scholarly journals Comparative study of tramadol and ketorolac in the pain management of third molar tooth extraction

1970 ◽  
Vol 6 (1) ◽  
pp. 35-43 ◽  
Author(s):  
MM Shaik ◽  
J Kumar ◽  
S Mobina ◽  
N Satyanarayana ◽  
P Sunitha

Objective: Clinical comparison of efficacy, duration of action, onset of action, side effects of two most commonly used analgesics tramadol and ketorolac after the third molar tooth extraction. Materials and methods: The present study was carried out at department of oral surgery, Mamata Dental Hospital, Khammam, India. 150 patients were randomly selected and divided into two groups. Group A received 50 mg of tramadol orally and Group B received 10 mg of ketorolac orally. In both groups dose was repeated for next 24 hrs. Visual scale analog was used for the collection of pain intensity from the patients. Results: In Group A, the analgesia started within 1hour and at the end of 24 hours, pain intensity was 2.12 out of 10 on visual analog scale. In Group B, analgesia started within 30 mins and at the end of 24 hours, the pain intensity was 2.98 on visual analog scale. Sedation associated with dizziness and muscle relaxation was observed with tramadol in 5% of patients and sweating in 8% patients. While in case of ketorolac, 33% of patients suffered with side effects. Among them 33% patients suffered with bleeding at the site of tooth extraction and 20% patients suffered with epigastric pain. The analgesic effect of 50 mg tramadol lasted up to 6 hours and that of ketorolac lasted for 5 hour. Conclusion: The study shows that tramadol is a suitable and safe analgesic for the relief of post-extraction pain and is more effective than ketorolac with prolonged analgesia and minimal side effects. Key Words: Tramadol; ketorolac; third molar tooth extraction DOI: 10.3126/jcmsn.v6i1.3600 Journal of College of Medical Sciences-Nepal, 2010, Vol. 6, No. 1, 35-43

2016 ◽  
Vol 3 (4) ◽  
pp. 775
Author(s):  
R Chethan ◽  
T K Ramamuthy ◽  
Shilpa Patil ◽  
Satheesha Reddy

AIM: Assessing the efficacy of drug in controlling pain intensity after surgical removal of impacted  mandibular third molar teeth and to compare the effects. MATERIAL AND METHODS: A double-blind, randomized, controlled clinical trial was conducted. 40 patients were randomly selected and divided into two equal groups. Group A received 50 mg of tramadol orally and Group B received 10 mg of ketorolac orally. In both groups dose was repeated for next 24 hrs. Visual analogue scale was used for the collection of pain intensity from the patients. RESULTS: The results revealed, in Group A, the analgesia started within 1 hour and reached the maximum analgesic effect in 4 hours, pain intensity was 1.8 out of 10, on visual analog scale. In Group B, analgesia started within 1hour and showed it’s maximum analgesic effect. The pain intensity was 2.5 on visual analog scale. The analgesic effect of 50 mg tramadol lasted up to 6 hours and that of ketorolac lasted for 5 hour. CONCLUSION: The study shows that 50mg tramadol is a suitable and safe analgesic for the relief of post-extraction pain and is more effective than 10mg ketorolac with prolonged analgesia and minimal side effects, we recommend studies with randomized clinical trials with larger sample size are needed it in clinical practice.


1999 ◽  
Vol 90 (2) ◽  
pp. 432-436 ◽  
Author(s):  
Alain Borgeat ◽  
Hans-Ruedi Stirnemann

Background Spinally and epidurally administered morphine is frequently associated with pruritus. Isolated case reports indicate that ondansetron may be effective in this context. This study aims to investigate the effectiveness of ondansetron to treat this side effect. Methods In a prospective, randomized, double-blind, placebo-controlled study, 100 patients with pruritus (> 4 on a visual analog scale, on which 0 represents no pruritus and 10 represents worst pruritus imaginable) after spinal or epidural administration of morphine, received either 8 mg ondansetron intravenously (ondansetron group) in 100 ml NaCl 0.9% or vehicle (placebo group). A decrease of more than 4 points on the visual analog scale 60 min after treatment was considered a success. Changes in levels of pain and sedation, hemodynamic values, and other side effects were checked regularly. The presence or absence of pruritus was assessed for the last time 24 h later. Results The two groups were similar for demographic characteristics, the route of administration of morphine, and severity of pruritus at the beginning of the study. The ondansetron group showed a success rate of 70% versus 30% for the placebo group (P > 0.05). Among the successfully treated patients, three (9%) in the ondansetron group and six (40%) in the placebo group reported the recurrence of pruritus (P < 0.05). Among the successfully treated patients, none complained of residual pruritus 24 h later. No changes in pain or sedation levels were noted. Hemodynamic values remained stable, hemoglobin oxygen saturation did not decrease, and no other side effects were observed. Conclusion The administration of 8 mg ondansetron intravenously is an effective treatment for spinally or epidurally administered morphine-induced pruritus. In this clinical condition the treatment is safe and well tolerated.


2020 ◽  
Vol 14 ◽  
Author(s):  
Zhenkai Han ◽  
Tao Hong ◽  
Yuanyuan Ding ◽  
Shimeng Wang ◽  
Peng Yao

BackgroundPostherpetic neuralgia (PHN) is a form of long-lasting neuropathic pain that can severely affect patients’ quality of life. Pulsed radiofrequency (PRF) has been proven to be effective in treating PHN, but the optimal radiofrequency parameters are still not well defined. This retrospective study aimed to compare the efficacy and safety of CT-guided PRF at three different voltages for the treatment of PHN patients.MethodsThis study included 109 patients with PHN involving the thoracic dermatome who were treated in the Department of Pain Management of Shengjing Hospital, China Medical University, from January 2017 to May 2019. They were divided into three groups based on the PRF voltage used: group A (45 V), group B (55 V), and group C (65 V). The PRF therapy (voltage 45, 55, and 65 V) was performed in all patients by targeting the thoracic dorsal root ganglion. After surgery, patients were followed at 3 days, 1 month, 3 months, 6 months, and 12 months. Observation at each follow-up included basic patient characteristics, visual analog scale (VAS), 36-Item Short Form Health Survey (SF-36) scores, patient satisfaction, complications, and side effects.ResultsVisual analog scale scores decreased and SF-36 scores increased for all patients in the three groups at each post-operative time point (1, 3, 6, and 12 months; all P < 0.01). Pain relief, improvement in quality of life, and overall satisfaction were more significant for patients in group C than for those in groups A and B at the 3-, 6-, and 12-month follow-ups (all P < 0.05). Patients in group B had lower VAS scores and higher overall satisfaction levels than those in group A (both P < 0.01). A small number of patients from each group (n ≤ 3) experienced mild intraoperative and post-operative complications, which bore no relationship with group assignment (all P > 0.05). At post-operative day 3, patients in group C had skin numbness affecting a larger area than patients in the other two groups (both P < 0.05), but the differences were no longer statistically significant at day 30 after the operation. All patients experienced a drop in numbness area of more than 30% after surgery.ConclusionCompared with PFR at 45 and 55 V, PFR at 65 V had superior efficacy in treating PNH, with a favorable safety profile.


2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Qing Wan ◽  
Shaoling Wu ◽  
Xiao Li ◽  
Caina Lin ◽  
Songjian Ke ◽  
...  

Objective. The aim of this study was to compare the accuracy and efficacy of sonographically guided lumbar periradicular injections through in-plane or out-of-plane approach techniques for patients with unilateral lower lumbar radicular pain. The feasibility and accuracy of these techniques were studied by means of computed tomography (CT). Methods. A total of 46 patients with chronic unilateral lumbar radicular pain were recruited and randomly assigned to either the in-plane or out-of-plane injection group. A mixture of 3 mL 1% lidocaine and 7 mg betamethasone was injected. The visual analog scale (VAS) was used to assess pain before and after treatment. Results. The pain intensity, as measured by VAS, significantly decreased in both in-plane and out-of-plane injection groups. Conclusions. The sonographically guided periradicular injections are feasible and effective in treating lumbar unilateral radicular pain.


2015 ◽  
Vol 6 (4) ◽  
pp. 129-133
Author(s):  
Subbhabrata Das

ABSTRACT Aim This is a randomized case-control study to know the efficacy of postoperative pain relief with transdermal diclofenac patch 200 mg and comparison with injection diclofenac sodium 75 mg. Materials and methods A total of 100 patients with head and neck cancer were included in the study and were randomly divided into two groups (A and B). Anesthetic procedure was standardized. A transdermal diclofenac diethylamine patch of 200 mg was applied to group A, just before the skin closure. And in group B, injection diclofenac was given 8 hourly. In group A, injection diclofenac was given on an as-needed basis whenever patient had visual analog scale (VAS) of pain > 5. Visual analog scale at 2nd, 4th, 8th, 12th, and 24th hour postoperatively was recorded for 5 days. Injection diclofenac needed in groups A and B was recorded for five postoperative days and the mean number of injections of diclofenac per patient per day needed in both groups was calculated. Results In group A, we needed only 0.96 injections (diclofenac 75 mg)/patient on the first day and no injection was needed further, while in group B, we had to use three injections/day/ patient. Visual analog scale and pain relief were more steady and better in group A as compared with group B. Conclusion Transdermal patch of diclofenac diethylamine 200 mg is very effective in providing postoperative analgesia and is better than intravenous injection diclofenac 75 mg. How to cite this article Singh SP, Jain DK, Das S, Jain S. A Prospective Case-control Study on the Comparison of Postoperative Pain Relief with Transdermal Diclofenac Patch and Injection Diclofenac. Int J Head Neck Surg 2015;6(4):129-133.


Author(s):  
Carlo Cagini ◽  
Alessio Muzi ◽  
Greta Castellucci ◽  
Giulia Ragna ◽  
Marco Lupidi ◽  
...  

Aim of the study: Hydrocortisone is a soft steroid with low anti-inflammatory properties and a short duration of action, used to manage several ocular conditions. The clinical benefits and side effects associated with hydrocortisone are well documented, but its basic pharmacokinetic in the eye is yet to be fully elucidated. The purpose of this study is to investigate the anterior chamber penetration capabilities of hydrocortisone when used in different concentrations as eye drops treatment. Materials and Methods: This is a double-blind, single-center, randomized clinical trial performed at the Department of Medicine and Surgery of the University of Perugia (Italy) on consecutive patients who have undergone phacoemulsification with intraocular lens implantation. Patients were randomly assigned on the morning of surgery to receive a single instillation of 0.33% (group A) or 0.001% (group B) hydrocortisone sodium phosphate solution. Group of patients C did not receive any treatment and was used to measure the hydrocortisone endogenous levels. Before surgery, one aliquot of aqueous humor for each patient was aspirated. The time of collection for each sample was recorded. Hydrocortisone concentrations were then stratified into six interval classes of 30 minutes each. Results: The mean concentration of hydrocortisone was significantly higher in group A (25.2±12.4 ng/ml) compared with group B (7.11±1.51 ng/ml) and compared to the mean hydrocortisone endogenous levels (3.92±1.18 ng/ml) (p<0.0001). No statistically significant differences of hydrocortisone mean concentrations between group B and the mean endogenous levels were found. Conclusions: Considering the frequent need for prolonged topical steroid therapies and the possible consequent undesirable side effects, ophthalmologists should consider the lowest clinically effective dose of hydrocortisone useful to obtain the desired therapeutic effect and in an adequate time, to minimize the amount of steroids into the anterior chamber and to avoid side effects, such as intraocular pressure increase or cataract development.


Author(s):  
Swati Pandey ◽  
S. S. Smruthi Kiran

Background: To assess and compare the Visual Analog Scale (VAS) for pain on intravenous injection in patients receiving the two different formulations of Propofol.Methods: Total 170 eligible patients were randomized into Group A receiving Propofol MCT/LCT and Group B receiving Propofol LCT. After standard pre-anaesthetic preparation and baseline values recording, the blinded investigator recorded pain intensity after injection of 1mL study drug propofol, using Visual Analog Scale (0-10). Haemodynamic parameters were recorded every minute for 5 minutes. Calculated Propofol dose was injected in 20 seconds, and signs of pain (hand withdrawal, grimacing) were noted. After patient regained full consciousness, recall of injection pain was asked for.Results: The proportion of patients who experienced pain was similar in both groups (group A: 76/85 =89.41%, group B: 81/85 = 95.29%; statistically not significant (p value=0.247). Patients in group A had longer time for pain onset (11.3 seconds-group A Vs 9.8 seconds-group B; statistically significant, p value =0.008). Pain on injection was higher in Propofol LCT group as compared to Propofol MCT/LCT (VAS scores of group A=3.94±2.0 vs group B = 5.49±1.96; statistically significant; p value = 0.0018). Full dose of Propofol MCT/LCT produced significantly less pain when compared to Propofol LCT (p value = 0.0424). Recall of pain was comparable between the groups. Haemodynamic parameters (Heart rate and Mean Arterial Pressure) remained comparable in both groups.Conclusions: Pain on injection was higher and statistically significant in Propofol LCT group as compared to Propofol MCT/LCT.


2005 ◽  
Vol 24 (07) ◽  
pp. 626-639 ◽  
Author(s):  
V. Pfaffenrath ◽  
L. Pageler ◽  
H. Peil ◽  
B. Aicher ◽  
H. C. Diener

ZusammenfassungDie Wirksamkeit, Sicherheit und Verträglichkeit einer Einzelgabe von zwei Tabletten der fixen Dreierkombination mit 250 mg Azetylsalizylsäure (ASS) plus 200 mg Paracetamol plus 50 mg Koffein (Thomapyrin®) gegenüber zwei Tabletten mit 500 mg ASS, oder zwei Tabletten mit 500 mg Paracetamol, oder zwei Tabletten mit 50 mg Koffein beziehungsweise Plazebo wurde in einer klinischen Studie an 1 743 Patienten geprüft, die ihre episodischen Kopfschmerzen vom Spannungstyp oder ihre Migräne mit und ohne Aura üblicherweise erfolgreich mit verschreibungsfreien Analgetika behandeln. Die Dreierkombination war im a priori definierten primären Endpunkt “Zeit bis zu 50% Schmerzreduktion” sowohl der Zweierkombination aus ASS plus Paracetamol (p = 0,0181), als auch den Monoanalgetika ASS (p = 0,0398) und Paracetamol (p = 0,0016), sowie auch der Monotherapie mit Koffein (p < 0,0001) und Plazebo (p < 0,0001) überlegen. Alle Behandlungen außer der Koffein-Monotherapie waren der Plazebobehandlung überlegen (p < 0,0001). Die überlegene Wirksamkeit der Dreierkombination gilt auch für alle sekundären Endpunkte wie beispielsweise der “Verringerung der Kopfschmerzen auf 10 mm VAS (visual analog scale = visuelle Analogskala zur Schmerzmessung), dem gewichteten % SPID (sum of pain intensity difference = aufsummierte Schmerzintensitätsdifferenz gegenüber dem Ausgangsschmerz in Prozent), dem Ausmaß der Beeinträchtigung der alltäglichen Aktivitäten und der globalen Beurteilung der Wirksamkeit durch die Patienten. Alle Behandlungen waren gut verträglich, die Inzidenz von unerwünschten Begleiterscheinungen war gering.


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

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


2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Rie Ishikawa ◽  
Masako Iseki ◽  
Rie Koga ◽  
Eiichi Inada

Postherpetic itch (PHI), or herpes zoster itch, is an intractable and poorly understood disease. We targeted 94 herpes zoster patients to investigate their pain and itch intensities at three separate stages of the condition (acute, subacute, and chronic). We used painDETECT questionnaire (PDQ) scores to investigate the correlation between PHI and neuropathic pain. Seventy-six patients were able to complete follow-up surveys. The prevalence of PHI was 47/76 (62%), 28/76 (37%), and 34/76 (45%) at the acute, subacute, and chronic stages, respectively. PHI manifestation times and patterns varied. We investigated the relationship of PHI with neuropathic pain using the visual analog scale (VAS), which is a measure of pain intensity, and the PDQ, which is a questionnaire used to evaluate the elements of neuropathic pain. The VAS and PDQ scores did not differ significantly between PHI-positive and PHI-negative patients. A large neuropathic component was not found for herpes zoster itch, suggesting that neuropathic pain treatments may not able to adequately control the itch. Accordingly, we suggest that a more PHI-focused therapy is required to address this condition.


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