scholarly journals LAPAROSCOPIC CHOLECYSTECTOMY

2018 ◽  
Vol 21 (04) ◽  
pp. 593-600
Author(s):  
Ayaz Gul ◽  
Imtiaz Khan ◽  
Ahmad Faraz ◽  
Irum Sabir Ali

Introduction: Laparoscopic cholecystectomy is the treatment of choice forsymptomatic cholelithiasis. Intraperitoneal instillation of bupivacaine is one of the methods usedto improve pain relief after laparoscopic cholecystectomy. Objective: To compare the mean painscore after intraperitoneal instillation of bupivacaine with placebo during laparoscopiccholecystectomy. Study Design: Randomized Control trial. Setting: This study was carried out asurgical unit PGMI Lady Reading Hospital and Hayatabad Medical Complex, Peshawar.Duration: The duration of study was 6 months from 15th May to 15th December, 2013. Subjectsand Methods: 92 patients in each group were included in study to compare the mean pain scoreof intraperitoneal instillation of bupivacaine (Group A; study group) with 0.9% normal salinesolution (Group B; placebo group) using visual analogue scale after laparoscopiccholecystectomy at 12th hour after surgery. Data was entered in software SPSS version 16.0. Ttest was used to compare the mean pain scores. Results: The mean age of patients in Group Aand B was 41.82 ± 7.34 and 40.95 ± 9.24 respectively (p=0.483). Group A has low mean painscore (3.619 ± 0.676) according to Visual Analogue Scale then Group B (3.837 ± 0.667) with astatistically significant p value (p=0.036). A t test failed to reveal a statistically reliable differencebetween gender (p=0.513) and age (p=0.767) wise distribution of mean pain between group Aand B. Conclusions: Mean pain score of intraperitoneal instillation of bupivacaine is significantlyless than 0.9% normal saline solution at 12th hour after laparoscopic cholecystectomy.

2018 ◽  
Vol 63 (No. 6) ◽  
pp. 279-286
Author(s):  
SY Heo ◽  
SJ Kim ◽  
NS Kim

The purpose of this prospective double blind clinical study was to evaluate the analgesic efficacy of meloxicam with/without a buprenorphine patch for pain management after ovariohysterectomy in cats. Cats were randomly divided into two groups: ten cats were treated with meloxicam s.c. after ovariohysterectomy (Group A), and eight cats were treated with s.c. meloxicam and a 20 µg/h buprenorphine transdermal patch (Group B). For patch treatment, the cat’s hair was clipped on the left side in the thoracic area. Pain scores were assessed at 0.5, 1, 2, 4, 6, 8, 24 and 30 h post-ovariohysterectomy extubation. To evaluate postoperative pain, 4A-VET pain scale and visual analogue scale pain scores were used. In addition, blood was collected from all cats to determine the cortisol levels at –2 h and at 0.5, 4, 6 and 24 h after extubation. The 4A-VET scores for Group B were significantly lower at 1, 4, 6, 8, 24 and 30 h than the scores for Group A. The visual analogue scale pain scores for Group B were significantly lower at 4, 6, 24 and 30 h than the scores for Group A. Serum cortisol concentrations were not significantly different between Groups A and B at any of the measured intervals. There was a significant positive correlation between postoperative visual analogue scale and 4A-VET pain scores in both groups. Our results should be subject to careful interpretation as the study was limited by its small sample size and by observer subjectivity.


2017 ◽  
Vol 24 (09) ◽  
pp. 1331-1335
Author(s):  
Khalid Hussain ◽  
Maria Tarique ◽  
Attiq ur Rehman Khan ◽  
Asim Bukhari ◽  
Bilal Akhter ◽  
...  

Objectives: To compare Tamsulosin versus ESWL for lower ureteric stonesexpulsion. Study Design: Randomized controlled trial. Setting: Outpatient Department ofUrology at Services Hospital, Lahore. Period: January 2015 to December 2015. Material& Methods: Total 50 patients were enrolled in study. Patients were divided into 2 groups.In group A, 25 patients received daily oral treatment of 0.4mg Tamsulosin for 28 days, andin group B, 25 patients were treated with ESWL. A stone-free condition, was defined as thecomplete absence of any stone based on plain abdominal X-rays observed and during followupvisits at the time of treatment of stone was noted. Results: The mean age of the patientswere recorded as 33.20±9.23 years. There were 40(80%) males and 10(20%) females with maleto female ratio of 4:1. Out of 50 patients, 16(32%) presented with hematuria, 3(6%) had feverwhile 31(62%) appeared with no complication status. Out of 50 patients, 21(42%) presentedwith expulsion time 08-14 days in which 14(28%) were from tamsulosin group and 07(14%)were from ESWL group, similarly 19(38%) patients appeared with expulsion time of 15-28 daysin which 10(20%) were from tamsulosin group and 09(18%) were from ESWL group. Statisticallythere is insignificant difference between the groups i.e. p-value=0.28 Ns. Conclusion: Thisstudy suggests that the tamsulosin helps in the earlier clearance of stone fragments andreduces the complications as compared to ESWL.


2019 ◽  
Vol 26 (07) ◽  
pp. 1197-1202
Author(s):  
Hajra Shuja ◽  
Mehmood Ali Shah ◽  
Sadaf Bokhari

Background: Laparoscopic cholecystectomy is a standard treatment for cholelithiasis. It is a safe and effective treatment in many cases. General anesthesia has a high incidence for PONV. But anti-emetic drugs can help in preventing PONV. Objectives: To compare the efficacy of ondansetron and metoclopramide in patients undergoing laparoscopic cholecystectomy under general anesthesia. Study Design: Randomized controlled trial. Setting: Department of Anaesthesia, Sheikh Zayed Hospital, Lahore. Period: 6 months i.e. from 15-2-2017 to 15-8-2017. Material & Methods: The patients were divided into two groups. Ondansetron was given to group A patients within 15 minutes of induction, and metoclopramide to group B patients within 15 minutes of induction. Then patients were shifted to the ward after surgery and followed-up for 24 hours for assessment of PONV. All the data was entered and analyzed on SPSS version 20. Results: The mean age of patients in group A was 38.40±12.07 years and in group B was 42.63±11.77 years. The efficacy achieved in 53 were from group A and 39 were from group B Statistically significant difference was found between the study groups i.e. p-value=0.003. Conclusion: Ondansetron showed significantly better efficacy than metoclopramide in preventing PONV after laparoscopic cholecystectomy under general anesthesia.


2019 ◽  
Vol 26 (07) ◽  
pp. 1057-1061
Author(s):  
Dr. Hafiz Salman Saeed ◽  
Farhad Alam ◽  
Muhammad Yousaf ◽  
Iqra Fayyaz

The objective of this study was to compare the mean residual pain after cemented versus uncemented hemiarthroplasty of hip. Study Design: Randomized Controlled Trial. Setting: Orthopaedic Department, Allied Hospital, Faisalabad. Period: September 2016 to October 2017. Materials and Methods: Total 150 patients were admitted in orthopedic Department of Allied Hospital Faisalabad according to inclusion & exclusion criteria. After taking informed written consent, all patients were divided into two groups randomly. Cementedhemiarthroplasty was done in Group A patients and uncemented hemiarthroplasty was done in group B patient. All procedures were done by surgeon who has minimum 5yrs post fellowship experience. Monthly Follow up was done and residual pain was noticed at the end of 6th month. All the data was analyzed by using SPSS version 20.0. Results: In this study, in Group-A the patients between 65-75 years of age were 57.33% (n=43) and between 76-85 of age were 42.67% (n=32). In Group B the patients between 65-75 years of age were 56%(n=42) and between 76-85 years were 44% (n=33). The mean+sd was calculated and it is 73.49+4.99 years in Group-A patients and 73.73+4.74 years in Group-B patients. In Group A, males were 61.33% (n=46) and female were 38.67% (n=29). In Group B, males were 57.33% (n=43) and female were 42.67% (n=32). When we compared the residual pain after cemented versus uncemented hemiarthroplasty of the hip, it shows 1.69+0.35 in Group-A patients and 2.62+0.30 in Group-B patients. When we calculated p-value it was 0.0001 showing a significantdifference. Conclusion: It is concluded that residual pain in cemented hemiarthroplasty is lower than uncemented hemiarthroplasty. 


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.


Author(s):  
Dr. Sara Sultana ◽  
Dr. Braj Nandan Kumar Sah

Objectives: This present study was done to compare the tolerability and efficacy of tramadol versus aceclofenac in terms of WOMAC Osteoarthritis Index and Visual Analogue Scale of patients with osteoarthritis of knee joint. Methods: A detail history, clinical examinations and relevant investigations were performed to all cases of osteoarthritis of knee joint. Group A patients were advised to receive tramadol 75 mg twice daily for 8 weeks, and group B patients were advised to receive aceclofenac 100 mg twice daily for 8 weeks. And we had evaluated the WOMAC Osteoarthritis Index and VAS score of first day and last day visit of patients with osteoarthritis of knee joint. Results: Data was analyzed by using SPSS (version 26) software. Paired sample statistical methods were used. Mean and standard deviation was observed and mean differences were compared. P value was taken less than or equal to 0.05 (p≤0.05) for significant differences. Conclusions: This present study concluded that the WOMAC Osteoarthritis Index score and VAS score of patients who had received aceclofenac medication had statistically significant differences as well as greater mean differences than patients who received tramadol. Hence, aceclofenac is effective drugs than tramadol in terms of efficacy and tolerability of patients with osteoarthritis of knee joint. Key words: Osteoarthritis of knee, WOMAC osteoarthritis index, Visual Analogue Scale.


2019 ◽  
Vol 12 (2) ◽  
pp. 925-929
Author(s):  
Zaffar Abbas ◽  
Amina Bashir ◽  
Zaffar Abbas

The aim of this study is to determine the effect of preoperative use of gabapentin on postoperative pain in patients undergoing laparoscopic cholecystectomy. Sixty adult patients listed for laparoscopic cholecystectomy were randomly allocated to two groups of 30 each to receive gabapentin 600 mg p.o. or a matching placebo 2 hours before surgery. Postoperative pain was monitored using 100 mm visual analogue scale (0 for no pain and 100 for worst imaginable pain) at 1, 2, 6, 12 and 24 hours. Diclofenac 75 mg IM was used as rescue analgesic and total analgesic requirement (mg/24hr) in first 24 hours following surgery was recorded. Postoperative pain scores and total analgesic requirement was significantly less in gabapentin group compared to placebo group. A single 600 mg dose of gabapentin given preoperatively decreased postoperative pain and total analgesic requirement following laparoscopic cholecystectomy. Preemptive use of gabapentin can be used to treat postoperative pain caused by laparoscopic cholecystectomy.


2018 ◽  
Vol 09 (01) ◽  
pp. 53-56
Author(s):  
Jamshed Ahmed ◽  
Syed Abrar Ali ◽  
Rizwan Jouhar ◽  
Haroon Shah

Objective: To compare the mean reduction in pain scores between Bonding agent (GLUMA® Comfort® Bond+ Desensitizer, and Fluoride varnish. Methodology: The study was conducted at Operative Dentistry, Department at Altamash Institute of Dental Medicine, Karachi from July 2015 to August 2016. Total 152 patients were selected. Patients were randomly allocated into two groups A and B. Gluma comfort bond plus desensitizer® was applied to the patients in group A and Duraphet® was applied to the patients in group B. Initial assessment was done after the application of the above products and thermal test was performed. The outcomes were based on a Visual Analogue Scale (VAS). Re-Evaluation was done again after 30 days of treatment in terms of mean reduction in pain from baseline by applying thermal test on visual analogue scale. Results: The average age of the patients was 37.4 ±8.38 years. After 30 days, mean Visual Analog Scale was significantly low in Group A i.e. 2.95±0.0.86 as compared to Group B i.e. 4.01±0.79(p=0.0005). Significant more reduction in mean pain score was observed in Bonding agent (Gluma desensitizer) as compared to Fluoride varnish Duraphat. Conclusion: In our study we found that bonding agent ( Gluma Desensitizer) is more effective in treating Dentine Hypersensitivity compared to fluoride varnish (Duraphat desensitizer group).


2019 ◽  
Vol 6 (5) ◽  
pp. 1716
Author(s):  
Anurag Bijalwan ◽  
Pradeep Singhal ◽  
Syed Altamash

Background: Post-operative adequate analgesia plays an important role in early mobilization, short hospital stay and patient satisfaction in laparoscopic cholecystectomy. The use of opioids for providing postoperative analgesia has been marked by side effects like vomiting, nausea, sedation, respiratory distress, etc. hence, alternate drugs like paracetamol (PCM) and diclofenac are commonly used. In this study, we have compared the analgesic efficacy and any associated side effects of the two commonly used non-opioid NSAIDS namely paracetamol and diclofenac.Methods: We compared 50 patients undergoing laparoscopic cholecystectomy in ASA I and II. They were randomly divided into two groups, Group A and Group B. Group A was administered intravenous PCM and Group B was administered injection diclofenac sodium. Postoperatively, these patients were assessed for pain, blood pressure, respiratory rate, and presence of any side effects like nausea, vomiting or any respiratory discomfort.Results: The mean DBP, MAP and VAS score was significantly (p-value <0.05) in Group A as compared to Group B patients at 4, 8, 12 and 24 hours postoperatively. There was no statistically significant difference in mean SBP and O2 saturation in both groups. The mean pulse rate was lower in Group A as compared to Group B at 8, 12 and 24 hours.Conclusions: This study concluded that postoperative PCM infusion provided better analgesia for a prolonged period of time with minimal side effects. 


2021 ◽  
Vol 71 (4) ◽  
pp. 1360-63
Author(s):  
Ramish Tariq ◽  
Omer Sefvan Janjua ◽  
Sana Mehmood ◽  
Muhammad Usman Khalid ◽  
Khurram Jah Zafar ◽  
...  

Objective: To compare the effectiveness of Carbamazepine versus Topiramate for the management of trigeminal neuralgia. Study Design: Comparative prospective study. Place and Duration of Study: Oral and Maxillofacial Surgery department, Allied Hospital, Faisalabad Pakistan, from Nov 2017 to Nov 2018. Methodology: A total of 60 patients (30 in each group) were included. Group A was treated with Carbamazepine 100mg TDS and group B with Topiramate 25mg TDS. Visual analogue scale was used to access pain and was calculated at 1st visit (baseline), at 7th day, at 14th day and at 28th day. Results: Out of 60 patients, mean of age was 54.78 ± 8.49 years. Right and left side of the face was involved in 41 (68.3%) and 19 (31.7%) patients respectively. Maxillary branch was involved in 24 (40%) and mandibular branch was involved in 36 (60%) patients. The mean of visual analogue scale after 7 days in group A was 4.53 ± 0.93 and in group B was 7.1 ± 1.07, after 14 days mean of visual analogue scale in group A was 3.7 ± 1.02 and in group B was 4.03 ± 1.27. Mean of visual analogue scale after 28 days in group A was 3.27 ± 1.01 3.93 ± 1.28. The results were statistically significant with p-value of 0.03. Conclusion: Topiramate has comparable efficacy as that of Carbamazepine at dose of 75-100mg with lesser side effects. So Topiramate can be used as first line of treatment in trigeminal neuralgia.


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