The effect of local tramadol infiltration in post pyelolithotomy pain.

Objective: To compare the analgesic efficacy of tramadol wound infiltration with normal saline wound infiltration in patients undergoing Pyelolithotomy. Study Design: Randomized Controlled Trial. Setting: Department of Anesthesia, ICU and Pain Medicine, DG Khan Teaching Hospital, Dera Ghazi Khan. Period: July 2019 to September 2019. Material & Methods: Total 60 patients were included in this study. There were 30 patients in whom normal saline was used for wound infiltration and in other 30 patients tramadol was used for wound infiltration. Analgesic outcomes were noted in terms of Numerical Rating Scale (NRS) of pain in the recovery room, at 06 hours and 24 hours after surgery, mean time of first rescue analgesia and total dose of tramadol within 24 hours after surgery. Results: Mean pain score in the recovery room was 5.20±2.10 in saline group versus 2.60±1.13 in tramadol group (p<0.001). Mean post-operative pain score after 06 hours of surgery was 5.43±1.45 in saline group versus 2.30±1.05 in tramadol group (p<0.001). Pain score was 3.63±1.40 in saline group versus 1.67±0.80 in tramadol group after 24 hours of surgery (p<0.001). Mean time of first rescue analgesia was 6.16±2.47hours in tramadol group versus 0.97±1.46hours in saline group (p<0.001). Total dose of tramadol used for analgesia within 24 hours after surgery was 56.67±70.38mg in tramadol group versus 253.33±73.02mg in saline group (p<0.001). Conclusion: Wound infiltration with tramadol provides better analgesia as compared to normal saline in patients undergoing Pyelolithotomy.

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DEXMEDETOMIDINE REDUCES AGITATION AND PROVIDES SMOOTH EXTUBATION AFTER PAEDIATRIC ADENOTONSILLECTOMY

10.36106/ijsr/6018820 ◽

2020 ◽

pp. 1-5

Author(s):

Mehak Gul ◽

Umar Nisar Shah ◽

Mohd Rafi Denthoo ◽

Basharat Ahad

Keyword(s):

Pain Score ◽

Normal Saline ◽

Pediatric Patients ◽

Tracheal Extubation ◽

Sevoflurane Anesthesia ◽

Emergence Agitation ◽

Rescue Analgesia ◽

Extubation Time ◽

Operative Recovery ◽

Post Operative Nausea

OBJECTIVES : To study the role of dexmedetomidine on emergence agitation and its effect on extubation in paediatric adenotonsillectomy. Our study involves the assessment of postoperative pain by Objective Pain Scale and need for rescue analgesia and other untoward events in PACU. The study also included the comparision of post operative recovery time by Modified Aldrete Recovery Score using dexmedetomidine and normal saline in adenotonsillectomy for pediatric patients. METHODS : After induction of general anesthesia patient was put on controlled ventilation and maintained on sevoflurane 1.5-2% with 66% O2 and 33% N2O. At the end of surgery patients received either dexmedetomidine or normal saline over a period of 5 minutes, sevoﬂurane and nitrous oxide were discontinued, and residual muscle relaxation was reversed. Tracheal extubation time (time from anesthetic gas discontinue to tracheal extubation) and emergence time (time from anesthetic gas discontinue to eye opening on command) were recorded. Incidence of untoward airway events after extubation were also noted. The subject’s postoperative behaviour was assessed using Pediatric Anesthesia Emergence Delirium (PAED). In PACU, the intensity of pain was assessed by using an observational pain score (OPS). Any untoward events were noted and patient was shifted as per modified PACU score. RESULTS: In this randomized comparative study, single dose of dexmedetomidine (0.5mcg/kg) was found to be associated with a statistically significant decrease in the incidence of emergence agitation along with smooth extubation in pediatric patients undergoing adenotonsillectomy with sevoflurane anesthesia. In addition, lower incidence of post-operative nausea and vomiting, lower pain score and shorter duration of stay in post-anesthesia care unit were observed. Although it was seen that the extubation was prolonged in the dexmedetomidine group in comparison to the placebo. CONCLUSION: Dexmedetomidine reduces emergence agitation and provides smooth extubation in pediatric adenotonsillectomy patients on sevoflurane anesthesia.

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The Effect of Subtenons Lidocaine on Emergence Agitation after General Anesthesia in Pediatric Strabismus Surgery

European Scientific Journal ESJ ◽

10.19044/esj.2016.v12n6p48 ◽

2016 ◽

Vol 12 (6) ◽

pp. 48

Author(s):

Agolli. L ◽

Shuteriqi. B

Keyword(s):

General Anesthesia ◽

Normal Saline ◽

Recovery Room ◽

Eye Contact ◽

Saline Group ◽

Strabismus Surgery ◽

Emergence Agitation ◽

Surrounding Environment ◽

Lidocaine Injection ◽

In The Beginning

Objectives: To study the effect of subtenon lidocaine injection at the end of intervention on the post-operative emergence agitation in pediatric strabismus surgery under general anesthesia with sevofluran. Material: We studied 191 children patients undergoing muscle surgery for strabismus from 2-6 years old. Children were (prospectively) randomized to one of the four groups. These groups include: A –Group Sevofluran fentanyl; B –Group sevoflurane fentanyl, Subtenon lidocaine injection; C – Group Propofol, fentanyl, sevofluran; and D – Group Propofol, fentanyl, Sevoflurane, Subtenon lidocaine injection. In the beginning of the induction of anesthesia, children received dexametasone and metoclopropamide. At the end of the surgery, children received either lidocaine (2%) or normal saline (1ml) into the subtenons space. This was conducted on the recovery room using five scoring scale. These scale include: 1- the child makes eye contact, 2- Purposeful response after repeated stimuli, 3 – the child is aware of the surrounding environment, 4- severe restlessness, and 5 – The child is inconsolable. The degree of emergence agitation was observed. Furthermore, the score 4 and 5 was considered as an emergence agitation. Results: There are no differences regarding age and weight. The incidence of emergence agitation was significantly lower in the groups which were receiving subtenon lidocaine compared with saline group injections (p< 0.05). Conclusions: A lidocaine injection into subtenon space reduces the emergence agitation after general anesthesia in pediatric strabismus surgery.

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Effect of Low-Dose (Single-Dose) Magnesium Sulfate on Postoperative Analgesia in Hysterectomy Patients Receiving Balanced General Anesthesia

Anesthesiology Research and Practice ◽

10.1155/2015/306145 ◽

2015 ◽

Vol 2015 ◽

pp. 1-6 ◽

Cited By ~ 4

Author(s):

Arman Taheri ◽

Katayoun Haryalchi ◽

Mandana Mansour Ghanaie ◽

Neda Habibi Arejan

Keyword(s):

Single Dose ◽

Postoperative Pain ◽

General Anesthesia ◽

Magnesium Sulfate ◽

Pain Score ◽

Normal Saline ◽

Low Dose ◽

Rating Scale ◽

Controlled Trial ◽

Control Group

Background and Aim. Aparallel, randomized, double blinded, placebo-controlled trial study was designed to assess the efficacy of single low dose of intravenous magnesium sulfate on post-total abdominal hysterectomy (TAH) pain relief under balanced general anesthesia.Subject and Methods. Forty women undergoing TAH surgery were assigned to two magnesium sulfate (N=20) and normal saline (N=20) groups randomly. The magnesium group received magnesium sulfate 50 mg·kg−1in 100 mL of normal saline solution i.v as single-dose, just 15 minutes before induction of anesthesia whereas patients in control group received 100 mL of 0.9% sodium chloride solution at the same time. The same balanced general anesthesia was induced for two groups. Pethidine consumption was recorded over 24 hours precisely as postoperative analgesic. Pain score was evaluated with Numeric Rating Scale (NRS) at 0, 6, 12, and 24 hours after the surgeries.Results. Postoperative pain score was lower in magnesium group at 6, 12, and 24 hours after the operations significantly (P<0.05).Pethidinerequirement was significantly lower in magnesium group throughout 24 hours after the surgeries (P=0.0001).Conclusion. Single dose of magnesium sulfate during balanced general anesthesia could be considered as effective and safe method to reduce postoperative pain and opioid consumption after TAH.

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Comparative Evaluation of Tramadol Wound Infiltration over Bupivacaine for Postoperative Analgesia in Children Undergoing Inguinal Herniotomy and Orchidopexy

JMS SKIMS ◽

10.33883/jms.v14i2.83 ◽

2011 ◽

Vol 14 (2) ◽

pp. 52-55

Author(s):

Abdul Qayoom Lone ◽

Nazia Nazir ◽

Shehnaz Gilani ◽

Mohammad Ommid ◽

Showkat H Nengroo ◽

...

Keyword(s):

Saline Group ◽

Good Choice ◽

Controlled Study ◽

Wound Infiltration ◽

Rescue Analgesia ◽

Post Operative Pain ◽

Elective Repair ◽

Group A ◽

Group B ◽

Inguinal Herniotomy

BACKGROUND: Recent clinical studies have demonstrated that children experience a similar severity of post operative pain as adults and that even preterm infants demonstrate alterations in heart rate, blood pressure and oxygen saturation in response to pain. OBJECTIVE: To study the advantage of tramadol wound infiltration over bupivacaine on post operative pain relief in children following inguinal herniotomy and orchiodopexy METHODS: In this prospective single blinded randomized controlled study, 705 children aged between 1–7 years undergoing elective repair of unilateral inguinal hernia and orchiodopexy were randomly divided into 3 groups of 25 each. Group A (Tramadol) à wound infiltration with 2mg/Kg Tramadol in 0.2ml/Kg saline, Group B (Bupivacaine) à wound infiltration with 0.2ml/Kg of 0.25% of Bupivacaine and Group C (Tramadol i/m) à 2mg/Kg tramadol intra muscularly 20 minutes before the end of surgery. Children were assessed post-anesthesia for pain score and discharged from Post Anesthesia Care Unit when they achieved a score of 10. RESULTS: Group A had lower pain scores than group B and C for the first 24 hours in the postoperative period. The other two parameters pulse rate and respiratory rate were also lower in group A. Moreover use of rescue analgesia was significantly lower in group A. CONCLUSION: Wound infiltration with tramadol is a good choice for post operative analgesia in children undergoing inguinal herniotomy and orchidopexy. JMS 2011;14(2):52-55

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Effect of Low Dose Ketamine on Propofol Injection Pain: A Double-Blind Clinical Trial

KYAMC Journal ◽

10.3329/kyamcj.v11i2.48423 ◽

2020 ◽

Vol 11 (2) ◽

pp. 96-99

Author(s):

Muhammad Sazzad Hossain ◽

Md Afzalur Rahman ◽

Syed Ariful Islam ◽

Sanzida Munira ◽

Mohammad Iftakhairul Hasan ◽

...

Keyword(s):

General Anesthesia ◽

Normal Saline ◽

Low Dose ◽

Group Versus ◽

Saline Group ◽

Injection Pain ◽

Double Blind ◽

Group I ◽

Double Blind Clinical Trial ◽

Elective Surgical Procedure

Background: Propofol, most frequently used intravenous anesthetic for induction of routine elective surgical procedure. Pain on propofol injection (POPI) still remains a considerable concern for the anesthesiologist. A number of techniques has been tried to minimize propofol-induced pain with variable results. Objective: This study was performed to determine the effect of ketamine on reducing pain on propofol injection (POPI) at the onset of anesthesia. Materials and Methods: A total of 80 adult healthy patients were selected in this study of either sex, scheduled for routine elective ENT surgery under general anesthesia. The patients enrolled were divided randomly into two groups of 40 patients each. Group I (ketamine group) received 10 mg intravenous ketamine in 10 ml normal saline. Group II (placebo group) received 10 ml of 0.9% intravenous normal saline. Then the patients were induced with propofol and asked to report their pain during injection of propofol and recorded according to the Mc Cririck and Hunter scale. Results: The incidence of pain experienced in ketamine group was 10% patients and in saline group was 60% patients, which is statistically significant p<0.05. The severity of POPI was also lower in ketamine group than the saline group (p<0.05). The incidence of mild and moderate pain in ketamine group versus saline group was 7.5% versus 45% and 2.5% versus 15% respectively p<0.05. There was no severe pain recorded in any groups. Conclusion:Intravenous ketamine in low dose before induction of general anesthesia can be effective medication in reducing pain on propofol injection. KYAMC Journal Vol. 11, No.-2, July 2020, Page 96-99

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Comparing the Effect of Dexamethasone, Normal Saline, and Metoclopramide on Prevention of Postoperative Nausea, Vomiting and Pain in Patient Undergoing Laparoscopic Cholecystectomy or Open Appendectomy: A Randomized Clinical Trial

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2020.4095 ◽

2020 ◽

Vol 8 (B) ◽

pp. 139-144

Author(s):

Mohanad Y. Al-Radeef ◽

Sattar J. Abood ◽

Waleed K. Abdulsahib ◽

Salah O. Hamad

Keyword(s):

Laparoscopic Cholecystectomy ◽

Pain Score ◽

Normal Saline ◽

Open Appendectomy ◽

Saline Group ◽

Significant Difference ◽

Group 3 ◽

Group 2 ◽

Lower Pain Score ◽

Group 1

BACKGROUND: Post-operative nausea and vomiting (PONV) and pain are a common complications of adult patients undergoing anesthesia, but the incidence of these complications in patients go through laparoscopic cholecystectomy or open appendectomy is unknown. AIM: We conduct this study for comparing the effect of dexamethasone administration with normal saline and with metoclopramide for reducing these undesirable effects. DESIGN: This was a three-armed, parallel-group, double-blind, and randomized controlled clinical trial. METHODS: Seventy-two patients of both genders underwent elective surgeries (laparoscopic cholecystectomy or open appendectomy), randomly assigned to three groups: A dexamethasone-treated (8 mg) group (Group 1) (n = 24), normal saline-treated (100 ml) group (Group 2) (n = 24), and metoclopramide-treated (10 mg) group (Group 3) (n = 24). All nausea, vomiting, and pain episodes were recorded during 24 h after anesthesia in three time periods: 0–4, 4–12, and 12–24 h post-anesthesia. Results: Nausea and vomiting grading scale shows no significant difference when compare dexamethasone (Group 1) with normal saline (Group 2), significant difference when compare dexamethasone (Group 1) with metoclopramide (Group 3), and also significant difference when compare normal saline (Group 2) with metoclopramide (Group 3). Group 1 showed a lower pain score (p < 0.01 and p < 0.0001) compared with pain score recorded by patients of Groups 2 and 3, respectively. Besides that, Group 2 also showed a lower pain score (p < 0.0001) compared with pain score recorded by Group 3 patients. CONCLUSION: Dexamethasone has unimportant effect when compare with normal saline, more effectiveness than metoclopramide in reducing PONV. However, dexamethasone more effective in reducing pain when comparing with normal saline and metoclopramide for patients they underwent laparoscopic cholecystectomy or open appendectomy surgery under general anesthesia.

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Comparison of post-tonsillectomy pain by using tramadol, lignocaine with adrenaline and normal saline swab in tonsillar fossae.

The Professional Medical Journal ◽

10.29309/tpmj/2021.28.08.6606 ◽

2021 ◽

Vol 28 (08) ◽

pp. 1206-1210

Author(s):

Tahir Hussain Khan ◽

◽

Ashfaq Hussain Rana ◽

Mohammad Afzal ◽

Farooq Bhutta ◽

...

Keyword(s):

Pain Score ◽

Normal Saline ◽

Pain Control ◽

Sampling Technique ◽

Saline Group ◽

Post Operative Pain ◽

Control Versus ◽

Group 3 ◽

Group 2 ◽

Group 1

Objective: To compare the effects of pain by using tramadol, lignocaine 2% with adrenaline and normal saline (placebo) after tonsillectomy. Study Design: Randomized Controls Trial. Setting: Department of ENT, Social Security Landhi Hospital Karachi. Period: March 2019 to October 2019. Sampling Technique: Non probability. Material & Methods: One hundred and twenty (120) patients with ASA-I status, age between 12 to 22 years were included randomly for this study. Divided the patients into three groups, group-1(L), group-2(T) and group-3(S) and forty (40) patients were in each group. In group-1(L), Lignocaine 2% with adrenaline used. In group-2 (T), Tramadol used and in group-3 (S), normal saline swab (placebo) used in tonsillar fossae at the end of tonsillectomies. Pain assessment done after 30 minutes in PACU and every one hourly for 6 hours post operatively in ward. If recorded VAS for pain was more than 5 analgesic injection given in ward for pain control. Result: The result of our research revealed that there were no significant differences in the mean ages of the patients, weight of patients, sex distribution and the duration of surgeries among the all three groups. Post-operative pain score were significantly higher in (S) group than in the other two groups (p<0.05). In Group-1(L) and Group-2 (T) pain score had non-significant (p>0.05). Duration of first analgesic demand was longer in Group-L and in Group-T versus normal saline (Group-S), it was 134 + 18 minutes in Group-L and in Group -T, it was 135 + 15 minutes while in Group-S, it was 34 + 11 minutes and p < 0.01 significant. Conclusion: Uses of lignocaine 2% with adrenaline swab and Tramadol swab are better choice in tonsillar fossae at the end of tonsillectomies for post-operative pain control versus normal saline (placebo) swab.

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Electroacupuncture versus morphine for the postoperative control pain in dogs

Acta Cirurgica Brasileira ◽

10.1590/s0102-86502011000500004 ◽

2011 ◽

Vol 26 (5) ◽

pp. 346-351 ◽

Cited By ~ 23

Author(s):

Hugo Higa Gakiya ◽

Danielle Alves Silva ◽

Juliano Gomes ◽

Helaine Stevanin ◽

Renata Navarro Cassu

Keyword(s):

Pain Score ◽

Rating Scale ◽

Numerical Rating Scale ◽

Serum Cortisol ◽

Sham Acupuncture ◽

Cortisol Concentration ◽

Analgesic Requirement ◽

Rescue Analgesia ◽

Postoperative Control ◽

Serum Cortisol Concentration

PROPOSE: To compare the postoperative analgesic effects of electroacupuncture, morphine or sham acupuncture in dogs undergoing mastectomy. METHODS: Thirty client-owed dogs undergoing to mastectomy were randomly assigned to three groups of 10 animals each and received either morphine (T-M), the electroacupuncture (T-EA) or sham procedure (T-Sham). Pre-anesthetic medication was acepromazine (0.05 mg kg-1, IM). Anesthesia was induced with propofol (4 to 5 mg kg-1, IV) and maintained with isoflurane. Postoperatively pain degree was assessed using a numerical rating scale. Dogs were scored at 1, 3, 6 and 12 hours post-extubation. If the pain score was ≥6, supplemental morphine was administered. Serum cortisol concentration was measured before pre-anesthetic medication, at 45 minutes after the anesthetic induction, and at 1, 3 and 6 hours post-extubation. RESULTS: The pain score did not differ among the treatments, but rescue analgesia was lower in the T-EA group (2 of 10 dogs), when compared with T-Sham (6 of 10 dogs) and T-M (6 of 10 dogs) groups. Serum cortisol concentration did not differ among the treatments. CONCLUSION: Electroacupuncture reduces the postoperative analgesic requirement and promotes satisfactory analgesia in dogs undergoing mastectomy.

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Effect of dexmedetomidine on intraoperative Surgical Pleth Index in patients undergoing video-assisted thoracoscopic lung lobectomy

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-020-01346-1 ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Yu-Lan Wang ◽

Xiao-Qi Kong ◽

Fu-Hai Ji

Keyword(s):

Heart Rate ◽

Normal Saline ◽

Rating Scale ◽

Thoracoscopic Surgery ◽

Saline Group ◽

Postanesthesia Care Unit ◽

Normal Saline Group ◽

Monitoring Method ◽

Video Assisted ◽

Lung Lobectomy

Abstract Background The Surgical Pleth Index (SPI) is a monitoring method that reflects painful stimuli during general anesthesia, and dexmedetomidine is an analgesic adjuvant with an opioid-sparing effect. But up to now, it is still unclear whether dexmedetomidine has any influence on SPI. To investigate whether dexmedetomidine has an effect on SPI during video-assisted thoracoscopic surgery. Methods We enrolled 94 patients who underwent video-assisted thoracoscopic lung lobectomy. Patients were randomly assigned to a dexmedetomidine group (dexmedetomidine: 0.8 μg/kg administered for 10 min before anesthesia) or normal saline group (equal volume of normal saline). SPI and vital signs were recorded. The number rating scale (NRS) pain score was also evaluated. Results SPI values were significantly lower in the dexmedetomidine group than in the normal saline group at intubation and at discharge from the postanesthesia care unit. Compared with the normal saline group, mean arterial pressure and heart rate were both significantly lower in the dexmedetomidine group at intubation. Heart rate was lower at skin incision in the dexmedetomidine group. The NRS score in the normal saline group was noticeably higher vs. the dexmedetomidine group at discharge from the postanesthesia care unit. Conclusions Dexmedetomidine decreased intraoperative SPI and NRS scores. Our results showed that dexmedetomidine attenuated noxious stimuli. Trial registration Chinese Clinical Trial Registry (ChiCTR): ChiCTR-OOC-16009450, Registered 16 October, 2016.

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Comparison of Analgesic Efficacy of Nalbuphine Versus Tramadol as Adjuvant to Local Anaesthetic in Caudal Block in Children

10.53350/pjmhs2115113458 ◽

2021 ◽

Vol 15 (11) ◽

pp. 3458-3460

Author(s):

Muhammad Sharif ◽

Muhammad Arif Baloch ◽

Nazeer Ahmed ◽

Zafar ullah ◽

Yasir Reda Toble

Keyword(s):

Group Versus ◽

Analgesic Efficacy ◽

P Value ◽

Caudal Block ◽

Rescue Analgesia ◽

Post Operative Pain ◽

Group A ◽

Male Patients ◽

Group B ◽

Mean Time

Objective: To compare the mean time of first analgesia with nalbuphine versus tramadol as adjuvant to bupivacaine for caudal block in children. Patients and Methods: In this randomized clinical trial, a total number of 60 children who were planned for caudal block after infra-abdominal surgeries having age 3-12 years were included. A caudal block was performed under general anaesthesia immediately after surgery for postoperative analgesia. Tramadol 2mg/kg body weight was given caudally to individuals in group A. Group B patients had 0.125 percent bupivacaine with 0.1mg/kg nalbuphine caudally. Time of requirement of first analgesia was noted in all patients. Paracetamol 10 mg/kg was given as rescue analgesic in all patients. Results: Mean age of patients was 8.30±3.03 years. Mean weight of patients was 23.33±6.92 Kg. There were 26 (43.33%) female patients and 34 (56.67%) male patients. There were 50 (83.33%) children who were having ASA status I, and remaining 10 (16.67%) children were having ASA status II. Mean pain score was 3.53±1.43 in tramadol group and 1.86±1.25 in Nalbuphine group (p-value <0.001. Mean time of first rescue analgesia was significantly prolonged in Nalbuphine group, mean time was 6.13±1.07 hours in Nalbuphine group versus 4.03±1.03 hours in tramadol group (p-value <0.001). Conclusion: Single dose of nalbuphine as an adjunct to bupivacaine is superior as compared to tramadol in reducing the post-operative pain, it also significantly prolongs the duration of analgesia in children. Keywords: Caudal Block, Nalbuphine, Tramadol, Post-operative pain, Time of first rescue analgesia.

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