scholarly journals Comparison of the Effect of Ketamine, Ketamine-Midazolam and Ketamine-Propofol on Post-Tonsillectomy Agitation in Children

2021 ◽  
Vol 28 (5) ◽  
pp. 72-81
Author(s):  
Zeinabsadat Fattahi-Saravi ◽  
◽  
Reza Jouybar ◽  
Rezvan Haghighat ◽  
Naeimehossadat Asmarian ◽  
...  
Keyword(s):  
Recovery Time ◽  
Emergence Agitation ◽  
Sedation Scale ◽  
Richmond Agitation Sedation Scale ◽  
Double Blind ◽  
Post Anaesthesia Care Unit ◽  
Recovery Score ◽  
Haemodynamic Stability ◽  
Double Blind Clinical Trial ◽  
Anaesthesia Care

Background: Emergence agitation (EA) in children is one of the most common complications following anaesthesia. We aimed to compare the effect of ketamine, ketaminemidazolam and ketamine-propofol on EA after tonsillectomy. Methods: This study was a randomised, double-blind clinical trial conducted on 162 children undergoing adenotonsillectomy surgery. The participants were randomly divided into three groups of receiving ketamine (0.5 mg/kg) (N = 54), ketamine (0.5 mg/kg) + propofol (1 mg/kg) (N = 54) and ketamine (0.5 mg/kg) + midazolam (0.01 mg/kg) (N = 54) 10 min before the end of the operation. At the time of the patients’ entry into the post-anaesthesia care unit (PACU) and at intervals of 5 min, 10 min and 20 min after that, consciousness, mobility, breathing, circulation and SpO2 were recorded. Modified Aldrete recovery score (MARS), the objective pain score (OPS) and Richmond agitation-sedation scale (RASS) were also evaluated. Results: At the time of entrance to the PACU and 5 min later, the ketamine-midazolam and ketamine-propofol groups had lower RASS scores than the ketamine group (P < 0.001); after 10 min and 20 min, the ketamine-propofol group showed the lowest RASS score (P < 0.001). Ketamine-propofol group had a significantly lower MARS score at all-time points (P < 0.001). Recovery time was the longest for the ketamine-propofol group (P = 0.008). Conclusion: The ketamine-midazolam group had lower RASS, greater haemodynamic stability and MARS values without delayed awakening.

scholarly journals Therapeutic Effects of Sansevieria Trifasciata Ointment in Callosities of Toes

2016 ◽  
Vol 9 (2) ◽  
pp. 264 ◽  
Author(s):  
Hamidollah Afrasiabian ◽  
Reza Hododi ◽  
Mohammad Hadi Imanieh ◽  
Alireza Salehi
Keyword(s):  
Recovery Time ◽  
Lesion Size ◽  
Therapeutic Effects ◽  
Double Blind ◽  
Dermatology Clinic ◽  
Double Blind Clinical Trial ◽  
Group A ◽  
Spss Software ◽  
Group B ◽  
Methods Of Treatment

<p>Currently study was a double-blind clinical trial in terms of ointments with different contents and the variables such as sex, drug charges, occupation, age, number of lesions, patients, lesions location, time of manifestation, lesion size and methods of treatment and recovery time. In addition, total patients under studied were 100 people in dermatology clinic of Farshchian hospital of Hamadan in Iran that they were divided into two groups. The first group (A) contained of 68 individual who were divided into three groups which used <em>sanseveria</em> extract with different percentage of containing 5, 10, and 20%. Further, the second group (B) included 32 patients who used from other methods of treatment were divided into three groups. In one group12 patients have been treated by using salicylic acid, in the other groups 12 individuals used from electro cautery and 8 patients were used of the corn plasters method. In addition, 116 patients in this study were in the range of 7 to 57 years of age. In fact 100 of them have used the drug correctly while 16 patients were excluded due to wrong usage. Also the plant (<em>Sansevieria Trifasciata</em>) was prepared in Hamedan Research Center from plant by dried extracts method. Finally, the results were analyzed statistically using SPSS software. In conclusion, based on the results of significant impact on the treatment of corns, all patients (100%) in the first group have been treated, additionally all participants in the study were improved within 4 weeks such that the recovery time for the 5% ointment was 25 days, while for 10% and 20% ointment was 15 and 10 days respectively. </p>

scholarly journals Comparison between Fluconazole with Oral Protexin Combination and Fluconazole in the Treatment of Vulvovaginal Candidiasis

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
S. Nouraei ◽  
S. Amir Ali Akbari ◽  
M. Jorjani ◽  
H. Alavi Majd ◽  
M. Afrakhteh ◽  
...  
Keyword(s):  
Recovery Time ◽  
Vaginal Discharge ◽  
Therapeutic Response ◽  
Agar Medium ◽  
Treatment Success ◽  
Vulvovaginal Candidiasis ◽  
Double Blind ◽  
Negative Culture ◽  
Double Blind Clinical Trial ◽  
New Treatments

Background. According to the limited studies reporting new treatments for vulvovaginal candidiasis, this study was designed to compare the combination of fluconazole and oral protexin with fluconazole in the treatment of vulvovaginal candidiasis. Methods. A double-blind clinical trial was conducted, involving 90 women who were referred to the gynecology clinic. Vulvovaginal candidiasis was diagnosed with itching, cheesy vaginal discharge, and any one of the following: dysuria, pH < 4.5, dyspareunia, vulvar erythema, or vulvar edema and if branched hyphae and Candida buds were visible after addition of KOH 10% in the culture and the result of cultivation in Sabouraud’s dextrose agar medium was positive. Patients were randomly classified into two groups Absence of discharge, itching, and negative culture results 5–7 days after completion of treatment indicated treatment success. Data in this study were analyzed using the SPSS version 17.0 software. Results. The combinations, fluconazole-oral protexin and fluconazole-placebo, were equally effective in reduction of complaints and symptoms, but fluconazole-oral protexin combination elicited a better therapeutic response (, ). In addition, fluconazole-oral protexin combination treatment demonstrated better recovery time (, ). Conclusion. This study demonstrated that complementary treatment with probiotic Lactobacillus increased the efficacy of fluconazole in treatment of vulvovaginal candidiasis. Further research is recommended.

scholarly journals Dexmedetomidine and propofol for cerebral angiography in non-intubated patients: A comparative study

2015 ◽  
Vol 02 (02) ◽  
pp. 121-126 ◽  
Author(s):  
Sujoy Banik ◽  
Pallav Kumar ◽  
Hemanshu Prabhakar ◽  
Gyaninder Singh
Keyword(s):  
Cerebral Angiography ◽  
Repeated Measures ◽  
Recovery Time ◽  
Double Blind ◽  
Safe Alternative ◽  
Recovery Score ◽  
Respiratory Parameters ◽  
Group D ◽  
Median Rate ◽  
Rate Of Movement

Abstract Context: Patients posted for cerebral angiography may be restless and drowsy with high chance of inadvertent movements. Aims: The primary objective was to compare the incidence of inadvertent movements between propofol and dexmedetomidine groups. The secondary objectives include comparison of recovery time and characteristics, Steward’s score, and haemodynamic and respiratory parameters between the two groups. Settings and Design: Prospective, randomised, double-blind, pilot study. Materials and Methods: In all, 20 adult uncooperative, drowsy patients were randomised to dexmedetomidine (1 μg/kg bolus over 10 minutes followed by 0.3-0.7 μg/kg/hour infusion) or propofol (100 μg/kg/min for 10 minutes followed by 25-75 μg/kg/min infusion). Rate of movement, success of sedation, haemodynamics, respiratory parameters, Steward’s recovery score and recovery time were recorded. Statistical analysis used: Repeated measures of analysis of variance, Mann-Whitney test, independent and paired t-tests, and Fisher test. Results: The median rate of movement was similar (1, P = 0.206) with success of sedation achieved in 7 (70%) patients in Group D and 9 (90%) patients in Group P, which was comparable (P = 0.582). The median recovery time in patients in Group D was 150 (37–764) seconds and in Group P was 128 (54–174) seconds (P = 0.519) with similar Steward’s scores (P = 0.363). Haemodynamics and respiratory variables were well-maintained during loading and maintenance dose infusions in both the groups. Conclusions: Dexmedetomidine is a safe alternative for diagnostic cerebral angiography. Its success of sedation, median rate of movement during the imaging procedure, haemodynamics, respiratory parameters, recovery time and Steward’s recovery score were similar to propofol in our study.

Acute complications in the post-anaesthesia care unit after infrainguinal surgery for lower limb ischaemia – a prospective observational cohort study

VASA ◽  
2019 ◽  
Vol 48 (1) ◽  
pp. 89-97
Author(s):  
Karin Yeung ◽  
Jonas Peter Eiberg ◽  
Henrik Kehlet ◽  
Eske Kvanner Aasvang
Keyword(s):  
Lower Limb ◽  
Severe Pain ◽  
Observational Cohort Study ◽  
Limb Ischaemia ◽  
Post Anaesthesia Care Unit ◽  
Lower Limb Ischaemia ◽  
Acute Complications ◽  
Observational Cohort ◽  
Anaesthesia Care ◽  
Pacu Stay

Abstract. Background: Arterial surgery for lower limb ischaemia is a frequently performed procedure in patients with severe cardio-pulmonary comorbidities, making them high-risk patients for acute postoperative complications with a need for prolonged stay in the post-anaesthesia care unit (PACU). However, detailed information on complications during the PACU stay is limited, hindering mechanism-based interventions for early enhanced recovery. Thus, we aimed to systematically describe acute complications and related risk factors in the immediate postoperative phase after infrainguinal arterial surgery. Patients and methods: Patients transferred to the PACU after infrainguinal arterial surgery due to chronic or acute lower limb ischaemia were consecutively included in a six-month observational cohort study. Pre- and intraoperative data included comorbidities as well as surgical and anaesthetic technique. Data on complications and treatments in the PACU were collected every 15 minutes using a standardised assessment tool. The primary endpoint was occurrence of predefined moderate or severe complications occurring during PACU stay. Results: In total, 155 patients were included for analysis. Eighty (52 %) patients experienced episodes with oxygen desaturation (< 85 %) and moderate or severe pain occurred in 72 patients (47 %); however, circulatory complications (hypotension, tachycardia) were rare. Preoperative opioid use was a significant risk factor for moderate or severe pain in PACU (59 vs. 38 % chronic vs. opioid naïve patients (P = 0.01). Conclusions: Complications in the PACU after infrainguinal arterial surgery relates to saturation and pain, suggesting that future efforts should focus on anaesthesia and analgesic techniques including opioid sparing regimes to enhance early postoperative recovery.

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