Comparison of the preventive effect of ketamine, paracetamol and metoclopramide on postoperative pain intensity in general anesthesia: a double-blind clinical trial

Impacted and semi-impacted third molar surgery is a frequent dental procedure. Due to potentially major tissue manipulation during surgery, antibiotic prophylaxis may be indicated to prevent infection of the surgical wound. This study evaluated the surgical conditions of patients following extraction of impacted and semi-impacted third molars with or without prior antibiotic prophylaxis. Signs of infection and inflammation, postoperative pain level and efficacy of the prescribed drugs were recorded. This was a prospective, randomized, double blind clinical trial with split-mouth design. A total of 23 healthy (ASA I) volunteers with indication for bilateral mandibular third molar extraction were recruited, totaling 46 surgical procedures. One hour prior to the procedure, volunteers received 1g of amoxicillin or placebo and a drug for pain prevention and control. The surgical acts were performed by last-year dental students. Postoperative pain was assessed using a visual analogue scale and an 11-point box scale at selected postoperative intervals of 4 h, 12 h, and 24 h. After seven postoperative days, study volunteers were examined for clinical signs of infection and/or inflammation, such as pus, intra and extraoral swelling, trismus, heat, flushing and temperature change. There were only two cases of postoperative complications, one of intraoral edema (placebo group) and one of trismus (antibiotic prophylaxis group). There were no statistically significant differences for any of the indicative signs of infection. The pain scales revealed no differences between pain levels in both groups at all times evaluated, regardless of the pain scale used (P > 0.05). To conclude, the low infection rate observed in our study does not reflect any need for antibiotic prescription in systemically healthy patients. The adverse effects of antibiotics in addition to selection for resistant bacteria outweigh the benefits of antibiotic prophylaxis in healthy (ASA I) patients.

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The Effect of Adding Low-Dose Naloxone to Intrathecal Morphine on Postoperative Pain and Morphine Related Side Effects after Cesarean Section: A Double-Blind, Randomized, Clinical Trial

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2019.852 ◽

2019 ◽

Vol 7 (23) ◽

pp. 3979-3983 ◽

Cited By ~ 1

Author(s):

Saloumeh Peivandi ◽

Mohammad Reza Habibi ◽

Afshin Gholipour Baradari ◽

Abdolmajid Gholinataj ◽

Ali Habibi ◽

...

Keyword(s):

Clinical Trial ◽

Postoperative Pain ◽

Pain Intensity ◽

Spinal Anaesthesia ◽

Postoperative Nausea ◽

Low Dose ◽

Intrathecal Morphine ◽

Control Group ◽

Study Group ◽

Double Blind

BACKGROUND: Nowadays, spinal anaesthesia is a suitable choice for most elective and emergency cesarean section (C-section) deliveries. AIM: This study aimed to determine the effect of adding low-dose naloxone to intrathecal morphine on postoperative pain and morphine related side effects after C-section. MATERIAL AND METHODS: In the present double-blind, randomised clinical trial, 70 women aged over 18 years, who were candidates for elective medical C-section under spinal anaesthesia were selected and randomly assigned to either the study group or the control group. For spinal anaesthesia, 10 mg of Bupivacaine plus 100 μg of morphine was administered for all patients. However, patients in the study group received 20 µg of naloxone intrathecally; but the patients in the control group only received normal saline as a placebo. After surgery, patient-controlled analgesia (PCA) pump with paracetamol (Apotel®) was connected to each patient. The intensity of postoperative pain in the patients was evaluated and recorded using Visual Acuity Screening (VAS) at 2, 4, 6 and 24 hours after the surgery. The patients were also examined for postoperative nausea and pruritus. RESULTS: Regardless of the groups to which the patients were assigned, a significant difference in pain intensity was observed during the study period (time effect; p < 0.001). Although the intensity of pain was lower in the study group, the difference was not statistically significant (group effect; p = 0.84). Also, there was no group time interaction between pain intensity and the times studied (p = 0.61). The incidence rates of postoperative nausea and pruritus were significantly lower in the study group compared to the control group (p < 0.001). CONCLUSION: According to the results of this study, adding low dose naloxone to intrathecal morphine did not significantly change postoperative pain intensity in the patients undergone elective C-section using spinal anaesthesia; however, significantly decreased the severity of postoperative nausea and pruritus.

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Comparison of the effectiveness of fentanyl versus morphine for severe postoperative pain management. A randomized, double blind, clinical trial☆

Colombian Journal of Anesthesiology ◽

10.1097/01819236-201704000-00005 ◽

2017 ◽

Vol 45 (2) ◽

pp. 100-107

Author(s):

Adriana Cadavid-Puentes ◽

Francisco José Bermúdez-Guerrero ◽

Olga Giraldo-Salazar ◽

Fabio Muñoz-Zapata ◽

Juan Otálvaro-Henao ◽

...

Keyword(s):

Clinical Trial ◽

Pain Management ◽

Postoperative Pain ◽

Postoperative Pain Management ◽

Double Blind ◽

Double Blind Clinical Trial ◽

Severe Postoperative Pain

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Preventive Effect of Korean Red Ginseng for Acute Respiratory Illness: A Randomized and Double-Blind Clinical Trial

Journal of Korean Medical Science ◽

10.3346/jkms.2012.27.12.1472 ◽

2012 ◽

Vol 27 (12) ◽

pp. 1472 ◽

Cited By ~ 22

Author(s):

Chang-Seop Lee ◽

Ju-Hyung Lee ◽

Mira Oh ◽

Kyung-Min Choi ◽

Mi Ran Jeong ◽

...

Keyword(s):

Clinical Trial ◽

Respiratory Illness ◽

Acute Respiratory Illness ◽

Red Ginseng ◽

Preventive Effect ◽

Korean Red Ginseng ◽

Double Blind ◽

Double Blind Clinical Trial

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Interferential current and photobiomodulation in knee osteoarthritis: A randomized, placebo-controlled, double-blind clinical trial

Clinical Rehabilitation ◽

10.1177/02692155211012004 ◽

2021 ◽

pp. 026921552110120

Author(s):

Renata Alqualo-Costa ◽

Érika Patrícia Rampazo ◽

Gustavo Ribeiro Thome ◽

Mônica Rodrigues Perracini ◽

Richard Eloin Liebano

Keyword(s):

Clinical Trial ◽

Knee Osteoarthritis ◽

Pain Intensity ◽

Rating Scale ◽

Pain Modulation ◽

Double Blind ◽

Time Points ◽

Double Blind Clinical Trial ◽

Interferential Current

Objectives: To evaluate the effects of interferential current and photobiomodulation in patients with knee osteoarthritis. Design: A randomized, placebo-controlled, double-blind clinical trial. Setting: Physiotherapy Clinic of City University of São Paulo. Subjects: A total of 184 patients with knee osteoarthritis were recruited and, of these, 168 were included and randomized into four groups with 42 each: interferential current, photobiomodulation, interferential current plus photobiomodulation or placebo groups. One hundred and sixty-four patients completed the study. Intervention: Patients received 12 sessions (three times a week) of treatment: 30 minutes of interferential current (active or placebo) followed by photobiomodulation (active or placebo). Main measures: Primary outcome: pain intensity at rest and during movement (numeric rating scale) after 12 sessions. Secondary outcomes: functional capacity (Timed Up & Go and Sit and Lift tests and Lequesne and WOMAC questionnaires), pressure pain threshold, conditioned pain modulation, and muscle strength production (isokinetic evaluation). Patients were assessed at baseline, after 12 sessions, and three and six months after the end of the treatment. Results: Interferential current plus photobiomodulation reduced pain intensity at rest and during movement compared to placebo and interferential current at all time points ( P < 0.05). Photobiomodulation reduced pain intensity at rest compared to placebo at all time points ( P < 0.05) and compared to interferential current at six months follow-up ( P < 0.05). Photobiomodulation reduced pain intensity during movement compared to placebo at six months follow-up ( P < 0.05). Conclusion: Interferential current plus photobiomodulation or isolated photobiomodulation improve pain intensity in knee osteoarthritis.

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