scholarly journals The Effect of Oral Pregabalin on Epidural-Induced Shivering and Epidural Characteristics in Gynecological Surgeries, a Prospective Randomized Double-Blind Study

2018 ◽  
Author(s):  
Tarek Al Menesy ◽  
Ghada Adel ◽  
Ahmed A. Badawy ◽  
Samaa A. Kasem ◽  
Ashraf Abd Elmawgoud ◽  
...  

Abstract Purpose: The previous reports tried to reduce shivering and improve neuraxial anesthesia characteristics by the systemic use of different drugs. This study was directed to evaluate the effect of pregabalin premedication on both shivering and epidural characteristics following single shot loading. Patients and Methods: Eighty female patients, ASA grade I and II, scheduled for gynecological surgeries under epidural anesthesia were studied. The patients were divided into two groups: Pregabalin (P) group and Control (C) group in which the patients received 150 mg of pregabalin and placebo capsules respectively sixty minutes prior to surgery. Following epidural loading, the onset and degree of shivering were compared between the two groups. Also, the epidural onset, level and duration were compared. The perioperative hemodynamics, sedation scores, meperidine consumption and side effects were followed up and registered. Results: The onset of shivering was significantly prolonged and the degree of shivering was less in pregabalin group compared to Control group. The duration of epidural shot was shorter in the control group in relation to the pregabalin treated patients. Regarding both onset and level of block, no significant changes were detected. The patients were more sedated with less meperidine consumption in the pregabalin group. The two groups were similar as regards the perioperative hemodynamics and occurrence of side effect. Conclusion: The premedication with pregabalin reduced onset and degree of shivering and prolonged the duration of single shot epidural block.

1998 ◽  
Vol 89 (6) ◽  
pp. 1414-1417 ◽  
Author(s):  
Yung-Liang Wang ◽  
Jing-Ru Hsieh ◽  
Ham-See Chung ◽  
Chi-Lun Yu ◽  
Angie C. Y. Ho ◽  
...  

Background Postepidural backache is a common postoperative complaint after lumbar epidural anesthesia. Useful interventions to decrease the incidence of postepidural backache would be helpful. Methods We performed a prospective, randomized, double-blind study to compare the effect of local addition of tenoxicam on the incidence of postepidural backache after nonobstetric surgery. One thousand unpremedicated ASA physical status I or II patients scheduled for hemorrhoidectomy were assigned randomly to tenoxicam or control groups. Patients in the control group received 25 ml lidocaine, 2%, with epinephrine 1:200,000 epidurally and 4 ml lidocaine, 1%, for local skin infiltration. Patients in the tenoxicam group received 25 ml lidocaine, 2%, with epinephrine 1:200,000 epidurally and 4 ml lidocaine, 1%, with tenoxicam (2 mg) 1:2,000 for local skin infiltration. Patients were interviewed at 24, 48, and 72 h postoperatively using a standard visual analog scale for evaluation of postepidural backache. A patient was considered to have postepidural backache when the postoperative visual analog scale score was higher than the preoperative score. Results The incidence of postepidural backache in patients in the control group for the 3 days were 22.8%, 17.4%, and 9.2%, all of which were significantly more frequent than observed in the patients in the tenoxicam group (6.8%, 4.0%, and 1.2%, P < 0.01). There was a significant association between backache and multiple attempts at epidural needle insertion. Conclusion In summary, the local addition of tenoxicam reduced the incidence and severity of postepidural backache.


2011 ◽  
Vol 26 (S2) ◽  
pp. 624-624 ◽  
Author(s):  
N. Parvin ◽  
S. Farzaneh ◽  
M. Nikfarjam ◽  
N. Shahinfard ◽  
N. Asarzadegan

Background and aimMedical plants have been used for centuries as a medicinal agent in treatment of depression and anxiety. The purpose of this study was to explore the effects of the lavendula officinalis on depression in patients using citalopram.MethodsThis clinical trial study was performed in Hajar hospital, Shahrekord, Iran. In this study eighty patients randomly allocated into two groups (40 patients in each group). Patients who complained from depression were studied during a two-month double-blind study. In control group, patients were given 20 mg citalopram twice daily plus placebo and case group were treated with 5 g arial part of dried Lavendula officinalis and citaloperam (20 mg, twice per day). After 4 and 8 weeks, patients were followed for evaluations of their depression and complications. Depression severity was scored using standard Hamilton’s depression questionnaire. Data were analyzed using Chi square and Paired-t test.ResultsAfter 1 month treatment, mean depression score in case and control groups were 15.2 ± 3.6 and 17.5 ± 3.5, respectively (P < 0.05). After 2 months the mean score of depression in case and control groups was 14.8 ± 4 and 16.8 ± 4.6, respectively (P < 0.01). The most common side effects in two groups were confusion and dry mouth, which were not significantly different between two groups.ConclusionLavendula officinalis has a positive effect on depressed patients and may be useful to decrease the severity of depression in patients using other antidepressants.


2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Mina Mirnezami ◽  
Hoda Rahimi

Background. Acne vulgaris is an inflammatory disease of pilosebaceous units which may cause permanent dyspigmentation and/or scars if not treated. Isotretinoin is recommended in the treatment of recalcitrant or severe acne, but it is associated with common adverse effects that frequently result in patients incompliance and discontinuation of the drug. The present study was designed to assess the efficacy of oral omega-3 in decreasing the adverse effects of isotretinoin. Materials and Methods. In this randomized double-blind clinical trial, a total of 118 patients with moderate or severe acne were randomly divided into two (case and control) groups. The control group was treated with isotretinoin 0.5 mg/kg, and the case group was treated with the same dose of isotretinoin combined with oral omega-3 (1 g/day). The treatment was lasted for 16 weeks and mucocutaneous side effects of isotretinoin were recorded and compared between the two groups in weeks 4, 8, 12, and 16. Results. Cheilitis (at weeks 4, 8, and 12), xerosis, dryness of nose at all weeks, and dryness of eyes (at week 4) were less frequent in the group that received isotretinoin combined with oral omega-3 compared to the group that received isotretinoin alone. Conclusion. Administration of oral omega-3 in acne patients who are receiving isotretinoin decreases the mucocutaneous side effects of isotretinoin. This trial is registered with  IRCT201306238241N2.


1998 ◽  
Vol 118 (6) ◽  
pp. 880-882 ◽  
Author(s):  
CAN KOÇ ◽  
FALIH KOCAMAN ◽  
ERDINÇ AYGENÇ ◽  
CAFER ÖZDEM ◽  
ALI ÇEKIÇ

The most important complications from tonsillectomy and adenoidectomy are bleeding, stridor, and laryngospasm. This controlled, double-blind study was designed to investigate the effects of topical and intravenous lidocaine on stridor and laryngospasm. A total of 134 patients scheduled for elective tonsillectomy and/or adenoidectomy were randomly separated into four groups. In the topical lidocaine group 4 mg/kg of 2% lidocaine was applied to subglottic, glottic, and supraglottic areas before endotracheal intubation. Normal saline solution was used topically for the first control group. In the intravenous lidocaine group, patients were given 1 mg/kg of 2% lidocaine before extubation, and the same amount of 0.9% NaCl was given to the second control group. Postoperative stridor, laryngospasm, cyanosis, bleeding, sedation degree, and respiratory depression were observed, and plasma lidocaine levels were measured. Both topical and intravenous lidocaine groups revealed less stridor and laryngospasm than the control groups, and no difference was found between the topical and intravenous lidocaine groups except the higher sedation scores in the early postoperative period for the intravenous lidocaine group. (Otolaryngol Head Neck Surg 1998;118:880–2.)


1993 ◽  
Vol 21 (1) ◽  
pp. 79-84 ◽  
Author(s):  
M. J. Paech

A randomised, double-blind study was conducted to investigate the postoperative effects of subarachnoid morphine, with or without adrenaline, after major gynaecological surgery. Seventy-five women having spinal anaesthesia combined with either sedation or general anaesthesia were randomised to receive subarachnoid morphine 0.25 mg with (group MA) or without (group M) adrenaline 200 ūg; or normal saline (group C). Groups M (n=22) and MA (n=25) differed significantly from control (n=23) with respect to the quality and duration of postoperative analgesia (P<0.0002) and to a higher incidence of pruritus (P<0.02). Groups were similar with respect to the incidence of other postoperative side-effects and respiratory data, although the latter showed a trend to less hypoxaemia in the control group. There was no significant difference in any outcome between groups MA and M. It was concluded that, under the study conditions in a post-gynaecological surgery population, the addition of adrenaline to subarachnoid morphine was of no benefit.


2020 ◽  
pp. 014556132097486
Author(s):  
Irem Ates ◽  
Muhammed Enes Aydin ◽  
Erkan Cem Celik ◽  
Mustafa Sitki Gozeler ◽  
Ali Ahiskalioglu

Objectives: Studies investigating the effects of intravenous (IV) ketamine in pain management after septorhinoplasty is limited. This study aims to evaluate the efficacy of low-dose IV infusion of ketamine on pain scores. Methods: This randomized, prospective, double-blind study was conducted with 48 patients who underwent septorhinoplasty. Intravenous ketamine bolus (0.5 mg/kg) was administered to the ketamine group (group K, n = 24) at anesthesia induction, and ketamine infusion was continued (0.25 mg/kg/h) during the surgery. In the control group (group C, n = 24), the same protocol was administered using saline instead of ketamine. Furthermore, 50-mg dexketoprofen trometamol was administered to both groups 30 minutes before the end of the surgery. Then it was repeated at the 12th and 24th hours postoperatively. Pain scores were evaluated with the visual analogue scale. Consumptions intraoperative of opioid and sevoflurane, rescue opioid requirement, patient satisfaction, and side effects were recorded. Results: Pain scores were significantly lower in group K at all postoperative periods ( P < .05). There was no significant difference between the groups in terms of intraoperative sevoflurane and remifentanil consumptions ( P > .05). Rescue opioid analgesic requirements were significantly lower in group K than group C (0/24 vs 6/24, respectively; P  = .022). Side effects were similar between the groups ( P > .05). Conclusion: We recommend the administration of low-dose ketamine infusion during septorhinoplasty surgery because it reduces the requirement for rescue opioid analgesia and postoperative pain scores.


2004 ◽  
Vol 100 (4) ◽  
pp. 935-938 ◽  
Author(s):  
Alparslan Turan ◽  
Beyhan Karamanlıoğlu ◽  
Dilek Memiş ◽  
Mustafa Kemal Hamamcıoglu ◽  
Barış Tükenmez ◽  
...  

Background A combination of opioid and nonopioid analgesic drugs may improve the quality of postoperative analgesia as well as reduce opioid requirements and their associated side effects. Studies have shown synergism between gabapentin and morphine in animal and human experiments and in the treatment of incisional pain. Therefore, the authors investigated, in a randomized, placebo-controlled, double-blind study, the effects of gabapentin on acute postoperative pain and morphine consumption in patients undergoing spinal surgery. Methods After standard premedication, 25 patients in the control group received oral placebo, and 25 patients in the gabapentin group received 1,200 mg of gabapentin, 1 h before surgery in a randomized fashion. Anesthesia was induced with propofol and cisatracurium and was maintained with sevoflurane and remifentanil. The total intraoperative remifentanil consumption by each patient was noted. All patients postoperatively received patient-controlled analgesia with morphine (1 mg/ml) with an incremental dose of 2 mg, a lockout interval of 10 min, and a 4-h limit of 40 mg. The incremental dose was increased to 3 mg, and the 4-h limit to 50 mg, if analgesia was inadequate after 1 h. Patients were questioned for the first 1 h in the PACU and were later evaluated in the ward at 1, 2, 4, 6, 12, and 24 h. Pain scores, heart rate, oxygen saturation measured by pulse oximetry, mean blood pressure, respiratory rate, sedation, morphine use, and total dose of morphine were recorded. Results Overall, pain scores at 1, 2, and 4 h were significantly lower in the gabapentin group when compared with the placebo group. Total morphine consumption in the gabapentin group was 16.3 +/- 8.9 mg (mean +/- SD) versus 42.8 +/- 10.9 mg in the placebo patients. The incidence of vomiting and urinary retention was significantly (P &lt; 0.05) higher in the placebo group, but there was no difference in incidence of other adverse effects between the groups. Conclusions Preoperative oral gabapentin decreased pain scores in the early postoperative period and postoperative morphine consumption in spinal surgery patients while decreasing some morphine-associated side effects.


2019 ◽  
Vol 6 (5) ◽  
pp. 1487
Author(s):  
Mukesh Kumar Maheshwari ◽  
Rahil Singh ◽  
Surabhi Gupta

Background: The benefit of use of prophylactic antibiotic in mesh inguinal hernia repair needs evaluation in view of emergence of resistant micro-organisms with indiscriminate use of antibiotics and also to avoid unnecessary expenditure.Methods: 100 patients of primary inguinal hernia, fulfilling inclusion criteria, were recruited in a prospective, randomized, double blind study where single dose of prophylactic antibiotic half hour prior to mesh repair surgery was administered to 50 patients in study group and routine antibiotics to remaining 50 in control group. Follow up was done for any evidence of infection till one month after the surgery.Results: The incidence of infection in both the groups was analyzed. Prophylactic antibiotic group reported to have an infection rate of 12% as compared to 10% in control group Incidence of infection in both groups was 2% at time of discharge and 0% after one week, at the time of suture removal. Two week after discharge 6% in study and 4% in control groups had infection. After one month of surgery, incidence of infection was 4% in both prophylactic antibiotic group and control group. None of the patients required mesh removal and results was statistically similar in both groups.Conclusions: The use of prophylactic antibiotic in our study was seen to be as effective as routine preoperative and postoperative antibiotics and should be recommended as it reduces the cost burden to the patient significantly and also prevents development of bacterial resistance to drugs.


1994 ◽  
Vol 35 (2) ◽  
pp. 182-185 ◽  
Author(s):  
A. Wagner ◽  
C. Jensen ◽  
A. Sæbye ◽  
T. B. Rasmussen

In a double-blind study 238 patients were examined with lumbar myelography using iotrolan or iohexol in randomized sequence in order to evaluate the image quality, the safety and tolerance of iotrolan by monitoring the adverse effects with special attention to late reactions. There were no serious complications. On the first day 28 patients (24%) had headache after iotrolan and 41 (34%) after iohexol. This difference was not significant, and these frequencies are similiar to those found after spinal puncture alone. The second most frequent side effect was neck pain; the duration of neck pain were significantly longer after myelography with iohexol than with iotrolan. There was a significantly higher frequency of adverse effects in females the first 24 hours, but during examination and on days 2 to 4 there were no differences between males and females. Anamnestic information or myelographic diagnosis could not predict which patients would have side effects. The image quality was excellent or good in all examinations but one. It is concluded that iotrolan is a safe contrast medium well suited for lumbar myelography.


2016 ◽  
Vol 1 (1) ◽  
pp. 22
Author(s):  
Nazli Zainuddin ◽  
Nurul Azira Mohd Shah ◽  
Rosdan Salim

Introduction: The role of virgin coconut oil in the treatment of allergic rhinitis is controversial. Thus, the aim of the present study is to determine the effects of virgin coconut oil ingestion, in addition to standard medications, on allergic rhinitis. We also studied the side effects of consumption of virgin coconut oil. Methods: Fifty two subjects were equally divided into test and control groups. All subjects received a daily dose of 10mg of loratadine for 28 days. The test group was given 10ml of virgin coconut oil three times a day in addition to loratadine. The symptoms of allergic rhinitis were scored at the beginning and end of the study. Results:, the symptom score were divided into nasal and non-nasal symptom scores. Sneezing score showed a significant difference, however the score was more in control group than test group, indicating that improvement in symptom was more in control group. The rest of the nasal symptom and non-nasal symptom score showed no significant difference between test and control groups. Approximately 58% of the test subjects developed side effects from consumption of virgin coconut oil, mainly gastrointestinal side effects. Conclusion: In the present study, ingestion of virgin coconut oil does not improve the overall and individual symptoms of allergic rhinitis, furthermore it has side effects.


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