The Effects of Moderate Neuromuscular Blockade Combined with Transverse Abdominal Plane Block on Surgical Space Conditions During Laparoscopic Colorectal Surgery: A Randomised Clinical Study

Abstract Background Deep neuromuscular blockade may be beneficial on surgical space conditions during laparoscopic surgery. The effects of moderate neuromuscular blockade combined with transverse abdominal plane block (TAPB) on the surgical space conditions during laparoscopic surgery has not been described. We investigated if moderate neuromuscular blockade combined with TAPB would be associated with similar surgical space conditions compared with deep neuromuscular blockade. Methods Eighty patients undergoing elective laparoscopic surgery for colorectal cancer were randomly divided into two groups. The intervention group was treated with moderate neuromuscular blockade (train-of-four (TOF) count between 1 and 3) combined with TAPB (M group), while the control group was treated with deep neuromuscular blockade (D group), with a TOF count of 0 and a post-tetanic count (PTC) ≥ 1. Both groups received the same anesthesia management. The distance between the sacral promontory and the umbilical skin during the operation was compared between the two groups. The surgeon scored the surgical space conditions according to a five-point ordinal scale. Patients’ pain scores were evaluated eight hours after the operation. Results The 95% confidence intervals of the difference in the distance from the sacral promontory to the umbilical skin between the groups were − 1.45–0.77cm. According to the preset non-inferior standard of 1.5cm, (-1.45, ∞) completely fell within (-1.50, ∞), and the non-inferior effect test was qualified. There was no significant difference in the surgical rating score between the two groups. The dosage of rocuronium in group D was significantly higher than that in group M (P < 0.01). The M group had significantly lower pain scores than the D group eight hours after the operation (P < 0.05). Conclusions In laparoscopic colorectal cancer surgery, moderate neuromuscular blockade combined with TAPB can provide surgical space conditions similar to those of deep neuromuscular blockade, and at the same time, reduces the use of muscle relaxants, relieves postoperative pain within 4 hours after operation, shorten the time to extubation and stay in PACU. Trial registration: chictr.org.cn (ChiCTR2000034621), registered on 12, July, 2020

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Methylprednisolone or dexamethasone, which one is superior corticosteroid in the treatment of hospitalized COVID-19 patients: a triple-blinded randomized controlled trial

BMC Infectious Diseases ◽

10.1186/s12879-021-06045-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Keivan Ranjbar ◽

Mohsen Moghadami ◽

Alireza Mirahmadizadeh ◽

Mohammad Javad Fallahi ◽

Vahid Khaloo ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Controlled Trial ◽

Clinical Status ◽

Intervention Group ◽

Length Of Hospital Stay ◽

Ordinal Scale ◽

Control Group ◽

Randomized Controlled ◽

Group Data ◽

Significant Difference

Abstract Background Although almost a year has passed since the Coronavirus disease 2019 (COVID-19) outbreak and promising reports of vaccines have been presented, we still have a long way until these measures are available for all. Furthermore, the most appropriate corticosteroid and dose in the treatment of COVID-19 have remained uncertain. We conducted a study to assess the effectiveness of methylprednisolone treatment versus dexamethasone for hospitalized COVID-19 patients. Methods In this prospective triple-blinded randomized controlled trial, we enrolled 86 hospitalized COVID-19 patients from August to November 2020, in Shiraz, Iran. The patients were randomly allocated into two groups to receive either methylprednisolone (2 mg/kg/day; intervention group) or dexamethasone (6 mg/kg/day; control group). Data were assessed based on a 9-point WHO ordinal scale extending from uninfected (point 0) to death (point 8). Results There were no significant differences between the groups on admission. However, the intervention group demonstrated significantly better clinical status compared to the control group at day 5 (4.02 vs. 5.21, p = 0.002) and day 10 (2.90 vs. 4.71, p = 0.001) of admission. There was also a significant difference in the overall mean score between the intervention group and the control group, (3.909 vs. 4.873 respectively, p = 0.004). The mean length of hospital stay was 7.43 ± 3.64 and 10.52 ± 5.47 days in the intervention and control groups, respectively (p = 0.015). The need for a ventilator was significantly lower in the intervention group than in the control group (18.2% vs 38.1% p = 0.040). Conclusion In hospitalized hypoxic COVID-19 patients, methylprednisolone demonstrated better results compared to dexamethasone. Trial registration The trial was registered with IRCT.IR (08/04/2020-No. IRCT20200204046369N1).

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Modified Pro-Self Pain Control to Increase Activity in Patients with Colorectal Cancer

Nurse Media Journal of Nursing ◽

10.14710/nmjn.v7i1.15128 ◽

2017 ◽

Vol 7 (1) ◽

pp. 56

Author(s):

Khoirunnisa’ Munawaroh ◽

Untung Sujianto ◽

Mardiyono Mardiyono

Keyword(s):

Colorectal Cancer ◽

Experimental Design ◽

Activities Of Daily Living ◽

Pain Control ◽

Daily Living ◽

Intervention Group ◽

Control Group ◽

Patients With Cancer ◽

Katz Index ◽

Significant Difference

Background: Barriers to performing activities of daily living are common complaints of patients with cancer. One of the factors causing these barriers is pain. A modified pro-self pain control is a method used to enhance the patients’ ability to cope with pain to increase their activity.Purpose: This study aimed to evaluate the modified pro-self pain control to increase activity in patients with colorectal cancer undergoing chemotherapy.Methods: The present study employed an experimental design. Patients with colorectal cancer undergoing chemotherapy were randomly assigned to the intervention group (n=24) and the control group (n=24). The patients in the control group were given a standard hospital intervention, while the patients in the intervention group were given the modified pro-self pain control for nine days. The data were collected using the instrument of KATZ index and analyzed using the independent t-test.Results: The result of this study showed that there was a higher increase of activity among the patients in the intervention group than in the control group. Independent t-test showed that there was a significant difference between the intervention group and the control group (p=0.00).Conclusion: The modified pro-self pain control was found more effective to increase the activity in patients with colorectal cancer undergoing chemotherapy than that of the standard hospital intervention.

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A study of effect of topical anaesthetics on injection pain during immunization in infants

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20202542 ◽

2020 ◽

Vol 7 (7) ◽

pp. 1463

Author(s):

Magesh Kumar ◽

V. Venkateshwar

Keyword(s):

Intervention Group ◽

Injection Pain ◽

Control Group ◽

P Value ◽

Open Label ◽

Topical Anesthetic ◽

Vaccine Injection ◽

Pain Scores ◽

Significant Difference ◽

Group B

Background: Immunization is a necessary aspect of health care of children and injections are there for unavoidable. Many factors affect injection pain during immunization in infants. This study aims to see the effect of use of local anesthetics delivered by various modes for attenuation of vaccine related injection pain in infants and to compare them.Methods: An Open Label Four-Arm Randomized Control Trial of 300 healthy infants of age group 6 weeks to 6 months reported to immunization clinic for immunization with DPT-HiB-Hepatitis B combination vaccine were taken for study. The enrolled subjects were allocated into control group and intervention group (who were applied some form of local anesthesia).Results: Among the four groups of the patients studied we observed a statistical difference in the mean pain scores of the patients recorded at 15 second, 60 second and 5 min after vaccine injection (p value 0.0024 - 0.000). Group A (Infants with topical occlusive LA cream) showed minimum pain scores values at 15 second, 60 second and 5 min after vaccine injection, followed by Group C (Infants with topical LA spray with vapocoolant) whereas Control group (Infants not received any local anaesthesia) and Group B (Infants with topical LA spray without vapocoolant) exhibited the maximum pain scores.Conclusions: Topical occlusive local anesthetic cream and topical LA spray with vapocoolent, were found to be better than topical LA spray without vapocoolant or no topical anesthetic. Use of topical occlusive LA cream led to a lowest pain score. There was no significant difference in the profile of side effects following injection in the four group.

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Effectiveness of ColorApp Mobile Application for Health Education and Promotion on Colorectal Cancer: A Quasi-Experimental Study (Preprint)

10.2196/preprints.15487 ◽

2019 ◽

Cited By ~ 1

Author(s):

Nor Azwany Yaacob ◽

Muhamad Fadhil Mohamad Marzuki ◽

Najib Majdi Yaacob ◽

Shahrul Bariyah Ahmad ◽

Muhammad Radzi Abu Hassan

Keyword(s):

Colorectal Cancer ◽

Mobile Application ◽

Intervention Group ◽

Control Group ◽

The Public ◽

Screening Participation ◽

Significant Difference ◽

Quasi Experimental ◽

Knowledge And Attitude ◽

And Control

BACKGROUND Background: Lack of knowledge and poor attitude is one of the barriers to colorectal cancer screening participation. Printed material such as pamphlets and posters were the main approach in health education on disease prevention. Current information technology advancement had seen an increasing trend of the public to read from websites and mobile app using their smartphone. Thus, health information dissemination should also be diverted to the current trend of information search. Increase in knowledge and awareness will hopefully increase the screening participation and prevent late detection of diseases such as colorectal cancer. OBJECTIVE This study aimed to assess the effectiveness of ColorApp mobile applications in improving the knowledge and attitude on colorectal cancer among user aged 50 years old and above who are the population at risk for the disease in Kedah. METHODS Methods: A quasi-experimental study has been conducted involving 100 participants in Kedah, Malaysia. Participants from five randomly selected community empowerment program in Kota Setar district was chosen as the intervention group while Kuala Muda district was chosen as the control group. Participants were given a self-administered validated questionnaire on knowledge and attitude towards colorectal cancer. A usable mobile application, the ColorApp (Colorectal Cancer Application) was developed as a new educational tool on colorectal cancer prevention. The intervention group were given 2 weeks to use the ColorApp. The same questionnaire was redistributed to both groups after two weeks. The mean percentage score for knowledge and attitude between groups were compared using Repeated Measure ANCOVA. RESULTS Result: There was no significant difference of age, sex, highest education level, current occupation, and diabetic status between the two groups. The number of smokers was significantly higher in intervention groups as compared to control group and it has been controlled during analysis. There was a significant difference in mean knowledge score between intervention and control group with regards to time [Huynh Feldt: F (1,95) = 19.81; p < 0.001]. However, there was no significant difference in mean attitude score between intervention and control group with regards to time [F (1,95) = 0.36, p = 0.550]. CONCLUSIONS Conclusion: The mobile application can be one of the adjunct approaches in educating the public on colorectal cancer.

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Effectiveness of the ColorApp Mobile App for Health Education and Promotion for Colorectal Cancer: Quasi-Experimental Study

JMIR Human Factors ◽

10.2196/15487 ◽

2020 ◽

Vol 7 (1) ◽

pp. e15487

Author(s):

Nor Azwany Yaacob ◽

Muhamad Fadhil Mohamad Marzuki ◽

Najib Majdi Yaacob ◽

Shahrul Bariyah Ahmad ◽

Muhammad Radzi Abu Hassan

Keyword(s):

Colorectal Cancer ◽

Mobile Apps ◽

Intervention Group ◽

Mobile App ◽

Control Group ◽

The Public ◽

Screening Participation ◽

Significant Difference ◽

Quasi Experimental ◽

Knowledge And Attitude

Background Lack of knowledge and poor attitude are barriers to colorectal cancer screening participation. Printed material, such as pamphlets and posters, have been the main approach in health education on disease prevention in Malaysia. Current information technology advancements have led to an increasing trend of the public reading from websites and mobile apps using their mobile phones. Thus, health information dissemination should also be diverted to websites and mobile apps. Increasing knowledge and awareness could increase screening participation and prevent late detection of diseases such as colorectal cancer. Objective This study aimed to assess the effectiveness of the ColorApp mobile app in improving the knowledge and attitude on colorectal cancer among users aged 50 years and older, who are the population at risk for the disease in Kedah. Methods A quasi-experimental study was conducted with 100 participants in Kedah, Malaysia. Participants from five randomly selected community empowerment programs in Kota Setar district were in the intervention group; Kuala Muda district was the control group. Participants were given a self-administered validated questionnaire on knowledge and attitudes toward colorectal cancer. A mobile app, ColorApp (Colorectal Cancer Application), was developed as a new educational tool for colorectal cancer prevention. The intervention group used the app for two weeks. The same questionnaire was redistributed to both groups after two weeks. The mean percentage scores for knowledge and attitude between groups were compared using repeated measure ANCOVA. Results There was no significant difference in age, sex, highest education level, current occupation, and diabetic status between the two groups. The number of smokers was significantly higher in the intervention group compared with the control group and was controlled for during analysis. The intervention group showed a significantly higher mean knowledge score compared with the control group with regards to time (Huynh-Feldt: F1,95=19.81, P<.001). However, there was no significant difference in mean attitude scores between the intervention and control groups with regards to time (F1,95=0.36, P=.55). Conclusions The ColorApp mobile app may be an adjunct approach in educating the public on colorectal cancer.

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Methylprednisolone or Dexamethasone, Which One Is the Superior Corticosteroid in the Treatment of Hospitalized COVID-19 Patients: A Triple-Blinded Randomized Controlled Trial

10.21203/rs.3.rs-148529/v1 ◽

2021 ◽

Author(s):

Keivan Ranjbar ◽

Reza Shahriarirad ◽

Amirhossein Erfani ◽

Zohre Khodamoradi ◽

Mohammad Hasan Gholampoor Saadi ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Controlled Trial ◽

Clinical Status ◽

Intervention Group ◽

Length Of Hospital Stay ◽

Ordinal Scale ◽

Control Group ◽

Randomized Controlled ◽

Significant Difference ◽

And Control

Abstract BackgroundAlthough almost a year has passed since the Coronavirus disease 2019 (COVID-19) outbreak and promising reports of vaccines have been presented, we still have a long way until these measures are available for all. Furthermore, unsolved issues remained to choose appropriate corticosteroids treatment for COVID-19. We conducted a study to assess the effectiveness of methylprednisolone treatment versus dexamethasone for hospitalized COVID-19 patients.MethodIn this prospective triple-blinded randomized controlled trial, we enrolled 86 hospitalized COVID-19 patients from August to November 2020, in Shiraz, Iran. Patients were randomly allocated into two groups to receive either methylprednisolone (2mg/kg/day) or dexamethasone (6mg/kg/day). Data was assessed based on a 9-point WHO ordinal scale extending from uninfected (point 0) to death (point 8).ResultsThere was no significant variation among the groups on the admission. However, the intervention group demonstrated significantly better clinical status compared to the control group at day 5 (4.02 vs. 5.21, P = 0.002) and day 10 (2.90 vs. 4.71, P = 0.001) of admission. There was also a significant difference in the overall mean score between the intervention group, and the control group, (3.909 vs. 4.873 respectively, P = 0.004). The mean length of hospital stay was 7.43 ± 3.64 and 10.52 ± 5.47 days in the intervention and control groups, respectively (P = 0.015). The need for a ventilator was significantly lower in the intervention group than in the control group (18.2% vs 38.1% P = 0.040).ConclusionIn the context of treating hospitalized hypoxic COVID-19 patients, methylprednisolone demonstrated better results compared to dexamethasone.Trial Registration:The trial was registered with IRCT.IR (08/04/2020-No. IRCT20200204046369N1).

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Effect of chewing gum on the postoperative recovery of gastrointestinal function after gynaecological laparoscopic surgery

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20180187 ◽

2018 ◽

Vol 7 (2) ◽

pp. 644

Author(s):

Binti Bhatiyani ◽

Pandeeswari . ◽

Dolly Bhasani ◽

Shrikant Dhumale

Keyword(s):

Laparoscopic Surgery ◽

Intervention Group ◽

Postoperative Recovery ◽

Chewing Gum ◽

Control Group ◽

End Points ◽

Bowel Motility ◽

Bowel Sounds ◽

Gum Chewing ◽

Significant Difference

Background: The incidence of postoperative ileus (POI) after gynaecological surgery is 10-15%. Chewing gum following general surgery improves outcomes, including early flatus, early bowel sounds, and shortening of the hospitalisation period. This study aims to investigate the effect of postoperative gum chewing on bowel motility after laparoscopic gynaecologic surgery.Methods: 101 women who underwent laparoscopic surgery for benign gynaecological conditions under general anaesthesia were recruited. 50 patients received sugar free chewing gum post operatively and the outcomes were compared with the control group. The study’s primary end points were the time to first regular bowel sounds and time to passage of flatus after surgery. Secondary end points were the time to first defecation, patient satisfaction, and potential side effects of postoperative gum chewing.Results: We found a significantly shorter interval between surgery and passage of flatus in the intervention group (median 10 hours compared with 13 hours p=0.0151) and a significantly higher rate of regular bowel sounds 3 hours (74% compared with 45%; p= 0.003) and 5 hours after surgery (91% compared with 78%; p=0.01). There was no significant difference in time to first defecation between groups (median 18 hours compared with 20 hours; p=0.222).Conclusions: Gum chewing seems to have beneficial effects on bowel motility when used in postoperative care after minimally invasive surgery. Gum chewing should be recommended to patients after gynaecological laparoscopic surgery

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Efficacy of Listening to Murattal in Reducing the Pain Experienced by ICU Patients

Jurnal Keperawatan Soedirman ◽

10.20884/1.jks.2021.16.3.1567 ◽

2021 ◽

Vol 16 (3) ◽

Author(s):

Iwan Purnawan ◽

Arif Imam Hidayat ◽

Eman Sutrisna ◽

Galih Noor Alivian ◽

Ikit Netra Wirakhmi

Keyword(s):

Healing Process ◽

Intervention Group ◽

Sampling Technique ◽

Wilcoxon Test ◽

Pharmacological Intervention ◽

Control Group ◽

Control Group Design ◽

Icu Patients ◽

Pain Scores ◽

Significant Difference

<p>Background: Pain is one of the main problems in patients with ICU. Inadequate handling can cause adverse effects such as unstable hemodynamics, trigger stress, and thus hinder the healing process. Non-pharmacological intervention is needed to help manage pain in patients with ICU. Purpose: This study aims to identify the effect of murottal listening to pain in ICU patients. Methods: This is a quasi-experiment with pre-test and post-test with control group design. The sampling technique was simple random sampling, consisting of 40 respondents divided into two groups. The Critical Pain Observation Tool (CPOT) is used to measure pain. Statistics using a paired t-test, Wilcoxon-test, and Mann Whitney. Results: Significant decreases in pain scores were observed in treatment groups of 4, 5 to 4,0; p = 0,013. In the control group, there was a significant decrease in pain scores from 4,8 to 4,3; p = 0,001. There was no significant difference between the median decrease in pain in the intervention group (0.001 (-1-2.0) and the control group (0.001 (0.001-1.0)) with p = 0.242. Conclusion: Murottal listening does not have a significant effect on pain in patients of ICU.</p>

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Effect of Elastic Abdominal Binder on Pain and Functional Recovery Following Gynecologic Cancer Surgery: A Randomized Controlled Trial

Medicina ◽

10.3390/medicina57050481 ◽

2021 ◽

Vol 57 (5) ◽

pp. 481

Author(s):

Nopwaree Chantawong ◽

Kittipat Charoenkwan

Keyword(s):

Postoperative Pain ◽

Abdominal Surgery ◽

Functional Recovery ◽

Gynecologic Cancer ◽

Intervention Group ◽

Cancer Surgery ◽

Walking Distance ◽

Control Group ◽

Pain Scores ◽

Significant Difference

Background and Objectives: Clinicians have been using elastic abdominal binder for stabilizing incision site after major abdominal surgery. However, the benefits of that practice have never been formally assessed. The aim of this study was to examine the effects of the use of elastic abdominal binder on postoperative pain and recovery of gynecologic cancer patients. Materials and Methods: One-hundred and nine women diagnosed with cervical, endometrial, or ovarian cancer, who underwent open abdominal surgery were assigned randomly into two groups: intervention (56 patients) and control (53 patients). The women in the intervention group applied abdominal binder from postoperative day 1. For the control group, the women did not wear the binder or similar devices. The primary outcomes were pain and functional recovery. Subgroup analysis on participants age ≥ 50 was also performed. Results: For the entire study cohort, the baseline, postoperative day 1, and postoperative day 2 pain scores in the intervention group were significantly lower than the control group. However, there was no significant difference between the groups for postoperative day 3 pain score and for the change in pain scores from the baseline value. Of note, the age ≥ 50 subgroup represented a more balanced cohort with comparable baseline pain scores between the study groups. For this population, the pain scores for postoperative day 1–3 were significantly lower in the intervention group. The intervention group had a longer six-minute walking distance on postoperative day 3 with a trend toward a smaller difference in the day 3 distance from the baseline. Conclusions: The potential benefits of abdominal binder use in reducing postoperative pain and improving functional recovery after open gynecologic cancer surgery could be demonstrated only in those age ≥ 50.

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Breastfeeding Training through Role-Play and Effects on Mother-infant Attachment Behaviours: A Randomised Controlled Trial

Africa Journal of Nursing and Midwifery ◽

10.25159/2520-5293/6232 ◽

2020 ◽

Vol 22 (1) ◽

Author(s):

Farokh Saljughi ◽

Mitra Savabi-Esfahani ◽

Shahnaz Kohan ◽

Soheila Ehsanpour

Keyword(s):

Pregnant Women ◽

Maternal Employment ◽

Controlled Trial ◽

Role Play ◽

Intervention Group ◽

Control Group ◽

Maternal Behaviour ◽

Infant Attachment ◽

Significant Difference ◽

History Of

Mother-infant attachment is an intimate, lasting and satisfying relationship that leads to better cognitive, emotional and social growth of the infant. The aim of this study was to determine the effects of breastfeeding training by role-play on mother-infant attachment behaviours. This research was a randomised clinical trial (parallel design). Inclusion criteria were: no history of mental disorders; ability to read and write the Persian language to complete the questionnaire; no history of drug and tobacco intake in primigravida women. The sample comprised 100 pregnant women (in 2 groups), selected through simple random sampling at healthcare centres. The researcher reviewed prenatal care registries of selected healthcare centres and extracted the names of pregnant women in their early third trimester. The data were imported into randomisation software. The control group received routine breastfeeding training, while the intervention group received routine training together with training through role-play. The data collection tool was the Maternal Behaviour Inventory Questionnaire. Consequently 75 samples were analysed in SPSS16. Independent t-tests and chi-square tests were used to examine the difference between the two groups. Results showed that the mean score of mother-infant attachment one week after delivery was significantly higher in the intervention group in comparison to that in the control group (p<0.001). No significant difference was observed between the two groups in maternal age, age of marriage, neonatal gender, maternal employment and education, number of parity, and number of abortions (P>0.05). Since breastfeeding training through role-play could affect mother-infant attachment, it is suggested that this type of training should be provided for pregnant women to promote mother-infant attachment and exclusive breastfeeding.

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