Dor no pós-operatório em crianças submetidas a procedimentos cirúrgicos

O objetivo deste estudo foi avaliar os fatores sociodemográficos, clínicos e cirúrgicos relacionados com a intensidade dador no pós-operatório de crianças. Estudo descritivo e exploratório com abordagem quantitativa, realizado com 31 crianças de cinco a 12 anos nas primeiras 72 horas de pós-operatório utilizou-se um questionário com perguntas clínicas, sociodemográficas e as escalas de faces e numérica de dor. Foram realizados os testes Qui-quadrado e Exato de Fisher paraa análise dos resultados. Evidenciou-se que o tipo de cirurgia realizada influencia significativamente (p-valor= 0,036) napresença de dor nas 24h, após a cirurgia. A intensidade da dor com o tipo de cirurgia nos dois primeiros dias de pós-operatório apresentou valor significativo (p-valor=0,044) no primeiro dia e (p-valor=0,021) no segundo. No 2º dia de internação,a variável sexo (feminino) mostrou diferença significativa com relação à média de intensidade de dor (p-valor=0,032) eno 3º dia, a característica clínica que se fez significativa foram os antecedentes patológicos (p-valor=0,031) quando relacionado à intensidade da dor. Conclui-se que as variáveis sociodemográficas, clínica e cirúrgica interferem na presença eintensidade de dor em crianças no pós-operatório, principalmente tipo de cirurgia, sexo e antecedentes patológicos.Palavras-chave: Criança; Dor; Dor pós-operatória; Perfil de saúde.ABSTRACTThe aim of this study is evaluating the socio-demographic, clinical and surgical factors related to the pain intensity inthe children´s post-surgery. Descriptive and exploratory study with a quantitative approach conducted with 31 five totwelve-year-old children in the first 72 hours of the post-surgery, where it was applied a questionnaire with clinical andsocio- demographic questions, and the face and numerical scales of pain. The Chi-square and the Fischer Exact tests wereused for the analysis of the results. It was observed that the kind of surgery performed influences significantly (p-value=0.036) in the presence of pain in the first 24 hours, after the surgery. The intensity of pain with the kind of surgery in thefirst two post-surgery days presented a significant value (p-value=0.044) in the first day and (p-value=0.021) in the secondday. In the 2nd day of admission the variable sex (female) showed a significant difference in relation to the intensity of painaverage (p-value=0.032), and in the 3rd day the significant characteristic was the pathological background (p-value=0.031)when related to the intensity of pain. It is concluded that socio-demographic, clinical and surgical variables interfere in thepresence and intensity of pain in children in post-surgery, especially kind of surgery and pathological background.Keywords: Child; Health profile; Pain; Postoperative pain.

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Perbedaan Efektivitas Parasetamol Oral Dengan Tramadol Oral Sebagai Tatalaksana Nyeri Pasca Operasi Transurethral Resection of The Prostate

Jurnal Kesehatan Andalas ◽

10.25077/jka.v2i1.66 ◽

2013 ◽

Vol 2 (1) ◽

pp. 38

Author(s):

Ismail Muhammad ◽

Alvarino Alvarino ◽

Nasman Puar ◽

Hafni Bachtiar

Keyword(s):

Postoperative Pain ◽

Pain Intensity ◽

Spinal Anesthesia ◽

Transurethral Resection ◽

Prostate Gland ◽

Chi Square ◽

Anesthesia Group ◽

Significant Difference ◽

Spinal Anesthesia Group ◽

People Group

AbstrakPendahuluan. Transurethral Resection of The Prostate (TURP) merupakan tindakan operasi endoskopi yang sudah menjadi standar baku untuk penatalaksanaan pembesaran kelenjar prostat jinak yang memerlukan tindakan bedah. Nyeri pasca operasi TURP disebabkan karena trauma (reseksi jaringan prostat), iritasi foley kateter dan traksi kateter pasca TURP pada luka operasi. Metode. Merupakan jenis penelitian eksperimental yang membandingkan efektivitas pemakaian parasetamol oral 500 mg dengan tramadol oral 50 mg sebagai tatalaksana nyeri pasca TURP. Penelitian ini melibatkan 30 orang pasien yang dibagi 2 kelompok yaitu 15 orang kelompok parasetamol dan 15 orang kelompok tramadol. Intensitas nyeri dengan skala VAS dan efek samping obat dinilai pada 3jam, 5jam, 7jam pasca spinal anesthesia. Hasil penelitian kemudian diuji dengan independen T.test dan Chi-square. Hasil. Rata-rata nilai VAS 3 jam pasca spinal anastesia kelompok parasetamol adalah 0,6267 cm dan tramadol 0,6400 cm. Pada 5 jam pasca spinal anastesi rata-rata nilai VAS kelompok parasetamol 1,5800 cm, kelompok tramadol 1,4933 cm. Pada 7 jam pasca spinal anesthesia rata-rata nilai VAS kelompok parasetamol 3,5800 cm dan kelompok tramadol 3,1667 cm. Setelah uji statistik baik pada 3jam, 5jam, 7jam pasca spinal anesthesia tidak terdapat perbedaan yang bermakna intensitas nyeri pada ke 2 kelompok dengan p > 0,05. Sedangkan kejadian mual dan alergi juga tidak ada perbedaan yang bermakna pada kedua kelompok. p > 0,05. Kesimpulan. Parasetamol 500 mg oral versus tramadol 50 mg oral memiliki efektifitas yang sama dalam mengatasi nyeri pasca operasi TURP. Sedangkan kejadian mual dan alergi tidak ada perbedaan yang bermakna pada ke 2 kelompok.Kata kunci: TURP, parasetamol, tramadol, VASAbstractArial 9 italic Introduction. Transurethral Resection of the Prostate (TURP) is an endoscopic surgery that become the gold standard for the treatment of benign enlargement of the prostate gland that requires surgery. Postoperative pain due to trauma TURP (resection of prostate tissue), irritation foley catheters and catheter traction after TURP surgery on the wound. Methods. This study was an experimental research that compares the effectiveness of the use of oral paracetamol 500 mg with 50 mg oral tramadol as a pain management of post-TURP. This study involved 30 patients divided into 2 groups: 15 people group of paracetamol and 15 people group of tramadol. Pain intensity with the VAS scale and drug side effects rated at 3 hours, 5 hours, 7 hours after spinal anesthesia. Results were then tested with independent T.test and Chi-square Results were then tested with independent T.test and Chi-square. Results. Mean VAS values after 3 hours spinal anesthesia group of paracetamol and tramadol were 0.6267 cm 0.6400 cm. At 5 hours after spinal anesthesia the mean VAS value of paracetamol group was 1.5800 cm, group of tramadol was 1.4933 cm. At 7 hours after spinal anesthesia mean VAS value group of paracetamol was 3.5 800 cm and group of tramadol was 3.1667 cm. After a statistical test at 3 hours, 5 hours, 7 hours after spinal anesthesia, we conclude that there was no significant difference in pain intensity on the 2 groups with P> 0.05. While the incidence of nausea and allergies also had no significant difference in both groups. P> 0.05. Conclusion. Paracetamol 500 mg orally versus tramadol 50 mg orally had the same effectiveness in addressing postoperative pain TURP. While there was no significant difference in the 2 groups in the incidence of nausea and allergies

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The Effectiveness Of Murottal Al-Qur'an Therapy And Virtual Reality To Reduce Pain Intensity In Post Operating Patients

South East Asia Nursing Research ◽

10.26714/seanr.2.2.2020.74-81 ◽

2020 ◽

Vol 2 (2) ◽

pp. 74

Author(s):

Kirnawan Fadholi ◽

Akhmad Mustofa

Keyword(s):

Virtual Reality ◽

Postoperative Pain ◽

Pain Intensity ◽

Rating Scale ◽

Intervention Group ◽

Complementary Therapy ◽

Control Group ◽

P Value ◽

Control Group Design ◽

Significant Difference

Pain management in postoperative patients so far in the Shofa Room of PKU Muhammadiyah Hospital in Temanggung is still limited to pharmacotherapy in the form of 1 gram injection metamizole or 30mg ketorolac injection and the provision of deep breath therapy. Giving this therapy is not optimal in dealing with patient pain. Therefore other therapies need to be given for example non-pharmacology, one of them is a combination of murottal Al-Qur'an therapy and virtual reality when the pharmacotherapy reaction is finished and the complementary therapy has never been done in the room. The purpose of this study was to determine the effect of a combination of Murottal Al-Qur'an therapy and virtual reality on pain intensity in postoperative patients. The research design used in this study was quasi-experimental with a pre-posttest with a control group design approach. The subjects of this study were 32 post-operative patients at PKU Muhammadiyah Temanggung Hospital. The sampling technique used was purposive sampling. The instrument used in obtaining data is the Numeric Rating Scale. The results showed that: 1) there were differences in the average pretest and posttest intensity of postoperative pain in the intervention group with a p-value of 0,000; 2) there is a difference in the average pretest and posttest intensity of postoperative pain in the control group with a p-value of 0.003; and 3) there is a significant difference in the decrease in intensity of postoperative pain in the intervention group and the control group with a p-value of 0.009 where the experimental group showed a decrease in intensity more effectively than the control group. The results of this study indicate that the combination of Murottal Al-Qur'an therapy and virtual reality is effective in reducing pain intensity in postoperative patients.

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COMPARISON OF EFFECTS OF ABDOMINAL STRETCHING EXERCISE AND COLD COMPRESS THERAPY ON MENSTRUAL PAIN INTENSITY IN TEENAGE GIRLS

Belitung Nursing Journal ◽

10.33546/bnj.98 ◽

2017 ◽

Vol 3 (3) ◽

pp. 221-228

Author(s):

Desta Ayu Cahya Rosyida ◽

Agus Suwandono ◽

Ida Ariyanti ◽

Suhartono Suhartono ◽

Imam Djamaluddin Mashoedi ◽

...

Keyword(s):

Pain Intensity ◽

Exercise Group ◽

P Value ◽

Menstrual Pain ◽

Chi Square ◽

Teenage Girls ◽

Significant Difference ◽

Background Pain ◽

Before And After ◽

Alternative Choice

Background: Pain during menstruation is not uncommon, especially in young women, which has an impact on their life activities.Objective: To examine the effect of abdominal stretching exercise and cold compress therapy on decreasing intensity of menstrual pain in teenage girls at SMK Bakti Indonesia Medika.Design: A Quasy Experimental Study with two group comparison pretest-postest design. There were 46 respondents selected in this study by consecutive sampling that consisted of 23 samples in the abdominal stretching exercise group and 23 samples in the cold compress group. The menstrual pain was measured using VAS (visual analog scale). Data were analyzed using Mann-Whitney, Chi-Square, and Wilcoxon test.Results: Findings showed that the mean of menstrual pain before intervention in the abdominal stretching exercise was 7.04 and in the cold compress therapy was 6.74 with p-value 0.211 (<0.05), which indicated that there was no mean difference of pain between both groups. However, after intervention, the menstrual pain was reduced from 7.04 to 1.91 (5.09 difference) in the abdominal stretching exercise group; and from 6.74 to 5.52 (1.22 difference) in the cold compress group with p-value 0.000 (<0.05), which indicated that there was statistically significant difference of menstrual pain before and after intervention, both abdominal stretching exercise and cold compress therapy.Conclusion: There were statistically significant effects of abdominal stretching exercise and cold compress therapy on menstrual pain in teenage girls. The abdominal stretching exercise is more effective than cold compress therapy in reducing menstrual pain intensity. Thus, it is suggested that abdominal stretching exercise can be an alternative choice of management of dysmenorrhea in teenage girls, and can be a part of subject in the education as non-pharmacological medicine.

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A Study to Evaluate the Effectiveness of Webinar on Knowledge Regarding the Strategies to Prevent Covid 19 among Nursing Students of SIIHS, Honavar, Uttara Kannada

Journal of Community and Social Health Nursing ◽

10.46610/jcshn.2021.v03i02.005 ◽

2021 ◽

Vol 3 (2) ◽

Author(s):

Sagaya Arockiya Mary. A ◽

Susai Mari.A ◽

Wincy. C ◽

Thirumurugan. M ◽

Verginia Dsouza ◽

...

Keyword(s):

Nursing Students ◽

Student Nurses ◽

Sampling Technique ◽

Knowledge Score ◽

P Value ◽

Sufficient Information ◽

Knowledge Level ◽

Chi Square ◽

Significant Difference ◽

Post Test

Background: The one virus stumbled the whole universe is the novel corona virus and impacted physical, emotional and social health status of almost every individual in the world irrespectively. Since the existence of Covid-19 till now it is been noticed that student nurses also affected by this fatal viral infection during their clinical practice. Objectives: The study focused on evaluating the effectiveness of webinar on knowledge regarding the strategies to prevent Covid -19 among student nurses of SIIHS, Honavar, Uttara Kannada. The study aimed at enhancing the knowledge level and influences others through effective health teaching at clinical areas and even in community settings. Methodology: An evaluative approach with pre- experimental, non-randomized, one group pre and post-test research design was adapted. The sample size was 294, purposive sampling technique was adapted. Data collected through testmoz web page and webinar was conducted by google meet app for one week. Data analysed by descriptive and statistical methods (chi-square and z-test) and interpreted by graphs. Results: The findings show that in pre-test 10(3.41%) had poor, 127(43.19%) had average, 157(53.40%) Good and 00% excellent knowledge level whereas in post-test 00% had Poor, 59(20.06%) Average, 176(59.86%) Good and 59 (20.06%) had excellent knowledge level. The pre-test mean score was 23.1 (46.2 %.) and of post-test was 35.6 (71.2%). The computed z’-test value showing significant difference in the pre (x?1=23.1) and post-test (x?2=35.6) knowledge score (p=1.18357, < z= -5.1679, critical z score=-1.6449 ? =0.05 level of significance). Hence the p value is greater than the z value (p(x?Z) = 1.18357e-7), it indicates the webinar was effective and the null hypothesis (H0) is rejected. Conclusion: The study was concluded as the webinar was highly effective and influenced the participant to gain sufficient information on prevention and the spread of Covid 19. Hopefully this enables them to apply

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A Comparative Study between Ketamine and Lidocaine ro Decrease Propofol Injection Pain During Induction of Anesthesia

Birat Journal of Health Sciences ◽

10.3126/bjhs.v6i1.37564 ◽

2021 ◽

Vol 6 (1) ◽

pp. 1304-1309

Author(s):

Bikash Khadka ◽

Nil Raj Sharma

Keyword(s):

Comparative Study ◽

Venous Occlusion ◽

Verbal Response ◽

Injection Pain ◽

P Value ◽

Chi Square ◽

Cross Sectional ◽

Lidocaine Group ◽

Mild Pain ◽

Significant Difference

Introduction: Pain during the injection of anesthetic agents may be distressing and can reduce the acceptability of an otherwise useful agent such as propofol during daycare surgeries. Lidocaine and ketamine both are used as pre-treatment to decrease propofol induced pain. This study aims to compare the effectiveness of ketamine injection to decrease propofol-induced pain in comparison to lidocaine injection. Methodology: This is a prospective cross-sectional comparative study. Eighty-nine cases were divided into two groups where group K received ketamine 2 ml (0.2 mg/kg) whereas group L received lidocaine 2% 2ml (0.5 mg/kg) after venous occlusion with rubber tourniquet. One-fourth dose of propofol was injected 1 min after release of tourniquet and pain accessed at 0, 1, and 2 minutes of propofol injection with a verbal response and behavioral signs. Chi-square test and paired T-test were used and a p-value less than 0.05 was considered significant. Result: Regarding hemodynamic, oxygenation, and adverse effects there was no significant difference. Immediately after propofol injection, only 1 patient of the ketamine group had mild pain (2.22%) while 12 patients from the lignocaine group had mild pain (27.27%) with a p-value of 0.009. Also after 2 minutes of propofol injection, only 12 cases had mild pain i.e. 13.48% (1 from ketamine group i.e. 2.22% and 11 from lidocaine group i.e. 25%) with p-value of 0.002. Conclusion: Our study helps prove low-dose ketamine is more effective in reducing the incidence and severity of pain on injection of propofol in comparison to Lidocaine with better hemodynamic stability.

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589 Methadone in Procedural Care for Burn Injuries of 20–30% Total Burn Surface Area: A Retrospective Chart Review

Journal of Burn Care & Research ◽

10.1093/jbcr/irab032.239 ◽

2021 ◽

Vol 42 (Supplement_1) ◽

pp. S146-S146

Author(s):

Loryn Taylor ◽

Kimberly Maynell ◽

Thanh Tran ◽

David J Smith

Keyword(s):

Physical Therapy ◽

Postoperative Pain ◽

Pain Intensity ◽

Surface Area ◽

Chart Review ◽

Retrospective Chart Review ◽

Opioid Consumption ◽

Burn Injuries ◽

Methadone Group ◽

Significant Difference

Abstract Introduction Prolonged opioid usage remains a concern in pain management in procedural care. Recent evidence also suggests that a considerable number of patients who were prescribed opioids struggle with transitioning to non-opioid pain medications. As a continuous effort to reduce opioid consumption following burn surgical procedures, our institution recently evaluated methadone administration for burn procedural care in patients with 20–30% total burn surface area (TBSA) requiring excision and grafting. Methods After IRB approval, we performed a retrospective chart review of patients who underwent excision and grafting procedure for 20–30% TBSA burn injuries between January 1, 2019 and June 30, 2020. The following data was evaluated: postoperative opioid consumption, postoperative pain intensity (rated as “No Pain” [NRS=0], “Minor Pain” [NRS 1 to 3], “Moderate Pain” [NRS 4 to 6], “Severe Pain” [NRS 7 to 10]), time to physical therapy and time to hospital discharge. Data was analyzed using chi square/Fisher exact test for categorical variables and t-test/Wilcoxon rank sum test for continuous variables. Results Our preliminary data included 12 patients who met inclusion criteria, of which two patients received methadone administration. Our patient sample consisted of average age of 43 years, 75% male, and 24% TBSA (92% were flame burns). Patients in both methadone and non-methadone groups had no significant differences in medical histories and TBSA (23% TBSA in methadone, 25% TBSA in non-methadone). There was no significant difference in reported preoperative pain intensity between the two groups, rating moderate to severe. Postoperative pain intensity remained the same, rating moderate to severe and controlled with fentanyl, oxycodone, morphine and non-opioid analgesics. While there was no difference in postoperative fentanyl, opioid and non-opioid analgesic consumptions between the two groups, morphine consumption was significantly lower in the methadone group compared to non-methadone group (2±2 mg vs 51±54 mg, respectively, p=0.02). There was no significant difference between average time from surgery to first physical therapy session and time to hospital discharge (about 21 days after surgery) between the two groups. Conclusions This evaluation shows a potential trend in reduction of inpatient postoperative opioid consumption with the conjunctive administration of methadone, although a bigger sample size is needed for further assessment.

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Orthodontics-Awareness Amongst Medical Students

Orthodontic Journal of Nepal ◽

10.3126/ojn.v10i3.35496 ◽

2020 ◽

Vol 10 (3) ◽

pp. 49-56

Author(s):

Türkan SEZEN ERHAMZA ◽

Kübra A ARSLAN ÇARPAR

Keyword(s):

Medical Students ◽

Statistical Evaluation ◽

P Value ◽

Chi Square ◽

Level Of Education ◽

Significant Difference ◽

Chi Square Test ◽

Treatment Procedures

Introduction: The study aimed to evaluate the knowledge and awareness of orthodontics, a specialty of dentistry,amongst Medical Students. Materials and Method: A sample of 550 students (279 female, 226 male aged between 18 and 36 years) were attented.Of the subjects, 58.6% (n = 296) were preclinical students, while 41.4% (n = 209) were clinical students. The students were informed about the questionnaire and asked to fill in the questionnaire forms. For the comparison of data between groups (gender, level of education), the chi-square test was used. A chi-square test was used for statistical evaluation and the p-value < 0.05 was considered statistically significant. Result: 385 students (76.2%) had heard the term orthodontics although 41.2% of the subjects knew that orthodonticswas concerned with malocclusions and their treatment. The question about treatment procedures was answeredas scaling by 35.8%, tooth polishing by 40%, tooth aligning by 89.9% of the students. The percentage of knowingorthodontics to be related to tooth aligning showed a significant difference between female and male (p = 0.006), andpreclinical and clinical students (p = 0.033). Of the participants, 42.8% thought that dentures, 83% brackets, 78.8% ofremovable appliances were used by orthodontists. Conclusion: Our results have shown that medical students should have more information about orthodontics, aspecialty of dentistry.

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Comparison between scalpel incision and electrocautery incision in midline abdominal surgery: a comparative study

International Surgery Journal ◽

10.18203/2349-2902.isj20211817 ◽

2021 ◽

Vol 8 (5) ◽

pp. 1507

Author(s):

Amit Yadav ◽

Lakshman Agarwal ◽

Sumit A. Jain ◽

Sanjay Kumawat ◽

Sandeep Sharma

Keyword(s):

Postoperative Pain ◽

Blood Loss ◽

Abdominal Surgery ◽

Wound Infection ◽

Skin Incision ◽

P Value ◽

Wound Area ◽

Significant Difference ◽

Group A ◽

Group B

Background: Fear of poor wound healing have curtailed the use of diathermy for making skin incision. Scalpel produces little damage to surrounding tissue but causing more blood loss. Our aim of study was to compare electrocautery incision with scalpel incision in terms of incision time, blood loss, postoperative pain and wound infection.Methods: Total of 104 patients were included in the study undergoing midline abdominal surgery. Patients were randomized into electrocautery (group A) and scalpel (group B). The incision dimension, incision time and blood loss were noted intraoperatively. Postoperative pain was noted on postoperative day 2 using visual analog scale. Wound complications were recorded on every postoperative day till the patient was discharged.Results: 52 patients in each of the two groups were analyzed. There was significant difference found between group A and group B in terms of mean incision time per unit wound area, 8.16±1.59 s\cm2 and 11.02±1.72 s\cm2 respectively (p value=0.0001). The mean blood loss per unit wound area was found to be significantly lower in group A (0.31±0.04 ml\cm2) as compared to group B (1.21±0.21), p value=0.0001. There was no significant difference noted in terms of postoperative pain and wound infection between both groups.Conclusions: Electrocautery can be considered safe in making skin incision in midline laparotomy compared to scalpel incision with comparable postoperative pain and wound infection with less intraoperative blood loss and less time consuming.

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Effect of platelet rich-fibrin on alveolar osteitis incidence following surgical removal of impacted mandibular third molars: A comparative study

Journal of Baghdad College of Dentistry ◽

10.26477/jbcd.v31i4.2723 ◽

2019 ◽

Vol 31 (4) ◽

Author(s):

Ali S. Abdul Kareem ◽

Ali H. Al Hussaini

Keyword(s):

Postoperative Pain ◽

Control Group ◽

P Value ◽

Surgical Removal ◽

Similar Distribution ◽

Extraction Socket ◽

Platelet Rich Fibrin ◽

Significant Difference ◽

Alveolar Osteitis

Background: Postoperative morbidity after extraction of the impacted mandibular third molar (IMTM) is inevitable. One of the most common postoperative complication is alveolar osteitis (AO) which is a painful non healed socket. Many researches were attempted to prevent the occurrence of AO by introducing and applying a new materials inside the extraction socket. Platelet rich fibrin (PRF) is a biological complex fibrin matrix where autologous platelets and leucocytes are present, used to enhance tissue healing process and reduce the early adverse effects of the inflammation. Aims: To evaluate the effect of PRF on the incidence of AO. Also to assess PRF effect on pain, swelling, and trismus following the surgical removal of IMTM and compare it with the control group. Materials and methods: This clinical prospective study was conducted from October 2016 to October 2017 at the Department of Oral & Maxillofacial Surgery, College of dentistry/University of Baghdad; and Al-Sadr Specialized Health Center. A total number of 50 IMTMs were surgically removed from 45 patients who met the inclusion criteria (21 males and 24 females) with age ranged from 16-41 years. The cases were divided into two groups: a study group (25 cases) where PRF were placed inside the extraction socket and control group (25 cases) where traditional surgery were performed. AO, trismus and swelling were assessed at the 2nd and 7th postoperative day. Pain scored by numeric rating scale daily by the patients. Results: The study showed that age, gender, side of impaction, oral hygiene condition, impacted tooth classification, surgical difficulty, and the time of procedure in both control and study groups had nearly similar distribution with non- significant difference. At the 1st follow up period: Trismus (P-value = 0.834) and Swelling (P-value = 0.592) were non- significant between the two groups. AO had overall incidence of 4% occurred only in the control group, while the PRF group had no occurrence (0%), but the difference was statistically non significant. Postoperative pain had no significance difference in both groups. At the 2nd follow up period there was no significant difference regarding trismus, swelling, and incidence of AO between both groups. Conclusion: Local application of PRF can reduce the incidence of AO but not to a significant level. PRF had no effect concerning postoperative pain, swelling, and trismus.

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A double-blind randomized placebo-controlled study of low dose mirtazapine once daily in patients of major depressive disorders on escitalopram

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20191602 ◽

2019 ◽

Vol 8 (5) ◽

pp. 1067

Author(s):

Mallikarjuna Rao I. ◽

Usha Kiran Prayaga ◽

Dharma Rao Uppada ◽

Ramachandra Rao E. ◽

B. L. Kudagi

Keyword(s):

Depressive Disorders ◽

Low Dose ◽

Rating Scale ◽

Controlled Study ◽

P Value ◽

Chi Square ◽

Double Blind ◽

Increased Risk ◽

Significant Difference ◽

Chi Square Test

Background: The SSRIs being used as 1st line therapy in treatment of depression have delayed therapeutic effect which makes the patient vulnerable to an increased risk of suicide and decreased adherence to the treatment and will prematurely discontinue the therapy. The present study was conducted to evaluate if low dose mirtazapine-escitalopram combination therapy has any add on benefit over monotherapy with escitalopram.Methods: In a single-centered, comparative study involving patients with depression attending the out-patient after screening and exclusion, 60 eligible patients were randomly assigned to receive tablet mirtazapine 7.5 mg plus tablet escitalopram 10 mg intervention or tablet escitalopram 10 mg plus placebo intervention in a double-blind 6-week treatment phase. The primary outcome measure was the change in the 17-item Hamilton Depression Rating Scale (HDRS) and Montgomery-Asberg Depression Rating Scale (MADRS) score from baseline. Participants were evaluated at baseline, 1st, 2nd,4th and 6th week. Results were analyzed using Chi-Square test for adverse effects and independent t-test analysis for efficacy parameter.Results: In the analysis of results at 6th week the numbers of patients achieved remission in mirtazapine group are more with a p-value of 0.018 which is significant and the numbers of responders in mirtazapine group are also more which is statistically significant on chi-square test. There is no significant difference was observed between the two groups with reference to occurrence of adverse effect.Conclusions: Adding low dose mirtazapine has an added benefit in terms of efficacy and getting remission early with more number of responders in the treatment of major depression.

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