scholarly journals Comparison of analgesic effect of peritonsillar infiltration with bupivacaine versus bupivacaine-dexamethasone in children undergoing tonsillectomy.

2020 ◽  
Vol 27 (07) ◽  
pp. 1377-1381
Author(s):  
Humaira Ahmad ◽  
Asif Sagheer ◽  
Muhammad Saleem ◽  
Khansa Tariq ◽  
Samina Aslam ◽  
...  

Objective: To compare analgesic effect of peritonsillar infiltration with bupivacaine versus bupivacaine-dexamethasone in children undergoing tonsillectomy. Study Design: Randomized Control study. Setting: Aziz Fatimah Hospital, Faisalabad. Period: 01-03-2018 to 31-12-2018. Material & Methods: 80 patients were enrolled in the clinical study using non-probability consecutive sampling technique. They were divided into two groups, before start of surgery group BD received peritonsillar infiltration of bupivacaine and dexamethasone combination, whereas group B received local infiltration of bupivacaine only. Primary outcome measures were pain score recorded immediately after recovery of patient (0 hour) and at 2, 6, 12 and 24 hours after surgery and requirement for analgesia postoperatively. Other parameters recorded were time to first oral intake and sleep pattern over 24 hours. Results: Mean pain scores in group BD were 0.075, 0.225, 1.675, 0.75, 0.275 and in1 group B were 0.65, 0.975, 2.95, 1.5, 0.95 at 0, 2, 6, 12, 24 hours postoperatively respectively. 92.5% patients in group BD and & 57.5% in group B had good sleep whereas 7.5% in group BD and 42.5% in group B had disturbed sleep. 6 patients in BD group and 26 in B group required analgesia. Conclusion: Our study concluded that infiltration of tonsillar fossa with bupivacaine – dexamethasone prior to the start of surgery provides better postoperative analgesia, early start of oral intake, less rescue analgesic requirements and better sleep pattern.

2021 ◽  
Vol 23 (05) ◽  
pp. 421-432
Author(s):  
Dr. Mohammad Kheiri Mahmod ◽  
◽  
Dr. Bashar Naser Hussein ◽  
Dr. Ammar Hamid Hanoosh ◽  
◽  
...  

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.


2021 ◽  
Vol 9 (10) ◽  
pp. 1136-1143
Author(s):  
Alshehri a ◽  
◽  
Ali Abdullah A. ◽  

Introduction Septorhinoplasty operates on cartilage and bone of the nose and is ensued by severe postoperative pain. The objective of this study is to evaluate effects of preoperative administration of intravenous (IV) paracetamol and ibuprofen on postoperative pain scores in patients undergoing septorhinoplasty. Methodology 150 patients undergoing septorhinoplasty were randomly assigned into three groups with 50 patients in each group. The control group (Group A) was administered 100 ml saline solution, paracetamol group (Group B) was administered 1000 mg IV paracetamol in 100 ml saline and ibuprofen group (Group C) was administered 800 mg IV ibuprofen in 100 ml saline before surgery. Opioid analgesics were employed to achieve postoperative analgesia. Postoperative pain was evaluated using Visual Analogue Scale (VAS). Postoperative opioid consumption and adverse effects were also recorded for each patient. Results In comparison with Group A, VAS in Group B and Group C was statistically lower in all the time intervals (p<0.05). In 1st and 6th hours postoperatively, VAS in Group C was lower than Group B (p<0.05). In control group, total opioid consumption was highest in all time intervals (p<0.05). In Group C, total opioid consumption was significantly lower than Group B at 0-6 and 6-12 hours interval. (p<0.05). Conclusion- Single-dose pre-emptive administration of ibuprofen has more profound postoperative analgesic effect than paracetamol during first 6 hours in septorhinoplasty. After first 6 hours of the procedure, there is no difference in analgesic effect between ibuprofen and paracetamol.


2018 ◽  
Vol 7 (1) ◽  
pp. 35-41
Author(s):  
Muhammad Usman Khan ◽  
Ghazala Noor Nizami ◽  
Ali Farhad

OBJECTIVE To compare the effectiveness of mobilization and self-exercises in the management of adhesive capsulitis of shoulder STUDY DESIGN Randomized Control Trial SAMPLE SELECTION 30 patients of adhesive capsulitis of shoulder from physiotherapy department of tertiary care hospitals of Karachi were selected through simple random sampling technique. PROCEDURE Treatment was continued for 5 days per week for the period of 3 weeks followed by assessment. Patients were randomly divided into two equal groups. Group A was treated with midrange mobilization while group B performed self-exercises. Both groups received TENS and hot pack prior to the exercises. Mean ± SD, frequencies and percentages were used for descriptive analysis. ROM via goniometry and pain intensity through VAS was analyzed by paired t-test within the groups and by independent t-test between the groups, using SPSS. P-value of less than 0.05 was considered significant. RESULTS 60% were females (n=18) and 40% were males (n=12) with mean age of 50.17±6.37 years. Significant improvement (p-value <0.05) in pain and shoulder ROM was observed among patients of Group A as compared to Group B. Pain intensity was decreased to 1.67 ± 0.62 in group A, whereas ROMs in these patients were also better than other group.


2019 ◽  
Vol 10 (1) ◽  
Author(s):  
Nathália Carolina Tomazelli Crespo ◽  
Rosimere Ferreira Santana ◽  
Valdecyr Herdy Alves ◽  
Audrey Vidal Pereira ◽  
Giovanna Rosario Soanno Marchiori ◽  
...  

Objetivo: conhecer o perfil de Diagnósticos de Enfermagem em mulheres nutrizes atendidas no Banco de Leite Humano. Metodologia: estudo descritivo, com 30 mulheres atendidas no Banco de Leite Humano entre doadoras e não doadoras. Os dados foram coletados nos meses de março a maio de 2012. A análise se deu por meio de estatística descritiva. Resultados: os diagnósticos foram descritos para dois grupos: Não doadoras: Disposição para conhecimento melhorado (100,0%), Risco de infecção (80,9%), Integridade Tissular prejudicada (80,9%), Padrão de sono prejudicado (76,1%), Conhecimento deficiente (66,6%), Ansiedade (52,3%); Em Doadoras: Padrão de sono prejudicado (77,7%) e Ansiedade (55,5%). Conclusão: a taxonomia diagnóstica encontra-se de acordo com a população estudada. Validou-se a necessidade do uso dessa tecnologia como um sistema padrão de linguagem.Descritores: Bancos de leite; Diagnóstico de enfermagem; Cuidados de enfermagem; Saúde da mulher; Aleitamento materno.NURSING DIAGNOSIS IDENTIFIED IN WOMEN AT THE HUMAN MILK BANKObjective: to know the profile of Nursing Diagnosis in women hosted in the Human Milk Bank. Methodology: descriptive study, with 30 women attended at the Human Milk Bank between donors and no donors. Data were collected from March to May 2012. The analysis was done through simple descriptive statistics. Results: diagnosis were described for two groups: No donors: Readiness for enhanced knowledge (100.0%), Risk for infection (80.9%), Impaired tissue integrity (80.9%), Disturbed sleep pattern (76.1%), Deficient knowledge (66.6%), Anxiety (52.3%); In Donors: Disturbed sleep pattern (77.7%) and Anxiety (55.5%). Conclusion: the diagnostic taxonomy is in agreement with the studied population. The need to use this technology as a standard language system was validated.Descriptors: Milk banks; Nursing diagnosis; Nursing care; Women’s health; Breastfeeding.ENFERMERÍA DE DIAGNÓSTICO IDENTIFICADOS EN MUJERES ASISTIDA EN BANCO DE LECHE HUMANAObjetivo: conocer el perfil de los diagnósticos de enfermería de las mujeres dio la bienvenida al Banco de Leche Humana. Metodology: estúdio descriptivo, con 30 mujeres atendidas enel Banco de Leche Humana entre los donantes y no donantes. Los datos fueron recolectados entre marzo y mayo de 2012. El análisis se realizó utilizando estadísticas descriptivas simples. Resultados: los diagnósticos han sido descritos por dos grupos: No donantes: Disposición para mejorar los conocimientos (100%), Riesgo de infección (80,9%), Deterioro de la integridade cutánea (80,9%), Trastorno del patrón de sueño (76, 1%), Conocimientos deficientes (66,6%), Ansiedad (52,3%); Em Donantes: Trastorno del patrón de sueño (77,7%) y Ansiedad (55,5%). Conclusión: la taxonomía diagnóstica es función de la población estudiada. Han verificado la necesidad de la utilización de esta tecnología como un sistema estándar de lenguaje.Descriptores: Bancos de leche; Diagnóstico de enfermería; Atención de enfermería; Salud de lamujer; Lactancia materna.


2007 ◽  
Vol 122 (6) ◽  
pp. 603-608 ◽  
Author(s):  
S Elwany ◽  
Y A Nour ◽  
E A Magdy

AbstractIntroduction:Laryngopharyngeal reflux is increasingly being implicated in several otolaryngological disorders.Aims:To study a potential correlation between pre-operative laryngopharyngeal reflux and wound healing and recovery after tonsillectomy, based on subjective and objective findings.Materials and methods:A prospective, blinded study was undertaken, including 60 patients scheduled for tonsillectomy, divided into two equal groups: a study group (group A) with pre-operative laryngopharyngeal reflux documented using ambulatory 24-hour pH monitoring; and a control group (group B) without laryngopharyngeal reflux.Results:Group A had significantly higher pain scores on the seventh and 14th post-operative days (p = 0.022 and p = 0.000, respectively) and took a significantly longer time to return to normal eating (p = 0.013), compared with group B. Group A also showed significantly slower healing on the seventh and 14th post-operative days, as estimated by assessing the grade of post-operative slough formation (p = 0.016 and p = 0.029, respectively). A significant correlation between the number of pharyngeal reflux episodes and the degree of post-operative slough was also found.Conclusions:Laryngopharyngeal reflux can significantly decrease wound healing following tonsillectomy. Therefore, pre-operative recognition and management of this condition is desirable in order to eliminate its negative post-operative effect.


Author(s):  
Rekiku Fikre ◽  
Samuel Ejeta ◽  
Taye Gari ◽  
Akalewold Alemayhu

Abstract Background Globally over 2.6 million pregnancy ends with stillbirth annually. Despite this fact, only a few sherds of evidence were available about factors associated with stillbirth in Ethiopia. Therefore, the study aimed to spot factors related to stillbirth among women who gave birth at Hawassa University Comprehensive Specialized Hospital Hawassa, Sidama Ethiopia, 2019. Methods Facility-based unmatched case-control study was conducted at Hawassa University Comprehensive Specialized Hospital. Cases were selected using simple random sampling technique and controls were recruited to the study consecutively after every case selection with case to control ratio of 1 to 3. Data were coded and entered into Epi-data version 3.1 and exported to SPSS version 24 for analysis. Results A total of 106 cases and 318 controls were included in the study. Number of antenatal care visit [AOR = 0.38, 95% CI (0.15, 0.95)], lack of partograph utilization [AOR = 4.1 95% CI (2.04, 10.5)], prolonged labor [AOR = 6.5, 95% CI (2.9, 14.4)], obstructed labor [AOR = 3.5, 95% CI (1.5, 9.4)], and congenital defect [AOR = 9.7, 95% CI (4.08, 23.0)] were significantly associated with stillbirth. Conclusion Absence of partograph utilization, prolonged labor, obstructed labor, antepartum hemorrhage and congenital anomaly were found to have positive association with stillbirth.


2021 ◽  
Vol 15 (8) ◽  
pp. 1788-1789
Author(s):  
Tazeen Kohari ◽  
Farah Malik ◽  
Aftab Ahmad

Background: The histology of Cerebellar gray matter consists of a middle Purkinje cells layer with flask shaped Purkinje cells. The field of Neurology has documented that different organic compounds and metals are lethal to the excitatory Purkinje Neurons. Researches have proved Lithium to be hazardous to nervous tissue and especially Cerebellum For the past sixty years Lithium is the favorable drug for treatment of Bipolar Disorder. Aim: To Analyse and record the changes of decrement of the size of Purkinje cell Diameter after chronic Lithium ingestion. Methods: Sixteen albino rats were selected and were treated with lithium for a period of fifteen days and the data for changes in Purkinje cells Diameter was observed. Results: The Observations of Our study showed highly significantly decreased diameter of the Purinje cells in Group B (Lithium Carbonate) animals as compared to Group A Animals which were on Lab Diet Conclusion: The Morphometric Data proved that Lithium Carbonate is Toxic to Purkinje cells, and it educated our Population to use Lithium with caution. Keywords: Purkinje cell Diameter, Gray matter, Hazardous


2021 ◽  
pp. 039156032110481
Author(s):  
Abhishek Chandna ◽  
Santosh Kumar ◽  
Kalpesh M Parmar ◽  
Aditya P Sharma ◽  
Sudheer K Devana ◽  
...  

Background: The present study aims to assess the efficacy of mirabegron, a novel beta-3 agonist for ameliorating stent related symptoms (SRSs) as compared to tamsulosin and solifenacin. Methods: Total of 150 patients undergoing ureteral stent placement following ureteroscopic lithotripsy, percutaneous nephrolithotomy, or laparoscopic/robotic pyeloplasty were randomized in 1:1:1 fashion to receive mirabegron 50 mg (group A), solifenacin 5 mg (group B), and tamsulosin 0.4 mg (group C) OD respectively. Patients were followed at POD10 (I visit), 4 weeks (II visit) after surgery, and 2 weeks post-stent removal. Validated vernacular version of ureteric stent symptoms questionnaire (USSQ) was administered to the patients at each visit. Results: Out of 150 patients randomized, 123 patients (A; n = 41, B; n = 40, and C; n = 42) completed the study. The groups were comparable in terms of urinary index score of USSQ at I and II visits ( p = 0.119 and 0.076, respectively). A lower proportion of patients in group B experiencing bodily pain at II visit ( p = 0.039), however, pain scores were comparable. Significantly lower general health index scores were observed in group A at I visit and over 4 weeks ( p = 0.007). No significant differences were observed in other domains of USSQ. Age, sex, and surgical procedure undertaken did not significantly impact the scores in various USSQ domains. Conclusion: Mirabegron demonstrates comparable benefit in alleviating SRSs with better general health indices and may be an effective alternative for SRSs, especially when tamsulosin or solifenacin are contra-indicated or poorly tolerated.


2017 ◽  
Vol 99 (6) ◽  
pp. 485-489 ◽  
Author(s):  
F Basak ◽  
M Hasbahceci ◽  
A Sisik ◽  
A Acar ◽  
Y Ozel ◽  
...  

INTRODUCTION Postoperative pain after laparoscopic cholecystectomy has three components: parietal, visceral and referred pain felt at the shoulder. Visceral peritoneal injury on the liver (Glisson’s capsule) during cauterisation sometimes occurs as an unavoidable complication of the operation. Its effect on postoperative pain has not been quantified. In this study, we aimed to evaluate the association between Glisson’s capsule injury and postoperative pain following laparoscopic cholecystectomy. METHODS The study was a prospective case–control of planned standard laparoscopic cholecystectomy with standardized anaesthesia protocol in patients with benign gallbladder disease. Visual analogue scale (VAS) abdominal pain scores were noted at 2 and 24 hours after the operation. One surgical team performed the operations. Operative videos were recorded and examined later by another team to detect presence of Glisson’s capsule cauterisation. Eighty-one patients were enrolled into the study. After examination of the operative videos, 46 patients with visceral peritoneal injury were included in the study group, and the remaining 35 formed the control group. RESULTS VAS pain score at postoperative 2 and 24 hours was significantly higher in the study group than control (P = 0.027 and 0.017, respectively). CONCLUSIONS Glisson’s capsule cauterisation in laparoscopic cholecystectomy is associated with increased postoperative pain. Additional efforts are recommended to prevent unintentional cauterisation.


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