Pregabalin As A Premedicant To Attenuate Pressor Response In Patients Undergoing Laparoscopic Cholecystectomy: A Prospective, Randomized, Double-Blind, Placebo-Controlled Study

2020 ◽  
Vol 11 (3) ◽  
pp. 3418-3423
Author(s):  
Sweety Agrawal ◽  
Shubdha Bhagat ◽  
Pratibha Deshmukh ◽  
Amol Singham
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Pressor Response ◽  
Controlled Study ◽  
Double Blind ◽  
Co2 Insufflation ◽  
Ramsay Sedation Scale ◽  
Minute Interval ◽  
Group A ◽  
Group B ◽  
Induction Of Anaesthesia

The present study was done to evaluate the ability of oral pregabalin to attenuate the pressor response to airway instrumentation in patients undergoing laparoscopic cholecystectomy under general anesthesia. Sixty-four adult patients aged between 25-55 year of either gender belonging to ASA-1 or ASA2 physical status weighing 50-70 kg were enrolled in this study. Thirty-two patients each were randomized to group A, or group B. Patients in group A received tablet Pregabalin (150mg) and those in group B received placebo orally one hour before induction of anaesthesia. Heart rate, blood pressure, and sedation were assessed preoperatively before giving the tablets and after 30 minutes, and just before induction of anaesthesia. Intraoperative, pulse rate, mean arterial pressure, ECG in the lead II, SPO2 and ETCO2 were monitored. All the above parameters were noted during laryngoscopy and intubation, 3 minutes after CO2 insufflation, and then at every 10-minute interval till the end of surgery. These parameters were also recorded after extubating the patient. The Ramsay sedation scale was used to assess the sedation at the baseline, one hour after drug intake , one hour after extubation and 4 hour after surgery. Any adverse effects in the postoperative period were recorded. The result of our study shows that pre-emptive administration of oral pregabalin 150 mg significantly reduced the pressor response at the time of laryngoscopy and intubation, after CO2 insufflation and just after extubation. We conclude that oral pregabalin premedication is effective in successful attenuation of hemodynamic pressor response to laryngoscopy, intubation and pneumoperitoneum in patients undergoing laparoscopic cholecystectomy

scholarly journals Effects of Dexmedetomidine on Intraoperative Hemodynamic Responses in Patients Undergoing Laparoscopic Cholecystectomy: A Randomised Double Blind Trial

2021 ◽  
Author(s):  
Dhanashree Dongare ◽  
Smita Gharde
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Base Line ◽  
Loading Dose ◽  
Double Blind Trial ◽  
Hemodynamic Responses ◽  
Double Blind ◽  
Significant Difference ◽  
Group A ◽  
American Society ◽  
Group B

Background: Dexmedetomidine is selective alpha 2 agonist with sedative sympatholytic, analgesic properties and is used as an anaesthetic adjuvant. We have evaluated the effect of dexmedetomidine on various hemodynamic responses to incidences such as laryngoscopy, endotracheal intubation, exubation and pneumoperitoneum in patients who were undergoing surgeries like laparoscopic cholecystectomy. We have used loading dose of 0.5mcg/kg of inj. Dexmedetomidine given over 10 minutes followed by infusion of a dose of 0.3mcg/kg/hour for the control of hemodynamic response to laparoscopy. Methods: Patient of either sex aged between 18-50 yrs, belongs to ASA I and II (AMERICAN SOCIETY OF ANAESTHESIOLOGY) posted for laparoscopic cholecystectomy were included. Institutional ethical committee clearance was obtained prior to study. After enrolment and valid written consent was taken. 60 patients were enrolled written valid informed consent was taken. Patients were divided into two groups 30 each with computerized randomization. Base line parameters were noted. Observer and patient was blinded for the content of syringe. Group A received injection dexmedetomidine and group B received bolus and infusion of normal saline at same rate. Routine general anaesthesia was instituted. Parameters were noted after induction, after intubation, after co2 insufflation, after 20 min, after 40 min, after co2 deflation, after extubation, after 1 and 2 hrs post-extubation. Results: Group A showed significantly less rise in HR and MAP than Group B. Requirement of intraoperative propofol was more in Group B. There was no significant difference for time taken to awakening in both groups. Conclusion: We found Injection Dexmedetomidine in given doses gave good hemodynamic control with minimal undesired effects during laparoscopy.

Evaluation of the Effect of Timolol Alone and in Combination with Hydrochlorothiazide and Amiloride in the Treatment of Mild to Moderate Arterial Hypertension: A Double-Blind, Controlled Study

1976 ◽  
Vol 51 (s3) ◽  
pp. 529s-531s ◽  
Author(s):  
G. Muiesan ◽  
B. Magnani ◽  
E. Agabiti-Rosei ◽  
C. Alicandri ◽  
E. Ambrosioni ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Side Effects ◽  
Moderate Essential Hypertension ◽  
Fixed Dose ◽  
Controlled Study ◽  
Double Blind ◽  
Combination Tablet ◽  
Group A ◽  
Group B

1. The effects of timolol alone and in combination with a fixed dose of hydrochlorothiazide and amiloride have been studied in a double-blind, controlled study in fifty-four patients with mild to moderate essential hypertension. 2. After a 4 weeks placebo period patients were randomly assigned to enter groups receiving timolol alone (group A), hydrochlorothiazide + amiloride (group B) or timolol + hydrochlorothiazide + amiloride (group C). Each treatment was carried out for 6 weeks. 3. The use of timolol (10 mg), hydrochlorothiazide (25 mg) and amiloride (2·5 mg) in a combination tablet given twice daily gave better control of blood pressure in patients with mild to moderate essential hypertension than did equivalent dosages of timolol alone or of hydrochlorothiazide and amiloride. 4. Clinical and laboratory side effects were minimal.

Role of a modified epigastric port in reducing post operative pain and causing early ambulation in a patient undergoing laparoscopic cholecystectomy as compared to a standard four port procedure, a randomized controlled study

2020 ◽  
Vol 7 (12) ◽  
pp. 3986
Author(s):  
Arijit Roy ◽  
Pramatha Nath Datta ◽  
Kushankur Guha
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Recovery ◽  
Controlled Study ◽  
Post Operative Pain ◽  
Quality Life ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
To Receive ◽  
Better Than

Background: Standard four port laparoscopic cholecystectomy is the gold standard in the treatment of gall stones. Modified epigastric port laparoscopic cholecystectomy may be considered an alternative, as this procedure maintains the advantages of four ports and does not require any special set of instruments. In this study we aimed to see whether this procedure is comparable to the standard four port laparoscopic cholecystectomy based on the primary objectives of postoperative pain score, degree of ambulation, time to return to normal activities.Methods: Consecutive patients due to undergo laparoscopic cholecystectomy, meeting all the predefined criteria were recruited into the study. The group A was assigned to receive intervention in the form of modified epigastric port laparoscopic cholecystectomy. The group B was assigned to receive intervention in the form of standard four port laparoscopic cholecystectomy. Patients in group A were compared with patients in group B based on multiple pre-defined parameters.Results: Pain scores were significantly better in group A. Degree of ambulation at was significantly better in group A. In respect to the time to resumption of normal activities there was no significant difference between the two groups. When comparing the quality life at 1 month following surgery with SF-36 health survey, the patients in group A did better than patients in group B with respect to the six scales. Conclusions: Modified epigastric port laparoscopic cholecystectomy appears to be significantly better than the standard four port cholecystectomy in terms of postoperative recovery.

Acupuncture for Diagnostic Fiberoptic Bronchoscopy: A Prospective, Randomized, Placebo-Controlled Study

2006 ◽  
Vol 34 (03) ◽  
pp. 409-415 ◽  
Author(s):  
Luca Cabrini ◽  
Luigi Gioia ◽  
Marco Gemma ◽  
Giulio Melloni ◽  
Angelo Carretta ◽  
...  
Keyword(s):  
Fiberoptic Bronchoscopy ◽  
Sham Acupuncture ◽  
Controlled Study ◽  
Double Blind Study ◽  
Patient Anxiety ◽  
Double Blind ◽  
Before And After ◽  
Routine Basis ◽  
Group A ◽  
Group B

Patients usually fear fiberoptic bronchoscopy (FBS) and they report a low level of satisfaction after this examination. We evaluated the efficacy of acupuncture in decreasing patient anxiety before diagnostic FBS and in improving tolerance to the examination. In a prospective double-blind study, we enrolled 48 patients scheduled to undergo diagnostic FBS. Patients were randomly assigned to one of three groups. Group A (16 patients): standard FBS, with airway topic anesthesia; Group B (16 patients): standard FBS, with airway topic anesthesia and acupuncture treatment; Group C (16 patients): standard FBS, with airway topic anesthesia and sham acupuncture. EKG, non-invasive arterial pressure, and pulse oximetry were monitored on a routine basis. We evaluated patient anxiety before and after acupuncture and, at the end of FBS, the discomfort suffered during the examination by a 100-mm Visual Analog Scale (VAS). Patient satisfaction in Group A was 50% worse than in Group B ( p = 0.04). We observed a strong, even if not statistically significant, tendency toward a lower pre-FBS anxiety in Group B. Patients in group C had values very close to those recorded in group A. We observed no adverse event and no differences in cardio-respiratory parameters in these three groups; in particular, we did not observe a respiratory depression in Group B. Acupuncture seems an effective resource for a Thoracic Endoscopic Room to improve patient tolerance to FBS.

XP-828L in the Treatment of Mild to Moderate Psoriasis: Randomized, Double-Blind, Placebo-Controlled Study

2006 ◽  
Vol 10 (5) ◽  
pp. 241-248 ◽  
Author(s):  
Yves Poulin ◽  
Robert Bissonnette ◽  
Christina Juneau ◽  
Kim Cantin ◽  
Rejean Drouin ◽  
...  
Keyword(s):  
Severity Index ◽  
Controlled Study ◽  
Open Label ◽  
Double Blind ◽  
Open Label Study ◽  
Double Blind Placebo ◽  
Sweet Whey ◽  
Severity Index Score ◽  
Group A ◽  
Group B

Background: XP-828L, a protein extract obtained from sweet whey, has demonstrated potential benefit for the treatment of mild to moderate psoriasis in an open-label study. Objective: To study in a randomized, double-blind, placebo-controlled study the safety and efficacy of XP-828L in the treatment of mild to moderate psoriasis. Design: XP-828L 5 g/d (group A, n = 42) or placebo (group B, n = 42) was given orally for 56 days followed by XP-828L 5 g/d in group A and by XP-828L 10 g/d in group B for an additional 56 days. Results: Patients receiving XP-828L 5 g/d for 56 days had an improved Physician's Global Assessment (PGA) score compared with patients under placebo ( p < .05). Considering the data of group A only, the PGA score improved from day 1 to day 56 ( p < .01); the Psoriasis Area and Severity Index score improved as well, but to a lesser extent ( p < .05). Conclusion: Oral administration of 5 g/d XP-828L compared with a placebo significantly improved the PGA score of patients with mild to moderate psoriasis.

scholarly journals Efficacy of green jackfruit flour as a medical nutrition therapy replacing rice or wheat in patients with type 2 diabetes mellitus: a randomized, double-blind, placebo-controlled study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
A. Gopal Rao ◽  
K. Sunil Naik ◽  
A. G. Unnikrishnan ◽  
James Joseph
Keyword(s):  
Diabetes Mellitus ◽  
Nutrition Therapy ◽  
Controlled Study ◽  
Medical Nutrition Therapy ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Group A ◽  
Group B ◽  
Medical Nutrition

Abstract Background/Objectives Medical nutrition therapy along with pharmacological interventions as a multidisciplinary approach is required to treat type 2 diabetes mellitus (T2DM). This study evaluated the efficacy of Jackfruit365™ green jackfruit flour as an integral part of daily meal in patients with T2DM. Subjects/Methods This was a randomized, double-blind, placebo-controlled study conducted between May 2019 and February 2020. Patients of either sex aged ≥18 to ≤60 years with a diagnosis of T2DM for >1 year receiving oral antihyperglycemic agents were randomized (1:1) to receive either jackfruit flour 30 g/day (Group A) or placebo flour (Group B) (breakfast and dinner) daily for 12 weeks replacing an equal volume of rice or wheat flour. The primary endpoint was a mean change in glycosylated hemoglobin (HbA1c). Other endpoints were mean changes in fasting plasma glucose (FPG), postprandial plasma glucose (PPG), lipid profile, and body weight. The independent t-test was used to compare changes between the groups. Results A total of 40 patients were enrolled (n = 20 each). A significantly higher reduction in HbA1c was observed in Group A compared to Group B from baseline to week 12 [−2.73 mmol/mol (−0.25%) vs. 0.22 mmol/mol (0.02%), p = 0.006]. The mean change in FPG and PPG was significantly higher in Group A than that of Group B (p = 0.043 and p = 0.001). The continuous glucose monitoring showed decreasing mean blood glucose in 7 days of administration of jackfruit flour meal. Conclusion Patients from Group A had a significantly higher reduction in HbA1c, FPG, and PPG than Group B demonstrating the efficacy of jackfruit flour in glycemic control as medical nutrition therapy replacing an equal volume of rice or wheat flour in daily meal. Clinical trial registry CTRI/2019/05/019417.

scholarly journals Emergency Laparoscopic Cholecystectomy with Low Pressure Pneumo-Peritoneum in Cardiopulmonary Risk Patients: Fundus-Calot Cholecystectomy VS Calot first Cholecystectomy. Randomized Controlled Trial.

2020 ◽  
Author(s):  
Tamer A.A.M Habeeb ◽  
Gamal Osman ◽  
Amr Ibrahim ◽  
Mohamed Riad ◽  
Abd-Elrahman M. Metwalli ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Low Pressure ◽  
Controlled Study ◽  
Open Approach ◽  
Randomized Controlled ◽  
Bladder Diseases ◽  
Risk Patients ◽  
Group A ◽  
Group B

Abstract Background:The numbers of elderly persons have greatly increased worldwide due to improvement of medical health. Elderly complains of cardiopulmonary diseases and the incidence of emergent gall bladder diseases increase with age. Laparoscopic cholecystectomy is the usual approach in dealing with cholithiasis that greatly replace open approach even in acute emergency gall bladder diseases.Aim: compare between initial Fundus first cholecystectomy followed by Calot dissection VS Calot first cholecystectomy in Emergency laparoscopic cholecystectomy with low pressure pneumo-peritoneum in cardiopulmonary risk patients as regard intraoperative data and postoperative complications.Patients and methods:This prospective randomized controlled study was carried out in the Department of Emergency General Surgery on 470 cases with acute cholecystitis, biliary colic, mucocele and pyocele of gall bladder. The patients were divided into two groups, Group A: fundus-Calot group (235cases) and Group B (235cases): classical Calot first approach.ResultsIn most cases of group A, the operating time was up to 90 minutes, while in group B, most cases were more than 90 minutes. Intraoperative bleeding, visceral injury and biliary injury were higher in group B than in group A and therefore the conversion was higher in group B than in group A (14% vs. 4%). Postoperative sequelae were reported to be greater than in group B in regard to bleeding, biliary leakage and wound infections. Remote complications were more pronounced for biliary restrictions in Group B (14%) than in Group A (2%)Conclusion:Laparoscopic low-pressure pneumoperitoneum cholecystectomy with initial Fundus first method is an excellent and safe approach in treating acute gallbladder diseases in cardiopulmonary risk patients.

scholarly journals Prevention of Hypertension at Intubation: A Controlled Study of Sublingual Nifedipine

2020 ◽  
Vol 2 (1) ◽  
pp. 37-40
Author(s):  
Nirmal Kumar Gyawali
Keyword(s):  
Controlled Study ◽  
Control Group ◽  
Double Blind ◽  
Inhalation Anesthesia ◽  
Randomized Controlled ◽  
Sublingual Nifedipine ◽  
Group A ◽  
Prevention Of Hypertension ◽  
Group B ◽  
Adrenergic Blocking

Background: Hypertension and tachycardia-induced after laryngoscopy and intubation can be prevented by various methods like deep inhalation anesthesia, intravenous opioids, topical intravenous lidocaine, intravenous adrenergic blocking drugs, and pretreatment with antihypertensive.Methods: It is a randomized controlled double-blind prospective study of two groups consisting of 30 patients in each group. Group A was the control group and group B were Nifedipine group who were pretreated with Nifedipine. This study aimed to assess the effectiveness of pretreatment with nifedipine in the prevention of the hypertensive response to laryngoscopy and endotracheal intubation in normotensive patients undergoing elective surgery.Result: Sublingual nifedipine was significantly effective in decreasing systolic and diastolic blood pressure produced by laryngoscopy and tracheal intubation, but its role in decreasing pulse rate was not significant. Conclusion: Nifedipine is useful to prevent laryngoscopy and intubation induced hemodynamic response.

scholarly journals A Comparative Study on the Efficacy of Kantkari and Vasa Lozenges in Children with Kasa (Cough)-Study Protocol

2021 ◽  
pp. 25-33
Author(s):  
Sabir Ali ◽  
Renu Rathi ◽  
Bharat Rathi
Keyword(s):  
Comparative Study ◽  
Controlled Study ◽  
Control Group ◽  
Double Blind ◽  
Abnormal Sound ◽  
Sequence Method ◽  
Group A ◽  
Objective Outcomes ◽  
Group B

Background: Kasa is the outcome due to release of obstructed Vayu resulting in the production of abnormal sound, which may be productive or dry. Kasa is one of the primary diseases of Pranavaha srotas, and can cause disturbances in other body functions. Prevalence of cough in India is 5% to 10% while acute cases of cough is 39% and chronic cases of cough is 29% reported in Maharashtra. This research drug is taken to check its efficacy on both the types of cough, dry as well as productive with acute or chronic origin. It has a good palatability and liked by children as it appears as candy. Many studies have been carried out on Kasa with different formulations so far like vati, churna, ghrita but they have no fast and long lasting action with different level of efficacy. Many lozenges are also available in the market but no studies have been done. Objective: Comparative Study on the efficacy of Kantakari lozenges with Vasa lozenges in the clinical features of Kasa by subjective criteria such as Peenasa-(running nose), Kasa, Aruchi-(taste impliedness), kanthkandu(throat itching), kaphnishthivan (Sputum) and objective criteria as adventitious sound and AEC-absolute eosinophil count, TLC-total leucocytes count, and DLC-differential leucocyte count. Materials and Methods: The present study is designed as a Double Blind, Randomized Controlled Study in which total 60 patients will be enrolled. Patients will be randomly divided (by computer generated sequence method) in two with 30 patients in each group. In group A, Vasa lozenges and in group B Kantkari lozenges will be given for 7 days. Assessment of the patients will be done on 3rd and 7th day during study after intervention and post treatment follow up will be taken on 14th& 21st day from the enrolled date. Results: Efficacy of both the lozenges will be observed in subjective and objective outcomes. Conclusion: Kantkari lozenges (trial group) is expected to be more effective than Vasa lozenges (control group) in the management of Kasa as Vata, Kapha are more dominant in the pathology of Kasa in children and Kantakari is a good Vatakaphahar drug added with Pippali to act synergistically.

scholarly journals Design of the Tocilizumab in Giant Cell Arteritis Trial

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
Sebastian H. Unizony ◽  
Bhaskar Dasgupta ◽  
Elena Fisheleva ◽  
Lucy Rowell ◽  
Georg Schett ◽  
...  
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Treatment Phase ◽  
Controlled Study ◽  
Sustained Remission ◽  
Open Label ◽  
Double Blind ◽  
Open Label Extension ◽  
Group A ◽  
Group B

Overview. The GiACTA trial is a multicenter, randomized, double-blind, and placebo-controlled study designed to test the ability of tocilizumab (TCZ), an interleukin (IL)-6 receptor antagonist, to maintain disease remission in patients with giant cell arteritis (GCA).Design. Approximately 100 centers will enroll 250 patients with active disease. The trial consists of a 52-week blinded treatment phase followed by 104 weeks of open-label extension. Patients will be randomized into one of four groups. Group A (TCZ 162 mg weekly plus a 6-month prednisone-taper); group B (TCZ 162 mg every other week plus a 6-month prednisone-taper); group C (placebo plus a 6-month prednisone-taper); and group D (placebo plus a 12-month prednisone taper). We hypothesize that patients assigned to TCZ in addition to a 6-month prednisone course are more likely to achieve the primary efficacy endpoint of sustained remission (SR) at 52 weeks compared with those assigned to a 6-month prednisone course alone, thus potentially minimizing the long-term adverse effects of corticosteroids.Conclusion. GiACTA will test the hypothesis that interference with IL-6 signaling exerts a beneficial effect on patients with GCA. The objective of this paper is to describe the design of the trial and address major issues related to its development.

Sign in / Sign up

Export Citation Format

Share Document