scholarly journals Postoperative Analgesia for Pediatric Craniotomy Patients: A Randomized Controlled Trial

2019 ◽  
Author(s):  
Fei Xing ◽  
LiXin An ◽  
FuShan Xue ◽  
ChunMei Zhao ◽  
YaFan Bai
Keyword(s):  
Postoperative Analgesia ◽  
Severe Pain ◽  
Pediatric Patients ◽  
Controlled Trial ◽  
Pediatric Neurosurgery ◽  
Control Group ◽  
Clinical Trial Registry ◽  
Pain Scores ◽  
Significant Difference ◽  
Lower Pain

Abstract Background: Pain is often observed in pediatric patients after craniotomy procedures, which could lead to some serious postoperative complications. However, the optimal formula for postoperative analgesia for pediatric neurosurgery has not been well established. This study aimed to explore the optimal options and formulas for postoperative analgesia in pediatric neurosurgery. Methods: Three hundred and twenty patients aged 1 to 12-years old who underwent craniotomy were randomly assigned to receive 4 different regimens of patient-controlled analgesia (PCIA or NCIA). Postoperative pain scores at different time point after surgery and analgesia-related complication were recorded respectively. Comparative analysis was performed between the four groups. Results: In all groups, significantly lower pain scores were observed at one to 8 hours in the morphine group (P<0.05). There was no significant difference in pain scores between the fentanyl and tramadol groups (P>0.05), both of which had lower pain scores than the placebo group (P<0.05). However, a higher incidence of nausea and vomiting occurred in the tramadol group during the 48 hours of NCIA usage after operation (P=0.020). Much more rescue medicines including ibuprofen and morphine were used in control group (CI=0.000-0.019). No consciousness change and respiratory depression was observed in all groups. There were 56 children experienced moderate-severe pain(17.5%), younger children (OR=1.161, 1.027-1.312, P=0.017), occipital craniotomy (OR=0.374, 0.155-0.905, P=0.029), morphine treatment, were relevant factors of moderate-severe pain in pediatric patients. Conclusions: Compared with other analgesic projects, PCIA or NCIA analgesia with morphine appears to be the safest and most effective postoperative analgesia program for pediatric patients who underwent neurosurgical operations. Trial registration: Chinese Clinical Trial Registry. No: ChiCTR-IOC-15007676. Prospective registration. http://www.chictr.org.cn. Keywords: Pain, Postoperative, Child, Craniotomy

scholarly journals Postoperative Analgesia for Pediatric Craniotomy Patients: A Randomized Controlled Trial

2019 ◽  
Author(s):  
Fei Xing ◽  
LiXin An ◽  
FuShan Xue ◽  
ChunMei Zhao ◽  
YaFan Bai
Keyword(s):  
Postoperative Analgesia ◽  
Severe Pain ◽  
Pediatric Patients ◽  
Group Versus ◽  
Pediatric Neurosurgery ◽  
Control Group ◽  
Morphine Group ◽  
Pain Scores ◽  
Background Infusion ◽  
Lower Pain

Abstract Background: Pain is often observed in pediatric patients after craniotomy procedures, which could lead to some serious postoperative complications. However, the optimal formula for postoperative analgesia for pediatric neurosurgery has not been well established. This study aimed to explore the optimal options and formulas for postoperative analgesia in pediatric neurosurgery. Methods: Three hundred and twenty patients aged 1 to 12-years old who underwent craniotomy were randomly assigned to receive 4 different regimens of patient-controlled analgesia. The formulas used were as follows: Control group included normal saline 100 ml, with a background infusion of 2 ml/h, bolus 0.5 ml; Fentanyl group was used with a background infusion of 0.1-0.2 μg/k·h, bolus 0.1-0.2 μg/kg; Morphine group was used with a background infusion of 10-20 μg/kg·h, bolus 10-20 μg/kg; while Tramadol group was used with a background infusion of 100-400 μg/kg·h, bolus 100-200 μg/kg. Postoperative pain scores and analgesia-related complication were recorded respectively. Comparative analysis was performed between the four groups. Results: In comparison of all groups with each other, lower pain scores were shown at 1 hour and 8 hour after surgery in Morphine group versus Tramadol, Fentanyl and Control groups (P<0.05). Both Tramadol and Fentanyl groups showed lower pain scores in comparison to Control group (P<0.05). Nausea and vomiting were observed more in Tramadol group in comparison to all other groups during the 48 hours of PCIA usage after operation (P=0.020). Much more rescue medicines including ibuprofen and morphine were used in Control group (CI=0.000-0.019). Changes in consciousness and respiratory depression were not observed in study groups. Moderate-to-severe pain was observed in a total of 56 (17.5%) of the study population. Multiple regression analysis for identifying risk factors for moderate-to-severe pain revealed that, younger children (OR=1.161, 1.027-1.312, P=0.017), occipital craniotomy (OR=0.374, 0.155-0.905, P=0.029), and morphine treatment (OR=0.077, 0.021-0.281, P<0.001) are the relevant factors. Conclusions: Compared with other analgesic projects, PCIA or NCIA analgesia with morphine appears to be the safest and most effective postoperative analgesia program for pediatric patients who underwent neurosurgical operations. Trial registration: Chinese Clinical Trial Registry. No: ChiCTR-IOC-15007676. Prospective registration. http://www.chictr.org.cn.

scholarly journals Postoperative Analgesia for Pediatric Craniotomy Patients: A Randomized Controlled Trial

2019 ◽  
Author(s):  
Fei Xing ◽  
LiXin An ◽  
FuShan Xue ◽  
ChunMei Zhao ◽  
YaFan Bai
Keyword(s):  
Postoperative Analgesia ◽  
Severe Pain ◽  
Pediatric Patients ◽  
Group Versus ◽  
Pediatric Neurosurgery ◽  
Control Group ◽  
Morphine Group ◽  
Pain Scores ◽  
Background Infusion ◽  
Lower Pain

Abstract Background: Pain is often observed in pediatric patients after craniotomy procedures, which could lead to some serious postoperative complications. However, the optimal formula for postoperative analgesia for pediatric neurosurgery has not been well established. This study aimed to explore the optimal options and formulas for postoperative analgesia in pediatric neurosurgery. Methods: Three hundred and twenty patients aged 1 to 12-years old who underwent craniotomy were randomly assigned to receive 4 different regimens of patient-controlled analgesia. The formulas used were as follows: Control group included normal saline 100 ml, with a background infusion of 2 ml/h, bolus 0.5 ml; Fentanyl group was used with a background infusion of 0.1-0.2 μg/k·h, bolus 0.1-0.2 μg/kg; Morphine group was used with a background infusion of 10-20 μg/kg·h, bolus 10-20 μg/kg; while Tramadol group was used with a background infusion of 100-400 μg/kg·h, bolus 100-200 μg/kg. Postoperative pain scores and analgesia-related complication were recorded respectively. Comparative analysis was performed between the four groups. Results: In comparison of all groups with each other, lower pain scores were shown at 1 hour and 8 hour after surgery in Morphine group versus Tramadol, Fentanyl and Control groups (P<0.05). Both Tramadol and Fentanyl groups showed lower pain scores in comparison to Control group (P<0.05). Nausea and vomiting were observed more in Tramadol group in comparison to all other groups during the 48 hours of PCIA usage after operation (P=0.020). Much more rescue medicines including ibuprofen and morphine were used in Control group (CI=0.000-0.019). Changes in consciousness and respiratory depression were not observed in study groups. Moderate-to-severe pain was observed in a total of 56 (17.5%) of the study population. Multiple regression analysis for identifying risk factors for moderate-to-severe pain revealed that, younger children (OR=1.161, 1.027-1.312, P=0.017), occipital craniotomy (OR=0.374, 0.155-0.905, P=0.029), and morphine treatment (OR=0.077, 0.021-0.281, P<0.001) are the relevant factors. Conclusions: Compared with other analgesic projects, PCIA or NCIA analgesia with morphine appears to be the safest and most effective postoperative analgesia program for pediatric patients who underwent neurosurgical operations. Trial registration: Chinese Clinical Trial Registry. No: ChiCTR-IOC-15007676. Prospective registration. http://www.chictr.org.cn.

scholarly journals Lung recruitment improves the efficacy of intubation-surfactant-extubation treatment for respiratory distress syndrome in preterm neonates, a randomized controlled trial

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Yong Yang ◽  
Wenkang Yan ◽  
Minyi Ruan ◽  
Lan Zhang ◽  
Jinzhen Su ◽  
...  
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Controlled Trial ◽  
Multivariate Logistic Regression Analysis ◽  
Lung Recruitment ◽  
Preterm Neonates ◽  
Control Group ◽  
Clinical Trial Registry ◽  
Significant Difference

Abstract Background Lung recruitment is a maneuver used to decrease the length of intubation in preterm neonates. This study aimed to compare the therapeutic efficacy of lung recruitment plus intubation-surfactant-extubation (INSURE) procedure and INSURE alone for the preterm neonates with respiratory distress syndrome. Methods From 2017 to 2019, 184 preterm neonates (gestational age 24–32 weeks) with respiratory distress syndrome were enrolled and randomized into the lung recruitment group receiving lung recruitment (25 cm H2O, 15 s) plus INSURE and the control group receiving INSURE only. The primary outcome was the need for mechanical ventilation (MV) within 72 h after extubation. The secondary outcomes included duration of MV, noninvasive ventilation, total oxygen therapy, hospitalization time, and complications. Results Compared to the control group, the lung recruitment group had a significantly lower proportion of preterm neonates requiring MV within 72 h after extubation (23% vs. 38%, P = 0.025) and pulmonary surfactant administration, as well as a shorter MV duration. There was no significant difference in the incidences of complications (all P > 0.05) and in-hospital mortality (2% vs. 4%, P = 0.4) between the lung recruitment group and control group. Multivariate logistic regression analysis demonstrated that the control group had a 2.17-time higher risk of requiring MV than the lung recruitment group (AOR: 2.17, 95% CI: 1.13–4.18; P = 0.021). Compared with infants with a normotensive mother, infants with a hypertensive mother have a 2.41-time higher risk of requiring MV (AOR: 2.41, 95% CI: 1.15–5.05; P = 0.020). Conclusion Lung recruitment plus INSURE can reduce the need for MV within 72 h after extubation and did not increase the incidence of complications and mortality. Trial registration Chinese Clinical Trial Registry ChiCTR1800020125, retrospectively registered on December 15, 2018.

scholarly journals A structured exercise to relieve musculoskeletal pain caused by face-down posture after retinal surgery: a randomized controlled trial

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
A-Young Kim ◽  
Sungsoon Hwang ◽  
Se Woong Kang ◽  
So Yeon Shin ◽  
Won Hyuk Chang ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Musculoskeletal Pain ◽  
Controlled Trial ◽  
Exercise Group ◽  
Control Group ◽  
Randomized Controlled ◽  
Pain Scores ◽  
Lower Back ◽  
Physical Burden ◽  
Lower Pain

AbstractFace-down posture after vitrectomy physically burdens patients. Despite being of significant concern for patients, the intraoperative pain and discomfort has not been of great interest to retinal surgeons or researchers. This randomized controlled trial evaluated the effect of a 3-day novel structured exercise on reducing musculoskeletal pain from the face-down posture in 61 participants (31 in the exercise group) who underwent vitrectomy. Among the subjects, the median age was 62 years, 42 were female, 42 had macular holes, and 19 had retinal detachments. Participants in the exercise group received initial education on the exercise and performed three daily active exercise sessions. After the sessions, the exercise group had median numeric pain scores of 2, 1, and 1 at the back neck, shoulder, and lower back, respectively, while the control group had corresponding scores of 5, 3, and 4, respectively. The exercise group reported significantly lower pain scores (P = .003, .039, and .006 for the back neck, shoulder, and lower back, respectively). Application of the structured exercise would alleviate the patients’ position-induced postoperative physical burden, by reducing pain and discomfort.

P-750 Clinical efficacy of virtual reality for acute pain and anxiety management during outpatient hysteroscopy and endometrial biopsy in subfertile patients

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
V Schutyser ◽  
R Buyl ◽  
M De Vos ◽  
H Tournaye ◽  
C Blockeel
Keyword(s):  
Virtual Reality ◽  
Controlled Trial ◽  
Tertiary Care ◽  
Cochrane Review ◽  
Endometrial Biopsy ◽  
Cognitive Capacity ◽  
Control Group ◽  
Preliminary Results ◽  
Pain Scores ◽  
Significant Difference

Abstract Study question Does the use of virtual reality (VR) headsets in diagnostic office hysteroscopy (HSC) with endometrial biopsy (EB) reduce anxiety and pain scores in the patient? Summary answer Virtual reality during office HSC do not seem to improve relaxation, anxiety, or pain scores. Physicians have a good perception of patients’ pain. What is known already Women undergoing outpatient HSC experience high levels of preoperative anxiety, which increase pain and discomfort during the procedure. The experience of pain is a complex phenomenon, which simultaneously occurs on cognitive, emotional, and behavioural levels, and is influenced by many factors. A Cochrane review failed to show a significant difference between different types of pain relief (analgesics, local anaesthetic and verbal support techniques …). VR is a multisensory immersion providing an interactive high level distraction, occupying a large portion of humans’ finite attentional resources (vision and audio), and leaving less cognitive capacity available to process pain. Study design, size, duration The sample size for this prospective randomized controlled trial was calculated at 196 patients (98 per group), considering a power of at least 80% to detect superiority of adding a VR headset versus standard care, standard deviation (SD = 2.0), using a two-sided, t-test, at significance level alpha of 0.05. The preliminary results after 1 month include a sample of 48 patients 25 in the VR group and 23 controls. Participants/materials, setting, methods All 48 patients suffer subfertility and underwent HSC with EB at our tertiary-care fertility center. We used Oncomfort®, a commercially available VR autohypnosis relaxation program designed for perioperative settings. The headmounted smartphone display with headphones provides image sound distraction with suggestive hypnosis techniques incorporated. Before and immediately after the exam, both patients and surgeons fill out a questionnaire using the 10.0cm visual analog scale (VAS). Main results and the role of chance The mean duration of HSC was 3min43sec in the VR group, (range 2-6min), compared to 4min50 in the control group (range 1-12minutes), which was not significantly different (p = 0.09). Subjective variables of stress, anxiety and pain were evaluated at four different time points, i.e. before, during, immediately after HSC and one week later. According to VAS, stress levels did not differ significantly (p &gt; 0.05) between the VR group and the control group, or within time 5.08 to 5.36 to 3.08 vs 4.48 to 4.83 to 2.48 before, during and after HSC respectively. Fear levels prior to HSC at 4.28 for VR patients and 3.52 for controls did not increase significantly during HSC in both groups: 4.44 vs 4.17. During HSC, pain levels increased from 1.40 to 4.720 in the VR group vs 0.65 to 4.109 (NS) in the controls, to decrease again afterwards to 2.60 vs 2.17 (NS) respectively. Physicians rated the average pain levels of VR patients as 3.32 compared to 3.0 for controls, which was significantly correlated to patients’ perception (p &lt; 0,005). Patients gave a positive rating to the VR experience (satisfaction score 7.17). Limitations, reasons for caution These are preliminary results, evaluating only a fourth of the required sample. A population selection bias could exist, as recruited patients were willing to accept VR. The very short induction period of 2 minutes could influence the effect of (immersiveness into) VR. Wider implications of the findings Pain management in ambulatory procedures should be multimodal and should include both pharmacological and non-pharmacological interventions. Introducing VR might increase patient tolerance for longer or more painful procedures. Offering a range of options will increase the spectrum of successful procedures in the outpatient setting and improve patient experience. Trial registration number B.U.N. 1432020000050

scholarly journals Evaluation of Intraperitoneal and Incisional Bupivacaine or Levobupivacaine for Postoperative Analgesia in Ovariohysterectomized Dogs

2019 ◽  
Vol 47 (1) ◽  
Author(s):  
Musa Korkmaz ◽  
Oktay Yilmaz ◽  
Zulfukar Kadir Saritas ◽  
Ibrahim Demirkan ◽  
Jerzy Jaroszewski
Keyword(s):  
Postoperative Pain ◽  
General Anaesthesia ◽  
Postoperative Analgesia ◽  
Abdominal Cavity ◽  
Companion Animals ◽  
Assessment System ◽  
Cervix Uteri ◽  
Control Group ◽  
Pain Scores ◽  
Significant Difference

Background: Ovariohysterectomy (OHE) is the most commonly performed elective surgical procedure in companion animals. OHE offers benefits of control of population and decreased risk of potentially life-threatening diseases such as mammarian tumours and pyometra.  Traditional OHE intervention causes inflammation and pain due to trauma during organ manipulation. The purpose of this study was to compare the effect of intraperitoneal and incisional administration of bupivacaine (BP) or levobupivacaine (LP) on postoperative analgesia in dogs undergoing the OHE procedure.Materials, Methods & Results: A total of 24 mix-breed bitches aged between 1 - 3 years and weighed 19 - 20 kg were used in this study. The animals were divided into three groups as control (n = 8), BP (n = 8) and LP group (n = 8). The animals were kept under surveillance at the hospitalisation unit of the animal hospital for one day before the elective OHE. The dogs were fasted for 12 h before the surgery, with adlib water consumption. Atropine sulphate 0.045 mg/kg was administered subcutaneously approximately 30 min before general anaesthesia. Midazolam (0.3 mg/kg) was intravenously injected into all dogs for pre-anaesthetic medication. After sedation, anaesthesia was induced with propofol (4 mg/kg, IV) and then the dogs were orotracheally intubated using cuffed endotracheal tubes. General anaesthesia was maintained by administration of 2% isoflurane. The ventral abdomen was prepared aseptically for OHE following the general anaesthesia. All animals were operated on by the same surgeon. During surgery, sprayed bupivacaine 0.5% (4.4 mg/kg) with an equal volume of saline in BP group, levobupivacaine 0.5% (4.4 mg/kg) with an equal volume of saline in LP were then applied over the ovaries, uterine broad ligaments and cervix uteri. After removal of the uterine body, either LP or BP was sprayed to left and right, or cranial and caudal parts of the abdominal cavity. Finally, the incision line was sprayed before closing the skin. The control group received only sprayed saline.  The pain evaluation was carried out with modified Melbourne pain scoring scale. To determine cortisol concentrations, blood samples were taken before anaesthesia induction (baseline) and postoperative 0, 0.5, 1, 2, 4, 6, 12 and 24 h. Postoperative pain scores were higher in the control group than BP and LP groups following surgery at 30 min, 1st, 4th, and 6th h. In all groups, cortisol levels increased postoperatively, whereas they decreased more rapidly in BP and LP groups. There was a steady increase at postoperative 0 min, 30 min, 1st, 2nd, 4th and 6th h in the control group and at postoperative 0 min, 30 min and 1 h in BP and LP groups (P < 0.05).Discussion: Intraperitoneal and incisional bupivacaine shows significantly superior postoperative pain management benefits after the closure of skin, compared to untreated dogs and it is also superior to lidocaine treatment at 0.5 h following the visual analogy pain assessment system. In the present study, the observation of lower pain scores in BP group at 0.5, 1, 4 and 6 h as compared to the control group was similar to findings of other studies. LP group also showed decreased pain scores at above-mentioned h without any significant difference. However, only in LP group, pain scores at 24 h were lower than postoperative pain scores. In conclusion, it is suggested that sprayed intraperitoneal and incisional BP and LP are very effective for preventing postoperative pain ovariohysterectomized dogs.

scholarly journals Intrauterine levobupivacaine for pain control during intrauterine device insertion

2017 ◽  
Vol 6 (3) ◽  
pp. 1117
Author(s):  
Nilufer Akgun ◽  
Esra Keskin ◽  
Muberra Namlı Kalem ◽  
Batuhan Bakirarar
Keyword(s):  
Pain Control ◽  
Controlled Trial ◽  
Intrauterine Device ◽  
Saline Control ◽  
Control Group ◽  
Double Blind ◽  
Pain Scores ◽  
Significant Difference ◽  
Vas Scores

Background: Safe, effective, long term and a reversible contraception method is offered by intrauterine devices (IUDs).  The objective was to determine the potency of intrauterine administration of 5 cc levobupivacain for pain relief with IUD insertion, when compared with saline placebo.Methods: This was a prospective randomized, double blind placebo-controlled trial undergoing İUD insertion. The trial medication was intrauterine anesthesia, either 5 mL 0.9% saline (control group), or 5 mL 0.5% levobupivacaine. Our primary outcome was self-reported pain scores on a 10 cm visual analogue scale (VAS) immediately following IUD insertion.Results: 95 women were enrolled, and data for 88 women were analyzed. In IUD insertion procedure, no difference was observed between groups during teneculum placement and solution administration, in the course of VAS scores (p=0.349, p=0.396). There was a significant difference in the VAS scores measuring pain suffering during and after IUD procedure (p=0.001).Conclusions: Intrauterine instillation of 5 cc of levobupivacaine along with saline solution reduces pain with IUD insertion when compared to intrauterine saline placebo. Broad deviation in pain scores and persistent pain after IUD insertion recommends that patient would benefit from more functioning method of pain control than before at IUD insertion and during the post interval.

scholarly journals Ketorolac tromethamine pretreatment suppresses sufentanil-induced cough during general anesthesia induction: a prospective randomized controlled trial

2020 ◽  
Author(s):  
Zhen Tian ◽  
Bei Hu ◽  
Min Miao ◽  
Lulu Zhang ◽  
Lin Wang ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Elective Surgery ◽  
Controlled Trial ◽  
Recovery Period ◽  
Control Group ◽  
Anesthesia Induction ◽  
Observation Group ◽  
Ketorolac Tromethamine ◽  
Clinical Trial Registry ◽  
Significant Difference

Abstract Background: To observe the effect about pretreatment of ketorolac tromethamine on sufentanil-induced cough in general anesthesia patients. Methods: 102 patients were screened, and a total of 90 patients were scheduled for elective surgery under general anesthesia. 90 patients were randomly divided into two groups: the control group（C group）and the observation group（KT group）. 5 minutes before anesthesia induction, observation group were given ketorolac tromethamine 0.5mg/kg intravenously within 3 s, while the control group were given the same amount of normal saline intravenously. All patients were given a sufentanil bolus of 0.5 ug/kg（within 3 s）intravenously,1 minute later, propofol 2.5mg/kg, vecuronium 0.15mg/kg were injected intravenously, and endotracheal intubation was guided by laryngoscope. The number of coughs that occurred within 1 min after sufentanil injection were recorded. The mean arterial pressure (MAP)，heart rate (HR) and pulse oxygen saturation(SpO2) were recorded at T0 (immediately before pretreatment), T1 (5 minutes after pretreatment), T2（before intubation），T3 (1 min after intubation) and T4 (5 min after intubation).The incidence of adverse reactions were analyzed. Results: Within 1 min after sufentanil injection, the incidence and severity of cough in KT group was significantly lower than that in C group ( P < 0.05). At the time points of T0, T1, T2, T3 and T4, there was no significant difference in MAP, HR and SpO2 between the two groups ( P > 0.05). And there was no significant difference in the dosage of sufentanil, propofol, remifentanil and vecuronium, incidence of nausea and vomiting, delay of recovery, dizziness, drowsiness and respiratory depression between the two groups( P > 0.05). However, there were significant differences in the number of restlessness during waking period ( P < 0.05). Conclusion: Pretreatment of intravenous ketorolac tromethamine can significantly reduce the incidence of sufentanil-induced cough during induction period of general anesthesia patients, and can also significantly reduce the restlessness during recovery period of patients. Trial registration: Chinese Clinical Trial Registry (registration number# ChiCTR2000030287; date of registration: 27/02/2020).

Analgesia for the Change of Dressing in Burn Victims: A Comparison Between Oral Ketamine and Oral Dexmedetomidine

Esculapio ◽  
2021 ◽  
Vol 17 (1) ◽  
pp. 39-44
Author(s):  
Faridah Sohail ◽  
Lala Rukh Bangash ◽  
Waqar Azim ◽  
Farah Arshad ◽  
Anum Anwar ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Total Body Surface Area ◽  
P Value ◽  
Burn Victims ◽  
Oral Ketamine ◽  
Pain Scores ◽  
Significant Difference ◽  
Lower Pain ◽  
Group A ◽  
Group B

Objective: To compare the efficacy of oral ketamine with oral dexmedetomidine for providing adequate analgesia for change of dressing in burn patients in burn dressing room. Methods: This randomized controlled trial was carried out in Jinnah Burn and Reconstructive Surgery Center, Lahore, from April 2019 to September 2019 after getting the approval from the Ethical Committee of Jinnah Hospital / Allama Iqbal Medical College, Lahore. 80 patients between 20 to 50 years, with 1st and 2nd degree burns and 20 to 40% of total body surface area involved were allocated in two groups A and B. The patients in group A received oral ketamine at a dose of 5mg/kg in 15 ml of water 30 mins while those in group B received dexmedetomidine, 4 ug/kg orally, in 15 ml of water 30 mins before the start of dressing change. The change of dressing was carried out with continuous vital monitoring. Pain was assessed via visual analogue scale (VAS) and sedation via Ramsay sedation score. All the observations were recorded on the predesigned proforma. SPSS version 21 was used for data analysis. Result: The baseline mean VAS score of patients in group A was 7.67 + 0.55 and in group B was 7.70 + 0.57 (p value = 0.799). Significant decrease in pain score in both groups was noted after 30 mins of drugs administration (p=0.000). Also a significant difference in pain scores was seen between the two groups (p< 0.05), with the patients in group A having lower pain scores as compared to patients in group B. Conclusion: both ketamine and dexmedetomidine provide adequate analgesia for the change of burn dressing when administered orally with ketamine providing better analgesic state as compared to dexmedetomidine. Key Words: Burn, ketamine, dexmedetomidine, analgesia. How to cite: Sohail F., Bangash R.L., Azim W., Arshad F, Anwar A., Niazi K.A. Analgesia for the Change of Dressing in Burn Victims: A Comparison between Oral Ketamine and Oral Dexmedetomidine. Esulapio 2021;17(01):39-44

Comparison of the efficacy of Acupuncture and Conventional Physiotherapy treatment in the management of SIJ dysfunction- A Randomised controlled trial (RCT)

2016 ◽  
Author(s):  
Ganiyu Oluwaleke Sokunbi ◽  
Fatima Gujba Kachalla
Keyword(s):  
Pain Intensity ◽  
Functional Disability ◽  
Controlled Trial ◽  
Control Group ◽  
Invasive Treatment ◽  
Pain Scores ◽  
Significant Difference ◽  
Conventional Physiotherapy ◽  
Randomised Controlled

Background: The question of what form of non-invasive treatment is most effective for sacroiliac joint (SIJ) dysfunction has not been sufficiently addressed. The quality of evidence regarding the efficacy of a conservative treatment approach is low, and there is no evidence for sustained benefits.Objectives: To compare the efficacy of acupuncture and conventional physiotherapy in the management of pain and functional disability in patients with SIJ dysfunction.Methods: Forty women with SIJ dysfunction with a mean age of 29.3± 4.3 years participated in the study. Ten participants were randomised into each of three intervention groups (acupuncture (ACT); conventional physiotherapy (CPT); and acupuncture combined with conventional physiotherapy (ACPT)) and a control group (CG) (education and advice). Treatment interventions were provided three times a week for five weeks. The main outcome measures were pain intensity measured with visual analogue scale (VAS) and functional disability measured with Roland Morris Disability Questionnaire (RMDQ). Assessments were carried out by an independent examiner before and after the intervention and at 3 months follow-up.Results: Baseline VAS and RMDQ scores did not show significant differences among the groups. After treatment, the participants in all the intervention groups had reduced pain scores on the VAS scale (ACT= 3.5±0.06, CPT =3.0±0.08 and ACPT=1.2±0.98) and improved function on RMDQ scores (ACT =7.0±1.53, CPT = 6.0±.01, ACPT = 3.0± 0.08) compared to those in the control group, who recorded 7.4±0.08 and 17.5± 4.32 for pain intensity and functional disability, respectively. However, pain reduction and improvement in function was greatest in the ACPT at the end of the 5-week treatment and at 3-month follow-up (VAS=1.0±0.04, RMDQ =2.0± 0.07) compared with the other intervention groups (VAS: ACT= 4.0±0.97, CPT = 3.5±1.00 and RMDQ: ACT=7.0±1.6, CPT=5.0±0.87). There was a significant difference in the pain scores on VAS (F =67.171, P=0.000) and functional disability on RMDQ scores (F=62.467, P=0.000) among the groups after 5 weeks of treatment and at 3-month post-treatment follow-up assessment VAS (F =79.903, P=0.000) and RMDQ (F =75.301, P=0.000), which was not present at the baseline.Conclusion: Findings from this study showed that acupuncture or conventional physiotherapy alone or in combination is more effective than advice and education. The combination of acupuncture and conventional therapy is more effective than both treatments alone.

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