scholarly journals Comparison of morphine and fentanyl in attenuation of Intra operative stress response under general anesthesia: A randomized double blinded study

2014 ◽  
Vol 5 (4) ◽  
pp. 65-68
Author(s):  
R Krishna Prabu ◽  
P Rani ◽  
NP Madhu
Keyword(s):  
Body Weight ◽  
Stress Response ◽  
General Anesthesia ◽  
Elective Surgery ◽  
Serum Cortisol ◽  
Blood Samples ◽  
Significant Difference ◽  
Blinded Study ◽  
Cortisol Levels ◽  
Double Blinded

Background: This randomized double blinded study was done to compare the effect of intravenous morphine and fentanyl in attenuation of stress response during surgeries under general anesthesia in adults. The attenuation of stress response was analyzed with changes in serum cortisol and glucose levels one hour after induction of anesthesia. Methods: Fifty consented healthy volunteers in age group 20-50, under ASA I and ASA II posted for elective surgery were included in the study. Two groups of 25 each, group M who received 0.2 mg/kg body weight of morphine and group F who received 2 microgram/kg body weight of fentanyl before anaesthetic induction were compared. The members of two groups were randomly allocated and double blinded using sealed envelope technique. Blood samples were collected for baseline glucose and cortisol in all the subjects. One hour after the administration of study drugs, which was given at the time of induction blood samples were collected for analysis of glucose and cortisol. The changes in blood glucose and serum cortisol levels were compared at the end of the study using independent samples ‘t’ test. Results: There was no significant difference in blood sugar levels in both groups at the end of 1 hour. But there was significant increase in serum cortisol levels in group F compared to group M. Conclusion: This study concludes that morphine is better than fentanyl in attenuation of Intraoperative stress by effectively controlling serum cortisol levels. DOI: http://dx.doi.org/10.3126/ajms.v5i4.9796 Asian Journal of Medical Sciences 2014 Vol.5(4); 65-68

scholarly journals Oxycodone 5 Miligram is More Effective Than Ketorolac 30 Miligram in Suppressing Cortisol Levels During General Anesthesia

2021 ◽  
Vol 2 (1) ◽  
pp. 148-158
Author(s):  
Kelvin ◽  
Rizal Zainal ◽  
Irwanto FH ◽  
Erial Bahar
Keyword(s):  
General Anesthesia ◽  
Sample Size ◽  
Intravenous Administration ◽  
Elective Surgery ◽  
Controlled Trial ◽  
Post Intervention ◽  
Chi Square ◽  
Double Blind ◽  
Significant Difference ◽  
Cortisol Levels

Background: Preemptive analgesia is a developing clinical concept, which involves administering analgesics before pain stimulation occurs, to prevent the sensitization of the nervous system to further stimuli that can cause pain. Ketorolac has strong analgesic properties oxycodone is a semisynthetic opioid that is synthesized from the alkaloid thebaine opiate. Pain could induce stress hormone such as cortisol. Study to compare ketorolac and oxycodone with cortisol has not been investigated. This study aimed to assess intravenous administration of ketorolac 30 mg compared with intravenous 5 mg oxycodone for pain as measured by cortisol levels post-intervention in surgery performed under general anesthesia. Method: A study randomized controlled trial in double-blind form for patients at dr. Mohammad Hoesin Palembang, who will undergo elective surgery with general anesthesia at the Central Surgical Installation building, with the period September-October 2020. There are 24 study samples, to anticipate dropouts, an added sample size is 10%, so the sample size is 26 for each treatment group. The selection of subjects according to the purpose of the study was carried out by simple random. Data analysis using SPSS ver 22.0 software. Data were analyzed using Independent T-Test, Mann Whitney, and Chi-Square Test. Result: The results showed, there was a significant difference in the effectiveness of intravenous administration of ketorolac 30 mg and intravenous oxycodone 5 mg on pain as measured by cortisol levels in patients undergoing general anesthesia at dr. Mohammad Hoesin Palembang (p = 0.013). The value of cortisol levels in pre- operative patients who will be given general anesthesia at dr. There was no statistically significant difference between Mohammad Hoesin in the two groups (p = 0.107). The value of cortisol levels in preoperative patients who were given ketorolac 30 mg intravenously at dr. Mohammad Hoesin was 9.90 ± 4.2. The value of cortisol levels in postoperative patients who were given ketorolac 30 mg intravenously at dr. Mohammad Hoesin was 17.75 ± 6.08. The value of preoperative cortisol levels for patients who were given oxycodone 5 mg intravenously at dr. Mohammad Hoesin was 12.03 ± 5.10. The value of postoperative cortisol levels for patients who were given oxycodone 5 mg intravenously at dr. Mohammad Hoesin is 14.50 ± 4.75. Conclusion: There was a significant difference in the effectiveness of intravenous administration of ketorolac 30 mg and oxycodone 5 mg intravenously on BSS levels (p = 0.005) and VAS scores (p = 0.001) who underwent general anesthesia at dr. Mohammad Hoesin Palembang.

scholarly journals SERUM-CORTISOL LEVELS IN SEVERITY OF STROKE

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Akshat Agarwal ◽  
Haroon Iqbaal
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Stress Response ◽  
Acute Stroke ◽  
Cortisol Level ◽  
Serum Cortisol ◽  
Blood Samples ◽  
Significance Level ◽  
History Of ◽  
Cortisol Levels

Introduction: Cortisol, an important hormone in the hypothalamic pituitary adrenal axis, has important effects on the metabolism of glucose, protein and lipid[i]. A stress response consists of increased levels of cortisol and catecholamines in the 1st weeks after acute stroke. The cortisol response has been observed in cerebral infarction as well as in intracerebral haemorrhage. Change in serum level of cortisol has been reported in patients with ischemic stroke and studies reported that high levels of this hormone are independently associated with increase in ischemic lesion volume. Also it has been observed that cortisol level in patients with ischemic stroke is associated with significantly increased mortality rate. Increase in the circulating levels of catecholamines was shown in insular damage in experimental stroke suggesting this as a mechanism for the cardiac complications associated with stroke. Patients and Methods: All patients were included in the study who was admitted within 6 hours in the hospital after the episode of stroke. Scandinavian Stroke Scale (SSS)[ii] was monitored in all patients from admission. SSS was performed every 2 hours in the first 24 hours, every 4 hours in the next 48 hours and then daily up to day 7. Blood samples were obtained for routine investigation and estimation of serum cortisol. No patients had blood samples drawn for cortisol determination between 01:00 and 07:00 am. Results: Mean age was observed in the current series was 72.8 ± 12.54 years. There were 34 (53.1%) male and 30(46.9%) female. SSS was observed to be 36 (21-47) on admission. History of hypertension, History of stroke, Diabetes mellitus and Atrial fibrillation was observed in 38(59.4%), 12(18.8%), 24(37.5%) and 11(17.2%) respectively. In univariate logistic regression analysis of the relations to 7 days of mortality, s-cortisol, SSS on admission, and pulse rate reached a significance level. Age, atrial fibrillation, blood glucose, body temperature 12 h after stroke onset, and the presence of early infarctions signs did not reach a significance level of 0.1 in univariate testing. S-cortisol level was higher in patients with insular involvement, 635 nmol/l, in comparison to patients without insular involvement, 589 nmol/l. Conclusion: Adrenal glucocorticoid stress response in acute stroke is harmful. High cortisol levels are associated with the poor outcome and mortality of the patients with stroke. Keywords: Cortisol, HPA, Stroke, SSS

Assessing the efficacy of perioperative carprofen administration in dogs undergoing surgical repair of a ruptured cranial cruciate ligament

2000 ◽  
Vol 36 (5) ◽  
pp. 448-455 ◽  
Author(s):  
CJ Reese ◽  
EJ Trotter ◽  
CE Short ◽  
HN Erb ◽  
LL Barlow
Keyword(s):  
Body Weight ◽  
Postoperative Pain ◽  
Pain Score ◽  
Surgical Repair ◽  
Cruciate Ligament ◽  
Serum Cortisol ◽  
Cranial Cruciate Ligament ◽  
Significant Difference ◽  
Subjective Pain ◽  
Cortisol Levels

Twenty-one otherwise healthy dogs that presented for surgical repair of a ruptured cranial cruciate ligament were blindly and randomly given either carprofen (2.2 mg/kg body weight, orally) or a placebo beginning 12 hours preoperatively and continuing every 12 hours for a total of three doses. The patients were assessed for postoperative pain using a subjective pain score and given oxymorphone (0.1 mg/kg body weight, intramuscularly) every four hours if the pain score was 2 or greater. Blood samples were also collected to determine serum cortisol levels. There was a significant increase in serum cortisol levels in the immediate postoperative period in both the placebo group and the carprofen group (p less than 0.05). There was no significant difference in the percentage of increase in serum cortisol levels between the two groups. No correlation was evident between the serum cortisol levels and the corresponding pain scores in either group. This subjective method of assessing postoperative pain was not accurate and should not be relied upon for determination of postoperative analgesic administration. Perioperative oral administration of carprofen did not appear to be effective in controlling postoperative pain in these patients.

scholarly journals The Acute Effect of Aerobic Exercise on Serum Cortisol Levels of Athletes and Sedentary Individuals

2018 ◽  
Vol 6 (12a) ◽  
pp. 29
Author(s):  
Selahattin Koc
Keyword(s):  
Aerobic Exercise ◽  
Anaerobic Respiration ◽  
Serum Cortisol ◽  
Acute Effect ◽  
Blood Parameters ◽  
Post Exercise ◽  
Blood Samples ◽  
Significant Difference ◽  
Before And After ◽  
Cortisol Levels

The purpose of this study was to investigate the effect of post-challenge acute values of serum cortisol levels in elite and sedentary athletes before aerobic exercise. This study included 22 elite middle-distance runners from various clubs around Turkey and 16 voluntary non-athlete men. The Cooper test was applied to study subjects. Heart rate values and blood samples of the subjects were taken before and after the Cooper test. The blood samples were analyzed at Central Biochemistry Laboratory of Şahinbey Research and Application Hospital of Gaziantep University. The results showed statistically significant difference between sedentary and athlete groups in comparison of BMI (P<0.05). A statistically significant difference was also found in pre-exercise cortisol and potassium levels and post-exercise lactate and potassium levels between both groups (P<0.05). No statistically significant difference was detected between groups in comparison of other blood parameters (P>0.05). Again, no statistically significant difference was found between pre-test and post-test values of pre and post-exercise Cortisol and Potassium levels of both groups (P>0.05).Consequently, cortisol levels were same in both groups and were not affected by exercise. According to these results, it can be said that athletes’ volume of air entering the lungs is higher than those who do not do sports, and the level of their anaerobic respiration is lower.

scholarly journals EFFECT OF ORAL MOXONIDINE IN THE ATTENUATION OF THE HAEMODYNAMIC RESPONSES SEEN DURING LAPAROSCOPIC SURGERIES

2017 ◽  
Vol 10 (3) ◽  
pp. 409
Author(s):  
Sidharth Sraban Routray ◽  
Ramakanta Mohanty
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Placebo Group ◽  
Stress Response ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Significant Rise ◽  
Hemodynamic Stability ◽  
Blinded Study ◽  
Double Blinded

ABSTRACTObjective: During laparoscopic surgeries, pneumoperitoneum can lead to various pathophysiologic changes in the cardiovascular system resulting inhypertension and tachycardia. Search for ideal drug to prevent this hemodynamic response goes on. The aim of our study was to evaluate the effect oforally administered moxonidine in attenuating the hemodynamic responses that occur during the laparoscopic surgeries.Methods: A total of 50 adult acetylsalicylic acid I and II patients scheduled for elective laparoscopic surgeries were selected for this prospectiverandomized double-blinded study. They were randomly allocated into two groups: moxonidine group (M) and placebo group (P). M group receivedoral moxonidine 0.3 mg at 8 pm on the day before surgery and at 8 am on the day of surgery. P group received a placebo at the same timing as that ofthe M group.Results: Following pneumoperitoneum rise in systolic blood pressure (SBP), diastolic BP (DBP), mean arterial pressure (MAP), and heart rate (HR)was higher in P group in comparison to M group which was statistically significant.Conclusion: Significant rise in HR, SBP, DBP, and mean BP was noted in the P group in comparison to moxonidine group. Moxonidine provided betterperioperative hemodynamic stability in patients undergoing laparoscopic surgeries.Keywords: Moxonidine, Stress response, Laparoscopic.

scholarly journals Comparison of cortisol levels in patients with vasovagal syncope and postural tachycardia syndrome

2021 ◽  
Vol 38 (1) ◽  
Author(s):  
Humaira Fayyaz ◽  
Shazadi Ambreen ◽  
Hammad Raziq ◽  
Azmat Hayyat
Keyword(s):  
Vasovagal Syncope ◽  
Serum Cortisol ◽  
Tilt Test ◽  
Control Group ◽  
Postural Tachycardia Syndrome ◽  
P Value ◽  
Cross Sectional ◽  
Postural Tachycardia ◽  
Significant Difference ◽  
Cortisol Levels

Objectives: To compare the levels of cortisol in patients of vasovagal syncope (VVS) and postural tachycardia syndrome (POTS). Methods: A cross-sectional analytical study was conducted at Islamic International Medical College, Rawalpindi and Electrophysiology Department at (AFIC). This study included 80 subjects, comprising of 35 patients in each group of vasovagal syncope and postural tachycardia syndrome and 10 healthy subjects. Patients with complaint of syncope was evaluated for vasovagal syncope and postural tachycardia syndrome using Head Up Tilt Test (HUTT). Blood samples of all the participants were taken and serum cortisol was analyzed using ELISA method. Results were analyzed on SPSS Statistics 21 using ANOVA with a p-value of ≤0.05 regarded as significant. Results: Hormonal analysis shows that cortisol levels in the vasovagal, postural tachycardia syndrome and in control group was 153±16.7pg/ml, 160.17±pg/ml, and 69.65±5.8pg/ml respectively. Cortisol levels were significantly higher in both vasovagal and POTS groups as compared to controls with a p-value of 0.04 and 0.023 respectively. However, there was no significant difference between vasovagal and POTS patients with p value 0.570. Conclusion: It is concluded from the study that cortisol responses of VVS and POTS were positive. doi: https://doi.org/10.12669/pjms.38.1.4122 How to cite this:Khan HF, Ambreen S, Raziq H, Hayat A. Comparison of cortisol levels in patients with vasovagal syncope and postural tachycardia syndrome. Pak J Med Sci. 2022;38(1):---------. doi: https://doi.org/10.12669/pjms.38.1.4122 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Articaine VS Lignocaine in Orthodontic Extraction of Maxillary Premolars - A Randomized, Double-Blinded Study

2021 ◽  
Vol 10 (35) ◽  
pp. 2969-2974
Author(s):  
Meenu Jain ◽  
Namrata Dogra ◽  
Manish Gupta ◽  
Seema Grover
Keyword(s):  
Local Anaesthetics ◽  
Contralateral Side ◽  
Primary Objective ◽  
Premolar Extraction ◽  
Anaesthetic Solution ◽  
Dental Procedures ◽  
Significant Difference ◽  
Blinded Study ◽  
Maxillary Premolars ◽  
Double Blinded

BACKGROUND Local anaesthetics helps in preventing pain during surgical and dental procedures by blocking the peripheral nerves. The primary objective of this investigation was to compare and evaluate 4 % articaine hydrochloride (with 1 : 100000 adrenaline) and 2 % lignocaine hydrochloride (with 1 : 80000 adrenaline) in terms of pulpal anaesthesia, volume of anaesthetic solution administered, need of re-anaesthesia and difficulty of extraction during orthodontic extraction of maxillary first premolars. METHODS This prospective randomized, double-blinded study was conducted on 43 patients of less than 40 years of age requiring bilateral maxillary first premolar extractions for orthodontic purposes. Each patient was randomly assigned to receive either 2 % lignocaine hydrochloride or 4 % articaine hydrochloride for premolar extraction of one side and other solution was administered for premolar extraction of contralateral side spaced 1 to 3 weeks apart. In each patient, the difference in pulpal anaesthesia, volume of anaesthetic solution administered, need of re-anaesthesia, difficulty of extraction and duration of anaesthesia was assessed on administration of lignocaine hydrochloride and articaine hydrochloride. RESULTS Statistically significant difference in pulpal anaesthesia levels was found when the articaine and lignocaine groups (P > 0.05) were compared, with a higher mean pulpal anaesthesia among the articaine group. There was no difference in volume of anaesthetic solution administered on buccal and palatal side among the articaine and lignocaine groups. Only 2.3 % of patients in both the groups required re-anaesthesia on the buccal side. There was no significant difference in difficulty of extraction in both the groups. The articaine group had a longer mean duration of anaesthesia as compared to the lignocaine group which was highly significant. CONCLUSIONS Articaine may be used to replace lignocaine in orthodontic extraction of maxillary premolars with clinical advantages like higher pulpal anaesthesia and longer duration of anaesthesia. KEY WORDS Local Anaesthetic, Lignocaine Hydrochloride, Articaine Hydrochloride, Orthodontic Extraction, Prospective Study, Double-Blinded Study.

scholarly journals A Comparative Study of Oral Dexmedetomidine versus Oral Midazolam As preanesthesia Medication in Pediatric Patients to Reduce anxiety

2019 ◽  
Vol 4 (2) ◽  
pp. 724-728
Author(s):  
Sabin Gauchan ◽  
Chitra Thapa ◽  
Abha Prasai
Keyword(s):  
General Anesthesia ◽  
Separation Anxiety ◽  
Elective Surgery ◽  
Sedation Score ◽  
Preoperative Anxiety ◽  
Parental Separation ◽  
Emergence Agitation ◽  
Oral Midazolam ◽  
Significant Difference ◽  
Group D

Introduction: Preoperative period is a stressful period. In children the preoperative anxiety is expressed as difficult separation from parents and difficult mask induction. The level of preoperative anxiety also affects postoperative outcomes. To overcome anxiety premedication is often used by pediatric anesthesiologist. Objective: The objective of this study was to compare the effect of oral midazolam 0.5mg/kg and oral dexmedetomidine 4μg/kg on parental separation, mask induction and postoperative emergence agitation in children undergoing elective surgery under general anesthesia. Methodology: 120 children aged 2-8years undergoing elective surgery under general anesthesia were divided into two groups: Group M and Group D. Patients in group M received oral midazolam 0.5mg/kg and patients in group D received oral dexmedetomidine 4μg/kg. After 45min of premedication sedation score was assessed in both the groups. Ease of parental separation and mask acceptance was compared in both the groups. In the postoperative period occurrence of emergence agitation was compared in both the groups. Results: There was no statistically significant difference in preoperative sedation score in both the groups. Parent separation anxiety score and mask acceptance score were statistically similar in both the groups. But emergence agitation was significantly lesser in patients who received dexmedetomidine premedication. Conclusions: Premedication with oral midazolam as well as oral dexmedetomidine effectively reduces parental separation anxiety and produces satisfactory mask induction in pediatric age group. However, dexmedetomidine is more effective in reducing emergence delirium in comparison to midazolam.

scholarly journals 50 Effects of post-weaning supplementation of immunomodulatory feed ingredient on body weight and cortisol levels in programmed fed beef heifers

2019 ◽  
Vol 97 (Supplement_1) ◽  
pp. 82-82
Author(s):  
Jessica L Danielo ◽  
Jessie Tipton ◽  
Ralph Ricks ◽  
Keelee J McCarty ◽  
Nathan Long
Keyword(s):  
Body Weight ◽  
Repeated Measures ◽  
Serum Cortisol ◽  
Corn Germ ◽  
Experimental Unit ◽  
Beef Heifers ◽  
Feed Ingredient ◽  
Repeated Measures Analysis ◽  
Post Infusion ◽  
Cortisol Levels

Abstract The objective of this study was to determine the effects of an immunomodulatory feed ingredient during post-weaning on growth and cortisol levels of beef heifers. Commercial Angus heifers (n = 72) from two AI sires were blocked (n = 9) by sire and BW and then randomly assigned to one of two pens per block. Each pen (4 heifers/pen) per block was assigned to one of the treatments. Heifers were fed a commercial TMR twice daily from d 0 to 60 to gain 0.75 kg/day. The feed was top-dressed once a day with either 72g of Celmanax (CEL) or 72g of corn germ (CON) per pen. Body weight was collected on d -1, 0, 15, 30, 45, 60 and 61. Blood samples were collected on d 0, 15, 30, 45 and 60. Sixteen heifers (n = 8 CEL; n = 8 CON) were randomly selected for a corticotropin releasing hormone/ arginine vasopressin (CRH/AVP) challenge after the 60 d period. Two heifers per pen (n = 32) were randomly selected for a transportation challenge to evaluate stress response on d 61 or 62 of the study. Pen was the experimental unit and data was analyzed by ANOVA or repeated measures analysis as appropriate. Feed efficiency and BW gain was increased (P = 0.04) in CEL heifers compared to CON heifers. Serum cortisol concentrations were decreased (P < 0.01) in CEL heifers compared to CON heifers on d 30 to 60 post-weaning. Serum cortisol concentrations were decreased (P < 0.05) in CEL heifers compared to CON heifers during the CRH/AVP challenge from 60 to 150 minutes post infusion. Serum cortisol concentrations were decreased (P < 0.05) in CEL heifers compared to CON heifers throughout the transportation challenge. In summary, supplementation of Celmanax post-weaning increased BW gain and reduced cortisol concentrations in beef heifers.

Topical 5-fluorouracil for granular myringitis: a double-blinded study

2009 ◽  
Vol 124 (3) ◽  
pp. 279-284 ◽  
Author(s):  
A M Atef ◽  
M M Hamouda ◽  
A H A Mohamed ◽  
A F A Fattah
Keyword(s):  
Treatment Options ◽  
Chronic Otitis Media ◽  
Local Application ◽  
Response To Treatment ◽  
Control Group ◽  
Petroleum Jelly ◽  
Persistent Disease ◽  
Significant Difference ◽  
Blinded Study ◽  
Double Blinded

AbstractBackground:Granular myringitis is a poorly understood disease which causes considerable discomfort and concern to affected individuals. Some cases may progress to inflammatory obliteration of the deep ear canal. Treatment options are diverse, and no single accepted treatment modality exists. Local application of 5-fluorouracil has recently been trialled in the treatment of chronic otitis media, with promising results.Aim:To investigate the efficacy and safety of topical 5-fluorouracil in cases of granular myringitis.Methods:Sixty patients with granular myringitis were enrolled in this controlled, double-blinded study. Patients were divided randomly into two equal groups. Patients in the study group (n = 30) received three successive applications of topical 5-fluorouracil 5 per cent cream, with two-week intervals between treatments. Patients in the control group (n = 30) received only local petroleum jelly cream packing at the same intervals. Follow-up appointments were scheduled every two weeks for the first three months; patients were then seen again after two years for evaluation of any persistent disease. Outcome measures were: (1) after three months, symptomatic response to treatment (i.e. quantity of aural discharge as reported by patient) and change in the amount of granulation tissue (as assessed by the physician via endoscopic examination); and (2) persistent disease after two years.Results:There was a highly statistically significant difference in the studied outcomes, comparing the study and control groups.Conclusion:Local application of 5-fluorouracil is a new treatment method for granular myringitis. In this study, it proved safe and efficacious, with no serious local reactions or complications.

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