scholarly journals Benefits of dexamethasone use in thyroid surgery: A prospective, randomized study

2020 ◽  
Vol 148 (9-10) ◽  
pp. 565-570
Author(s):  
Dragana Radovanovic ◽  
Sanja Milosev ◽  
Zoran Radovanovic ◽  
Svetlana Skoric-Jokic ◽  
Silvija Lucic ◽  
...  
Keyword(s):  
Single Dose ◽  
Thyroid Surgery ◽  
Randomized Study ◽  
Postoperative Nausea And Vomiting ◽  
Double Blind Study ◽  
Nacl Solution ◽  
Double Blind ◽  
Time Period ◽  
Group A ◽  
Group B

Introduction/Objective. This study aimed to investigate the effects of preoperative dexamethasone use on the incidence and severity of postoperative nausea and vomiting (PONV), postsurgical pain, and vocal impairment after thyroid surgery. Methods. We performed a prospective, randomized, double-blind study with 50 patients who underwent thyroid surgery. Group A patients (n = 25) received 0.9% NaCl solution (2 ml) before anesthesia, patients in Group B (n = 25) were administered 8 mg of dexamethasone. All the patients preoperatively received 4 mg of ondansetron. During the first 48 hours after surgery, postoperative complications were monitored in defined periods. Results. PONV rate and severity was significantly lower in Group B than in Group A (p < 0.05). Patients in Group B reported less pain in resting and in activity (p < 0.05) and lower vocal impairment (p < 0.05) than patients in Group A in each defined time period. Conclusion. Preoperatively adding dexamethasone to ondansetron is more effective than use of ondansetron alone in the prevention of PONV. Dexamethasone significantly reduces the pain and improves voice function; therefore, we could advise routine single-dose dexamethasone use before thyroid surgery.

Comparison of the effects of Dexamethasone and Ondansetron on the Reduction of Postoperative Nausea and Vomiting following Cesarean Section under Spinal Anesthesia

2020 ◽  
Vol 15 ◽  
Author(s):  
Arash karimi ◽  
Jahanbakhsh Nejadi ◽  
Mahnaz Shamseh ◽  
Nooshin Ronasi ◽  
Mehdi Birjandi
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Postoperative Nausea ◽  
Demographic Data ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Elective Cesarean Section ◽  
Double Blind ◽  
Group A ◽  
Group B

Background: Postoperative nausea and vomiting (PONV) is a common complication associated with the use of anesthesia. Several antiemetics are used to reduce the incidence and severity of PONV. The aim of this study is to investigate the role of dexamethasone and ondansetron to treat PONV in patients undergoing cesarean section (c-section) under spinal anesthesia. Methods: This double-blind clinical trial study was performed on patients who were referred to the operating room of Haji Karim Asali Hospital of Khorramabad for elective cesarean section in 2016-17. Upon meeting the inclusion criteria, patients were allotted into two groups (n=60). Group A received 8mg of dexamethasone and group B received 4mg of ondansetron after spinal anesthesia. The Visual Analog Scale (VAS) questionnaire and Depression-Anxiety-Stress Scale (DASS) questionnaire was used for the analysis. Patients with mild to moderate stress, anxiety, and depression were included in the study. Data were analyzed using SPSS 16 software. Results: There was no difference in the demographic data of the two groups. The mean severity of nausea in group A was significantly higher than in group B. The frequency of vomiting in group A was 20 times higher than group B, which was found to be statistically significant, p = 0.018. Concerning the type of delivery with the frequency of nausea, the results showed that the frequency of nausea in group A was 3.24 times higher than group B, however, this difference was not statistically significant, p = 0.106. Conclusion: Based on the results of this study, ondansetron had a significant effect on the alleviation of postoperative nausea and vomiting, as compared to dexamethasone in c-section surgical candidates.

The role of tolvaptan in prevention of hyponatremia in patients undergoing transurethral resection of prostate surgery- A randomized double blind study

2021 ◽  
Vol 8 (2) ◽  
pp. 321-325
Author(s):  
Dinesh Kumar Singh ◽  
B B Baj ◽  
Vipin Goyal
Keyword(s):  
Transurethral Resection ◽  
Blind Study ◽  
Transurethral Resection Of Prostate ◽  
Double Blind Study ◽  
Double Blind ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B

The aim of our study to determine the role of tolvaptan in prevention of hyponatremia in transurethral resection of prostate surgery. This is randomized double-blind study conducted in 60 ASA grade status 1 and 2 patients age group between 45-80 yrs undergoing TURP under spinal anaesthesia in urology operation theatre in Mahatma Gandhi hospital Jaipur after receiving permission from hospital ethical committee. A detailed history, complete physical examination and routine investigation were done for all patients followed by informed written consent was obtained. Patients are randomly divided into 2 groups. In group A -30 patients who received orally tab tolvaptan 15 mg and group B-30 patients who received orally tab multivitamin 2 hrs before surgery after doing electrolytes of the patients in the morning. In both groups age (in yrs), wt (in kg), ASA grade, volume of irrigating fluid (in litres), volume of prostate resected (in gm) and duration of surgery (in minutes) all demographic and surgical details data were compared. Electrolytes were compared in both groups pre and post-operatively and statistical analysis was done.There was significant difference in post-operative sodium level between the two groups (A and B). The mean level of sodium significantly reduced post-operatively in group –B (control grp). The mean level of sodium significantly increased post-operatively in group –A (tolvaptan grp). We conclude single dose of tolvaptan -15 mg found to effective in prevention of hyponatremia in patients undergoing TURP.

scholarly journals Use of Warm Local Anaesthetic Solution for Caudal Blocks

1992 ◽  
Vol 20 (4) ◽  
pp. 453-455 ◽  
Author(s):  
E. T. M. Lim ◽  
K. Y. Chong ◽  
B. Singh ◽  
W. Jong
Keyword(s):  
Adverse Effects ◽  
Local Anaesthetic ◽  
Room Temperature ◽  
Double Blind Study ◽  
Double Blind ◽  
Anaesthetic Solution ◽  
Group A ◽  
Group B ◽  
Local Anaesthetic Solution ◽  
Speed Of Onset

A double-blind study was undertaken to investigate the effect of prewarmed local anaesthetic solution on the latency of onset of caudal blocks. Forty-four (ASA I-II) patients were allocated into two equal groups. In Group A, the local anaesthetic solutions were injected at room temperature (25°C), while in Group B, they were injected at 37°C. All the caudal blocks were performed using 20 ml of lignocaine 1.5% with adrenaline 1:200,000. The speed of onset of perianal analgesia was found to be significantly faster (39%) with the prewarmed local anaesthetic solution (P < 0.05). No adverse effects were observed.

scholarly journals EMLA Cream Prior to Insertion of Elective Epidurals

1995 ◽  
Vol 23 (3) ◽  
pp. 339-341 ◽  
Author(s):  
J. A. Elson ◽  
M. J. Paech
Keyword(s):  
Elective Caesarean Section ◽  
Needle Insertion ◽  
Patient Comfort ◽  
Epidural Needle ◽  
Double Blind Study ◽  
Double Blind ◽  
Emla Cream ◽  
Skin Infiltration ◽  
Group A ◽  
Group B

A randomized double-blind study was conducted in 83 women scheduled for elective caesarean section to determine the efficacy of EMLA and lignocaine infiltration for epidural insertion. The patients were randomly allocated to one of three groups: Group A (EM/LIG) received EMLA and intradermal and subdermal 1% lignocaine infiltration, Group B (EM/SAL) EMLA and saline while Group C (PL/LIG) received placebo cream and 1% lignocaine. Assessments using a 100 mm pain score were performed on skin infiltration and after subsequent insertion of a 16 gauge Tuohy needle into the supraspinous ligament. Skin changes under the applied cream and nursing rating of patients’ response were also noted. Statistical analyses were performed using Kruskal-Wallis and Fisher's Exact Tests. Groups were comparable for age, weight, parity and EMLA application time (interquartile range 105-150 minutes) There were significantly higher pain scores for skin infiltration in Group C (PL/LIG) (P<0.01) and for epidural needle insertion in Group B (EM/SAL) (P<0.05). We concluded that in this patient population, the application of EMLA cream for at least 90 minutes plus 1% lignocaine infiltration optimized patient comfort for epidural insertion.

scholarly journals A Double-Blind Randomized Prospective Study Comparing Ondansetron with Droperidol in the Prevention of Emesis following Strabismus Surgery

1995 ◽  
Vol 23 (4) ◽  
pp. 438-443 ◽  
Author(s):  
A. Davis ◽  
S. Krige ◽  
D. Moyes
Keyword(s):  
Recovery Time ◽  
Strabismus Surgery ◽  
Double Blind Study ◽  
Double Blind ◽  
Oral Fluids ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
To Receive ◽  
Mean Time

A prospective double-blind study was conducted to compare the anti-emetic efficacy of ondansetron and droperidol in preventing postoperative emesis following strabismus surgery. A sample size of 213 patients was divided into three equal groups to receive ondansetron 150 μg/kg (Group A), ondansetron 75 μg/kg (Group B), or droperidol 75 fig/kg (Group C). All patients received a standardized anaesthetic technique. All episodes of emesis, recovery time, and time to tolerating oral fluids were recorded. The incidence of emesis during 24 hours was Groups A and B 19.7%, and Group C 28.2%. The lower incidence of emesis recorded by the ondansetron groups compared with the droperidol group was not statistically significant. Ondansetron at 75 μg/kg was as effective as 150 μg/kg in reducing emesis when compared with droperidol. Mean time to discharge from the recovery room was 75.3 minutes (Group A), 44.4 minutes (Group B), and 41.0 minutes (Group C). The mean time to tolerating oral fluids was 356.5 minutes (Group A), 402.8 minutes (Group B), and 378.1 minutes (Group C). There was no statistical difference in discharge times from recovery or time to tolerating oral fluids in any of the three groups.

scholarly journals The Effect of Use of Anidulafungin on Failure of Weaning Due to Ventilator-associated Pneumonia which Complicate Contused Lungs

2018 ◽  
Vol 12 (1) ◽  
pp. 73-84
Author(s):  
Mohamed Gaber Ibrahium Mostafa Allam
Keyword(s):  
Broad Spectrum ◽  
Antifungal Drugs ◽  
Lung Contusion ◽  
Prolonged Treatment ◽  
Double Blind Study ◽  
Ventilator Associated Pneumonia ◽  
Double Blind ◽  
Broad Spectrum Antibiotics ◽  
Group A ◽  
Group B

Introduction:Failure of weaning is considered one of the most difficult challenges facing any intensivist especially in the devitalized lung due to infected lung contusion. Unsatisfactory results with prolonged treatment with the proper broad-spectrum antibiotics raise the point of exclusion of candidemia or suspected pulmonary candidiasis which is considered a major problem not only because of increasing rate (2-10 per 1000 ICU admission) but also because of difficult diagnosis. Patients with failure of weaning due to unresolved VAP after receiving broad-spectrum antibiotics for more than 10 days especially in preexisting severe lung contusion should be put on empirical systemic antifungal. Echinocandins are a new class of antifungal drugs used as a reliable class for empirical systemic antifungal treatment.Aim of Work:The study aims to evaluate and compare the effect of the use of anidulafungin on weaning from the ventilator due VAP which complicates traumatized contused lungs after 2 weeks from ventilation.Patients and Methods:This was a prospective double-blind study done on 200 patients admitted to King Abdulaziz Specialized Hospital, Taif, KSA between March 2015 and August 2018 in surgical ICU with the failure of weaning due to Ventilator Associated Pneumonia (VAP) complicate contused lungs. Group (A) 100 patients started on antibiotics regimen according to qualitative culture for 2 weeks while group (B) 100 patients received anidulafungin with the antibiotics regimen.In this study, diagnosis of lung contusion was made by Computerized Axial Tomography (CT) chest while both VAP was diagnosed by a modified Clinical Pulmonary Infection Score (CPIS). A score of 6 or more was considered VAP.Results:Comparing the data of the patients in the 3 studied periods (1st5 days, 2nd5 days and last 4 days) controlled tracheal secretion was recorded in 15, 38 and 46 patients in group A respectively in the 3 studied periods compared to 28, 75 and 83 in group B. Less parenchymatous lung infiltration in the chest X-ray found was in 12, 40 and 48 patients in group A compared to 24, 88 and 91 patients in group B. Improvement of the hypoxic index in 48, 76 and 85 patients in group A was compared to 66, 90 and 98 patients in B. Normalization of temperature in 16, 36 and 54 patients in group A while 40, 76 and 90 patients in B and reduction of total leucocytic count in 18, 35 and 57 patients in group A while 38, 70 and 87 patients in group B were observed. There were 15 out of 98 patients in Group A not weaned while only 5 out of 100 patients in group B failed to be weaned from mechanical ventilation within the study period (2 weeks).Conclusion:The use of anidulafungin with proper antibiotics in patients with failure of weaning due to VAP complicate contused lung efficiently treated VAP and reduced the morbidity by accelerating the weaning from the ventilator compared to the use of proper antibiotics alone.

scholarly journals To compare efficacy of Diclofenac by intramuscular route and rectal route in post surgical pain.

2021 ◽  
Vol 28 (09) ◽  
pp. 1269-1275
Author(s):  
Maryam Zulfiqar ◽  
Maimoona Ashraf ◽  
M. Imran Hassan Khan ◽  
Fareed Naeem ◽  
Salman Shakeel
Keyword(s):  
General Hospital ◽  
Cesarean Delivery ◽  
Diclofenac Sodium ◽  
Randomized Study ◽  
Double Blind ◽  
Surgical Pain ◽  
Rectal Route ◽  
Group A ◽  
Group B ◽  
Study Setting

Objective: This study was carried out in Lahore General Hospital, Lahore to test the results of Intramuscular vs Suppository form of Diclofenac Sodium on the severity of post-surgical pain in patients who underwent Cesarean delivery under Subarachnoid Block. Study Design: Randomized Study. Setting: Lahore General Hospital, Lahore. Period: April 2019 to September 2019. Material & Methods: This was a double-blind run on 100 patients who underwent for cesarean delivery irrespective of any indication for the procedure. The pain sufferers had been randomly divided into 2 groups. The group A: who received Diclofenac Sodium in the form of suppository and Group B: who received intramuscular Diclofanec Sodium? The pain severity was assessed using VAS scale at categorically unique times. Data was then analyzed using SPSS 23 version and the results were compiled in the form of mean and percentage. Results: The mean age (Years) of patients was (25.27±6.07). There was a big statistical difference between the 2 groups regarding pain score after the intervention (p=0.018). Conclusion: To reaffirm the effectiveness of Diclofenac for Post-Caesarean section, the physique part (Suppository) is established to hold advantages over the contractile organ (muscles).

scholarly journals Comparison of Intrathecal Fentanyl and Butorphanol as an Adjuvant to Intrathecal Bupivacaine 0.5% in Infraumbilical Surgeries- A Randomised Double Blind Study

2020 ◽  
Author(s):  
Sandip Roy Basunia ◽  
Prosenjit Mukherjee ◽  
Md Bakir Hossain Munshi
Keyword(s):  
Spinal Anaesthesia ◽  
Motor Block ◽  
Controlled Trial ◽  
Sensory Block ◽  
P Value ◽  
Double Blind Study ◽  
Hyperbaric Bupivacaine ◽  
Double Blind ◽  
Group A ◽  
Group B

Introduction: Neuraxial opioids are widely used as adjuvants to local anaesthetic as they improve quality and duration of block. Neuraxial opioids like Butorphanol and Fentanyl allow prolonged analgesia in the postoperative period and faster recovery from spinal anaesthesia. Aim: To compare the safety and efficacy of Butorphanol and Fentanyl combined with bupivacaine for spinal anaesthesia in infraumbilical surgeries. Materials and Methods: The present study was a randomised controlled trial in which 110, ASA I and II patients of either sex who underwent elective infraumbilical surgeries under spinal anaesthesia were selected. Patients were allocated randomly into two groups A (n=55) and B (n=55). Group A (F) received intrathecal 0.5% hyperbaric bupivacaine 12.5 mg (3 mL) with fentanyl 25 microgram (0.5 mL) to make it total 3.5 mL. Group B (B) received intrathecal 0.5% hyperbaric bupivacaine 12.5 mg (3 mL) with butorphanol 250 microgram (0.25 mL) and Normal Saline (NS) 0.25 mL to make it total 3.5 mL. Heart Rate (HR), Systolic and Diastolic Blood Pressure (SBP, DBP), two segment regression time of sensory block, motor block were assessed at preset intervals. Chi-square test or Fischer’s-exact test were used and a p-value ≤0.05 was considered as statistically significant. Results: Mean of two segment sensory regression time of Group A was 41.94±1.73 minutes and Group B was 50.56±4.43 minutes (p<0.0001). Time to onset of motor block in Group A was 5.28±.32 minutes and Group B was 5.27±.32 minutes (p=0.96). Mean duration of motor block in Group A was 81.23±4.87 minutes and Group B was 109.83±2.61 minutes (p<0.0001). Time to rescue analgesic was 289.27±7.37 minutes in Group A and 378.41±10.25 minutes in Group B (p<0.0001). HR, SBP and DBP were comparable among the groups. Conclusion: Intrathecal bupivacaine-butorphanol mixture was clinically better as it provided longer duration of analgesia with lesser incidences of pruritus and nausea/vomiting compared to intrathecal fentanyl-bupivacaine mixture.

scholarly journals Effect of Single Dose of Pregabalin on Post Tracheal Intubation Sore Throat after General Anesthesia

2019 ◽  
Author(s):  
Hassan Mohammadipour Anvari ◽  
Maarouf Ansari Kazaj ◽  
Khosro Kolahdouzan ◽  
Nasser Ghobanian ◽  
Afsaneh Khobeydeh
Keyword(s):  
Single Dose ◽  
Tracheal Intubation ◽  
General Anesthesia ◽  
Sore Throat ◽  
Control Group ◽  
Case Group ◽  
Double Blind ◽  
Analgesic Effects ◽  
Group A ◽  
Group B

Background: Sore throat is one of the major complications of tracheal intubation after general anesthesia. Pregabalin is an analgesic, the anti neuropathic pain and analgesic effects of which have been demonstrated in various studies. This study examined the effects of single dose pregabalin one hour before tracheal intubation, to prevent sore throat after extubation. Methods: In a double-blind, randomized clinical trial, 60 patients who had undergone general and urologic surgeries at Imam Reza hospital in Tabriz, Iran, since March to July 2015 that required tracheal intubation, were included in the study. The patients were randomly divided into two groups (group A, 30 patients and group B, 30 patients). In the group A, an hour before anesthesia, one pregabalin tablet (300mg) was given to the patients. For the patients of the group B, the placebo was given. After awareness of patients, the severity of sore throat was measured and recorded by VAS scale after 2, 6 and 24 hours of the surgery. Results: Severity and incidence of sore throat after tracheal intubation were not significantly different between two groups. Meanwhile, no side effects of pregabalin were observed in the group A. Conclusion: Administration of pregabalin as a single dose of 300 mg one hour prior to anesthesia and intubation decreased the incidence and severity of sore throat in the case group than the control group, although the amount of this reduction was not statistically significant between the two groups.

scholarly journals A COMPARATIVE STUDY OF CLONIDINE VERSUS NALBUPHINE AS INTRATHECAL ADJUVANTS TO 0.5% HYPERBARIC BUPIVACAINE DURING LOWER ABDOMINAL SURGERIES – A RANDOMIZED DOUBLE BLIND INTERVENTIONAL STUDY.

2020 ◽  
Vol 4 (3) ◽  
Author(s):  
Trishala Jain ◽  
Jaipal .
Keyword(s):  
Motor Block ◽  
Sensory Block ◽  
Double Blind Study ◽  
Hyperbaric Bupivacaine ◽  
Double Blind ◽  
Rescue Analgesia ◽  
Institutional Ethics ◽  
Group A ◽  
Group B ◽  
Intrathecal Clonidine

Background: Regional anesthesia techniques for gynecological procedures are on increasing trends due to their advantage of postoperative analgesia owing to intrathecal adjuvants. The present study was aimed to comparatively evaluate the clinical efficacy of clonidine with nalbuphine when co-administered intrathecally with 0.5% hyperbaric bupivacaine for Lower abdominal surgeries in Gynecology. Methods: With institutional ethics committee clearance No. 193MC/EC/2018, randomized, double blind study was conducted. After obtaining informed written consent total of 84 patients scheduled for lower abdominal surgeries were randomly allocated into two groups: Group A (n=42) - Inj.  3.5 ml Bupivacaine 0.5% + 0.2 ml Clonidine(30µg) intrathecally.  Group B (n=42) - Inj.3.5 ml Bupivacaine 0.5%+0.2 ml Nalbuphine(2mg) intrathecally. The characteristics of sensory and motor block, hemodynamic data, side effects were recorded. Results: The onset of sensory block was earlier in Group B than Group A (3.08±0.52 min vs 4.00±0.54 min, p<0.001 ). The onset of motor block was also earlier in Group B than Group A (7.78±0.80 min vs 8.80±0.95min, p<0.001). The time to first rescue analgesia in patients receiving intrathecal clonidine was significantly delayed than patients receiving intrathecal nalbuphine (284.95 ± 12.93 min vs 211.52 ± 15.92 min, p<0.001). Introperative hemodynamic changes were comparable and none of the patient suffered from respiratory depression except very little cases of shivering which are not significant. Conclusions: Intrathecal clonidine as adjuvant to bupivacaine provided was clinically more effective than nalbuphine for prolonging the duration of analgesia for gynecological procedures. Keywords: Bupivacaine, Clonidine, Lower abdominal surgeries in gynecology, Nalbuphine, Subarachnoid block.

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