Application of Iced Normal Saline Combined with Cocktail Perfusion in Total Knee Arthroplasty:Randomized Controlled Trialrandomized Controlled Trial

2021 ◽  
Author(s):  
Laijian Sui ◽  
Aihua Jiang ◽  
Pengzhou Gai ◽  
Xiaojun Qi ◽  
Jinwei Wang ◽  
...  
Keyword(s):  
Normal Saline ◽  
Controlled Trial ◽  
Postoperative Recovery ◽  
Control Group ◽  
Double Blind ◽  
Vas Score ◽  
Postoperative Drainage ◽  
Group A ◽  
Total Knee ◽  
Group B

Abstract Background: The present study was designed to investigate the safety and effectiveness of iced normal saline combined with cocktail perfusion during total knee arthroplasty (TKA).Method: Sixty patients undergoing TKA were divided into three groups, then three different intro-operative articular cavity perfusion treatment was given according to the randomized, double-blind and controlled rule. One way ANOVA analysis on visual analogue scale (VAS) score, functional recovery, drainage, and edema of the affected limb were performed to assess the efficiency of the treatment in the following three days after the operation.Results: Postoperative drainage in group A and B reduced significantly (P<0.05). The IHC scores of the surgical limbs were markedly lower comparing with the control group (P<0.05). No differential postoperative edema was observed and the patient acquired better rehabilitation in group A and B than control group. Compared with group A, no differential postoperative drainage and edema was seen in group B (P>0.05). The VAS score of group B was significantly lower than in group A(P<0.05). Postoperative recovery of the surgical limb function in group B was better than in group A (P<0.05), and PGE2 in the postoperative drainage volume of group B was significantly decreased (P<0.05).Conclusions: Intra-operation articular cavity perfusion therapy with iced normal saline combined with cocktail perfusion therapy can greatly reduce the early inflammation, contributing to the better rehabilitation of TKA.

scholarly journals Effect of Pregabalin on Postcraniotomy Pain in Patients Undergoing Supratentorial Tumor Surgery: A Randomized, Double-Blind, Placebo-Controlled Trial

2019 ◽  
Vol 10 (04) ◽  
pp. 641-645
Author(s):  
Ritesh Lamsal ◽  
Charu Mahajan ◽  
Vikas Chauhan ◽  
Nidhi Gupta ◽  
Nitasha Mishra ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Postoperative Pain Management ◽  
Attractive Alternative ◽  
Double Blind ◽  
Vas Score ◽  
Surgery Patient ◽  
Neurosurgical Patients ◽  
Duration Of Surgery ◽  
Group A ◽  
Group B

Abstract Background and Objectives Suboptimal management of postcraniotomy pain causes sympathetic and hemodynamic perturbations, leading to deleterious effects on the neurological system and overall patient outcome. Opioids are the mainstay of postoperative pain management but have various problems when given in high doses, or for prolonged durations in neurosurgical patients. The ideal method of pain control following craniotomy generally relies on a combination of various drugs. Oral pregabalin may be an attractive alternative in these patients. Materials and Methods Sixty, American Society of Anesthesiologists class I and II patients posted for elective supratentorial craniotomy, aged 18 and 60 years, were randomly assigned into three groups of 20 each to receive oral placebo (Group A), pregabalin 75 mg (Group B), or pregabalin 150 mg (Group C) before the induction of anesthesia. At the end of the surgery, patient-controlled analgesia was started with intravenous fentanyl. Visual analog scale (VAS) score was recorded every 2 hours for 24 hours, along with total postoperative fentanyl requirement. Results There were no differences in sex, duration of surgery or anesthesia and total intraoperative fentanyl administered among the three groups. The median postoperative VAS score (Group A—18.0, Group B—20, and Group C—22.0; p = 0.63) was similar in all the groups. However, postoperative fentanyl requirement over 24 hours was least in the group that received 150 mg pregabalin (Group A—190 μg, Group B—240 μg, and Group C—100 μg; p = 0.03). Conclusions Even though pain scores were not significantly different, patients receiving 150 mg oral pregabalin required the least amount of postoperative opioids.

scholarly journals Comparison of gabapentin and oxycodone-acetaminophen used for pre-emptive analgesia in patients undergoing double-port thoracoscopic pulmonary surgery: a randomized, double-blind, controlled trial.

2019 ◽  
Author(s):  
Li Li ◽  
XiJuan Li ◽  
JinMei Shen ◽  
LiJun Zhou
Keyword(s):  
Chronic Pain ◽  
Adverse Events ◽  
Controlled Trial ◽  
Opioid Consumption ◽  
Control Group ◽  
Double Blind ◽  
Pulmonary Surgery ◽  
Post Operative Pain ◽  
Group A ◽  
Group B

Abstract Background This study was designed to determine whether gabapentin is not inferior to the oxycodone-acetaminophen group used as pre-emptive analgesia in reducing post-operative pain. The post-operative pain of patients undergoing thoracoscopic pulmonary surgery, a routine operation procedure, is also a clinical problem that urgently needs to be further explored. We hypothesized that gabapentin is not inferior to oxycodone-acetaminophen.Methods Ninety patients were randomly divided into group A,n=30; group B,n=30; and group C,n=30. Patients in group A received oral gabapentin (300 mg) 2 h before surgery, similarly patients in group B received oral oxycodone-acetaminophen (330mg);Group C did not take any oral drugs; all patients were given self-controlled intravenous analgesia after surgery. NRS scores post-operative, opioid consumption 48 hours post-operative, analgesic-related adverse events, post-operative chronic pain after 2 months, were recorded.Results The NRS scores and opioid consumption 48 hours post-operative of intervention groups were significantly lower than the control group, and did not increase analgesic-related adverse events. The incidence of chronic pain 2 months post-operative in groups A and B was significantly lower than group C.Conclusion Oral gabapentin and oxycodone-acetaminophen alleviated the pain post-operative, reduced opioid consumption post-operative,promoted the recovery.

scholarly journals Effects of Different Doses of Dexmedetomidine on Intraocular Pressure after Suxamethonium in Non-ocular Surgeries: A Randomised Controlled Trial

2021 ◽  
Author(s):  
Saswati Das ◽  
Mousumi Das ◽  
Lingaraj Sahu ◽  
Gayatree Mohanty ◽  
Akshya Kumar Parida
Keyword(s):  
Intraocular Pressure ◽  
Controlled Trial ◽  
Optimum Dose ◽  
Control Group ◽  
Double Blind Study ◽  
Double Blind ◽  
Open Globe ◽  
Group A ◽  
Group B ◽  
Group D

Introduction: Succinylcholine causes a rise in Intraocular Pressure (IOP) and is deleterious in patients with open globe injuries. Dexmedetomidine, by its virtue of central sympatholytic action can help prevent this rise in IOP. Aim: To find out the optimal dose of Dexmedetomidine in preventing the rise of IOP after administration of Suxamethonium. Materials and Methods: One hundred American Society of Anesthesiologists (ASA) I or II patients posted for non-ophthalmic surgery were included in this randomised, prospective, double blind study. Patients were randomly allocated to four groups. Group A (n=25) received Dexmedetomidine 0.6 μg/kg, Group B (n=25) received Dexmedetomidine 0.8 μg/kg, Group C (n=25) received Dexmedetomidine 1 μg/kg, Group D (n=25) received Normal Saline (NS) over a period of 10 minutes and IOP was measured at different points in time. Results: Premedication with Dexmedetomidine at doses of 0.6 μg/kg, 0.8 μg/kg and 1 μg/kg intravenous (IV) were equally effective in attenuation of the rise in IOP associated with Succinylcholine administration. The IOP recorded was 15.53±1.10 mm of Hg in Group A, 14.49±0.94 mm of Hg in Group B, 14.72±1.03 mm of Hg in Group C as compared to 20.12±1.40 mm of Hg in the control group (Group D) after 60 seconds of injecting Suxamethonium. It also significantly obtunded the sympathetic response to laryngoscopy and intubation. However, the incidence of side effects increased with incremental doses. Conclusion: Dexmedetomidine 0.6 μg/kg IV premedication is the optimum dose to be used for attenuating the rise in IOP associated with Succinylcholine administration in situations where rise of IOP may be detrimental.

scholarly journals Effects of different thermal insulation methods on the nasopharyngeal temperature in patients undergoing laparoscopic hysterectomy: a prospective randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Guanyu Yang ◽  
Zefei Zhu ◽  
Hongyu Zheng ◽  
Shifeng He ◽  
Wanyue Zhang ◽  
...  
Keyword(s):  
Thermal Insulation ◽  
Primary Outcome ◽  
Controlled Trial ◽  
Laparoscopic Hysterectomy ◽  
Control Group ◽  
Prospective Randomized Controlled Trial ◽  
Warming Blanket ◽  
Group A ◽  
Insulation Effect ◽  
Group B

Abstract Background This study explored the comparison of the thermal insulation effect of incubator to infusion thermometer in laparoscopic hysterectomy. Methods We assigned 75 patients enrolled in the study randomly to three groups: Group A: Used warming blanket; group B: Used warming blanket and infusion thermometer; group C: Used warming blanket and incubator. The nasopharyngeal temperature at different time points during the operation served as the primary outcome. Results The nasopharyngeal temperature of the infusion heating group was significantly higher than that of the incubator group 60 min from the beginning of surgery (T3): 36.10 ± 0.20 vs 35.81 ± 0.20 (P<0.001)90 min from the beginning of surgery (T4): 36.35 ± 0.20 vs 35.85 ± 0.17 (P<0.001). Besides, the nasopharyngeal temperature of the incubator group was significantly higher compared to that of the control group 60 min from the beginning of surgery (T3): 35.81 ± 0.20 vs 35.62 ± 0.18 (P<0.001); 90 min from the beginning of surgery (T4): 35.85 ± 0.17 vs 35.60 ± 0.17 (P<0.001). Regarding the wake-up time, that of the control group was significantly higher compared to the infusion heating group: 24 ± 4 vs 21 ± 4 (P = 0.004) and the incubator group: 24 ± 4 vs 22 ± 4 (P = 0.035). Conclusion Warming blanket (38 °C) combined infusion thermometer (37 °C) provides better perioperative thermal insulation. Hospitals without an infusion thermometer can opt for an incubator as a substitute. Trial registration This trial was registered with ChiCTR2000039162, 20 October 2020.

The effect of external ventricular drain tunneling length on CSF infection rate in pediatric patients: a randomized, double-blind, 3-arm controlled trial

2021 ◽  
pp. 1-8
Author(s):  
Esmaeil Mohammadi ◽  
Sara Hanaei ◽  
Sina Azadnajafabad ◽  
Keyvan Tayebi Meybodi ◽  
Zohreh Habibi ◽  
...  
Keyword(s):  
Infection Rate ◽  
Pediatric Patients ◽  
Controlled Trial ◽  
External Ventricular Drain ◽  
Hazard Ratio ◽  
Spontaneous Discharge ◽  
Standard Group ◽  
Double Blind ◽  
Group A ◽  
Group B

OBJECTIVE The role of tunneling an external ventricular drain (EVD) more than the standard 5 cm for controlling device-related infections remains controversial. METHODS This is a randomized, double-blind, 3-arm controlled trial done in the Children’s Medical Center in Tehran, Iran. Pediatric patients (< 18 years old) with temporary hydrocephalus requiring an EVD and no evidence of CSF infection or prior EVD insertion were enrolled. Patients were randomly assigned (1:1:1) into the following arms: 5-cm (standard; group A); 10-cm (group B); or 15-cm (group C) EVD tunnel lengths. The investigators, parents, and person performing the analysis were masked. The surgeon was informed of the length of the EVD by the monitoring board just before operation. Patients were followed until the EVD’s fate was established. Infection rate and other complications related to EVDs were assessed. RESULTS A total of 105 patients were enrolled in three random groups (group A = 36, group B = 35, and group C = 34). The EVD was removed because there was no further need in most cases (67.6%), followed by conversion to a new EVD or ventriculoperitoneal shunt (15.2%), infection (11.4%), and spontaneous discharge without further CSF diversion requirement (5.7%). No statistical difference was found in infection rate (p = 0.47) or EVD duration (p = 0.81) between the three groups. No group reached the efficacy point sooner than the standard group (group B: hazard ratio 1.21, 95% CI 0.75–1.94, p = 0.429; group C: hazard ratio 1.03, 95% CI 0.64–1.65, p = 0.91). CONCLUSIONS EVD tunnel lengths of 5 cm and longer did not show a difference in the infection rate in pediatric patients. Indeed, tunneling lengths of 5 cm and greater seem to be equally effective in preventing EVD infection. Clinical trial registration no.: IRCT20160430027680N2 (IRCT.ir)

scholarly journals Effect of Intravenous Phloroglucinol Injections upon duration of Active First Stage of Labor

2020 ◽  
Vol 4 (2) ◽  
pp. 69-71
Author(s):  
Bilqees Akhtar Malik ◽  
Ambreen Shabbir ◽  
Zeb-Un-Nisa ◽  
Asma Ambreen
Keyword(s):  
Controlled Trial ◽  
Military Hospital ◽  
Control Group ◽  
Singleton Pregnancy ◽  
Uterine Contractions ◽  
Multiparous Women ◽  
History Of ◽  
Group A ◽  
Group B ◽  
First Stage Of Labor

Objective: In our part of the world poverty and illiteracy has adversely affected our core objective of pregnancy i.e. healthy mother and healthy child. Exploring the role of a routinely used drug in reducing the duration of labor could be a breakthrough. Present study was planned accordingly to evaluate the effect of phloroglucinol (PHL). Materials and Methods: It was a Randomized controlled trial conducted at Department of Obstetrics & Gynecology, Combined Military Hospital, Bahawalpur from January 2019 to June 2019. This study included 60 cases of age 18 to 40 years, having singleton pregnancy and in active first stage of uncomplicated labor. Patients with history of multiple pregnancies, obstetrical and surgical complications and cardiorespiratory diseases were excluded. The cases were placed randomly into Group A & Group B and given intravenous PHL and a placebo respectively. After this, duration of the first stage of labor was recorded in minutes from when there was 3-4 cm cervical dilatation with regular uterine contractions to complete cervical dilation i.e. 10 cm and descent of the presenting fetal part. Results: Mean duration of active first stage of labor in experimental group A (230.20 ± 52.96 minutes) was significantly higher than that of control group B (345.30 ± 50.57 minutes). Conclusion: This study concluded that intravenous PHL has efficiently reduced the duration of active first stage of labor in these randomly selected nulliparous and multiparous women. PHL is a useful drug serving the purpose of a spasmolytic, analgesic and labor augmentation at the same time.

scholarly journals Gamification as an entrepreneur well-being intervention: A study protocol for a single-blinded randomised controlled trial

2021 ◽  
Author(s):  
Waqar M. Naqvi
Keyword(s):  
Controlled Trial ◽  
Life Quality ◽  
Well Being ◽  
Likert Scale ◽  
Control Group ◽  
Group A ◽  
Measuring Scale ◽  
Group B ◽  
Randomised Controlled

Abstract Entrepreneurs usually work for long hours resulting in exhaustion, stress, and burnout. The prevalent symptoms of burnout are reduced levels of physical and mental energy, reduced job efficiency and diminished productivity. Therefore, it is important to improve the health of entrepreneurs. Gamification has a positive relationship with improvements in health and well-being as it influences positive experiences and satisfaction. This trial aims to study how 30-minutes of virtual reality game use via Kinect Azure and Oculus platforms 3-times per week, for 4 weeks, relates to differences in entrepreneur stress, burnout, subjective life quality, and downstream firm performance. We will recruit entrepreneurs over the age of 18 for the gamification analysis. Analysis of previous power using G*Power will determine the sample size. We will divide the participants into 3 groups, wherein Group A will undergo gamification on the Kinect platform, Group B will undergo the Oculus Quest intervention, and Group C will be the control group. We will conduct the study at two sites, one at the HuMen research. The outcome measures include a five-point Likert scale for measuring entrepreneurial stress, burnout-measuring scale (BMS) for burnout, five-point Likert scale for performance and SF-12 for Quality of life. Since current strains pave ways to future accomplishment, entrepreneurs' eudemonic well-being might particularly relate to forward-looking challenge stressors and burnouts. The results will provide an insight into how gamification could help entrepreneurs to deal with work stress and maintain high well-being.

The Value of Iron Therapy in Pica

PEDIATRICS ◽  
1964 ◽  
Vol 34 (4) ◽  
pp. 558-562
Author(s):  
ROBERT MCDONALD ◽  
SHEILA R. MARSHALL
Keyword(s):  
Normal Saline ◽  
Controlled Trial ◽  
Hemoglobin Level ◽  
Iron Therapy ◽  
Control Group ◽  
Double Blind ◽  
Intramuscular Injections ◽  
Significant Difference ◽  
Permanent Cure

As doubt had been cast upon the reputed efficacy of iron in the treatment of pica, a double blind controlled trial was carried out in an endeavor to establish a firmer conclusion in the matter. One group of children received intramuscular iron and a control group of equal mean age were given intramuscular injections of normal saline. Three to 4 months later nearly all of those given iron had lost their pica, but it was still present in three-quarters of the controls. After 5 to 6 months there was no significant difference between the two groups and this failure of maintenance of cure may have been related to a fall in mean hemoglobin level which occurred. Five children who initially received saline and in whom pica was still present were given iron at 6 months and all lost their pica. Our experience is that pica can be cured by iron in nearly all cases, but that permanent cure may be dependent upon the maintenance of adequate hemoglobin levels.

Knowledge transfer and retention of simulation-based learning for neurosurgical instruments: a randomised trial of perioperative nurses

2020 ◽  
pp. bmjstel-2019-000576
Author(s):  
David B Clarke ◽  
Alena I Galilee ◽  
Nelofar Kureshi ◽  
Murray Hong ◽  
Lynne Fenerty ◽  
...  
Keyword(s):  
Nursing Education ◽  
Simulation Training ◽  
Controlled Trial ◽  
Randomised Trial ◽  
Control Group ◽  
Perioperative Nurses ◽  
Instrument Recognition ◽  
Simulation Based ◽  
Group A ◽  
Group B

IntroductionPrevious studies have shown that simulation is an acceptable method of training in nursing education. The objectives of this study were to determine the effectiveness of tablet-based simulation in learning neurosurgical instruments and to assess whether skills learnt in the simulation environment are transferred to a real clinical task and retained over time.MethodsA randomised controlled trial was conducted. Perioperative nurses completed three consecutive sessions of a simulation. Group A performed simulation tasks prior to identifying real instruments, whereas Group B (control group) was asked to identify real instruments prior to the simulation tasks. Both groups were reassessed for knowledge recall after 1 week.ResultsNinety-three nurses completed the study. Participants in Group A, who had received tablet-based simulation, were 23% quicker in identifying real instruments and did so with better accuracy (93.2% vs 80.6%, p<0.0001) than Group B. Furthermore, the simulation-based learning was retained at 7 days with 97.8% correct instrument recognition in Group A and 96.2% in Group B while maintaining both speed and accuracy.ConclusionThis is the first study to assess the effectiveness of tablet-based simulation training for instrument recognition by perioperative nurses. Our results demonstrate that instrument knowledge acquired through tablet-based simulation training results in improved identification and retained recognition of real instruments.

scholarly journals Venous thromboembolism prevention protocol for adapting prophylaxis recommendations to the potential risk post total knee replacement: a randomized controlled trial

2020 ◽  
Vol 18 (3) ◽  
pp. 2025
Author(s):  
Mariam A. Alameri ◽  
Syed A. Syed Sulaiman ◽  
Abdullah M. Ashour ◽  
Ma’ad F. Al-Saati
Keyword(s):  
Randomized Controlled Trial ◽  
Patient Education ◽  
Risk Stratification ◽  
Controlled Trial ◽  
Education Programs ◽  
Randomized Controlled ◽  
Group A ◽  
Total Knee ◽  
The Mean ◽  
Group B

Background: Total knee replacement (TKR) is a major orthopedic surgery that is considered high risk for the development of venous thromboembolism (VTE). Objective: The aim of this study is to evaluate the clinical outcomes that resulted from the use of a new proposed VTE risk stratification protocol for selecting a suitable extended VTE prophylaxis for post TKR surgery patients administered in conjunction with patient education programs. Method: A randomized controlled trial was conducted in two medical centers in Saudi Arabia. A total of 242 patients were enrolled in the study, 121 patients in each group. The experimental group (A) was assessed by using the proposed VTE risk stratification protocol and also took part in patient education programs about TKR and its complications. The control group (B) was assessed by using the 2005 Caprini risk assessment tool and no education programs were given to this group. Both groups were followed for 35 days post operation. Results: The mean age of the participants was 65.86 (SD 8.67) and the majority of them were female 137 (56.6%). The mean body mass index of the study sample was 32.46 (SD 5.51). There were no significant differences between the two groups except for surgery type; the proportion of bilateral TKR in group A was higher than in group B (69/121 (28.5%) vs. 40/121(16.5%), p˂0.05). There were no confirmed pulmonary embolism cases in the study sample and diagnosis of deep-vein thrombosis was confirmed in 12/242 (5.0%) of patients: 1/121 (0.8%) in group A and 11/121 (9.1%) in group B (p˂0.05). The readmission rate for all patients was 2.5% (6/242), all of whom were in group B (p˂0.05). Conclusion: The proposed VTE risk stratification protocol that was applied in conjunction with patient education programs reduced VTE complications and readmission events, post TKR surgery. Trial Registration: ClinicalTrials.gov Identifier: NCT04031859.

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