scholarly journals Evaluation of Pain Following the Use of Scalpel Versus Electrosurgery for Skin Incisions in the Facial Regions

PRILOZI ◽  
2018 ◽  
Vol 39 (2-3) ◽  
pp. 107-112
Author(s):  
Margarita Peneva ◽  
Andrijana Gjorgjeska ◽  
Smilja Tudzarova Gjorgova ◽  
Boro Dzonov ◽  
Lazo Noveski ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Skin Lesions ◽  
Medical Problem ◽  
On Demand ◽  
Number Of Patients ◽  
Significant Difference ◽  
Malignant Skin ◽  
Electrosurgical Unit ◽  
Group B ◽  
Tip Radius

Abstract Introduction: Postoperative pain presents a significant medical problem. It can create a considerable discomfort in the immediate postoperative period and thus increase patient’s morbidity. Multiple mechanisms are involved in its’ etiology, one of them being the method of tissue incision. The aim of this study is to compare the early postoperative pain following incision with two different methods, scalpel and electrosurgery in the facial regions. Material and methods: Eighty patients with both benign and malignant skin lesions in the facial regions undergoing surgery were enrolled in this study. Patients were randomized in two groups. In group A, comprising 40 patients, cold steel surgical scalpel №15 was used for the surgical procedure. Electrosurgical microneedle with 0.06mm tip radius and generator unit KLS Martin Electrosurgical Unit ME MB 2 set on cutting mode, power 12 W was used for performing the surgery in group B including the same number of patients. After the surgery patients were given analgesics on their demand. The total number of on demand analgesics requirements was calculated. The patients were also asked to note the oral analgesics they were taking after being released from the hospital. Results: Results of this study showed a statistically significant difference between the groups in the analgesics demand on the day of the operation (p=0.041). On the day of the operation 52.5% patients in the scalpel group and only 30% of the patents of the electrosurgery group received analgesics on demand. In all other analysed time points, the patients in the scalpel group received analgesics more often than the patients in the microneedle group, but with no statistically confirmed difference between the groups (p>0.05). Even more significant is the fact that patients treated with electrosurgery that needed analgesics, had significantly bigger excision area median 471 (rank 283-589) compared to the patients treated with the conventional method 289 (rank 177-432) (p=0.016). Conclusion: In accordance with previous studies our results suggested a significantly reduced postoperative pain in the electrosurgery group.

scholarly journals Influence of maintaining apical patency in post-endodontic pain

2020 ◽  
Author(s):  
Snigdha Shubham ◽  
Manisha Nepal ◽  
Ravish Mishra ◽  
Kishor Dutta
Keyword(s):  
Postoperative Pain ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Preoperative Pain ◽  
Post Operative Pain ◽  
Number Of Patients ◽  
Significant Difference ◽  
Number Of Visits ◽  
Group B

Abstract Background The purpose of this study was to compare postoperative pain between apical patency and non-patency groups and to evaluate the influence of number of visits, vitality of teeth, group of teeth and preoperative pain on post-operative pain. Methods One hundred sixty patients were included in the study. Patients were randomly divided into: Group A (n = 80) contained apical patency maintaining group and Group B (n = 80) contained those treated without maintaining apical patency. Each group was subdivided into equal number of patients treated in single visit (n = 40) and multiple visits (n = 40), including vital (n = 20) and non-vital teeth (n = 20) and single- rooted teeth (n = 10) and multiple-rooted teeth (n = 10). Apical patency was maintained with a size 10 K-file during conventional hand filing step-back shaping procedure. Intensity of pain was recorded before treatment and on days 1, 2, and 7 after treatment using a numerical rating scale. Statistical analysis was done using Mann -Whitney U test and Spearman correlation. Results There was statistically significant difference (p < 0.05) in postoperative pain scores between the groups on 1st, 2nd and 7th day follow up. Postoperative pain in patency maintaining group was not influenced by number of visit and group of teeth treated. Whereas, vital teeth when patency was maintained in multiple visits root canal treatment post-operative pain was statistically significant (p = 0.02) in day 1 follow up. Pre-operative pain also influenced postoperative pain with statistically significant difference and positive correlation between the groups. Conclusions Our study concluded that maintenance of apical patency increased postoperative pain. Post-operative pain was not influenced by number of visits, and group of teeth. However, for patency group, vital tooth treated in multiple visits results in more postoperative in 1st day follow up. In addition, pre-operative pain also has influence on post-operative pain.

scholarly journals Comparison between scalpel incision and electrocautery incision in midline abdominal surgery: a comparative study

2021 ◽  
Vol 8 (5) ◽  
pp. 1507
Author(s):  
Amit Yadav ◽  
Lakshman Agarwal ◽  
Sumit A. Jain ◽  
Sanjay Kumawat ◽  
Sandeep Sharma
Keyword(s):  
Postoperative Pain ◽  
Blood Loss ◽  
Abdominal Surgery ◽  
Wound Infection ◽  
Skin Incision ◽  
P Value ◽  
Wound Area ◽  
Significant Difference ◽  
Group A ◽  
Group B

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.

The Effect of Combined Clopidogrel and Aspirin Therapy after Off-Pump Coronary Surgery

2009 ◽  
Vol 4 (5) ◽  
pp. 265-268 ◽  
Author(s):  
Emir Mujanovic ◽  
Midhat Nurkic ◽  
Jasmin Caluk ◽  
Ibrahim Terzic ◽  
Emir Kabil ◽  
...  
Keyword(s):  
Artery Bypass ◽  
Postoperative Bleeding ◽  
Median Sternotomy ◽  
Operation Time ◽  
Graft Patency ◽  
Off Pump ◽  
Number Of Patients ◽  
Significant Difference ◽  
Group A ◽  
Group B

Objective The purpose of this randomized study was to evaluate the effect on graft patency by adding clopidogrel to aspirin in off-pump coronary artery bypass (OPCAB) grafting and the possible side effects of such therapy. Methods Twenty patients who underwent standard OPCAB through median sternotomy were randomized immediately after surgery in two groups. Patients in group A (n = 10) received 100 mg of aspirin starting preoperatively, continuing indefinitely. Patients in group B received 100 mg of aspirin and, in addition, 75 mg of clopidogrel starting immediately after the operation and for 3 months. Postoperative bleeding and other perioperative parameters were compared. Angiography was repeated 3 months after surgery to determine the patency and quality of grafts. Results Preoperative risk factors were similar in the two groups. There was no significant difference in average number of distal anastomosis (P = 0.572), operation time (P = 0.686), postoperative bleeding (P = 0.256), ventilation time (P = 0.635), and intensive care unit stay (P = 0.065). Length of stay was shorter in group B (P = 0.024). There was no postoperative complication in either groups. Eight of 27 grafts in group A and 2 of 29 grafts in group B (P = 0.037) were occluded at the time of control angiography. Conclusions Early administration of a combined regimen of clopidogrel and aspirin after OPCAB grafting is not associated with increased postoperative bleeding or other major complications. Despite the small number of patients in this study and small number of examined grafts, the results suggest that the addition of clopidogrel may increase graft patency after OPCAB grafting.

scholarly journals Preoperative Anxiety and Postoperative Pain in Patients With Laparoscopic Hysterectomy

2021 ◽  
Vol 12 ◽  
Author(s):  
Lin Zhang ◽  
Li-Jun Hao ◽  
Xiao-Lai Hou ◽  
Ya-Ling Wu ◽  
Lu-Shi Jing ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Postoperative Analgesia ◽  
Rating Scale ◽  
Laparoscopic Hysterectomy ◽  
Preoperative Anxiety ◽  
Chinese Patients ◽  
Average Score ◽  
Significant Difference ◽  
Group A ◽  
Group B

Objective: This study was designed to investigate preoperative anxiety situations and postoperative pain degree in Chinese patients undergoing laparoscopic hysterectomy and to analyze the related factors of preoperative anxiety and the correlation between preoperative anxiety and postoperative pain to provide a reference for effective postoperative analgesia management.Methods: A total of 100 female patients undergoing laparoscopic hysterectomy were enrolled in this study and randomly divided into two groups (n = 50, each). In group A, the patients were treated with dexmedetomidine and sufentanil for postoperative analgesia. In group B, the patients were treated with sufentanil alone for postoperative analgesia. All patients were evaluated with a self-rating anxiety scale (SAS) 1 day before the operation. The patients’ pain was evaluated using the numerical rating scale (NRS) 1 day after the operation, and data were recorded.Results: In these 100 patients, the highest preoperative SAS score was 48, and the average score was 40.99 ± 4.55 points, which is higher than the norm in China. There were significant differences in preoperative SAS scores among patients with different occupations and previous surgical experience (P &lt; 0.05). There was no significant difference in SAS scores among patients with different education levels (P &gt; 0.05). The postoperative NRS score of group A was significantly higher than that of group B, and the difference was statistically significant (P &lt; 0.05). The correlation coefficients between SAS scores and NRS scores in groups A and B were 0.836 and 0.870, respectively, presenting with a significantly positive correlation.Conclusion: Preoperative anxiety is an important predictor of postoperative pain. Patients undergoing laparoscopic hysterectomy have preoperative anxiety. The degree of anxiety is influenced by the occupation and previous operation experience of the patients, and patients with higher preoperative anxiety have greater postoperative pain. In addition, we should not neglect the management of postoperative pain because of the small trauma of laparoscopic surgery, and dexmedetomidine combined with sufentanil can improve the postoperative analgesic effect.

scholarly journals 1379. Comparison of Inpatient Tuberculosis Screening Methods and Their Effect on Patient Duration in Airborne Isolation

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S501-S501
Author(s):  
Mary Katherine. Theoktisto ◽  
Delvina Ford ◽  
Omar Khan ◽  
Kelly R Reveles ◽  
Jose Cadena
Keyword(s):  
Statistical Significance ◽  
Nucleic Acid Amplification ◽  
Health Concern ◽  
Smear Microscopy ◽  
Screening Methods ◽  
Number Of Patients ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Crude Analysis

Abstract Background Tuberculosis (TB) remains a significant public health concern, and exposure in healthcare settings is prevalent. Current guidelines recommend testing for TB by acid-fast bacilli (AFB) smear microscopy with 3 sputum samples and/or using nucleic acid amplification test (NAAT), and mycobacterium culture. The purpose of this project is to compare how different TB diagnostic tests affect the duration of stay in respiratory isolation. Methods This study was conducted at the Veteran Affairs South Texas hospital, which includes a total of 437 beds. Data were collected retrospectively from medical records. Eligibility included patients admitted to the hospital and placed in airborne isolation for TB screening and diagnosis, had 3 sputum samples collected 8 hours apart and/or had 2 PCR MTB/RIF. Patients were excluded if they had TB or were not undergoing evaluation for TB. Three time periods analyzed included, 3 AFB sputum samples analyzed in-house from December 2012 to January 2014 (Group A), 3 AFB sputum samples analyzed at outside facility during 2013 to 2014 as well as 2 months in 2012 (Group B), and 2 MTB PCR/RIF in house during 2017 and 2018 (Group C). Duration of isolation was compared between groups using the Kruskal–Wallis test. A total number of 815 patients were screened, leaving 105 patients for analysis after exclusion. There were 49 patients analyzed from Group A, 28 from Group B, and 28 from Group C. Results Crude analysis of the data showed numerical differences in the total number of days and hours in isolation between the 3 groups. The average (mean) days in isolation were 4.2 for Group A, 7.4 for Group B, and 5.5 for Group C. There was no statistically significant difference in either days or hours of airborne precautions by “rule out” method. Days of isolation in airborne precautions (median IQR) was 4 for all groups (P = 0.3313). Likewise, hours of airborne precautions had a median IQR of 96 for all groups P = 0.4347. Conclusion Although there was no statistical significance between the groups, crude analysis did show a numerical difference in the mean total airborne days and hours. Lack of statistical difference may be due to low number of patients, timing of order placement for in-house PCR, and longer than expected stay in airborne precautions. Disclosures All authors: No reported disclosures.

Comparison of Alveolar Osteitis (AO) occurrence after impacted mandibular third molar removal with and without post-extraction socket irrigation

2021 ◽  
Vol 17 (3) ◽  
pp. 211-215
Author(s):  
Fatema Awan ◽  
Manahil Rahat ◽  
Muhammad Jamal ◽  
Saniya Sohail ◽  
Khalid Mahmood Siddiqi ◽  
...  
Keyword(s):  
Third Molar ◽  
Extraction Socket ◽  
Dry Socket ◽  
Number Of Patients ◽  
Mandibular Molar ◽  
Significant Difference ◽  
Alveolar Osteitis ◽  
Group A ◽  
Group B ◽  
Mandibular Third Molars

Objective: We wanted to see whether impacted third mandibular molar extractions resulted in Alveolar Osteitis if post-extraction socket irrigation was used or not. Methodology: A randomized control experiment on 70 patients study was conducted from July 2019 to January 2020 at Islamabad Dental Hospital's OMFS department. Patients presenting with the mandibular third molars fulfilling the inclusion criteria had their teeth extracted with and without socket irrigation using the computer lottery method. In cases of dry socket, clinical diagnosis was made between the 3rd, 5th, and 7th postoperative days. Results: 70 patients/sockets were evaluated with 35 having been irrigated and 35 non-irrigated. The age range was 16-50years with a mean of 29.49 and most patients were between the 16-35 age group. There were 48.6% males and 51.4% females. Dry Socket was evaluated on the 3rd, 5th, and 7th day between groups (A=irrigation, B=Non-irrigation). On the 3rd postop day, 14 (40%) patients in group A and 15(42.9%) patients were diagnosed as dry Sockets. A similar number of patients in both groups (20%) exhibited symptoms of dry socket on the fifth and seventh postoperative days, as did 5 (14.3 %) in group A, 3 (8.6 %) in group B, and 1(2.9 %t) in group A, all on the fifth postoperative day. Conclusion: On the third, fifth, and seventh postoperative days, there was no significant difference in the result of Alveolar Osteitis between the groups.

Clinical trial to assess role of ketamine in post operative analgesia after laparoscopic cholecystectomy

2021 ◽  
Vol 23 (05) ◽  
pp. 421-432
Author(s):  
Dr. Mohammad Kheiri Mahmod ◽  
◽  
Dr. Bashar Naser Hussein ◽  
Dr. Ammar Hamid Hanoosh ◽  
◽  
...  
Keyword(s):  
Clinical Trial ◽  
Laparoscopic Cholecystectomy ◽  
Postoperative Pain ◽  
Analgesic Effect ◽  
Analgesic Requirement ◽  
Pain Scores ◽  
Post Operative Pain ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: The physiological consequences of post-operative pain including Stress response to surgery, Respiratory complications, cardiovascular complications, Thromboembolic complications, Gastrointestinal complications, Musculoskeletal complications and Psychological complications, all of which could delay or impair postoperative recovery and increase the economic cost of surgery as a result of the longer period of hospitalization. Inadequate post-operative pain control may also lead to the development of chronic pain after surgery .Aim of This study: is to evaluate the preemptive analgesic effect of intravenous ketamine in laparoscopic cholecystectomy. Patients and Methods: double blinded randomized clinical trial conducted at Al-Yarmouk teaching hospital, over a period of one year from March 2013 to March 2014 on a total of 120 adult patients scheduled for elective laparoscopic cholecystectomy, Patients were divided in to three groups of 40 patients each, the study drug administered intravenously during induction. Groups A and B received ketamine in a dose of 1 and 0.5 mg/kg, respectively, whereas group C received isotonic saline. The degree of pain at rest and deep breathing postoperatively were estimated using VAS, time of first analgesic dose, total opioid consumption, nausea, vomiting and hallucination were recorded for 24 h postoperatively. Results: postoperative pain scores were significantly low in group A when compared with the other groups at most times in the first 24 hours. Highest pain score was in group C at 0 h. Postoperative analgesic consumption was minimum in group A then group B and highest in group C. There was little significant difference in the pain scores between groups B and C. Group A had a significantly higher blood MAP than group B at 0, 0.5 and 1 h. 7.5% incidence of hallucinations were in group A. Conclusion: According to this study we conclude that preemptive ketamine in a dose of 1 mg/kg has a definitive role in reducing postoperative pain and analgesic requirement in patients undergoing laparoscopic cholecystectomy. A low dose of 0.5 mg/kg had little significant in preemptive analgesic effect and in reducing analgesic requirement.

scholarly journals A randomised controlled trial of excision versus invagination in the management of indirect inguinal hernial sac

2019 ◽  
Vol 101 (2) ◽  
pp. 119-122
Author(s):  
M Sharma ◽  
OP Pathania ◽  
A Kapur ◽  
S Thomas ◽  
A Kumar
Keyword(s):  
Inguinal Hernia ◽  
Postoperative Pain ◽  
Testicular Atrophy ◽  
High Ligation ◽  
Indirect Inguinal Hernia ◽  
Tension Free ◽  
Hernial Sac ◽  
Significant Difference ◽  
Group A ◽  
Group B

Introduction Lichtenstein tension-free mesh hernioplasty of primary inguinal hernia is currently considered as the preferred method for the plastic reconstruction of inguinal hernia by the majority of surgeons. Several studies have examined the best way to manage the hernial sac in this surgery, but no consensus has been reached. This study was designed to compare the effects of excision of sac and invagination of sac on post-operative outcomes. Methods and methods This prospective randomised study included a total of 70 patients with primary unilateral uncomplicated indirect inguinal hernia. Group A (35 patients) underwent high dissection and invagination of the hernial sac and group B (35 patients) underwent high ligation and excision of the hernial sac. The repair of the posterior wall of the inguinal canal was done according to Lichtenstein tension-free technique. The primary outcome of this study was postoperative pain and secondary outcomes were wound infection, chronic sepsis, sinus formation, persistent pain, testicular atrophy and recurrence during the one-year follow-up period. Results There was a significant difference (P < 0.01) in pain experienced by the patients in the immediate post-operative period between the two groups; group A experienced less postoperative pain than group B. There was no significant difference in incidence of infection between the groups. Conclusions Invagination of the sac results in less postoperative pain compared with excision, with no significant difference in other postoperative outcomes.

Effectiveness of Antianxiety Drugs on Postoperative Pain Perception After Implant Placement: An In Vivo Study

2021 ◽  
Vol 12 (1) ◽  
pp. 144-152
Author(s):  
Minal Gopal Tulsani ◽  
Dhanraj Ganapathy ◽  
Divya Rupawat ◽  
Sanjana Devi
Keyword(s):  
Postoperative Pain ◽  
Analysis Of Variance ◽  
Pain Perception ◽  
Anxiety Level ◽  
In Vivo Study ◽  
Implant Placement ◽  
Significant Difference ◽  
Group A ◽  
Group B

Aim: To evaluate the effectiveness of midazolam and zolpidem on postoperative pain perception in patients undergoing implant placement. Materials and Methods: In the present in vivo study 60 patients undergoing implant placement were selected based on the inclusion criteria framed and were randomly allocated using sequentially numbered, opaque, and sealed envelope (SNOSE) method into 3 groups with 20 patients each after obtaining informed consent. Group A was the control group, Group B received midazolam 7.5 mg 30 minutes before the procedure. Group C received zolpidem 5 mg 30 minutes before the procedure. The anxiety level of patients was recorded using the Corah scale and postoperative pain was recorded after 2 hours of implant placement using the VAS scale. Statistical analysis was done using analysis of variance (ANOVA), one-way multivariate analysis of variance (one-way MANOVA), and then Tukey’s Honestly Significant Difference (HSD) test for comparison among groups at the 0.05 level of significance. Results: Group A had a mean anxiety level of 16 ± 1.451, Group B had a mean anxiety level of 11.2 ± 2.858, and Group C had a mean anxiety level of 13 ± 2.9019 and a statistically significant difference between the groups was observed ( P < .05). The mean for the postoperative pain perception for Group A was 6.8 ± 1.1965, for Group B was 3.8 ± 1.3611, and Group C was 5 ± 1.451 and a statistically significant difference between the groups was observed ( P < .05). Conclusion: This study concluded that both midazolam and zolpidem significantly reduced anxiety levels and postoperative pain in patients undergoing implant placement.

Therapeutic Efficacy of Calcium Hydroxide as an Intra Canal Dressing on Postoperative Reaction of Patients with Residual Pulpitis

2013 ◽  
Vol 749 ◽  
pp. 211-214
Author(s):  
Hui Xiao Yang
Keyword(s):  
Postoperative Pain ◽  
Calcium Hydroxide ◽  
Therapeutic Efficacy ◽  
Treatment Session ◽  
Chi Square ◽  
Anterior Teeth ◽  
Significant Difference ◽  
Chi Square Test ◽  
Group A ◽  
Group B

To evaluate the therapeutic efficacy of calcium hydroxide as an intra canal dressing on controlling postoperative pain and swelling in patients suffering from residual pulpitis. 118 patients with residual pulpitis in their anterior teeth participated in this study. These patients were randomly divided into two groups (group A and group B) of fifty-nine. All teeth were treated with root canal therapy with a two-visit approach. The patients in group A were treated with calcium hydroxide as an intra canal dressing , and in group B using formocresol as an intra canal dressing. All of the patients were followed up for 72 h after each treatment session. The postoperative incidence and severity of pain and swelling were recorded. The data were analyzed by chi-square test and variance analysis. After the first visit, the incidence and severity of pain and swelling showed to be higher in group B and lower in group A. These differences were statistically significant. After the second visit, the incidence and severity of pain and swelling showed to be still higher in group B and lower in group A. But there were no significant difference. Conclusion It is concluded that calcium hydroxide as an intra canal dressing could be effective to decrease the postoperative pain and swelling. It is recommended to use calcium hydroxide as an inter-appointment dressing in teeth with residual pulpitis.

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