancer who received routine nursing from February 2018 to February 2019 were included in the control group, and 55 patients who received routine nursing + KAP intervention from March 2019 to March 2020 were included in the observation group. The scores of Resilience Scale and cancer-related fatigue scale (CFS) before and 6 months after intervention were compared between the two groups. Results: After 6 months of intervention, the score of resilience of the two groups was higher than that before intervention, and that of the observation group was higher than that of the control group, the difference was statistically significant (P < 0.05); The CFS score of the two groups was lower than that before intervention, and that of the observation group was lower than that of the control group, the difference was statistically significant (P < 0.05). Conclusion: KAP intervention model can improve the resilience of patients with colorectal cancer chemotherapy, reduce cancer-related fatigue.

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P–328 Dienogest significantly decreases the size of the cyst and alters Anti-Müllerian Hormone concentration in patients with endometrioma

Human Reproduction ◽

10.1093/humrep/deab130.327 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

E Karataş ◽

B E Temiz ◽

S Mumusoglu ◽

H Yarali ◽

G Bozdag

Keyword(s):

Primary Outcome ◽

Statistical Significance ◽

Mean Difference ◽

Secondary Outcome ◽

Control Group ◽

Significant Drop ◽

Mean Size ◽

The Mean ◽

Respective Figure

Abstract Study question Does utilization of dienogest make any impact on the size of cyst and Anti-Müllerian Hormone (AMH) concentration in patients with endometrioma throughout 12-months? Summary answer Although dienogest makes a gradual reduction in the size of endometrioma cyst throughout 12-months, a significant drop in AMH serum concentration was also noticed. What is known already According to recent studies, pre-operative serum AMH levels might be illusively increased with parallel to the size of endometrioma which will be a misleading factor while deciding to operate the patient via cystectomy. Although dienogest is one of the medical options that might be commenced in patients with endometrioma cyst, there is limited data about its effect on the size of the endometrioma and hence serum AMH concentration throughout 12 months of follow up. Study design, size, duration The current observational cohort study was conducted among patients with endometrioma those treated with dienogest from January 2017 to January 2020. The primary outcome was alteration in diameter of endometrioma cyst at 6th and 12th months of treatment. Secondary outcome was alteration in serum AMH concentration in the same period. Of 104 patients treated with dienogest, 44 patients were excluded due to being treated with any type of surgical intervention during follow up period. Participants/materials, setting, methods A total of 60 patients were recruited for the final analysis. Of them, primary symptom was dysmenorrhea, chronic pelvic pain and menstrual irregularity in 16 (26.7%), 25 (41.7%) and 8 (13.3%) patients, respectively. Eighteen patients (30%) were asymptomatic. As 21 patients had bi-lateral endometrioma, size of the leading cyst was considered to be analyzed for the primary outcome measure. Paired-t test was used for comparison of numerical values and p ≤ 0.05 was taken as statistical significance. Main results and the role of chance The mean age was 31.5±8.0 years. In the time point when dienogest was started, the mean size of the endometrioma was 46.3±17.4 mm. The mean serum AMH concentration was 3.6±2.4 ng/ml. After 6 months of treatment, the mean size of the endometrioma decreased to 38.6±14.0 mm which corresponds to a mean difference of 7.8 mm (95% CI: 3.0 to 12.6; p: 0.003). The respective figure for AMH was 3.3±2.7 ng/ml which corresponds to a mean difference of 0.3 ng/ml (95% CI: –0.2 to 0.8; p: 0.23) at 6 months. After 12 months of treatment, the mean size of the endometrioma was 37.5±15.7 mm which corresponds to a mean difference of 8.9 mm (95% CI: 2.9 to 14.9; p: 0.005) at the end of 12 months. The respective figure for AMH was 2.7±1.9 ng/ml which corresponds to a mean difference of 0.9 ng/ml (95% CI: 0.1 to 1.7; p: 0.045) at the end of 12 months. The mean diameter of endometrioma and AMH concentration did not differ throughout the time period between 6th and 12th months of the treatment. Limitations, reasons for caution Although herein we present the largest data that depicts the alteration of endometrioma cyst and AMH concentration with the application of dienogest, the lack of control group is a limitation that avoids to perform any comparison. Wider implications of the findings: A shrinkage after commencement of treatment suggest that dienogest might present improvement in patients with endometrioma with respect to radiological findings, but further studies are required whether a decline in AMH concentration after 12 months refers to a genuine decrease in ovarian reserve or resolution of misleading high pre-treatment levels. Trial registration number not available

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Bismuth subgallate – its role in tonsillectomy

The Journal of Laryngology & Otology ◽

10.1017/s002221510012969x ◽

1995 ◽

Vol 109 (3) ◽

pp. 203-205 ◽

Cited By ~ 8

Author(s):

J. E. Fenton ◽

A. W. Blayney ◽

T. P. O'Dwyer

Keyword(s):

Randomized Trial ◽

Retrospective Studies ◽

Operating Time ◽

Prospective Randomized Trial ◽

Control Group ◽

Operative Morbidity ◽

Haemostatic Agent ◽

Paediatric Patients ◽

Bismuth Subgallate

AbstractThere have been many attempts at identifying substances and describing methods that would assist the surgeon and be of benefit to the patient undergoing a tonsillectomy. The use of bismuth subgallate as a haemostatic adjunct during tonsillectomy has only been described previously in retrospective studies. A controlled prospective randomized trial of 100 paediatric patients, in which 50 patients had a tonsillectomy performed using bismuth subgallate as a haemostatic agent and in which the remainder did not have any associated haemostatic substance, is presented here.Data on 72 patients was analysed, 39 patients belonging to the bismuth subgallate group and the remaining 33 to the control group. The time for haemostasis was three to 18 (mean 7.8) minutes in the bismuth group. It was four to 16 (mean 9.9) minutes in the non-bismuth group. These figures are statistically significant.The range of ties used in the bismuth group was none to three (mean 1.5) ties and one to seven (mean 3.4) ties in the non-bismuth group. These figures are also statistically significant. The remainder of the recorded parameters did not differ significantly.It was found that bismuth subgallate/adrenaline paste decreases operating time by significantly reducing the haemostasis time and the number of ties required but does not decrease post-operative morbidity.

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Effect of epidural clonidine on minimum local anesthetic concentration (ED50) of levobupivacaine for caudal block in children

Pediatric Anesthesia ◽

10.1111/j.1460-9592.2010.03478.x ◽

2010 ◽

Vol 21 (2) ◽

pp. 128-135 ◽

Cited By ~ 15

Author(s):

Nicola Disma ◽

Geoff Frawley ◽

Leila Mameli ◽

Angela Pistorio ◽

Ornella D. Casa Alberighi ◽

...

Keyword(s):

Local Anesthetic ◽

Caudal Block ◽

Anesthetic Concentration

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The Safety and Efficacy of Cervical Laminectomy and Fusion versus Cervical Laminoplasty Surgery in Degenerative Cervical Myelopathy: A Prospective Randomized Trial

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2020.4841 ◽

2020 ◽

Vol 8 (B) ◽

pp. 807-814

Author(s):

Mohamed Elmallawany ◽

Haitham Kandel ◽

Mohamed A. R. Soliman ◽

Tarek Ahmed Tareef ◽

Ahmed Atallah ◽

...

Keyword(s):

Hospital Stay ◽

Randomized Trial ◽

Operative Time ◽

Prospective Randomized Trial ◽

Cervical Laminectomy ◽

Significant Difference ◽

Operative Complications ◽

Cobb’S Angle ◽

The Mean ◽

Degenerative Cervical Myelopathy

BACKGROUND: There is a lack of evidence of whether degenerative cervical myelopathy (DCM) is best treated through cervical laminoplasty (CLP) or cervical laminectomy with lateral mass fusion due to the lack of prospective randomized studies that are well designed. We conducted the largest prospective randomized trial to date to determine the comparative effectiveness and safety of both approaches. METHODS: In this prospective, randomized trial, we randomly assigned patients who had symptoms or signs of DCM to undergo either cervical laminectomy and lateral mass fixation (CLF) or CLP. The primary outcome measures were the change in the Visual Analog Scale (VAS), neck disability index, modified Japanese Orthopedic Association (mJOA) score, and Nurick’s myelopathy grading 1 year after surgery. The secondary outcome measures were the intraoperative, post-operative complications, hospital stay, C2-7 Cobb’s angle, and Odom’s criteria. The follow-up period was at least 1 year. RESULTS: A total of 30 patients (mean age, 54.5 ± 5.5 years, 70% of men) underwent prospective randomization. There was a significantly greater improvement in neck pain (VAS) in the CLF group at 1 year (p < 0.05). The improvement in the mJOA and Nurick’s myelopathy grading showed insignificant improvement between both groups. Furthermore, there was no significant difference in the patient’s post-operative satisfaction (Odom’s criteria). The mean operative time was significantly longer in the CLF group (p < 0.001), with no significant difference in the post-operative complications, however, there was a higher rate of C5 palsy, dural tear and infection in the CLF, and a higher rate of instrumentation failure in the CLP. The mean hospital stay was significantly longer in the posterior group (p < 0.05). Finally, there was a significant better improvement in the C2-7 Cobb’s angle at 1 year in the CLF group (p < 0.05). CONCLUSION: Among patients with multilevel DCM, the CLF approach was significantly better regarding the post-operative pain and Cobb’s angle while the CLP was significantly better in terms of shorter hospital stay and operative time.

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The Effect of Sphenopalatine Block on the Postoperative Pain of Endoscopic Sinus Surgery: A Meta-analysis

Otolaryngology ◽

10.1177/0194599818805673 ◽

2018 ◽

Vol 160 (2) ◽

pp. 223-231 ◽

Cited By ~ 4

Author(s):

Do Hyun Kim ◽

Haram Kang ◽

Se Hwan Hwang

Keyword(s):

Treatment Group ◽

Postoperative Pain ◽

Adverse Effects ◽

Local Anesthetic ◽

Relevant Literature ◽

Transoral Approach ◽

Sinus Surgery ◽

Control Group ◽

Transnasal Approach ◽

Intraoperative Bleeding

Objectives The use of sphenopalatine ganglion block (SPGB) with a local anesthetic to decrease postoperative pain after endoscopic sinus surgery (ESS) is controversial. We investigated the role of a perioperative SPB to minimize postoperative pain related to ESS in patients with chronic sinusitis through a systematic review of the relevant literature. Data Sources PubMed, SCOPUS, Google Scholar, Embase, and the Cochrane Register of Controlled Trials. Review Methods We screened the relevant literature published before June 2018. Eight articles that compared perioperative SPGB (treatment group) with a placebo or no treatment (control group) were included for this analysis of the outcomes, which included perioperative morbidities in ESS. For quantitative variables, the standardized mean difference was applied to standardize and summate the results of the studies, and the odds ratio was used in outcome of incidence analysis. Results Intraoperative bleeding ( P < .0001), postoperative pain ( P = .0001), nausea and vomiting ( P = .0117), and recovery from sedation ( P < .0001) in the treatment group were significantly reduced compared with the control group. No significant adverse effects were reported in the enrolled studies. In subgroup analyses according to the SPGB approach (transoral or transnasal), the transnasal approach showed higher positive effects on intraoperative bleeding and postoperative pain compared to the transoral approach. Conclusion In our study, SPGB combined with a local anesthetic for ESS effectively reduced intra-and postoperative morbidities. This procedure showed no significant adverse effects. Given the ease and effectiveness of this procedure, the transnasal approach should be highly recommended as a routine procedure compared to the transoral approach.

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