scholarly journals A COMPARATIVE STUDY OF EFFICACY AND SAFETY OF LORNOXICAM AND DICLOFENAC AS POSTOPERATIVE ANALGESICS AFTER MASTOIDECTOMY SURGERY

Author(s):  
R. Nalini ◽  
J. Ezhilramya

<p><strong>Objective</strong>:<strong> </strong>The objective of the research was to evaluate the efficacy and safety of lornoxicam compared to diclofenac in the management of postoperative pain following mastoidectomy surgery.<strong> </strong></p><p><strong>Methods: </strong>The present study was a<strong> </strong>prospective, single-blinded, randomised study. 80 mastoidectomy patients were randomised into two groups. Group A received lornoxicam 8 mg and group B received diclofenac 75 mg intramuscularly twice daily for 3 consecutive days. The primary parameter was to analyse the postoperative pain using visual analogue scale (VAS) and Wong Bakers scale (WBS). The secondary parameters were the usage of rescue medication and time to use rescue medication.</p><p><strong>Results</strong>:<strong> </strong>There was a significant reduction in the postoperative pain in the lornoxicam group than the diclofenac group (p value&lt;0.05) throughout the study. Significantly 11 patients required rescue medication in diclofenac group, 3 patients in lornoxicam group. No serious adverse event was noted in two groups.</p><p><strong>Conclusion: </strong>Lornoxicam 8 mg was a better analgesic than diclofenac 75 mg in efficacy and safety in the management of postoperative pain following mastoidectomy surgery.</p>

2021 ◽  
Vol 8 (5) ◽  
pp. 1507
Author(s):  
Amit Yadav ◽  
Lakshman Agarwal ◽  
Sumit A. Jain ◽  
Sanjay Kumawat ◽  
Sandeep Sharma

Background: Fear of poor wound healing have curtailed the use of diathermy for making skin incision. Scalpel produces little damage to surrounding tissue but causing more blood loss. Our aim of study was to compare electrocautery incision with scalpel incision in terms of incision time, blood loss, postoperative pain and wound infection.Methods: Total of 104 patients were included in the study undergoing midline abdominal surgery. Patients were randomized into electrocautery (group A) and scalpel (group B). The incision dimension, incision time and blood loss were noted intraoperatively. Postoperative pain was noted on postoperative day 2 using visual analog scale. Wound complications were recorded on every postoperative day till the patient was discharged.Results: 52 patients in each of the two groups were analyzed. There was significant difference found between group A and group B in terms of mean incision time per unit wound area, 8.16±1.59 s\cm2 and 11.02±1.72 s\cm2 respectively (p value=0.0001). The mean blood loss per unit wound area was found to be significantly lower in group A (0.31±0.04 ml\cm2) as compared to group B (1.21±0.21), p value=0.0001. There was no significant difference noted in terms of postoperative pain and wound infection between both groups.Conclusions: Electrocautery can be considered safe in making skin incision in midline laparotomy compared to scalpel incision with comparable postoperative pain and wound infection with less intraoperative blood loss and less time consuming.


2011 ◽  
Vol 18 (01) ◽  
pp. 106-111
Author(s):  
ARSALAN SIRAJ ◽  
ATHAR ABBAS SHAH GILANI ◽  
MUHAMMAD FAROOQ DAR ◽  
Sohail Raziq

Objectives: To compare the diathermy incision with scalpel incision in patients undergoing midline elective laparotomy. Design of Study: A prospective, experimental comparative study. Place and Duration: Department of surgery, PNS Shifa Karachi, from March 2007 to June 2008. Patients and Methods: A total of 100 patients were included in the study, and equally divided into 2 groups. Group A received scalpel incision while in group B diathermy was employed to incise all layers. Peroperative parameters including, incision time and blood loss were calculated. Postoperatively, pain was assessed by visual analogue score and wound infection documented. Results: Both groups included fifty patients each out of the total 44 females and 56 were males, with similar gender preposition in both the groups. Mean age of patients in scalpel group was 48.78 (±14.47) while it was 44.92 (±15.87) in diathermy group. The mean incision related blood loss in Scalpel group was 1.53 (±0.20) ml/cm2 and in Diathermy group was 1.43 (±0.20) ml/cm2, showing significantly less bleeding in diathermy group (p-value= 0.014). Diathermy group, with incision related time of 6.20 sec/cm2 (±0.97 sec/cm2), was significantly quicker (p-value= 0.003) than scalpel incision, with incision time of 6.76 sec/cm2 (±0.84 sec/cm2). Postoperative pain scores, recorded daily over five days, showed insignificant difference between the two groups. Conclusions: Diathermy, employed for midline laparotomy, is quicker and hemostatic, compared to the scalpel. The two are, however, similar in terms of wound infection and postoperative pain.


2019 ◽  
Vol 26 (08) ◽  
pp. 1323-1327
Author(s):  
Ashook Kumar ◽  
Anny Memon ◽  
Suneel Kumar Panjabi ◽  
Salman Shams

To compare the Ward’s Flap Versus Modified Ward’s flap in relation to access, healing & postoperative complications in surgical extraction of mandibular third molar impaction. Study Design: Comparative Cross Sectional. Setting: Department of Oral & Maxillofacial Surgery LUMHS Jamshoro/Hyderabad: Period: March 2017 to November 2017. Materials and Methods: The history, clinical examination and radiographs (OPG and periapical) had done by team of researchers and recorded on proforma. After selection of patient into either group (Group A=Wards Flap, Group B Modified Wards), the surgical extraction was carried out under local anesthesia. For group A, a standard full thickness mucoperiosteal flap (ward’s flap) was raised. The incision was given mesial to the impacted lower third molar. For group B, a standard full thickness mucoperiosteal flap (Modified ward’s flap) was given mesial to second molar. At the end of the surgery, the flap design used for the extraction of impacted lower third molar tooth and the duration of each operation (from the first extraction maneuver to the completion of the last suture), Pain, Swelling and Trismus13 were recorded on the proforma. Every patient was called for follow up on the 3rd day and 7th day. Results: Mean age was found 27.93 years, with range of minimum 20 years and maximum 35 years. Male were found in the majority 72.3%. Majority of the cases 51.5% were found with class B, in class A 37.5% and 10.9% were found with class C. According to the impaction position 50% cases were in class I, and 50% cases were in class II. Preoperative pain measurement was done according VAS, 71.9% patients were found with mild pain, 9.4% were with moderate pain while 18.8% patients were without pain. Modified Wards flap showed good efficacy regarding duration of third molar extraction as compare to Ward’s flap P-value 0.018. Modified ward’s flap had showed less postoperative pain as compare to ward’s flap p-value 0.022. No significant difference was found between both groups on 3rd and 7th postoperative day in Mouth opening. Conclusion: This study concluded that both ward’s flap and modified ward’s flaps showed good efficacy, while duration of surgery and postoperative pain were significantly less in the modified ward’s flaps as compare to ward’s flap. More large sample size studies are required to evaluate more accurate findings.


2020 ◽  
Vol 27 (01) ◽  
pp. 166-171
Author(s):  
Ashar Ahmad Khan ◽  
Tania Mahar ◽  
Muhammad Kashif Adnan ◽  
Abdul Rasheed Surahio ◽  
Abdul Manan ◽  
...  

Conventional haemorrhoidectomy, a usual procedure for hemorrhoids in our set up have many short and long term complications. Some patients complained pain many weeks after surgery and are unable to do their routine work. Anal stenosis and recurrence are long term issues. There is need for some other procedure which can decrease postoperative pain and hospital stay. Objectives: To compare the postoperative recovery between stapled hemorrhoidopexy and conventional hemorrhoidectomy. Study Design: Randomized Clinical trial. Setting: Surgery Department of Nishtar Medical University Multan. Period: from 01-01-2018 to 31-12-2018. Material & Methods: Randomly 02 equal groups of the patients, A and B were made. Stapled hemorrhoidopexy (SH) and conventional haemorrhoidectomy was done in group A and B respectively. SPSS version 20 used for data analysis. Mean and standard deviation were used for quantitative variables including postoperative pain, age and hospital stay. Independent Student t test used for comparison of hospital stay and postoperative pain. Effect modifier including gender, age, duration and grade of hemorrhoids were controlled by stratification and Chi square test was applied. P value less than 0.05 was taken as significant. Results: Out of 60 patients, 32 were males and 28 females. In Group A (Stapled Hemorrhoidopexy), mean age was 37.37 + 6.36 years and 39.17 + 5.53 years in Group-B. Postoperative pain in Group A was 3.60 + 1.27 and 6.03 + 1.73 in Group B. Postoperative pain was significantly high in Group B (CH) and P value =0.000. Mean hospital stay was 0.90 + 0.48 days in Group A and 1.87 + 0.57 days in Group B with P value= 0.000. Conclusion: Stapled hemorrhoidopexy is associated with shorter hospital stay and decrease postoperative pain irrespective of age, sex and grade of the hemorrhoids.


2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Thi Thanh Thuy Truong ◽  
Jong Min Lim ◽  
Hyung-Rae Cho ◽  
Young Suk Kim ◽  
Duc Giang Dao ◽  
...  

Aim. The aim of the present study was to examine the efficacy and safety of Polycan, a β-glucan produced from the black yeast Aureobasidium pullulans SM-2001, in combination with glucosamine in reducing knee osteoarthritis-associated symptoms. Methods. This was a double-blind, randomized controlled trial of a formulated product composed of 16.7 mg of Polycan and 250 mg of glucosamine (Group A), 16.7 mg of Polycan and 500 mg of glucosamine (Group B), or 500 mg of glucosamine (control group) per capsule, administered as three capsules once per day over a period of 12 weeks, conducted with 100 osteoarthritis patients, aged 35–80 years. The primary outcome measure was osteoarthritis symptoms assessed by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire. The secondary outcome measures included rescue medication use (according to data from a patient-reported diary) and other safety indices (body weight, blood pressure, hematological, and biochemistry markers). Results. Compared with the control group, Group B demonstrated a statistically significant reduction in the total WOMAC score after 12 weeks of treatment (p < 0.05). There was a significant reduction in the frequency of rescue medication used in Groups A and B compared with the control group (p < 0.05). There were no significant changes in hematology and biochemistry parameters or health indices between the active and the control group. Conclusion. Among patients with mild or moderate osteoarthritis, a daily oral dose of Polycan (50 mg) in combination with glucosamine (750 mg or 1500 mg; Group A or B, respectively) resulted in a better treatment outcome than treatment with glucosamine (1500 mg) alone.


2019 ◽  
Vol 8 (1) ◽  
pp. 29-33
Author(s):  
Tabish Hussain ◽  
Asifa Anwar Mir ◽  
Jawad Zahir ◽  
Pervaiz Minhas

Background: Postoperative pain creates complications by increasing circulating level of catecholamines and systemic vascular resistance, thus putting the patients on increased risks of having stroke and myocardial infarction. In addition, it increases hospital stay, causing burden over economic as well as healthcare infrastructure. The aim of this study was to determine the frequency of pain in the postoperative period while using Pregabalin as pre-medication among patients undergoing laparoscopic cholecystectomy.Material and Methods: The randomized control trail was conducted at Department of Anesthesiology, Holy Family hospital, Rawalpindi from 1st Sept 2015 to 28th Feb 2016 over a period of 6 months. A total of 200 patients undergoing laparoscopic cholecystectomy were randomly divided in group A and B by consecutive non-probability lottery method. Group A received 100 mg oral Pregabalin 1 hour before surgery and Group B were not given Pregabalin and were taken as controls. Post-operative pain was measured by visual analog scale (VAS) in terms of pain scores at 4 hours postoperatively after the arrival of patient in the post-anesthesia care unit (PACU). SPSS version 17.0 was used to analyze the data.Results: A total of 200 patients were included in the study. There were 100 patients in each group. Based on the visual analog pain scores, 9 patients were pain free in group A compared with none in group B. Similarly, there were 55 patients in group A, who reported a pain score of 1 whereas no patient in group B had a VAS score of 1. There were 29 patients in group A and only 3 patients in group B with VAS score of 2 (90.6% vs. 9.4%). For VAS score of 3, there were 6 patients in group A and 34 patients from group B (15% vs. 85%). For a VAS score of 4, there were 1 patient in group A and 61 patients in group B (1.6% vs. 98.4%). Two patients in group B experienced a VAS score of 5. All this data was significant with chi square p value of 0.0001.Conclusion: Oral Pregabalin administered prior to laparoscopic cholecystectomy was effective in reducing postoperative pain in the patients. Further studies are needed for post-operative evaluation of side effects, different dosing schedules at different time intervals for both rest and dynamic pain.


2021 ◽  
Vol 28 (02) ◽  
pp. 192-196
Author(s):  
Nadia Bano ◽  
Nazim Hayat ◽  
Saira Saleem ◽  
Farhan Javaid ◽  
Ayesha Rehman ◽  
...  

Objective: To compare the effects of intraincisional and intraperitoneal infiltration of local anaesthetic to relieve early postoperative pain in laparoscopic cholecystectomy. Study Design: Randomized Control Trial. Setting: Department of Anaesthesia and Surgery, Madinah Teaching Hospital Faisalabad. Period: July 2017 to March 2018. Material & Methods: A sample of 100 patients with American Society of Anaesthesiologists Physical status (ASA) I and II, undergoing laparoscopic cholecystectomy were selected using simple random sampling technique. Patients were randomly assigned into groups A and B. Group A patients received intraperitoneal infiltration of 20 ml solution of 0.25% bupivacaine and group B patients received intraincisional infiltration of 20 ml solution of 0.25% bupivacaine. Results:  Demographic characteristics were not significantly different in both groups. Our study showed that Group A patients had better pain relief as compared to group B patients. Visual analogue score (VAS) for pain relief at 0, 3,6,12 and 24 hours was statistically different in both groups. The requirement of rescue analgesia between group A and B was found to be12% and 38% which is statically significant (p value 0.003). Conclusion: intraperitoneal infiltration of Bupivacaine offers better postoperative pain relief after laparoscopic cholecystectomy and is associated with less analgesic requirement in early postoperative period.


Author(s):  
Isha Sunil ◽  
Prabhjit Kour ◽  
Mitali Sharma

Background: Maternal anaemia is a common problem worldwide. The aim of this study is to compare the efficacy and safety of FCM vs iron sucrose for correction of iron deficiency during pregnancy.Methods: This study was conducted in Swasthya healthcare, Jammu for a period of ten months from Sep 2017 to June 2018. A total of 100 women with Hb 7-9.9g% enrolled. They were divided into two groups of 50 each. Group A were given Iron Carboxy maltose and Group B were given Iron Sucrose. These were compared for their efficacy and safety.Results: In the present study, the rise in mean hemoglobin at 4 weeks in Group A was 1.79±0.47 and 1.06±0.11 in Group B which was highly significant (p-value<0.0001). Rise in mean serum ferritin level at 4 weeks in Group A was 123.80±16.03 and in Group B was 84.78±10.53. Statistically, this rise was also highly significant (p<0.0001). In present study, adverse reactions were observed in 34% patients in Group A, while in Group B it was observed in 52% patients.Conclusions: Iron carboxy maltose shows higher rise in hemoglobin and ferritin levels as compared to Iron Sucrose and incidence of adverse effects is also comparatively lower in the former.


Author(s):  
Vaibhav B. Patil ◽  
Vidya D. Mule ◽  
Ravi M. Raval ◽  
Abhishek A. Kulkarni

Background: Considering higher rate of postoperative wound complications in Government set up hospitals, this study was an attempt to compare incision time, incisional blood loss, hospital stay, post-operative pain and postoperative wound complications when subcutaneous tissue is opened with either scalpel or electrocautery in elective gynaecological surgeries after keeping all other clinical and surgical variables same i.e. age, BMI, haemoglobin, incision depth and hospital stay.Methods: This was a prospective observational comparative study conducted in one of the tertiary teaching hospital in Western Maharashtra, India over 12 months. All patients (n=100) were divided into 2 groups. Group A in which skin and subcutaneous tissue was dissected by using scalpel and Group B in which after skin, anterior abdominal wall was opened by using electrocautery. Data analyzed for indication, incisional blood loss, incision time, postoperative pain, wound complications and hospital stay.Results: There were no significant association between preoperative diagnosis and the development of a post-operative wound complications. Mean incision blood loss was found to be significantly higher in group A compared to group B patients. Postoperative pain was significantly higher in group A (P value <0.05). Among wound complications, no statistically significant differences were seen regarding wound complications for the two groups.Conclusions: Electrosurgical dissection for abdominal incision is safe, less time consuming and with less blood loss during subcutaneous incision and produces less postoperative pain. We conclude that the method of subcutaneous tissue incision was unrelated to the development of postoperative abdominal incision problems.


2020 ◽  
Vol 27 (01) ◽  
pp. 68-73
Author(s):  
Mumtaz Ali ◽  
Mudassar Murtaza ◽  
Mohammad Aleem-ud-Din ◽  
Mohammad Burhan Ud Din ◽  
Assam Sarwar ◽  
...  

Harmonic scalpel is popular for use in a variety of surgical procedures including thyroid surgery. Proposed advantages of the harmonic scalpel include less lateral thermal tissue damage with no electrical energy transferred to the patient, no neuromuscular stimulation, less smoke formation as compared with electrocautery. Objectives: Our aim was to compare outcomes following thyroid surgery in terms of operative time, postoperative pain, drainage volume, recurrent laryngeal nerve and parathyroid gland injury with the use of the Harmonic Scalpel compared to conventional methods of hemostasis. Study Design: Randomized control trial. Setting: Surgical Department Lahore General Hospital. Period: Twelve Months June 2016 to June 2017. Material & Methods: 60 patients, 30 in each group. Patients were randomized in each group by balloting method. Operative time, postoperative pain and drainage volume was assessed during hospital stay. Recurrent laryngeal nerve and parathyroid gland injury was assessed during hospital stay and follow-up. Results: There was no significant difference in development of hoarseness of voice in both groups, p-value > 0.05. The mean operative time for group A was 69.47 ± 15.44 minutes and for group B it was 54.93 ± 11.56 minutes, p-value <0.05. The overall blood loss in group-A and group-B was 118.73 ± 50.72 ml and 44.60±10.70 ml, p-value<0.05. The mean post-op pain observed at 2nd day for group B was 2.93 ±3.57 and for group A it was 3.57±0.77, p-value < 0.05. Conclusion: Use of Harmonic Scalpel has better results in thyroid surgery in terms of less operative time, less postoperative pain, less drainage volume, while no RLN & parathyroid injury detected in either group.


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