Oxycodone reduced postoperative catheter-related bladder discomfort undergoing transurethral resection prostate. A prospective, double -blind randomized study

Mapping Intimacies ◽

10.21203/rs.3.rs-16139/v1 ◽

2020 ◽

Author(s):

jian li

Keyword(s):

Adverse Effects ◽

Visceral Pain ◽

Randomized Study ◽

Control Group ◽

Trial Registry ◽

Clinical Trial Registry ◽

Double Blind ◽

Unique Effect ◽

Vas Scores ◽

Opium Alkaloid

Abstract Background: Catheter-related bladder discomfort (CRBD) is a common and distressing complication that often occurs caused by urinary bladder catheterization and urethral mucosa injury postoperatively. Oxycodone is a semi-synthetic opioids prepared from opium alkaloid the baine plant derivative. Its μ and κ dual-receptor agonism has a unique effect in the treatment of visceral pain. The aim of this study to observe the efficacy of oxycodone for the treatment of CRBD undergo trans-urethral resection prostate (TURP). Methods: Patients with ASA I-III received trans-urethral resection prostate under general anesthesia were enrolled. Patients who complained CRBD were randomized allocated to the control group (n=42) received placebo and the observed group (n=41) received 0.03mg/kg of oxycodone. The severity of CRBD assessed by NRS were assessed at 0, 5min, 1/2h, and 2h after administration of the study agents. VAS scores were used to assess pain intensity during the same period. Postoperative PCA analgesic sufentanil dose during of PACU times and the incidences of agitation, nausea, vomiting, dizziness, over sedation were recorded in these patients. Results: Compared with the control group, the incidence of CRBD was significantly lower in the oxycodone group at 5min and 1/2h. Compared with the controlled group, VAS scores and incidences of agitation were lower in oxycodone group and significantly decreased sufentanil dosage within 6h (P<0.01). There were no significant differences in the incidence of postoperative adverse effects and during of PACU between two groups(P＜0.05). Conclusion: Oxycodone 0.03mg/kg effectively reduced patients with CRBD after TURP without incurring serious adverse effects.Trial registration: Chinese Clinical Trial Registry, ChiCTR-IPR-16008814.

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Comparison of the Perioperative and Postoperative Effects of Levobupivacaine and of Levobupivacaine + Adrenaline in Pediatric Tonsillectomy: A Double-Blind Randomized Study

Pain Research and Management ◽

10.1155/2017/8431823 ◽

2017 ◽

Vol 2017 ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

Faruk Cicekci ◽

Cigdem Sizer ◽

Sait Selcuk Atici ◽

Sule Arican ◽

Adnan Karaibrahimoglu ◽

...

Keyword(s):

Postoperative Pain ◽

Randomized Study ◽

Oral Intake ◽

Postoperative Nausea And Vomiting ◽

Trial Registry ◽

Zealand Clinical Trial Registry ◽

Clinical Trial Registry ◽

Double Blind ◽

Total Consumption ◽

Pain Scores

Objectives. We aimed to assess the effects of levobupivacaine and of levobupivacaine + adrenaline administered during pediatric tonsillectomy on the postoperative period. Methods. A total of 90 patients between the ages of five and twelve were divided randomly into two groups before tonsillectomy: levobupivacaine only (0.5%) 0.4 mg·kg−1 or levobupivacaine (0.5%) 0.4 mg·kg−1 + adrenaline (1 : 200.000) administered by means of peritonsillar infiltration. Primary outcomes were postoperative pain scores recorded at various intervals until 24 hours postoperatively. Secondary outcomes included postoperative nausea and vomiting (PONV), time to first oral intake, time to the first administration of analgesics and total consumption of analgesics, and the amount of bleeding for all children. Results. In both groups, patients had the same postoperative pain scores and PONV rates, and equal amounts of analgesics were consumed up to 24 hours postoperatively. The two groups also had the same time until first oral intake, recovery time and time to the first analgesic request, and amount of bleeding. Conclusions. Perioperative levobupivacaine infiltration on its own is a valid alternative to the combination of levobupivacaine + adrenaline for perioperative and postoperative effectiveness in pediatric tonsillectomy. This trial is registered with Australian New Zealand Clinical Trial Registry ACTRN: ACTRN12617001167358.

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Oxycodone versus morphine for analgesia after laparoscopic endometriosis resection

BMC Anesthesiology ◽

10.1186/s12871-021-01417-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Lijun Niu ◽

Lihong Chen ◽

Yanhua Luo ◽

Wenkao Huang ◽

Yunsheng Li

Keyword(s):

Respiratory Depression ◽

Visceral Pain ◽

Deep Infiltrating Endometriosis ◽

Trial Registry ◽

Clinical Trial Registry ◽

Morphine Group ◽

Registration Number ◽

To Receive ◽

Registry Record ◽

Infiltrating Endometriosis

Abstract Background The objective of this study was to compare the analgesic potency of oxycodone versus morphine after laparoscopic deep infiltrating endometriosis resection. Methods Fifty patients undergoing laparoscopic deep infiltrating endometriosis resection were randomized to receive oxycodone or morphine intravenous-PCA after surgery. The primary outcome was opioid consumption during the 24 h after surgery. Secondary outcomes included time to first request for analgesia, the number of bolus, pain, sedation, nausea, vomiting, respiratory depression, and bradycardia. The prominent pain that caused patients to press the analgesic device was also recorded. Results Oxycodone consumption (14.42 ± 2.83) was less than morphine consumption (20.14 ± 3.83). Compared with the morphine group, the total number of bolus (78 vs 123) was less and the average time to first request for analgesia (97.27 ± 59.79 vs 142.17 ± 51) was longer in the oxycodone group. The incidence of nausea was higher in the morphine group than in the oxycodone group at 0–2 h (45.45% vs 17.19%), 2–4 h (50% vs 17.19%),12–24 h (40.91% vs 13.04%) and 0–24 h (39.17% vs 19.13%). The overall incidence of vomiting was higher in the morphine group (27.27% vs 13.92%). There was no difference in visual analogue scale score, the incidence of respiratory depression, and bradycardia between groups. Of the three types of pain that prompted patients to request analgesia, the incidence of visceral pain was highest (59.9%, P < 0.01). Conclusion Oxycodone was more potent than morphine for analgesia after laparoscopic endometriosis resection, and oxycodone has fewer side effects than morphine. Name of the registry: Chinese Clinical Trial Registry Trial registration number: ChiCTR1900021870 URL of trial registry record:http://www.chictr.org.cn/edit.aspx?pid=35799&htm=4 Date of registration: 2019/3/13 0:00:00

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Effect of Nudge-Based Intervention on Adherence to Physician Visit Recommendations and Early Health Outcomes among Individuals Identified with Chronic Kidney Disease in Screens

Journal of the American Society of Nephrology ◽

10.1681/asn.2021050664 ◽

2021 ◽

pp. ASN.2021050664

Author(s):

Shingo Fukuma ◽

Shusaku Sasaki ◽

Masataka Taguri ◽

Rei Goto ◽

Toshihiro Misumi ◽

...

Keyword(s):

Clinical Trial ◽

Health Outcomes ◽

Behavioral Economics ◽

Physician Visit ◽

Group Versus ◽

Control Group ◽

Trial Registry ◽

Clinical Trial Registry ◽

Screening Programs ◽

Early Health

BackgroundAlthough CKD screening programs have been provided in many settings, little is known as to how we can effectively translate those screening programs into improved health.MethodsWe conducted a randomized clinical trial on national health screening for CKD in Japan between April 2018 and March 2019. A total of 4011 participants in CKD screening programs aged 40–63 years were randomly assigned to two interventions or the control, with a ratio of 2:2:1, respectively: (1) the nudge-based letter that contained a message on the basis of behavioral economics, (2) the clinical letter including general information about CKD risks, and (3) the control (informed only of the screening results). The main outcome was adherence to a recommended physician visit within 6 months of the intervention. The secondary outcomes were eGFR, proteinuria, and BP 1 year after the intervention.ResultsCompared with the control group, the probability of undergoing a recommended physician visit was higher among participants who received the nudge-based letter (19.7% for the intervention group versus 15.8% for the control; difference, +3.9 percentage points [pp]; 95% CI, +0.8 to +7.0; P=0.02) and the clinical letter (19.7% versus 15.8%; difference, +3.9 pp; 95% CI, +0.8 to +7.0; P=0.02). We found no evidence that interventions were associated with improved early health outcomes.ConclusionsThe behavioral economics intervention tested in this large RCT had limited effect on changing behavior or improving health outcomes. Although the approach has promise, this study demonstrates the challenge of developing behavioral interventions that improve the effectiveness of CKD screening programs.Clinical Trial registry name and registration number: University Hospital Medical Information Network Clinical Trial Registry, UMIN000035230

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Effectiveness and Prognosis: Drainage Skin-Bridge Sparing Surgery Combined with Fistulotomy versus Fistulotomy Only in the Treatment of Anal Fistula

Journal of Healthcare Engineering ◽

10.1155/2021/6940072 ◽

2021 ◽

Vol 2021 ◽

pp. 1-7

Author(s):

Xiao Wang ◽

Chunliang Wang ◽

Ruihua Qi

Keyword(s):

Anal Fistula ◽

Postoperative Bleeding ◽

Length Of Hospital Stay ◽

Control Group ◽

Anal Function ◽

Double Blind ◽

Voiding Function ◽

Vas Scores ◽

The Difference ◽

Better Than

Objective. This study intends to analyze the difference in the efficacy of drainage skin-bridge sparing surgery combined fistulotomy (DSCF) and fistulotomy alone. Methods. 125 patients with anal fistula were enrolled as study subjects and randomly divided into control group (CG) and observation group (OG) by double-blind lottery. The CG received drainage skin-bridge sparing surgery with fistulotomy and the OG received fistulotomy only. Results. The VAS scores of the trauma in the OG were lower than those in the CG on 1st day of surgery and 7 days after surgery ( P < 0.05 ). The length of hospital stay and time to wound healing were shorter in the OG than in the CG ( P < 0.05 ). The incidence of postoperative bleeding in the OG was 9.52%, which was lower than 22.58% in the CG ( P < 0.05 ). The rectal examination scores were lower in the OG than in the CG at 3 and 5 days postoperatively ( P < 0.05 ). The Wexner scores of solid incontinence (0 to 4), liquid incontinence (0 to 4), gas incontinence (0 to 4), pad wearing (0 to 4), and lifestyle alteration (0 to 4) in the OG were lower than those of the CG at 5 days postoperatively ( P < 0.05 ). Voiding function scores were lower in the OG than in the CG at 2 and 3 days postoperatively ( P < 0.05 ). Conclusions. The efficacy of drainage skin-bridge sparing surgery combined fistulotomy is better than that of fistulotomy alone, which can accelerate postoperative healing, enhance urinary function, reduce postoperative bleeding, and improve anal function.

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Effect of symbiotic supplementation on fecal calprotectin levels and lactic acid bacteria, Bifidobacteria, Escherichia coli and Salmonella DNA in patients with cervical cancer

Nutrición Hospitalaria ◽

10.20960/nh.1762 ◽

2018 ◽

Cited By ~ 1

Author(s):

Genaro Gabriel Ortiz ◽

Luis Humberto De Loera Rodríguez ◽

Paloma Rivero Moragrega ◽

Irma Ernestina Velázquez Brizuela ◽

Juan Francisco Santoscoy Gutiérrez ◽

...

Keyword(s):

Cervical Cancer ◽

Adverse Effects ◽

Pathogenic Bacteria ◽

The United States ◽

Fecal Calprotectin ◽

Control Group ◽

Double Blind ◽

Faecal Calprotectin ◽

Bacterial Dna ◽

Polymerase Chain

Background: Patients with cervical cancer (CC) receiving chemotherapy and radiotherapy have several gastrointestinal adverse effects. Objective: To evaluate the effect of dietary symbiotic supplementation on fecal calprotectin, bacterial DNA levels, and gastrointestinal adverse effects in patients with CC. Methods: Clinical, controlled, randomized, double-blind trial. Patients consumed symbiotics or placebo three times a day for 7 weeks. Fecal calprotectin was assessed by Elisa method. DNA from probiotic and pathogenic bacteria were determined by quantitative real-time polymerase chain reaction. Diarrheal evacuations were evaluated with the Bristol scale and nausea and vomiting were measured using the scale of the National Institute of Cancerology of the United States. Results: Fecal calprotectin concentration was lower in the symbiotic group compared to the control group (p <0.001). The concentrations and total proportions of the probiotic and pathogenic bacteria were similar in both groups. Nausea cases significantly diminished in both groups (p <0.001) at the end of the trial. Furthermore, the symbiotic group had a statistically significant decrease in the frequency and intensity of vomiting when compared to the control group (p <0.001). Conclusions: The symbiotic treatment decreases significantly the fecal calprotectin levels and the frequency and intensity of vomiting in patients with CC. KEYWORDS: faecal calprotectin, cervical cancer, symbiotic, qPCR.

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Efficacy and safety of cinepazide maleate injection in patients with acute ischemic stroke: A multicenter, randomized, double-blind, placebo-controlled trial

10.21203/rs.3.rs-16499/v2 ◽

2020 ◽

Author(s):

Jun Ni ◽

Huisheng Chen ◽

Guofang Chen ◽

Yong Ji ◽

Fei Yi ◽

...

Keyword(s):

Ischemic Stroke ◽

Thrombolytic Therapy ◽

Acute Ischemic Stroke ◽

Barthel Index ◽

Controlled Trial ◽

Survival Rates ◽

Control Group ◽

Efficacy And Safety ◽

Clinical Trial Registry ◽

Double Blind

Abstract Background: Ischemic stroke is a leading cause of morbidity and mortality. Thrombolytic therapy improves disability and survival rates; however, to be effective, it must be given within 4.5 hours of onset. Moreover, thrombolytic therapy is frequently contraindicated. Therefore, alternative therapeutic options are required. In China, cinepazide maleate injection has been shown to improve the cerebral collateral circulation and further reduce disability in stroke patients; however, very few studies investigating this therapy have been conducted to date. Therefore, this study aimed to further confirm the efficacy and safety of cinepazide maleate injection in patients with acute ischemic stroke.Methods: Patients with acute ischemic stroke were administered an intravenous infusion of 320 mg cinepazide maleate or placebo once daily for 14 days. All patients were also administered basic therapy (citicoline sodium). The primary efficacy endpoint was the proportion of patients with a modified Rankin scale (mRS) ≤2 on day 90. Secondary efficacy endpoints included Barthel Index ≥95. Safety was evaluated by recording all adverse events (AEs), monitoring laboratory parameters and vital signs, and electrocardiogram.Results: In total, 937 patients with an acute ischemic stroke were included, with a mean (standard deviation, SD) National Institutes of Health Stroke Scale score of 8.8 (2.4) and a mean (SD) stroke onset of 30.9 (11.4) hours prior. Following treatment for 90 days, the proportion of patients with an mRS score ≤2 was significantly higher in the cinepazide maleate group than in the control group (60.9% vs. 50.1%; p=0.0004). Moreover, the proportion of patients with a Barthel Index of ≥95 on day 90 was also significantly higher in the cinepazide maleate group than in the control group (53.4% vs. 46.7%; p=0.0230). There were no statistically significant differences in safety parameters between the cinepazide maleate and control groups.Conclusions: The results of this study show that cinepazide maleate injection is superior to placebo in improving neurological function and activities of daily living, reducing disability, and promoting functional recovery in patients with acute ischemic stroke. Cinepazide maleate injection was safe and well tolerated with no unexpected AEs reported.Trial registration: Chinese Clinical Trial Registry CTR20160292 and ChiCTR1900023827. Retrospectively registered June 13, 2019.

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Intracavitary anaesthesia for medical thoracoscopy procedural pain: the CAMP randomised trial

Egyptian Journal of Bronchology ◽

10.1186/s43168-021-00091-w ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Ahmed Mohamed Abdelhady ◽

Mohamed Gadallah ◽

Moustafa Shaheen ◽

Sahar Mourad ◽

Maged Hassan

Keyword(s):

Pain Score ◽

Chest Tube ◽

Randomised Trial ◽

Study Groups ◽

Procedural Pain ◽

Control Group ◽

Clinical Trial Registry ◽

Double Blind ◽

Lidocaine Group ◽

Medical Thoracoscopy

Abstract Background Medical thoracoscopy (MT) under conscious sedation can be a painful procedure. A pilot study reported reduction in procedural pain with lidocaine application via chest tube before procedure. This study aimed at assessing the extent of effect of intrapleural lidocaine on pain during MT in a double-blind randomised trial. Results Thirty patients (mean age 48.3 years) were recruited, 14 randomised to the lidocaine group and 16 to the saline group. In four patients (two from each group), chest tube insertion prior to MT failed, and they were excluded from the final analysis. The mean (SD) visual analogue scale (VAS) pain score during procedure was 49 ± 33.2 for the lidocaine group and 57.4 ± 27.6 for the control group (mean difference − 8.4 points, p = 0.49). The VAS pain score as assessed by operator was 45.6 ± 19.8 for the lidocaine group and 46.6 ± 29.8 for the control group (p = 0.97). There was no difference in the VAS pain score at 120 min post MT or in the doses of sedatives used during procedure between the study groups. Conclusion ICA for MT does not seem to improve procedural pain as suggested by previous studies. Trial registration The study has been registered with the Pan African Clinical Trial Registry (PACTR202008762D159889).

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The Optimal Administration Time of Butorphanol in Suppressing Sufentanil-induced Cough: A Single-Center Randomized Double-Blind Trial

10.21203/rs.3.rs-74936/v1 ◽

2020 ◽

Author(s):

Yuejiao Song ◽

Zhihong Xu ◽

Zhenyi Chen ◽

Qingwu Liao

Keyword(s):

Normal Saline ◽

Anesthesia Induction ◽

Double Blind Trial ◽

Trial Registry ◽

Single Center ◽

Clinical Trial Registry ◽

Double Blind ◽

Significant Difference ◽

Administration Time ◽

Registration Number

Abstract Backgroud: To evaluate the optimal administration time of butorphanol in suppressing sufentanil-induced cough(SIC) during the induction of general anesthesia.Methods:180 patients were randomly divided into 4 equally sized groups: at 5min, 2min and 0min before anesthesia induction, all patients were sequentially injected the drug labeled A/B/C (butorphanol 1mg or normal saline), GI received intravenously drug A/B/C (All were normal saline),GII received intravenously drug A/B/C (A was butorphanol, B and C were saline), GIII received intravenously drug A/B/C (B is butorphanol, A and C were saline), GIV received intravenously drug A/B/C (C is butorphanol，A and B were saline). ALL Patients were then administrated with sufentanil 0.4 µg/kg in 5s after drug C. The incidence and severity of SIC was recorded within 2 minutes after sufentanil injection. MAP, HR, and SpO2 were recorded at T0 (before the administration of any drug),Ta, Tb, Tc (before the injection of drug A/B/C), T1( 2minutes after sufentanil injection) and T2 (1 minutes after endotracheal intubation). Results: The incidences of cough in GII, GIII, and IV were lower than that in GI (0.09, 0.01, and 0 vs 42.2%, P<0.01), while there were no significant differences between GII, GIII, and GIV. The HR of all 4 groups at T2 were significantly higher than their levels at any other time (P<0.05,T2 vs other time), but there’s no significant difference among 4 groups at T2. The MBP of all 4 groups at Ta and Tb were significantly lower than their levels at any other time (P<0.05, Ta and Tb vs other time), but there’s no significant difference among 4 groups at Ta and Tb. At Ta, the SpO2 of GII was significantly lower than GI, GIII and GIV (P<0.05); at Tb, the SpO2 of GII was significantly lower than GI (P<0.05) and GIV (P<0.01); at Tc, the SpO2 of GIII were significantly lower than GIV (P<0.05).Conclusion: Intravenous butorphanol 1 mg could effectively suppress SIC before sufentanil injection. Without waiting time before administering the sufentanil may be feasible in clinical practice, it has the same suppressive effection and has no influence on BP, HR, SpO2 and the total amount of sufentanil. Trial registration: Chinese Clinical Trial Registry with registration number ChiCTR1900024394. Registered 9 July 2019.

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Efficacy of dexamethasone in reducing the incidence of postoperative sore throat: a double blind randomized study

Journal of Patan Academy of Health Sciences ◽

10.3126/jpahs.v5i1.24034 ◽

2018 ◽

Vol 5 (1) ◽

pp. 10-15 ◽

Cited By ~ 1

Author(s):

Sujita Manandhar ◽

Kishor Manandhar ◽

Sharad Khakrel

Keyword(s):

Endotracheal Tube ◽

Sore Throat ◽

Randomized Study ◽

Saline Group ◽

Controlled Study ◽

Control Group ◽

Lower Grade ◽

Postoperative Sore Throat ◽

Double Blind ◽

Dexamethasone Group

Introductions: Postoperative sore throat (POST) is a commonly seen adverse event after general anesthesia with endotracheal intubation. Dexamethasone, a potent corticosteroid with anti-inflammatory action is the most popular steroid studied in this regard with positive results. Methods: This randomized, prospective, double-blinded, placebo-controlled study was conducted on one hundred and ten adult patients of either sex, American Society of Anesthesiologists physical status I & II, undergoing elective surgeries requiring endotracheal tube intubation. After obtaining written informed consent, they were randomly divided into Control (A, n=55) and Dexamethasone (B, n=55) groups and received either an injection of Dexamethasone (Group B) 8 mg intravenously or an equivalent volume of Normal Saline (Group A) just before entering the operating theatre. All the patients received a similar anesthesia with endotracheal tube intubation and at the end of surgery, extubated and transferred to the post-anesthesia care unit. The incidence and severity of sore throat were assessed at 1, 6 and 24 hours post-extubation. Severity of sore throat were graded on a 4 point scale, p <0.05 was considered significant. Results: Incidence of POST in Dexamethasone group was found significantly low compared to the control group up to six hours (p<0.05) but was comparable at 24 hours post extubation. Severity of POST in the study group was of lower grade in compare to control group. Conclusions: Prophylactic intravenous Dexamethasone 8 mg administered to patients undergoing elective surgeries requiring endotracheal tube intubation significantly reduces the incidence and severity of POST up to six hours post-extubation.

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