Effects of intravenous infusion of lidocaine and dexmedetomidine on inhibiting cough during the tracheal extubation period after thyroid surgery

Abstract Background：Intravenous lidocaine and dexmedetomidine treatments have been proposed as methods for inhibiting cough. We compared the efficacy of intravenous lidocaine and dexmedetomidine treatments on inhibiting cough during the tracheal extubation period after thyroid surgery. Methods：One hundred eighty patients undergoing thyroid surgeries were randomly allocated to the LIDO group (received lidocaine 1.5 mg/kg loading, 1.5 mg/kg/h infusion), the DEX group (received dexmedetomidine 0.5 µg/kg loading, 0.4 µg/kg/h infusion) and the CON group (received saline), with 60 cases in each group. The primary outcomes of cough were recorded. Secondary outcomes included hemodynamic variables, awareness time, volume of drainage, the postoperative visual analogue scale and adverse effects were recorded. Results: The incidence of cough were significantly lower in the LIDO group (28.3%) and the DEX group (31.7%) than that in the CON group (66.7%) (P=0.000). Additionally, both moderate and severe cough were significantly lower in the LIDO group (13.3%) and the DEX group (13.4%) than these in the CON group (43.4%) (P<0.05). Compared with the two treatment groups, both mean arterial blood pressure and heart rate were significantly increased in the CON group during tracheal extubation (P<0.05). Compared with the CON group, the volume of drainage was significantly reduced in the two treatment groups within 48 hours after surgery (P<0.05). compared with the CON group, the postoperative visual analogue scale was significantly lower in groups LIDO and DEX after surgery(P<0.05). Compared with the LIDO group and the CON group, the time to awareness was longer in the DEX group (P<0.05). In the DEX group, bradycardia was noted in 35 patients, while no bradycardia was noted in LIDO group and CON group. Conclusion: Compared with intravenous infusions of normal saline, both lidocaine and dexmedetomidine had equal effectiveness in attenuating cough and hemodynamic changes during the tracheal extubation period after thyroid surgery, and both of these treatments were able to reduce the volume of postoperative bleeding and provide better analgesic effect after surgery. But intravenous infusions of dexmedetomidine resulted in bradycardia and delayed time to awareness when compared with lidocaine and normal saline.

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Effects of intravenous infusion of lidocaine and dexmedetomidine on inhibiting cough during the tracheal extubation period after thyroid surgery

10.21203/rs.2.216/v4 ◽

2019 ◽

Author(s):

Shenghong Hu ◽

Yuanhai Li ◽

Shengbin Wang ◽

Siqi Xu ◽

Xia Ju ◽

...

Keyword(s):

Visual Analogue Scale ◽

Normal Saline ◽

Thyroid Surgery ◽

Analogue Scale ◽

Postoperative Bleeding ◽

Tracheal Extubation ◽

Treatment Groups ◽

Hemodynamic Variables ◽

Arterial Blood ◽

Intravenous Infusions

Abstract Background：Intravenous lidocaine and dexmedetomidine treatments have been proposed as methods for inhibiting cough. We compared the efficacy of intravenous lidocaine and dexmedetomidine treatments on inhibiting cough during the tracheal extubation period after thyroid surgery. Methods：One hundred eighty patients undergoing thyroid surgeries were randomly allocated to the LIDO group (received lidocaine 1.5 mg/kg loading, 1.5 mg/kg/h infusion), the DEX group (received dexmedetomidine 0.5 µg/kg loading, 0.4 µg/kg/h infusion) and the CON group (received saline), with 60 cases in each group. The primary outcomes of cough were recorded. Secondary outcomes included hemodynamic variables, awareness time, volume of drainage, the postoperative visual analogue scale and adverse effects were recorded. Results: The incidence of cough were significantly lower in the LIDO group (28.3%) and the DEX group (31.7%) than that in the CON group (66.7%) (P=0.000). Additionally, both moderate and severe cough were significantly lower in the LIDO group (13.3%) and the DEX group (13.4%) than these in the CON group (43.4%) (P<0.05). Compared with the two treatment groups, both mean arterial blood pressure and heart rate were significantly increased in the CON group during tracheal extubation (P<0.05). Compared with the CON group, the volume of drainage was significantly reduced in the two treatment groups within 48 hours after surgery (P<0.05). compared with the CON group, the postoperative visual analogue scale was significantly lower in groups LIDO and DEX after surgery(P<0.05). Compared with the LIDO group and the CON group, the time to awareness was longer in the DEX group (P<0.05). In the DEX group, bradycardia was noted in 35 patients, while no bradycardia was noted in LIDO group and CON group. Conclusion: Compared with intravenous infusions of normal saline, both lidocaine and dexmedetomidine had equal effectiveness in attenuating cough and hemodynamic changes during the tracheal extubation period after thyroid surgery, and both of these treatments were able to reduce the volume of postoperative bleeding and provide better analgesic effect after surgery. But intravenous infusions of dexmedetomidine resulted in bradycardia and delayed time to awareness when compared with lidocaine and normal saline.

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Effects of intravenous infusion of lidocaine and dexmedetomidine on inhibiting cough during the tracheal extubation period after thyroid surgery

10.21203/rs.2.216/v1 ◽

2019 ◽

Author(s):

Shenghong Hu Shenghong Hu ◽

Yuanhai Li ◽

Shengbin Wang ◽

Siqi Xu ◽

Xia Ju ◽

...

Keyword(s):

Thyroid Surgery ◽

Tracheal Extubation ◽

Intravenous Lidocaine ◽

Clinical Trial Registry ◽

Treatment Groups ◽

Hemodynamic Variables ◽

Arterial Blood ◽

Significant Difference ◽

Postoperative Drainage ◽

Equal Effectiveness

Abstract Background: Intravenous lidocaine and dexmedetomidine treatments have been proposed as methods for inhibiting cough. We compared the efficacy of intravenous lidocaine and dexmedetomidine treatments on inhibiting cough during the tracheal extubation period after thyroid surgery. Methods: One hundred eighty patients undergoing thyroid surgeries were randomly allocated to the LIDO group (received lidocaine 1.5 mg/kg loading, 1.5 mg/kg/h infusion), the DEX group (received dexmedetomidine 0.5 µg/kg loading, 0.4 µg/kg/h infusion) and the CON group (received saline), with 60 cases in each group. The incidences and severities of cough were recorded within 2 minutes after the extubations. Hemodynamic variables were measured at T0 (before the induction of anesthesia), T1 (immediately after the extubation) and T2 (5 minutes after extubation). The volume of drainage was recorded within 24 hours after the surgeries. Results: The incidences of cough were significantly lower in the LIDO group (28.3%) and the DEX group (31.7%) than in the CON group (66.7%) (P=0.000). Additionally, both moderate and severe cough were significantly lower in the LIDO group (13.3%) and the DEX group (13.4%) than in the CON group (43.4%) (P<0.05). Compared with the two treatment groups, both mean arterial blood pressure and heart rate were significantly increased in the CON group at T1 and T2 (P<0.05). Compared with the CON group, the volume of drainage was significantly reduced in the two treatment groups within 24 hours after surgery (P<0.05). Conclusion: Both intravenous infusions of lidocaine and dexmedetomidine had equal effectiveness in attenuating cough, hypertension, and tachycardia during the tracheal extubation period in patients undergoing thyroid surgery. Additionally, there was no significant difference in the reduction of postoperative drainage between the two treatments. Trial registration: Chinese Clinical Trial Registry, ChiCTR1800017482 (date of registration August 2018). Keywords: Lidocaine, Dexmedetomidine, Cough, Thyroid surgery.

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Thermal antinociception after dexmedetomidine administration in cats: A comparison between intramuscular and oral transmucosal administration

Journal of Feline Medicine and Surgery ◽

10.1016/j.jfms.2009.03.009 ◽

2009 ◽

Vol 11 (10) ◽

pp. 829-834 ◽

Cited By ~ 40

Author(s):

Louisa S. Slingsby ◽

Polly M. Taylor ◽

Taylor Monroe

Keyword(s):

Standard Deviation ◽

Visual Analogue Scale ◽

Analogue Scale ◽

General Linear Model ◽

Test Drug ◽

Treatment Groups ◽

Antinociceptive Effects ◽

Sedation Scores ◽

Transmucosal Administration ◽

Over Time

Dexmedetomidine 40 μg/kg was administered either intramuscularly (IM) or oral transmucosally (OTM) to 12 cats in a randomised cross-over study. Thermal nociceptive thresholds and visual analogue scale (VAS) sedation scores were obtained before and at regular intervals up to 24 h after test drug administration. The summary measures of overall mean threshold, overall mean VAS sedation plus onset, offset and duration of analgesia were investigated using a univariate general linear model. There were no significant differences between treatment groups. Data are presented as mean±standard deviation: delta T mean increase over time (IM 6°C±3°C, OTM 6°C±2°C); overall mean VAS (IM 43±9 OTM 39±1); onset (IM 35±32 and OTM 30±40 min); offset (IM 96±56 and OTM 138±135 min); duration (IM 61±47 OTM 99±124 min). Dexmedetomidine is well absorbed through the oral mucosa in cats since OTM and IM administration of dexmedetomidine 40 μg/kg produced similar overall sedative and antinociceptive effects.

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Efficacy of clindamycin in reducing pain following tonsillectomy in adults: a double-blind, randomised trial

The Journal of Laryngology & Otology ◽

10.1017/s0022215113002351 ◽

2013 ◽

Vol 127 (11) ◽

pp. 1106-1110 ◽

Cited By ~ 3

Author(s):

M H Baradaranfar ◽

V Zand ◽

M H Dadgarnia ◽

S Atighechi

Keyword(s):

Visual Analogue Scale ◽

Normal Saline ◽

Analogue Scale ◽

Randomised Trial ◽

Randomised Clinical Trial ◽

Visual Analogue Scale Pain ◽

Double Blind ◽

Throat Pain ◽

Significant Difference ◽

Post Operation

AbstractObjective:Tonsillectomy is a common operation performed in children and young adults. Pain and post-operation haemorrhage are its most common complications. This study was designed to evaluate the efficacy of topical antibiotics in reducing throat pain after tonsillectomy in adult patients.Methods:A double-blind, placebo-controlled, randomised clinical trial was conducted, enrolling 30 patients older than 18 years who were scheduled to undergo tonsillectomy. Patients were randomly assigned to receive either clindamycin or normal saline (as placebo). Throat pain severity was evaluated using a visual analogue scale.Results:All patients in both groups had experienced a reduction in pain by the seventh day after surgery. There was no statistically significant difference in the extent of visual analogue scale pain score reduction, comparing the placebo and clindamycin groups throughout the study course (p = 0.424).Conclusion:Topical clindamycin was not demonstrated to be more effective than normal saline in the reduction of throat pain following tonsillectomy in adults.

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Transdermal Nitroglycerin as an Adjuvant to Patient-Controlled Morphine Analgesia after Total Knee Arthroplasty

Pain Research and Management ◽

10.1155/2009/817837 ◽

2009 ◽

Vol 14 (2) ◽

pp. 109-112 ◽

Cited By ~ 3

Author(s):

Sharon Orbach-Zinger ◽

Artium Lenchinsky ◽

Lesley Paul-Kesslin ◽

Steven Velks ◽

Moses Salai ◽

...

Keyword(s):

Visual Analogue Scale ◽

Total Knee Replacement ◽

Knee Replacement ◽

Pain Control ◽

Analogue Scale ◽

Pain Treatment ◽

Postoperative Bleeding ◽

Vital Signs ◽

Morphine Analgesia ◽

Total Knee

BACKGROUND: Nitroglycerin (NTG) has been shown to be a useful adjunct for pain treatment without increasing adverse side effects. The effects of NTG on postoperative morphine consumption after knee replacement were evaluated.METHODS: After undergoing total knee replacement, patients receiving patient-controlled morphine analgesia were randomly assigned to receive either an NTG or a placebo patch. The blinded investigator assessed each patient using a visual analogue scale at rest and while moving, as well as the patient’s morphine requirements, sedation score, sleep quality, nausea and vomiting, vital signs and postoperative bleeding.RESULTS: Two of the patients in the NTG group suffered postoperative myocardial infarctions after removal of the patch. Because of these two serious adverse effects, the study was stopped prematurely. In the subset of patients studied, NTG conferred no advantage over placebo in pain control (visual analogue scale at rest or during movement) and in satisfaction scores.CONCLUSIONS: The use of NTG patches conferred no advantage over the use of placebo in patients receiving patient-controlled morphine analgesia after total knee replacement. Two myocardial infarcts occurred in this group. Therefore, the safety of postoperative NTG patch use for pain control must be questioned.

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Intraoperative Use of Analgesics in Tonsillar Fossa and Postoperative Evaluation with Visual analogue Scale Scores—A Prospective, Randomized, Placebo-Controlled, Double-Blind Clinical Trial

International Archives of Otorhinolaryngology ◽

10.1055/s-0039-1684037 ◽

2019 ◽

Vol 24 (01) ◽

pp. e62-e67

Author(s):

Montasir Junaid ◽

Muhammad Sohail Halim ◽

Maisam Abbas Shiraz Onali ◽

Sadaf Qadeer ◽

Hareem Usman Khan ◽

...

Keyword(s):

Visual Analogue Scale ◽

Normal Saline ◽

Local Anesthetics ◽

Analogue Scale ◽

Double Blind Study ◽

Postoperative Evaluation ◽

Double Blind ◽

Tonsillar Fossa ◽

Double Blind Clinical Trial ◽

Scale Scores

Abstract Introduction Posttonsillectomy pain results in significant morbidity to the patients. There is a disagreement in the literature regarding the use of local anesthetics during tonsillectomy. The aim of this placebo-controlled, double-blind study is to evaluate the effect of peritonsillar administration of local anesthetics. Objective To evaluate the role of intraoperative use of analgesics in tonsillar fossa and postoperative evaluation with visual analogue scale (VAS) scores in achieving pain relief after tonsillectomy procedure Methods In this study, 180 patients were randomized to 1 of the 6 groups: bupivacaine infiltration, lidocaine infiltration, normal saline infiltration, bupivacaine packing, lidocaine packing, and normal saline packing. Pain caused by speaking, swallowing, and on rest was assessed using VAS at 4, 8, 12, 16 hours, and at discharge. Results Significant analgesia was obtained in patients who received bupivacaine infiltration and packing compared with placebo (p < 0.05). The majority of the study subjects had no postoperative complications, and patients receiving bupivacaine infiltration required less additional analgesics in the first 24 hours after surgery. Conclusion We advocate the use of bupivacaine infiltration or packing immediately following the procedure to achieve adequate postoperative analgesia.

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Efficacy and safety of pregabalin versus amitriptyline in patients with painful diabetic neuropathy

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20182129 ◽

2018 ◽

Vol 5 (3) ◽

pp. 716

Author(s):

Sujit R. Daniel ◽

Dinesh K. Badyal ◽

Jubbin J. Jacob ◽

Jasleen Kaur

Keyword(s):

Pain Relief ◽

Visual Analogue Scale ◽

Adverse Effects ◽

Diabetic Neuropathy ◽

General Condition ◽

Analogue Scale ◽

Dose Titration ◽

Painful Diabetic Neuropathy ◽

Efficacy And Safety ◽

Treatment Groups

Background: Painful diabetic neuropathy is a common complication of long standing diabetes mellitus. Amitriptyline is commonly used to treat painful diabetic neuropathy. Pregabalin has been shown to be effective in the treatment of painful diabetic neuropathy with lesser adverse effects. Sustained release (SR) of pregabalin has the advantage of once daily dosing and a better patient compliance. Hence, this study was planned to compare the efficacy and safety of pregabalin-SR with amitriptyline in painful diabetic neuropathy.Methods: It is a prospective, open labelled, randomized controlled study. A total of 80 patients diagnosed with painful diabetic neuropathy based on Diabetic neuropathy symptom score and Michigan neuropathy screening instrument, were randomized into two groups to receive amitriptyline and pregabalin SR. Amitriptyline was started at 25mg OD and pregabalin SR 75mg OD for 6 weeks with optional dose titration. Patients were assessed for pain relief by using visual analogue scale and an overall improvement in their general condition by patient’s global impression of change scale. Adverse drug reactions were recorded on each follow up.Results: All patients had significant improvement in pain relief in both the treatment groups. The median VAS (visual analogue scale) score was slightly higher in pregabalin SR group (25 vs 22) however it was not statistically significant. Intergroup comparison did not show any significant differences between the treatment groups. Good and moderate pain relief were noted in 37(92.5%) and 3(7.5%) patients on amitriptyline and 36 (90%) and 4 (10%) patients on pregabalin SR respectively. The common adverse effects reported in amitriptyline group were drowsiness (27.5%) and dry mouth (17.5%) and in pregabalin-SR group were drowsiness (15%) and dizziness (5%). No serious adverse event was reported in either of the groups.Conclusions: In patients with painful diabetic neuropathy both amitriptyline and pregabalin-SR are equally effective in alleviating pain and improving the patient’s general condition, but pregabalin-SR has the advantage of fewer adverse effects and convenient dosage timing.

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To study and evaluate the effect of intravenous lignocaine on haemodynamic responses to intubation, extubation and post‐operative analgesia in laparoscopic cholecystectomy surgeries

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20175183 ◽

2017 ◽

Vol 4 (6) ◽

pp. 1649

Author(s):

Amitha S. ◽

Vinay P. V.

Keyword(s):

Tracheal Intubation ◽

Normal Saline ◽

Intravenous Infusion ◽

Controlled Trial ◽

Tracheal Extubation ◽

Medical College ◽

Arterial Blood ◽

Group A ◽

Group B ◽

Double Blinded

Background: Laryngoscopy, tracheal intubation and subsequent extubation are often associated with an increase in arterial blood pressure (BP), heart rate, arrhythmias, and raised intracranial and intraocular pressure. Lignocaine as bolus I.V. dose just prior to tracheal intubation or extubation has been effectively used to decrease haemodynamic responses associated with them.Methods: Double blinded Randomized Controlled Trial was undertaken at Department of Anesthesia, Sri Siddartha Medical College for a period of one year among ASA 1 and 2 patients. Group A: 0.9% normal saline was used as placebo for perioperative intravenous infusion. Group B: Preservative free lignocaine (xylocard) diluted with normal saline and made to 1% used as intravenous infusion started at a dose of 1.5 mg per kg of lignocaine given as bolus over 10 minutes before induction followed by an infusion of 1.5mg/kg/hr till 1 hour post op.Results: There was significantly less rise in PR and MAP in Group B as compared to Group A. It was also seen that during tracheal extubation there was significantly less rise in PR and MAP in the Group B as compared to the Group A.Conclusions: Administration of lignocaine infusion attenuates the rise in PR as well as MAP duringthe peri‑intubation and peri‑extubation period. Furthermore, infusion of lignocaine significantly increases the mean pain‑free period post‑operatively.

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Intoxication Perception Visual Analogue Scale

PsycTESTS Dataset ◽

10.1037/t01686-000 ◽

2010 ◽

Author(s):

Jennifer R. Cromer ◽

Jason A. Cromer ◽

Paul Maruff ◽

Peter J. Snyder

Keyword(s):

Visual Analogue Scale ◽

Analogue Scale

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