scholarly journals Is Diclofenac Gargle Effective in Alleviating Post-Tonsillectomy Pain in Adults?

2020 ◽  
Vol 5 (2) ◽  
pp. 1031-1034
Author(s):  
Anup Acharya ◽  
Madan Mohan Singh ◽  
Bhuwan Raj Panday ◽  
Bandana Pokharel ◽  
Shiva Bhushan Pandit ◽  
...  
Keyword(s):  
Randomized Study ◽  
Oral Intake ◽  
Visual Analogue Score ◽  
Double Blind ◽  
Pain Scores ◽  
Post Operative Period ◽  
The Difference ◽  
Absence From Work ◽  
Prolonged Hospital ◽  
Posttonsillectomy Pain

Introduction: Pain in the post-operative period is a major concern following tonsillectomy in an adult resulting in prolonged hospital stay, decreased oral intake and absence from work. Various techniques and medications have been tried to reduce the pain. Objectives We attempted to study the efficacy of diclofenac gargle in reducing the post-tonsillectomy pain in adults. Methodology We conducted a double-blind randomized study in patients 18 years or older undergoing tonsillectomy. Cases were given diclofenac gargle in post-operative period whereas controls were given normal saline gargle. Other modality of treatment and medication were same in both the groups. Pain was assessed at rest and during swallowing with Visual Analogue Score (VAS) on first and second post-operative day, and then at the end of first and second week of the surgery. Pain scores between two groups were compared. Results There were 64 participants equally divided into cases and controls by block randomization. Pain score during swallowing was significantly less in cases. The difference at rest was not significant at any point of time studied. The pain gradually increased over a week in both the groups and then rapidly decreased by the end of second week. Conclusion Diclofenac gargle is effective in reducing the posttonsillectomy pain, especially during swallowing, in adults.

scholarly journals Comparison of the Perioperative and Postoperative Effects of Levobupivacaine and of Levobupivacaine + Adrenaline in Pediatric Tonsillectomy: A Double-Blind Randomized Study

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Faruk Cicekci ◽  
Cigdem Sizer ◽  
Sait Selcuk Atici ◽  
Sule Arican ◽  
Adnan Karaibrahimoglu ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Randomized Study ◽  
Oral Intake ◽  
Postoperative Nausea And Vomiting ◽  
Trial Registry ◽  
Zealand Clinical Trial Registry ◽  
Clinical Trial Registry ◽  
Double Blind ◽  
Total Consumption ◽  
Pain Scores

Objectives. We aimed to assess the effects of levobupivacaine and of levobupivacaine + adrenaline administered during pediatric tonsillectomy on the postoperative period. Methods. A total of 90 patients between the ages of five and twelve were divided randomly into two groups before tonsillectomy: levobupivacaine only (0.5%) 0.4 mg·kg−1 or levobupivacaine (0.5%) 0.4 mg·kg−1 + adrenaline (1 : 200.000) administered by means of peritonsillar infiltration. Primary outcomes were postoperative pain scores recorded at various intervals until 24 hours postoperatively. Secondary outcomes included postoperative nausea and vomiting (PONV), time to first oral intake, time to the first administration of analgesics and total consumption of analgesics, and the amount of bleeding for all children. Results. In both groups, patients had the same postoperative pain scores and PONV rates, and equal amounts of analgesics were consumed up to 24 hours postoperatively. The two groups also had the same time until first oral intake, recovery time and time to the first analgesic request, and amount of bleeding. Conclusions. Perioperative levobupivacaine infiltration on its own is a valid alternative to the combination of levobupivacaine + adrenaline for perioperative and postoperative effectiveness in pediatric tonsillectomy. This trial is registered with Australian New Zealand Clinical Trial Registry ACTRN: ACTRN12617001167358.

scholarly journals The Effect of Peritubal Infiltration with Bupivacaine and Morphine on Postoperative Analgesia in Patients Undergoing Percutaneous Nephrolithotomy

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Isra Karaduman ◽  
Derya Karasu ◽  
Canan Yilmaz ◽  
Sedat Oner ◽  
Hilal Erdem Solak ◽  
...  
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Subcutaneous Tissue ◽  
Randomized Study ◽  
Double Blind ◽  
Analgesic Consumption ◽  
Vas Score ◽  
Pain Scores ◽  
Study Results ◽  
The Mean ◽  
Perinephric Fat

Objective. We aimed to investigate the effect of peritubal local anesthetic and opioid infiltration on pain scores and analgesic consumption in patients who underwent percutaneous nephrolithotomy. Material and Methods. Patients aged between 18 and 65 years and ASA I-III were included in this double-blind, randomized study. The patients were divided into two groups. All patients underwent spinoepidural anesthesia. 20 mL of 0.25 percent bupivacaine + 5 mg morphine (0.5 mL), in Group P (n=66), infiltrated the renal capsule, perinephric fat, muscles, subcutaneous tissue, and skin under fluoroscopy. In Group C (n=64), none of the patients received a peritubal injection. In the first 24 h pain scores, time of the first analgesic demand, the mean number of analgesic demands, and postoperative complications were compared between groups. Results. The mean VAS score at postoperative 8, 12, and 24 h and dynamic VAS score at postoperative 4, 8, 12, and 24 h were significantly lower in Group P. VAS score at postoperative 4 h was not significant. Time of the first analgesic demand was significantly longer in Group P. Conclusion. Our study results suggest that peritubal infiltration of bupivacaine with morphine after percutaneous nephrolithotomy is an effective method for postoperative pain control and reduces analgesic consumption.

Local Infiltrative Anesthetic Effect of Tramadol Compared to Lidocaine for Excision of Cutaneous Lesions: Pilot Randomized, Double-Blind Clinical Study

2012 ◽  
Vol 16 (2) ◽  
pp. 101-106 ◽  
Author(s):  
Despoina Kakagia ◽  
Theodosia Vogiatzaki ◽  
Savvas Eleftheriadis ◽  
Gregory Trypsiannis ◽  
Christos Iatrou
Keyword(s):  
Injection Site ◽  
Postoperative Analgesia ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Demographic Data ◽  
Randomized Study ◽  
Cutaneous Lesions ◽  
Double Blind ◽  
Lidocaine Group ◽  
Pain Scores

Background: In this double-blind, randomized study, the efficacy of tramadol, an atypical opioid, was tested versus lidocaine in excision of cutaneous lesions of the face. Methods: Eighty-eight patients were randomly assigned to receive either 2 mg/kg tramadol 2% plus adrenaline 1:200,000 (group T, n = 46) or 3 mg/kg lidocaine 2% plus adrenaline 1:200,000 (group L, n = 42) for excision of cutaneous lesions. Pain at the injection site, 2 and 20 minutes postinjection and 3, 6, and 12 hours postoperatively, was monitored on a 0 to 10 numerical rating scale (NRS). Irritation at the injection point and the duration of postoperative analgesia were also recorded. Results: There were no significant differences in demographic data, topography, size of the lesions removed, and operative time between the two groups. A tendency toward lower injection NRS pain scores was observed in group L compared to group T (p = .064). No statistically significant differences between the two groups were found at 2 and 20 minutes postinjection (p = .741 and p = .142, respectively); however, pain scores were significantly higher in group L at 3, 6, and 12 hours postoperatively (all p < .001). Erythema at the injection site was observed in nine group T and two group L patients (p = .076). No postoperative analgesics were required in the tramadol group of patients, whereas acetaminophen with or without codeine was administered in all but five lidocaine group patients during the first 12 hours. Conclusion: Tramadol may be used as a reliable local anesthetic agent, providing longer postoperative analgesia compared to lidocaine; however, it bears a higher incidence of irritation at the injection site.

The lack of sustained effect of bright light in non-seasonal major depression

2006 ◽  
Vol 36 (9) ◽  
pp. 1247-1252 ◽  
Author(s):  
KLAUS MARTINY ◽  
MARIANNE LUNDE ◽  
MOGENS UNDÉN ◽  
HENRIK DAM ◽  
PER BECH
Keyword(s):  
Major Depression ◽  
Randomized Study ◽  
Bright Light ◽  
Light Therapy ◽  
Treated Group ◽  
Bright Light Therapy ◽  
Double Blind ◽  
Sustained Effect ◽  
The Difference

Background. Recently accumulated evidence has demonstrated that bright-light therapy in combination with antidepressants is effective in patients with non-seasonal major depression. Whether bright light has a sustained effect after discontinuation is, however, poorly investigated.Method. In this double-blind randomized study we report the results from a 4-week follow-up period in patients with major non-seasonal depression who had been treated for 5 weeks with sertraline combined with bright-light therapy or sertraline combined with dim-light therapy. At the beginning of the follow-up period the light therapy was stopped while sertraline treatment continued for 4 weeks.Results. Depression scores decreased substantially in both groups, resulting in high response and remission rates in both groups after 9 weeks of treatment. The difference in depression scores at week 5, favouring the bright-light-treated group, disappeared gradually in the 4-week follow-up period, resulting in similar end-point scores.Conclusions. Bright light did not have a sustained effect after discontinuation. The offset of effect was complete after 4 weeks.

Ergoloids and Ischaemic Strokes; Efficacy and Mechanism of Action

1995 ◽  
Vol 23 (3) ◽  
pp. 154-166 ◽  
Author(s):  
O Elwan ◽  
AA Helmy ◽  
ME Tamawy ◽  
MA Naseer ◽  
IE Banhawy ◽  
...  
Keyword(s):  
Short Term Memory ◽  
Randomized Study ◽  
Quantitative Difference ◽  
Short Term ◽  
Limb Function ◽  
Double Blind ◽  
The Difference ◽  
Ischaemic Insult ◽  
Assessment Geriatric ◽  
Computerized Electroencephalography

In this double-blind, randomized study the efficacy of the ergoloid compounds, co-dergocrine mesylate and nicergoline, in the rehabilitation of patients with ischaemic stroke was investigated. A group of 30 patients was treated daily with 60 mg nicergoline, orally, and a second group of 27 patients was given 1.8 – 6 mg co-dergocrine mesylate, orally or intramuscularly, daily (depending on the time since the initial ischaemic insult) for 6 months. Outcome measures included: motoricity index (limb function); Sandoz Clinical Assessment Geriatric (SCAG) scale; psychometric tests to assess functions such as attention, psychomotor performance, perception and sensory and short-term memory; conventional and computerized electroencephalography; and P300 and reaction time measures. The results showed improvements in some aspects such as limb function ( P < 0.05), SCAG score ( P < 0.01) and some electrophysiological parameters ( P < 0.01) after treatment with both drugs. Though statistically significant most of the changes were not large. The efficacy of both drugs was qualitatively similar. The quantitative difference in some aspects in favour of nicergoline could be attributed to differences in the mechanisms of action of the two drugs, although it is also possible that the difference may reflect the dosages used. Nootropic drugs may induce a condition that facilitates the effects of cognitive training.

scholarly journals Once-Daily Oral Gatifloxacin versus Oral Levofloxacin in Treatment of Uncomplicated Skin and Soft Tissue Infections: Double-Blind, Multicenter, Randomized Study

2001 ◽  
Vol 45 (8) ◽  
pp. 2358-2362 ◽  
Author(s):  
Gary A. Tarshis ◽  
Barry M. Miskin ◽  
Terry M. Jones ◽  
John Champlin ◽  
Kevin J. Wingert ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Randomized Study ◽  
Common Adverse Event ◽  
Soft Tissue Infections ◽  
Bacterial Eradication ◽  
Double Blind ◽  
Once Daily ◽  
End Of Treatment ◽  
The Difference ◽  
Cure Rates

ABSTRACT This was a double-blind, multicenter study in which 410 adults (≥18 years of age) with uncomplicated skin and soft tissue infections (SSTIs) were randomized to receive either 400 mg of gatifloxacin orally once daily or 500 mg of levofloxacin orally once daily for 7 to 10 days. The study protocol called for four assessments—before and during treatment, at the end of treatment, and posttreatment. Efficacy evaluations included clinical response and bacterial eradication rates. Of 407 treated patients, 202 (108 women, 94 men) received gatifloxacin and 205 (111 women, 94 men) received levofloxacin. For clinically evaluable patients, the cure rates were 91% for gatifloxacin and 84% for levofloxacin (95% confidence interval [CI] for the difference, −2.0 to 15.2%). Clinical cure rates for microbiologically evaluable patients were 93% for gatifloxacin and 88% for levofloxacin (95% CI for the difference, −6.5 to 16.8%). The bacterial eradication rate was 92% for each group, with gatifloxacin eradicating 93% of the methicillin-susceptible Staphylococcus aureus isolates and levofloxacin eradicating 91% of them. Both drugs were well tolerated. Most of the adverse events were mild to moderate, and nausea was the most common adverse event in each treatment arm. Once-daily oral gatifloxacin (400 mg) is clinically efficacious and well tolerated compared with once-daily levofloxacin (500 mg) for the treatment of patients with uncomplicated SSTIs.

Oral Flurbiprofen Spray for Posttonsillectomy Pain

2016 ◽  
Vol 155 (1) ◽  
pp. 166-172 ◽  
Author(s):  
Togay Muderris ◽  
Fatih Gul ◽  
Gokhan Yalciner ◽  
Mehmet Ali Babademez ◽  
Sami Bercin ◽  
...  
Keyword(s):  
Placebo Group ◽  
Rating Scale ◽  
Demographic Data ◽  
Double Blind ◽  
Pain Scores ◽  
Significant Difference ◽  
Lower Pain ◽  
Numeric Pain Rating Scale ◽  
Rating Scale Data ◽  
Posttonsillectomy Pain

Objective Tonsillectomy is still one of the most common surgical procedures, but there exists no standard guideline for pain management after tonsillectomy. Our aim is to determine whether oral spray of flurbiprofen reduces pain and has an influence on other morbid outcomes following tonsillectomy. Study Design Prospective, double-blind, randomized, placebo controlled. Setting Patients at Ataturk Training and Research Hospital, Ankara, Turkey. Subjects and Methods This study was performed on 84 patients (45 in flurbiprofen group, 39 in placebo group) who underwent tonsillectomy. The patients were randomly chosen, and each used oral spray of flurbiprofen 3 times daily or placebo solution at the same regimen. Efficacy was assessed by changes in Numeric Pain Rating Scale. Data were collected at postoperative days 1, 3, 5, and 7 for pain, bleeding, and healing. Data for Mallampati scores were also collected. Results There were no significant difference between groups with respect to the demographic data. The flurbiprofen group had statistically significant lower pain scores at days 1, 3, 5, and 7 ( P = .000, P = .002, P = .001, P = .000, respectively). On days 3 and 7, pain scores were significantly different between different Mallampati groups ( P = .049, P = .015, respectively). The flurbiprofen group required less analgesic than the placebo group during the study period on days 1, 3, 5, and 7 ( P = .001, P = .001, P = .03, P = .001, respectively). Healing and side effects were not significantly different between the groups. Conclusion In this study, topical use of flurbiprofen may reduce posttonsillectomy pain without any evidence of additional complications.

A Comparative Study of Lignocaine, Pethidine, Ketamine and Placebo for Prevention of Pain on Propofol Injection

2021 ◽  
Vol 12 (6) ◽  
pp. 29-33
Author(s):  
Shagufta Naaz ◽  
Erum Ozair ◽  
Adil Asghar
Keyword(s):  
Saline Group ◽  
Good Choice ◽  
The Other ◽  
Double Blind ◽  
Pain Scores ◽  
Hepatic Diseases ◽  
Reduction Of Pain ◽  
Group A ◽  
The Difference ◽  
Group B

Background: Pain caused by propofol injection is a common occurrence. Aims and Objectives: The aim of this study was to compare and evaluate the efficacy of three drugs, lignocaine, pethidine and ketamine for prevention of pain during propofol injection. Materials and Methods: This double blind, placebo-controlled, parallel multi-arm study was done after written informed consent and ethics clearance. Hundred patients of ASA I and II, 18-65 years of age, and with body mass index 18-30 kg/m2 were included. Exclusion criteria were significant cardiovascular or hepatic diseases, renal insufficiency, and a history of allergy to the study drugs. Group A (Normal Saline), Group B (Ketamine 25 mg), Group C (Lignocaine 20 mg) and Group D (Pethidine 25 mg) were pre-treated with 2 ml of the study agents before propofol injection. The primary outcome was the incidence of pain with propofol injection and the secondary outcomes were the induction time, pain scores at various time intervals, the incidence of recall of pain after surgery, haemodynamic changes and adverse effects. Results: There were highly significant differences (p<0.001) in the incidences of pain during propofol injection in group A and the other three groups. The difference in incidence of pain was also significant between Group C and other groups. The differences in the pain scores (p<0.001) and recall of pain (p<0.05) between group A and the other three groups were significant. Conclusion: Lidocaine may be considered as a good choice for the purpose of reduction of pain during propofol injection.

scholarly journals LO037: A randomized double-blind trial comparing the effect on pain of an oral sucrose solution versus placebo in children 1 to 3 months old needing urethral catheterization

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S42-S43
Author(s):  
M. Desjardins ◽  
S. Gouin ◽  
N. Gaucher ◽  
D. Lebel ◽  
J. Gravel
Keyword(s):  
Heart Rate ◽  
Sucrose Solution ◽  
Pain Scale ◽  
Urethral Catheterization ◽  
Double Blind ◽  
Solution Versus ◽  
Pain Scores ◽  
The Mean ◽  
Oral Sucrose ◽  
The Difference

Introduction: Oral sweet solutions have been accepted as effective analgesics for procedures in the neonatal population. However, there have been a limited number of trials in older infants. These studies have conflicting results. The objective of the study was to compare the efficacy of an oral sucrose solution versus placebo in reducing pain during urethral catheterization in infants 1 to 3 months old in the Emergency Department (ED). Methods: A randomized, double-blind clinical trial was conducted in a pediatric university-affiliated hospital ED. Infants, 1 to 3 months of age, were recruited and randomly allocated to receive 2 ml of 88% sucrose solution (SUC) or 2 ml of placebo solution (PLA) orally, 2 minutes before planned urethral catheterization. The primary outcome measure was the difference in pain scores as assessed by the Face, Legs, Activity, Cry and Consolability (FLACC) Pain Scale at 1 min post procedure. Secondary outcome measures were the difference in pain scores using the Neonatal Infant Pain Scale (NIPS), crying time and variations in heart rate. Results: Seventy-six participants were recruited and completed the study, 37 (group SUC) and 39 (group PLA) respectively. The mean difference in FLACC scores compared to baseline was 5.62 ± 1.32 (SUC) vs. 6.21 ± 1.15 (PLA) (p=.51) during catheterization, 2.70 ± 1.21 (SUC) vs. 2.26 ± 1.41 (PLA) at 1 min (p=.64) and 0.66 ± 1.32 (SUC) vs. 1.26 ± 1.00 (PLA) at 3 mins (p=.38). For the NIPS scores, it was 4.27 ± 1.06 (SUC) vs. 4.69 ± 0.92 (PLA) (p=.56) during procedure, 2.05 ± 0.91 (SUC) vs. 1.97 ± 1.19 (PLA) (p=.92) at 1 min and 0.49 ± 0.89 (SUC) vs. 0.89 ± 0.97 (PLA) (p=.54) at 3 mins. The difference in the mean crying time was not different between both groups: 99 ± 34 secs (SUC) vs. 100 ± 25 (PLA) (p=.99). No significant difference was found in participants’ heart rate variations during procedure 23 ± 8 BPM (SUC) vs. 26 ± 7 (PLA) (p=.60), after 1 min 19 ± 12 BPM (SUC) vs. 17 ± 7 (PLA) (p=.76) and after 3 mins -1 ± 12 BPM (SUC) vs. 3 ± 6 (PLA) (p=.53). Conclusion: In infants 1 to 3 months of age undergoing urethral catheterization in the ED, administration of an oral sweet solution did not statistically decrease pain scores as measured by the FLACC and NIPS scales. Participants’ heart rate variations and crying time were not significantly decreased when sucrose was provided.

scholarly journals Celecoxib is as Efficacious as Naproxen in the Management of Acute Shoulder Pain

2003 ◽  
Vol 31 (2) ◽  
pp. 102-112 ◽  
Author(s):  
P Bertin ◽  
J-M Béhier ◽  
E Noël ◽  
J-L Leroux
Keyword(s):  
Shoulder Pain ◽  
Epigastric Pain ◽  
Randomized Study ◽  
Specific Inhibitor ◽  
Analgesic Efficacy ◽  
Double Blind ◽  
Maximum Pain ◽  
Efficacy Measures ◽  
The Difference ◽  
Pain At Rest

This study compared the analgesic efficacy and safety of the cyclo-oxygenase-2 specific inhibitor celecoxib with the non-specific non-steroidal anti-inflammatory drug, naproxen, in patients with acute shoulder pain. Adult patients with shoulder pain, onset within the previous 14 days and shoulder pain of ≥ 40 mm on a 100 mm visual analogue scale (VAS), were treated with oral doses of celecoxib or naproxen for 14 days and followed by a visit at day 42 in a double-blind, randomized study. The primary efficacy assessment was change in maximum pain at rest on a 100 mm VAS at day 14 compared with baseline. In addition, secondary efficacy pain and functional assessments were analysed at baseline, day 14 and day 42. A total of 202 patients were included in the trial (99 celecoxib 400 mg/day; 103 naproxen 1 g/day). The difference in change from baseline at day 14 in maximum pain at rest was not statistically significant between the two treatment groups, but was numerically higher for celecoxib than for naproxen (−47.9 ± 2.5 versus −42.3 ± 2.5, respectively). According to the limits of the 95% confidence interval of the difference between groups (−12.52; 1.38), celecoxib appeared to be at least as effective as naproxen. All secondary efficacy measures followed the same pattern, showing similarity between the two treatments with a trend in favour of celecoxib. The incidences of adverse events were similar for both groups. Fewer patients experienced epigastric pain with celecoxib (seven patients versus 14 with naproxen). This adverse event led to discontinuation in two patients receiving celecoxib and five receiving naproxen. Celecoxib 400 mg/day was at least as effective as naproxen 1 g/day in managing pain in this condition.

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