scholarly journals Analgesic effect of lidocaine in paracervical block in women undergoing colposcopy and cervical biopsy: a randomized clinical trial

2021 ◽  
Author(s):  
Fahimeh Nokhostin ◽  
Shekoufeh Behdad ◽  
Reyhaneh Sadat Mousavi-Roknabadi ◽  
Razieh Sadat Mousavi-Roknabadi
Keyword(s):  
Treatment Group ◽  
Pain Score ◽  
Controlled Trial ◽  
Patients Satisfaction ◽  
Cervical Biopsy ◽  
The Mean ◽  
American Society ◽  
American Society Of Anesthesiologists ◽  
To Receive ◽  
Paracervical Block

Abstract Objective: To investigate the effect of lidocaine in paracervical block in women undergoing colposcopy and cervical biopsy.Methods: This a triple-blind randomized controlled trial (July-September 2020) was conducted on women who were candidate for the colposcopy and cervical biopsy with American Society of Anesthesiologists classification Class I or II. They were randomly allocated to receive a single dose of lidocaine hydrochloride 2% or injectable sodium chloride 0.9% paracervical block, and then, cervical biopsy was done. The pain score was asked and intra-procedural and 5-minutes post-procedural in both groups, using the VAS tool. Also, patients' satisfaction after the procedure and complications were recorded.Results: Totally, 74 patients (37 in each groups) were enrolled, with the mean±SD age of 35.91±8.10 years. The mean±SD of pain score intra-procedural was statistically higher in patients in the treatment group (0.92±1.53 vs. 2.73±2.34, P<0.001), as well the pain score 5-minutes post-procedural (0.27±0.65 vs. 0.95±1.15, P=0.003). Also, the mean±SD of patients' satisfaction score was higher in the treatment group (4.65±0.82 vs. 4.05±1.41, P=0.03). Dizziness were observed only in the treatment group, statistically (P<0.001).Conclusion: Paracervical block using lidocaine could reduce the intra-procedural and 5-minutes post-procedural pain. Also, it can increase the patients' satisfaction with the procedure.

Neuromuscular blockade effects of cisatracurium in 11 cats undergoing ophthalmological surgery anaesthetised with isoflurane

2021 ◽  
pp. 1098612X2110218
Author(s):  
Anne-Sophie Van Wijnsberghe ◽  
Keila K Ida ◽  
Petra Dmitrovic ◽  
Alexandru Tutunaru ◽  
Charlotte Sandersen
Keyword(s):  
Neuromuscular Blockade ◽  
Case Series ◽  
Neuromuscular Function ◽  
Duration Of Action ◽  
Cardiovascular Side Effects ◽  
Train Of Four ◽  
Physical Classification ◽  
The Mean ◽  
American Society ◽  
American Society Of Anesthesiologists

Case series summary This case series describes the neuromuscular blockade (NMB) following 0.15 mg/kg intravenous (IV) cisatracurium administration in 11 cats undergoing ophthalmological surgery and anaesthetised with isoflurane. Anaesthetic records were analysed retrospectively. Neuromuscular function was assessed by a calibrated train-of-four (TOF) monitor. Cats were 73 ± 53 months old, weighed 4 ± 1 kg and were of American Society of Anesthesiologists’ physical classification 2. Duration of anaesthesia and surgery were 144 ± 27 and 94 ± 24 mins, respectively. The lowest TOF count was zero in four cats, four in six cats and for one cat the TOF ratio never decreased below 31%. The time of onset was between 1 and 6 mins after the administration of cisatracurium and the mean duration of action was 20.4 ± 10.1 mins. Relevance and novel information Cisatracurium at a dose of 0.15 mg/kg IV did not consistently induce a TOF count of zero in all cats. The dose used in these cats did not produce any remarkable cardiovascular side effects. Although the NMB was not complete, the dose given was sufficient to produce central eyeball position, which was the goal of the ophthalmic surgeries.

Adding a Low Dose of Fentanyl to Propofol in Patients Receiving Electroconvulsive Therapy: A Randomized Controlled Trial

2021 ◽  
Vol 104 (10) ◽  
pp. 1692-1697
Keyword(s):  
Blood Pressure ◽  
Electroconvulsive Therapy ◽  
Low Dose ◽  
Controlled Trial ◽  
Optimal Dose ◽  
Hemodynamic Response ◽  
Mean Difference ◽  
Seizure Duration ◽  
American Society ◽  
To Receive

Objective: To evaluate the effects of low-dose fentanyl combined with a reduced dose of propofol on seizure duration and hemodynamic response during electroconvulsive therapy (ECT). Materials and Methods: Twenty-two patients with the American Society of Anesthesiologist Physical Status II to III undergoing ECT were enrolled in the present study. One hundred and five bilateral ECT sessions randomized to receive thiopental 2 mg/kg, propofol 1 mg/kg, and fentanyl 0.3 mcg/kg, followed by propofol 0.5 mg/kg. Succinylcholine 0.5 mg/kg was used for muscle paralysis. Seizure duration, awakening time and hemodynamic changes were compared between groups. Results: One hundred and five bilateral ECT treatments were randomized into thiopental group (n=35), propofol group (n=35), and fentanyl plus propofol group (n=35). The thiopental and fentanyl plus propofol groups had longer EEG and motor seizure durations than the propofol group, but the differences were not statistically significant. There was no difference in stimulus intensity across groups. However, fentanyl plus propofol group had statistically significant prolonged awakening time compare with thiopental group [mean difference 2.71, (95% CI 0.37 to 5.06, p=0.019)] and propofol group (mean difference 2.77, 95% CI 0.42 to 5.12, p=0.016). Only systolic blood pressure in propofol group was significantly lower than thiopental group [mean difference –10.4, (95% CI –19.4 to –1.38, p=0.018)]. There were no significant differences in diastolic blood pressure (df=2, F=2.546, p=0.083), heart rate (df=2, F=0.596, p=0.553), or oxygen saturation across group (df=2, F=2.914, p=0.059). Conclusion: Using a combination of low-dose fentanyl and low-dose propofol during ECT could be beneficial. Further investigation is needed to establish the optimal dose of propofol and fentanyl. Keywords: Electroconvulsive therapy; Fentanyl, Hemodynamic response; Propofol; Thiopental; Seizure duration

scholarly journals Reliable and rapid smooth extubation after Ketofol for induction of general anesthesia in Laparoscopic Drilling of polycystic ovary: A randomized controlled trial

2020 ◽  
Author(s):  
Atef Mohamed Sayed Mahmoud ◽  
Joseph Makram Botros ◽  
Safaa Gaber Ragab
Keyword(s):  
General Anesthesia ◽  
Polycystic Ovary ◽  
Controlled Trial ◽  
Controlled Study ◽  
Double Blind ◽  
Randomized Controlled ◽  
Airway Response ◽  
American Society ◽  
American Society Of Anesthesiologists ◽  
Better Than

Abstract Background the outcome of ketofol on the hemodynamics and the airway response during induction of general anesthesia has been studied before. Its effect on smoothness of extubation has not been studied before. So, we aimed to assess the effect of ketofol on the smoothness of extubation and compare it with propofol only for induction of general anesthesia. Methods This double-blind, randomized, and controlled study was conducted on one hundred and six American Society of Anesthesiologists Physical status ''ASA PS'' class I and II female patients aged 18–40 years old and scheduled for laparoscopic drilling for polycystic ovary disease under general anesthesia. The patients were assigned into one of two groups (53) patients each; group KP = ketofol and group P = propofol. Results There was good sedation score during suction and extubation in the ketofol group. Airway response and smoothness of extubation were better in the ketofol group better than the propofol group. Conclusion Ketofol as an induction anesthetic agent was effective in attenuating the airway response during extubation more than profofol only. Trial registration: This trial was retrospectively registered at the Clinical Trial.gov with the Identification Number: NCT04365686.

Epidural Neostigmine versus Fentanyl to Decrease Bupivacaine Use in Patient-controlled Epidural Analgesia during Labor

2017 ◽  
Vol 127 (1) ◽  
pp. 50-57 ◽  
Author(s):  
Jessica L. Booth ◽  
Vernon H. Ross ◽  
Kenneth E. Nelson ◽  
Lynnette Harris ◽  
James C. Eisenach ◽  
...  
Keyword(s):  
Epidural Analgesia ◽  
Local Anesthetic ◽  
Primary Outcome ◽  
A Priori ◽  
Regulatory Compliance ◽  
Epidural Bupivacaine ◽  
American Society ◽  
American Society Of Anesthesiologists ◽  
Labor Epidural ◽  
To Receive

Abstract Background The addition of opioids to epidural local anesthetic reduces local anesthetic consumption by 20% but at the expense of side effects and time spent for regulatory compliance paperwork. Epidural neostigmine also reduces local anesthetic use. The authors hypothesized that epidural bupivacaine with neostigmine would decrease total hourly bupivacaine use compared with epidural bupivacaine with fentanyl for patient-controlled epidural analgesia. Methods A total of 215 American Society of Anesthesiologists physical status II, laboring parturients requesting labor epidural analgesia consented to the study and were randomized to receive 0.125% bupivacaine with the addition of either fentanyl (2 μg/ml) or neostigmine (2, 4, or 8 μg/ml). The primary outcome was total hourly local anesthetic consumption, defined as total patient-controlled epidural analgesia use and top-ups (expressed as milliliters of 0.125% bupivacaine) divided by the infusion duration. A priori analysis determined a group size of 35 was needed to have 80% power at α = 0.05 to detect a 20% difference in the primary outcome. Results Of 215 subjects consented, 151 patients were evaluable. Demographics, maternal and fetal outcomes, and labor characteristics were similar among groups. Total hourly local anesthetic consumption did not differ among groups (P = 0.55). The total median hourly bupivacaine consumption in the fentanyl group was 16.0 ml/h compared with 15.3, 14.6, and 16.2 ml/h in the 2, 4, and 8 μg/ml neostigmine groups, respectively (P = 0.55). Conclusions The data do not support any difference in bupivacaine requirements for labor patient-controlled epidural analgesia whether patients receive epidural bupivacaine with 2 to 8 μg/ml neostigmine or epidural bupivacaine with 2 μg/ml fentanyl.

scholarly journals Management of Pain During Propofol Injection Using Intravenous Nitroglycerine

KYAMC Journal ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. 202-205
Author(s):  
Muhammad Sazzad Hossain ◽  
Mohammad Mamunur Rashid ◽  
Md Anisur Rahman Babu ◽  
Afsana Sultana ◽  
Md Sirajul Islam Mahfuz ◽  
...  
Keyword(s):  
Placebo Group ◽  
Venous Occlusion ◽  
Saline Group ◽  
Injection Pain ◽  
Group A ◽  
American Society ◽  
Group B ◽  
Double Blinded ◽  
American Society Of Anesthesiologists ◽  
To Receive

Background: Propofol is an intravenous (IV) anesthetic agent, can irritate the skin, mucous membrane and venous intima. The main drawback is the pain at injection site following its intravenous injection. Objectives: This study was performed to evaluate the effect of intravenous nitroglycerine on pain in patients following propofol injection. Materials and Methods: Eighty adult patients of both sexes, aged 20-50 years, according to American Society of Anesthesiologists (ASA) physical status were divided into two equal groups (n=40) to receive 200 mcg intravenous nitroglycerine diluted in 10 ml saline (group A) and 10 ml normal saline as placebo (group B) at an ambient operating room temperature in a randomized and double blinded fashion to compare the pain-relieving effects of the drugs during propofol injection before the patients lost consciousness. The pain on propofol injection was assessed according to the Mc Crirrick and Hunter scale. Results: The overall incidence and severity of pain were significantly less in Groups A (nitroglycerine group) than group B (placebo group) (p< 0.05). The incidence of mild and moderate pain in Group A versus group B was 25% vs 45% and 15% vs 30% respectively (p<0.05). The incidence of score '0' (no pain) was higher in Group A (60%) than Group B (25%) (p<0.05). Conclusion: Pretreatment with 200 mcg nitroglycerine with venous occlusion for one minute is effective pretreatment in alleviating propofol injection pain when compared to placebo. KYAMC Journal Vol. 10, No.-4, January 2020, Page 202-205

scholarly journals A randomised, double-blind, controlled trial on patients undergoing cardiac implantable electronic device implantation with local anaesthesia and sedation with and without pectoral nerve block

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
Y Wang ◽  
R Chandran ◽  
K.L Woon ◽  
S.S Chang ◽  
H.Y Quek ◽  
...  
Keyword(s):  
Pain Score ◽  
Local Anaesthesia ◽  
Electronic Device ◽  
Controlled Trial ◽  
Satisfaction Score ◽  
Funding Source ◽  
Patients Satisfaction ◽  
Pectoral Nerve ◽  
Significant Difference ◽  
Implantation Procedure

Abstract Background Implantation of cardiac implantable electronic devices (CIED) are generally carried out with local anaesthesia (LA) and sedation. However, peri-procedural hypoxaemia and hypotension are well recognised complications of this technique primarily due to sedation effect. The pectoral nerves block (PECs) targets the lateral and median pectoral nerves at interfascial plane between pectoralis major and minor muscles. This technique potentially lower sedation usage and therefore lower sedation-related complications. There is, however, no randomised study to date comparing CIED procedure with and without PECs block. Methods We randomly assigned 64 patients undergoing CIED implantation procedure with LA (subcutaneous lignocaine 1%) and sedation (intermittent bolus of intravenous midazolam and fentanyl according to pain score) with (32 patients) and without (32 patients) PECs. Those received PECs with be given 10 mls of 0.25% ropivacaine. Primary endpoint was total dose of sedation used. Secondary endpoints were perioperative incidence of hypoxia, hypotension and hypopnea, perioperative pain scores, proceduralists' and patients' satisfaction scores. Results Overall, majority were male (64.1%), mean age of 67.9±10.7 years, mean BMI of 25.7±5.5 kg/m2 and mean lignocaine 1% dosage was 15.3±3.1mL. Compare to those with and without PECs, there was no significant difference in baseline characteristics. The mean fentanyl [25.3±25.0 mcg (95% CI: 16.3–34.3) vs 32.2±26.7 mcg (95% CI: 22.6–41.8), p=0.29] and midazolam dosage [0.7±0.7mg (95% CI: 0.4–0.9) vs 0.8±0.8 (95% CI: 0.6±1.1), p=0.36] were trended lower in PECs compared to without PECs. PECs group had lower pain score at recovery (OR: 1.7, 95% CI: 0.38–7.93, p=0.48). Proceduralists' and patients' satisfaction score were trended higher in PECs compare to non-PECs group. There was no hypoxia, hypotension or hypopnea in both groups. Conclusion Patients underwent CIEDs implantation procedure with PECs received lower sedation dosage and lower periprocedure pain score as compare to non-PECs group. Satisfaction score for both proceduralists and patients were trended higher in PECs group compare to non-PECs group. Funding Acknowledgement Type of funding source: Public hospital(s). Main funding source(s): Changi General Hospital Research Grant

Electroacupuncture at St36 Accelerates the Recovery of Gastrointestinal Motility after Colorectal Surgery: A Randomised Controlled Trial

2014 ◽  
Vol 32 (3) ◽  
pp. 223-226 ◽  
Author(s):  
Zhaodi Zhang ◽  
Changsong Wang ◽  
Quanyi Li ◽  
Mingyue Zhang ◽  
Haifang Zhao ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Gastrointestinal Motility ◽  
Controlled Trial ◽  
Bowel Function ◽  
Group 13 ◽  
Group Data ◽  
Significant Difference ◽  
American Society ◽  
Randomised Controlled ◽  
American Society Of Anesthesiologists

Objectives To evaluate whether electroacupuncture (EA) at ST36 can accelerate the recovery of gastrointestinal motility after colorectal surgery. Methods Forty patients of American Society of Anesthesiologists physical status II and III undergoing elective open resection of malignant colorectal tumours were included in this study. Using a sealed envelope method, the patients were randomly divided into two groups either receiving EA (EA group) or sham EA (SEA group). Data regarding the recovery of bowel function (times to the first bowel sounds, passage of flatus and defaecation) were collected and analysed. Results In the EA group, the time intervals from surgery to the first bowel movement and passage of flatus were shorter than in the SEA group (13±10 h vs 19±13 h, p<0.05 and 23±14 h vs 32±18 h, p<0.05, respectively). There was no significant difference between the groups regarding the time to first defaecation (68±45 h vs 72±53 h, p>0.05). Conclusions EA at ST36 accelerates the recovery of gastrointestinal motility after colorectal surgery. Trial Registration JJ22011-15.

Clustered Randomized Controlled Trial of a Hand Hygiene Intervention Involving Pocket-Sized Containers of Alcohol-Based Hand Rub for the Control of Infections in Long-Term Care Facilities

2011 ◽  
Vol 32 (1) ◽  
pp. 67-76 ◽  
Author(s):  
Wing Kin Yeung ◽  
Wai San Wilson Tam ◽  
Tze Wai Wong
Keyword(s):  
Treatment Group ◽  
Hand Hygiene ◽  
Controlled Trial ◽  
Control Group ◽  
Term Care ◽  
Randomized Controlled ◽  
Serious Infections ◽  
Care Facilities ◽  
To Receive

Objective.To investigate the effectiveness of a multifaceted hand hygiene program involving the use of pocket-sized containers of antiseptic gel in long-term care facilities (LTCFs) with elderly residents.Methods.In this clustered randomized controlled trial, Hong Kong LTCFs for elderly persons were recruited via snowball sampling. Staff hand hygiene adherence was directly observed, and residents' infections necessitating hospitalization were recorded. After a 3-month preintervention period, LTCFs were randomized to receive pocket-sized containers of alcohol-based gel, reminder materials, and education for all HCWs (treatment group) or to receive basic life support education and workshops for all healthcare workers (HCWs) (control group). A 2-week intervention period (April 1-15, 2007) was followed by 7 months of postintervention observations.Results.In the 3 treatment LTCFs, adherence to hand rubbing increased from 5 (1.5%) of 333 to 233 (15.9%) of 1,465 hand hygiene opportunities (P = .001) and total hand hygiene adherence increased from 86 (25.8%) of 333 to 488 (33.3%) of 1,465 opportunities (P = .01) after intervention; the 3 control LTCFs showed no significant change. In the treatment group, the incidence of serious infections decreased from 31 cases in 21,862 resident-days (1.42 cases per 1,000 resident-days) to 33 cases in 50,441 resident-days (0.65 cases per 1,000 resident-days) (P = .002), whereas in the control group, it increased from 16 cases in 32,726 resident-days (0.49 cases per 1,000 resident-days) to 85 cases in 81,177 resident-days (1.05 cases per 1,000 resident-days) (P = .004). In the treatment group, the incidence of pneumonia decreased from 0.91 to 0.28 cases per 1,000 resident-days (P = .001) and the death rate due to infection decreased from 0.37 to 0.10 deaths per 1,000 resident-days (P = .01); the control group revealed no significant change.Conclusions.A hand hygiene program involving the use of pocket-sized containers of antiseptic gel and education could effectively increase adherence to hand rubbing and reduce the incidence of serious infections in LTCFs with elderly residents.

scholarly journals Oxycodone for prevention of etomidate-induced myoclonus: a randomized double-blind controlled trial

2018 ◽  
Vol 46 (5) ◽  
pp. 1839-1845
Author(s):  
Wei Wang ◽  
Jie Lv ◽  
Qi Wang ◽  
Lei Yang ◽  
Wanyou Yu
Keyword(s):  
General Anesthesia ◽  
Intravenous Injection ◽  
Adverse Reactions ◽  
Controlled Trial ◽  
Vital Signs ◽  
Physical Status ◽  
Double Blind ◽  
American Society ◽  
American Society Of Anesthesiologists

Objective This study was performed compare the effectiveness of oxycodone and fentanyl in reducing the incidence and severity of etomidate-induced myoclonus. Methods In total, 162 patients with an American Society of Anesthesiologists physical status of I or II were assigned at random to three groups. Patients assigned to Group O received 0.1 mg/kg of oxycodone (n = 54), those assigned to Group F were given 1 µg/kg of fentanyl (n = 54), and those assigned to Group S were given an equal volume of saline intravenously 2 minutes prior to administration of 0.3 mg/kg of etomidate (n = 54). The incidence and severity of myoclonus was evaluated 2 minutes after etomidate administration. The patients’ vital signs, coughing, nausea, dizziness, and other related adverse reactions were also recorded. Results The incidence of myoclonus was significantly lower in Group O (0.0%) than in Group F (31.5%) and Group S (72.2%); the intensity was also lowest in Group O. All patients in each group had stable cardiovascular profiles. Conclusions Intravenous injection of 0.1 mg/kg of oxycodone 2 minutes prior to etomidate is more effective in preventing etomidate-induced myoclonus during general anesthesia than is 1 µg/kg of fentanyl.

Xenon Provides Faster Emergence from Anesthesia than Does Nitrous Oxide-sevoflurane or Nitrous Oxide-isoflurane 

1997 ◽  
Vol 86 (6) ◽  
pp. 1273-1278 ◽  
Author(s):  
Takahisa Goto ◽  
Hayato Saito ◽  
Masahiro Shinkai ◽  
Yoshinori Nakata ◽  
Fumito Ichinose ◽  
...  
Keyword(s):  
Nitrous Oxide ◽  
Minimum Alveolar Concentration ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Patient Demographics ◽  
The Mean ◽  
American Society ◽  
End Tidal ◽  
To Receive ◽  
Rapid Emergence

Background Xenon, an inert gas with anesthetic properties (minimum alveolar concentration [MAC] = 71%), has an extremely low blood:gas partition coefficient (0.14). Therefore, we predicted that xenon would provide more rapid emergence from anesthesia than does N2O+isoflurane or N2O+sevoflurane of equivalent MAC. Methods Thirty American Society of Anesthsiologists class I or II patients undergoing total abdominal hysterectomy were randomly assigned to receive 60% xenon, 60% N2O + 0.5% isoflurane, or 60% N2O + 0.70% sevoflurane (all concentrations are end-tidal: n = 10 per group). After placement of an epidural catheter, anesthesia was induced with standardized doses of midazolam, thiopental, and fentanyl. Thirty minutes later, xenon, N2O+isoflurane, or N2O+sevoflurane was started as previously assigned. These regimens were supplemented with epidural anesthesia with mepivacaine so that the mean arterial pressure and heart rate were controlled within 20% of the preoperative values. At the end of operation lasting approximately 2 h, all inhalational anesthetics were discontinued, and the patients were allowed to awaken while breathing spontaneously on an 8 l/min inflow of oxygen. A blinded investigator recorded the time until the patient opened her eyes on command (T1), was judged ready for extubation (T2), could correctly state her name, her date of birth, and the name of the hospital (T3), and could count backward from 10 to 1 in less than 15 s (T4). Results Emergence times from xenon anesthesia were: T1, 3.4 +/- 0.9 min; T2, 3.6 +/- 1 min; T3, 5.2 +/- 1.4 min; and T4, 6.0 +/- 1.6 min (mean +/- SD). These were one half to one third of those from N2O+sevoflurane (T1, 6.0 +/- 1.7 min; T4, 10.5 +/- 2.5 min) or N2O+isoflurane (T1, 7.0 +/- 1.9 min; T4, 14.3 +/- 2.8 min) anesthesia. The three groups did not differ in terms of patient demographics, the duration of anesthesia, the amount of epidural mepivacaine administered, or the postoperative pain rating. No patient could recalls intraoperative events. Conclusions Emergence from xenon anesthesia is two or three times faster than that from equal-MAC N2O+isoflurane or N2O+sevoflurane anesthesia.

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