Comparison of the Effect of Different Dosages of Celecoxib on Reducing Pain after Cystocele and Rectocele Repair Surgery

Background: Administration of celecoxib reduces pain and inflammation and is associated with greater patient satisfaction. Objective: This study was designed to evaluate the efficacy of two different doses of oral celecoxib for reducing postoperative pain. Methods: This randomized clinical trial was performed on 90 patients undergoing cystocele and rectocele repair under spinal anesthesia. Patients were randomly divided into 3 groups: the first group received 200 mg/day celecoxib, the second group received 400 mg/day celecoxib and the third group was placebo. The pain was measured at 8, 16 and 24 hours after surgery using the VAS (Visual Analogue Scale) method. If the pain score was greater than 5, pethidine 1 mg/kg was prescribed. Pain score at 8, 16 and 24 hours, the need for pethidine, side effects and satisfaction score were recorded during the first 24 hours after surgery. Results: The pain score at postoperative 8 hours was 7.7, 3.9, and 8.1 in the 200 mg/day celecoxib, 400 mg/day celecoxib, and placebo group, respectively (p<0.001). Furthermore, the need for pethidine was significantly less in 400 mg/day group and with the greatest satisfaction score, p<0.01, respectively. Conclusion: Our study concludes that 400 mg/day of celecoxib can be effective against postoperative pain, following the cystocele and rectocele repair, as compared to 200 mg/day and placebo groups. Unwanted use of opioids can be avoided with economically cheaper and safer drugs.

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LigaSure Haemorrhoidectomy versus Conventional Diathermy for IV-Degree Haemorrhoids: Is It the Treatment of Choice? A Randomized, Clinical Trial

ISRN Gastroenterology ◽

10.5402/2011/467258 ◽

2011 ◽

Vol 2011 ◽

pp. 1-6 ◽

Cited By ~ 15

Author(s):

Maurizio Gentile ◽

Michele De Rosa ◽

Gabriele Carbone ◽

Vincenzo Pilone ◽

Francesca Mosella ◽

...

Keyword(s):

Clinical Trial ◽

Postoperative Pain ◽

Operative Time ◽

Randomized Study ◽

Late Complications ◽

The Third ◽

Effective Instrument ◽

The Mean ◽

Complications Rate

Introduction. Milligan-Morgan haemorrhoidectomy performed with LigaSure system (LS) seems to be mainly effective where a large tissue demolition is required. This randomized study is designed to compare LigaSure haemorrohidectomy with conventional diathermy (CD) for treatment of IV-degree haemorrhoids. Methods. 52 patients with IV-degree haemorrhoids were randomized to two groups (conventional diathermy versus LigaSure haemorrhoidectomy). They were evaluated on the basis of the following main outcomes: mean operative time, postoperative pain, day of discharge, early and late complications. The time of recovery of work was also assessed. All patients had a minimum follow-up of twelve months (range 12–24). All data were statistically evaluated. Results. 27 patients were treated by conventional diathermy, 25 by LigaSure. The mean operative time was significantly shorter in LS, such as postoperative pain, mainly lower on the third and fourth postoperative day: moreover pain disappeared earlier in LS than CD. The time off-work was shorter in LS, while there was no difference in hospital stay and overall complications rate. Conclusions. LigaSure is an effective instrument when a large tissue demolition is required. This study supports its use as treatment of choice for IV degree haemorrhoids, even if the procedure is more expansive than conventional operation.

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Using intravenous acetaminophen in the reduction of opioids in spinal cord surgeries by patient-controlled analgesia

International Surgery Journal ◽

10.18203/2349-2902.isj20185012 ◽

2018 ◽

Vol 5 (12) ◽

pp. 3883

Author(s):

Vadoud Nourouzi ◽

Ali Mohammadian ◽

Khatereh Isazadehfar ◽

Sona Rasouli

Keyword(s):

Spinal Cord ◽

Placebo Group ◽

Postoperative Pain ◽

Pain Relief ◽

Pain Score ◽

Postoperative Recovery ◽

Opioid Use ◽

Hospitalization Period ◽

Significant Difference ◽

Pain Pump

Background: Proper management of postoperative pain results in improved quality of patient's' life, early postoperative recovery, reduced hospitalization period and decreased treatment costs. Regarding significant efficacy and higher pain relief functions, opioids are amongst the best pain relief drugs. However, use of theses narcotics as pain killers is somehow controversial. Current study investigated the effects of IV acetaminophen in reduced use of opioids in surgeries of spinal cord by PCA method.Methods: Current double blinded clinical trial study performed upon 86 patients of 20-70 years of age who candidate for spinal CD implant with ASA class I or II. Patients randomly divided into two groups of IV Acetaminophen therapy (N=43) and placebo group (N=43) and each group were put equally under general anesthesia in which both received pain pump containing Fentanyl during recovery. Patients were examined regarding pain score, amount of opioid use and request for extra narcotics and the related complications including nausea, vomiting, dizziness, allergy, gastrointestinal bleeding and Ileus every 6 hours for 24 hours and the obtained results were recorded.Results: Regarding VAS, pain was significantly lower during 24 hours of study in IV Acetaminophen group (p<0.05). Mean use of opioid via pain pump was significantly lower in IV Acetaminophen group compared with placebo group (p=0.00). Request for extra doses of narcotics was higher in placebo group while regarding demand for extra pain relief, there was no significant difference between both groups. Regarding other results, no significant difference observed between both study groups.Conclusions: Results of the study indicated that use of a combination of IV acetaminophen along with opioids would be much more effective than use of narcotics alone in postoperative pain control of CD implant surgery of spinal cord and that leads to lower pain score and decreased use of opioids and its related complications.

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Safety and immunogenicity of anti-SARS CoV-2 conjugate vaccine SOBERANA 02 in a two-dose or three-dose heterologous scheme in adults: Phase IIb Clinical Trial

10.1101/2022.01.01.21268271 ◽

2022 ◽

Author(s):

Maria Eugenia-Toledo-Romani ◽

Mayra Garcia-Carmenate ◽

Leslyhana Verdecia-Sanchez ◽

Suzel Perez-Rodriguez ◽

Meybis Rodriguez-Gonzalez ◽

...

Keyword(s):

Clinical Trial ◽

Placebo Group ◽

Neutralizing Antibodies ◽

Seroconversion Rate ◽

Serious Adverse Events ◽

Double Blind ◽

The Third ◽

Functional Antibodies ◽

Dose Trial ◽

To Receive

Background: We report results of immunogenicity, safety and reactogenicity of SOBERANA 02 in a two-dose or three-dose heterologous scheme in adults in a phase IIb clinical trial. Method: This phase IIb trial was designed as parallel, multicentre, adaptive, double blind, randomized and placebo-controlled. Subjects (N=810) aged 19-80 years were randomized to receive two doses of the recombinant SARS CoV-2 receptor binding domain (RBD) conjugated to tetanus toxoid (SOBERANA 02) and a third dose of dimeric RBD (SOBERANA Plus) 28 days apart; two production batches of active ingredient of SOBERANA 02 were evaluated. Primary outcome was the percentage of seroconverted subjects with ≥4-fold the anti-RBD IgG concentration. Secondary outcomes were safety, reactogenicity and neutralizing antibodies. Results: Seroconversion rate in vaccinees was respectively 76.3 and 96.8% after two or three doses, compared with 7.3% in placebo group. Anti-RBD IgG increased significantly after first and second dose of SOBERANA 02 respect to placebo group; and the third dose with SOBERANA Plus boosts the response compared to the second dose. Neutralizing IgG antibodies were detected against D614G and VOCs α, β and δ. Specific and functional antibodies were detected until 7-8 months after the third dose. The frequency of serious adverse events (AEs) associated with vaccination was very low (0.1%); with only one serious AE consistent with vaccination. Local pain was the most frequent AE. Conclusions: Two doses of SOBERANA 02 were well tolerated, safe an immunogenic in adults aged 19-80 years old. The heterologous combination with a third dose of SOBERANA Plus increased neutralizing antibodies, detectable 7-8 months after the third dose. Trial registry: https://rpcec.sld.cu/trials/RPCEC00000347

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Effectiveness of Subconjunctival 0.5% Bupivacaine for Postoperative Analgesia after Intravitreal Silicon Oil Removal Surgery

Pain Research and Treatment ◽

10.1155/2018/8501519 ◽

2018 ◽

Vol 2018 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Aida Rosita Tantri ◽

Riyadh Firdaus ◽

Elvioza ◽

Immaculata Astrid Budiman

Keyword(s):

Placebo Group ◽

Postoperative Pain ◽

Pain Score ◽

Postoperative Analgesia ◽

Local Anesthetic ◽

Oil Removal ◽

Analgesic Requirement ◽

Silicon Oil ◽

Anesthetic Drugs ◽

Randomized Clinical Study

Background. Intravitreal silicon oil removal surgery can cause mild-to-moderate postoperative pain and discomfort in most patients. Postoperative pain can be managed by using many methods, including a local anesthetic drug. One of the common local anesthetic drugs is 0.5% bupivacaine. The application techniques also vary, such as subconjunctival application. It was a good alternative for postoperative analgesia in the ophthalmic surgery because of its minimal risks and complications. The purpose of this research was to measure the effectiveness of subconjunctival 0.5% bupivacaine for postoperative analgesia in silicon oil removal surgery. Method. This was a double-blind randomized clinical study in patients undergoing elective intravitreal silicon oil removal surgery at Cipto Mangunkusumo Hospital. Thirty consecutive patients, enrolled from October 2016 to February 2017, were randomized to receive subconjunctival 0.5% bupivacaine or subconjunctival placebo (0.9% NaCl) at the end of the surgery. The primary outcome was the pain score 24 hours after surgery, using a 100 mm Visual Analogue Scale (VAS). Intravenous injection of tramadol 50 mg was given if the VAS >4. Secondary outcomes were the time to first analgesic requirement and the incidence of nausea/vomiting. Statistical analysis was conducted to measure the difference between 24 h pain score in the bupivacaine group (B) and that in the placebo group (NS). Result. The overall 24 hours’ postoperative pain score was significantly different between the bupivacaine group and the placebo group (p=0.001). In the 24 hours after surgery, there were only five patients needing additional analgesia in the placebo group. The time to first analgesic requirement was significantly different between the two groups (p=0.042). Nausea/vomiting only happened in the placebo group with proportions 6% and 3%, respectively. Conclusion. Subconjunctival 0.5% bupivacaine was effective for postoperative analgesia in intravitreal silicon oil removal surgery.

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Effects of Gabapentin on Postoperative Pain and Total Analgesic Requirement After Laparoscopic Cholecystectomy

Biomedical & Pharmacology Journal ◽

10.13005/bpj/1718 ◽

2019 ◽

Vol 12 (2) ◽

pp. 925-929

Author(s):

Zaffar Abbas ◽

Amina Bashir ◽

Zaffar Abbas

Keyword(s):

Laparoscopic Cholecystectomy ◽

Placebo Group ◽

Postoperative Pain ◽

Visual Analogue Scale ◽

Analogue Scale ◽

Analgesic Requirement ◽

Matching Placebo ◽

Pain Scores ◽

Group A ◽

To Receive

The aim of this study is to determine the effect of preoperative use of gabapentin on postoperative pain in patients undergoing laparoscopic cholecystectomy. Sixty adult patients listed for laparoscopic cholecystectomy were randomly allocated to two groups of 30 each to receive gabapentin 600 mg p.o. or a matching placebo 2 hours before surgery. Postoperative pain was monitored using 100 mm visual analogue scale (0 for no pain and 100 for worst imaginable pain) at 1, 2, 6, 12 and 24 hours. Diclofenac 75 mg IM was used as rescue analgesic and total analgesic requirement (mg/24hr) in first 24 hours following surgery was recorded. Postoperative pain scores and total analgesic requirement was significantly less in gabapentin group compared to placebo group. A single 600 mg dose of gabapentin given preoperatively decreased postoperative pain and total analgesic requirement following laparoscopic cholecystectomy. Preemptive use of gabapentin can be used to treat postoperative pain caused by laparoscopic cholecystectomy.

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Effect of Pressure on the Yinmen Point in Relief of Pain After Middle Ear Surgery: A Randomized Clinical Trial

Anesthesiology and Pain Medicine ◽

10.5812/aapm.103328 ◽

2020 ◽

Vol 10 (5) ◽

Author(s):

Dawood Agha Mohammadi ◽

Eissa Bilehjani ◽

Haleh Farzin ◽

Solmaz Fakhari ◽

Masoud Naderpour

Keyword(s):

Clinical Trial ◽

Postoperative Pain ◽

Pain Intensity ◽

Pain Score ◽

Randomized Clinical Trial ◽

Middle Ear ◽

Nausea And Vomiting ◽

Middle Ear Surgery ◽

Ear Surgery ◽

First Pain

Background: Postoperative pain is a common problem after middle ear surgery. Several analgesic agents are available for pain relief, but they cause numerous side effects. Therefore, complementary analgesic methods are developed to reduce patient’s postoperative pain and discomfort. Objectives: The current study aimed to investigate the effect of the acupressure on post middle ear surgery pain, applying pressure on the Yinmen acupoint of the sciatic nerve. Methods: In this randomized clinical trial, 100 adult patients who were candidate for elective middle ear surgery were selected and divided into two groups of Yinmen and placebo, each with 50 subjects. After admission to the ward, patients’ postoperative pain score was measured using the visual analog score (VAS) tool. Then, patients were placed in the prone position. In the Yinmen group, using a fist, we applied a continuous pressure (11 - 20 kg) to the posterior aspect of the thighs at the Yinmen acupoint for 2 minutes. In the placebo group, only soft contact was kept between the fist and Yinmen point for the same period. The maneuver repeated every two hours for four times. The pain intensity surveyed 10 minutes after the first maneuver, then every hour for 8 hours. For those with a VAS score ≥ 4, intravenous paracetamol and/or meperidine was administered. Any nausea and vomiting was managed using ondansetron 2 mg, IV. The pain score, paracetamol, and meperidine consumption were recorded and compared between the two groups. The chi-square and student t-tests were used to compare the two groups. Results: No significant difference was found between patients’ characteristics and the first pain score. For all measurements, pain intensity was lower in the Yinmen group (P value < 0.01). The pain after the first maneuver was relieved exactly when the acupressure was true. The intervention could reduce patients’ need to take paracetamol (6.68 ± 2.58 vs. 10.42 ± 3.87 mg/kg) and meperidine (0.21 ± 0.17 vs. 0.39 ± 0.23 mg/kg) in the Yinmen group. The two groups were not significantly different concerning the need to take ondansetron to manage postoperative nausea and vomiting. Conclusions: Applying 2 minutes pressure (11 - 20 kg) on the Yinmen acupoint of the sciatic nerves can reduce post middle ear surgery pain and analgesic consumption.

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Effects of French Lavender Aromatherapy on the level of Pain and the Amount of Medications Prescribed to Reduce Post-Appendectomy Pain: A Single-Blind Randomized Clinical Trial

Journal of Archives in Military Medicine ◽

10.5812/jamm.109092 ◽

2020 ◽

Vol In Press (In Press) ◽

Author(s):

Fataneh Ghadirian ◽

Kobra Karami ◽

Razieh Shirzadegan ◽

Zeinab Raiesifar ◽

Noorollah Tahery ◽

...

Keyword(s):

Clinical Trial ◽

Postoperative Pain ◽

Randomized Clinical Trial ◽

Analogue Scale ◽

Intervention Group ◽

Analgesic Drug ◽

Surgical Interventions ◽

Almond Oil ◽

The Central Nervous System ◽

Single Blind

Background: Since surgical interventions often cause damage to tissues, which in turn stimulates the central nervous system, postoperative pain is unavoidable. Objectives: The current study aimed to investigate the effects of French lavender on pain and the amount of medications prescribed to reduce post-appendectomy pain. Methods: In this randomized clinical trial, 120 patients undergoing acute abdominal surgery are recruited. The intervention was defined as inhaling the essential oil of lavender, while those in the placebo group inhaled almond oil. Pain measurement was performed at baseline, half an hour after the first intervention, and after providing the second and third interventions using the Visual Analogue Scale. Results: At all stages of the study, the lavender aroma was associated with a significant reduction in pain (P < 0.0001). Also, the pain intensity was significantly lower in the intervention group than the control (P < 0.0001). Conclusions: The current study demonstrated that aromatherapy is an effective complementary option to reduce postoperative pain and as an analgesic drug.

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Randomized Controlled Trial Comparing the Effects of Vessel Sealing Device and Milligan Morgan Technique on Postoperative Pain Perception after Hemorrhoidectomy

Digestive Surgery ◽

10.1159/000381754 ◽

2015 ◽

Vol 32 (4) ◽

pp. 258-261 ◽

Cited By ~ 1

Author(s):

Mehmet Onur Gülseren ◽

Tolga Dinc ◽

Vasfi Özer ◽

Baris Yildiz ◽

Mükerrem Cete ◽

...

Keyword(s):

Postoperative Pain ◽

Visual Analogue Scale ◽

Analogue Scale ◽

Pain Perception ◽

Controlled Trial ◽

The Third ◽

Vessel Sealing ◽

Scale Scores ◽

The Difference ◽

Group 2

Background: The aim of this study was to compare postoperative pain perception after Milligan Morgan and Ligasure™ techniques in hemorrhoidectomy. Methods: Fifty-four patients diagnosed with Grade 3-4 hemorrhoids requiring surgery between May 2013 and September 2013 were enrolled in the study. Patients were randomized into either the Ligasure™ hemorrhoidectomy group (Group 1, n = 26) or the Milligan Morgan hemorrhoidectomy group (Group 2, n = 28). Results: The difference between visual analogue scale scores on postoperative day 1 was not statistically significant but on the third postoperative day, the Ligasure™ group had higher visual analogue scale scores (4 ± 2.61) when compared to the Milligan Morgan hemorrhoidectomy group (2.43 ± 1.20). This difference on the third postoperative day visual analogue scale scores was statistically significant (p < 0.025). Conclusions: Ligasure™ does not seem to have an advantage in postoperative pain when compared to Milligan Morgan hemorrhoidectomy.

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