scholarly journals Efficacy and safety of intrathecal morphine for post cesarean section analgesia

2015 ◽  
Vol 1 (1) ◽  
pp. 13-17
Author(s):  
Rupesh Kumar Gami ◽  
Kumar Jahan ◽  
Chandra Bhushan Jha
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Visual Analog Scale ◽  
Intrathecal Morphine ◽  
Safe Motherhood ◽  
Control Group ◽  
Efficacy And Safety ◽  
Analog Scale ◽  
Morphine Group ◽  
Significant Difference

Background: Government of Nepal has been conducting Cesarean section under “Safe Motherhood” program all over country. The purpose of this study was to evaluate the efficacy and safety of intrathecal morphine for post cesarean analgesia under spinal anesthesia.  Methods: A total of 300 parturients posted for Cesarean section under spinal anesthesia were divided into two groups of 150 each in this prospective randomized case-control study. Morphine group received 0.15 mg of intrathecal morphine mixed in 12 mg of 0.5% bupivacaine heavy while control group received 12 mg of 0.5% bupivacaine heavy alone, after proper preparation of spinal anesthesia. The parturients were assessed for first request of analgesic as per Visual Analog Scale, frequency of analgesics required within 24 hr, nausea, vomiting, pruritus, sedation and respiratory depression.Results: Postoperative analgesia was significantly greater in morphine group as compare to control group (12.1 ± 7.6 vs 3.7 ± 2.9 hr). Frequency of analgesics requirements was also significantly lower in morphine group (1.7 ± 2.0 vs 3.4 ± 8.1). Visual Analog Scale was below 4 at most of time in morphine group. The incidence of nausea, vomiting and pruritus were more in morphine group as compare to control group but without any respiratory depression. There was no significant difference in APGAR score among fetus.  Conclusion: Mixing low dose of intrathecal morphine in standard dose of spinal anesthesia effectively prolongs the duration of post cesarean analgesia and decreases the frequency of analgesics requirement without any major complication in parturients or fetus.Journal of Society of Anesthesiologists 2014 1(1): 13-17

scholarly journals Sub-hypnotic dose of propofol as antiemetic prophylaxis attenuates intrathecal morphine-induced postoperative nausea and vomiting, and pruritus in parturient undergoing cesarean section — a randomized control trial

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Sylvanus Kampo ◽  
Alfred Parker Afful ◽  
Shiraj Mohammed ◽  
Michael Ntim ◽  
Alexis D. B. Buunaaim ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Postoperative Nausea ◽  
Randomized Control Trial ◽  
Intrathecal Morphine ◽  
Postoperative Nausea And Vomiting ◽  
Control Group ◽  
Significant Difference ◽  
Randomized Control ◽  
Hypnotic Dose

Abstract Background Postoperative Nausea and Vomiting (PONV) is a dreadful and uncomfortable experience that significantly detracts patients’ quality of life after surgery. This study aimed to examine the antiemetic effect of a single sub-hypnotic dose of propofol as prophylaxis for PONV. Method In this prospective, double-blind, randomized control trial, 345 parturients presented for elective cesarean section at the Obstetric unit of Tamale Teaching Hospital were recruited. Each recruited parturient was randomly assigned to one of three groups; Propofol group (n = 115) represented those who received propofol 0.5 mg/kg, Metoclopramide group (n = 115) represented those who received metoclopramide 10 mg and, Control group (n = 115) represented those who received 0.9% saline. Spinal anesthesia with 0.5% hyperbaric bupivacaine 7.5–10 mg, and intrathecal morphine 0.2 mg was employed for the anesthesia. Results The data indicate that 108 (93.9%) parturients from the control group, 10 (8.7%) from the propofol group and 8 (7.0%) from the metoclopramide group experienced some incidence of PONV. There was no significant difference in the incidence of PONV (nausea, vomiting, and none) between the propofol and the metoclopramide groups (P = 0.99; 0.31; and 0.35 respectively). Parturients who received antiemetic agents were 105 (97.2%), 1 (10.0%) and 3 (37.5%) from the control, propofol and metoclopramide groups respectively. The data indicated that 98 (85.2%) parturients from the control, 3 (2.6%) from propofol group, and 100 (87.0%) from the metoclopramide group experienced some levels of pruritus. There was a significant difference in the incidence of pruritus (mild, moderate, and no pruritus) between the metoclopramide and propofol groups (P <  0.01; P <  0.01; and P <  0.01 respectively). Conclusion A sub-hypnotic dose of propofol is effective as metoclopramide in the prevention of PONV in parturient undergoing cesarean section under spinal anesthesia with intrathecal morphine. Sub-hypnotic dose of propofol significantly reduces the incidence of postoperative pruritus following intrathecal morphine use. Trial registration Current control trial, registered at ISRCTN trial registry: ISRCTN15475205. Date registered: 03/04/2019. Retrospectively registered.

scholarly journals The effect of local ketamine infiltration on post tonsillectomy pain scale

2020 ◽  
Vol 50 (1) ◽  
pp. 38
Author(s):  
Ade Asyari ◽  
Novialdi Novialdi ◽  
Elniza Morina ◽  
Rimelda Aquinas ◽  
Nasman Puar ◽  
...  
Keyword(s):  
Visual Analog Scale ◽  
Secondary Infection ◽  
Pain Scale ◽  
Control Group ◽  
Analog Scale ◽  
Noticeable Effect ◽  
Local Infiltration ◽  
Significant Difference ◽  
Post Test ◽  
Test Control

Background: Post tonsillectomy pain is one of the surgery side effects that most disturbing for patient’s comfort and will cause dysphagia, low intake, dehydration, secondary infection and bleeding. Ketamine is an anesthetic drug that has strong analgesic effect and easily available in any hospital at relatively cheap price. Objective: To find out the effect of local ketamine infiltration on the post tonsillectomy pain scale. Method: An experimental study during tonsillectomy with a Post Test Control Group on 12 samples without local infiltration of ketamine and 12 samples with local infiltration of ketamine in peritonsillar pillar. The pain was assessed 2 hours and 24 hours post extubation with pain Visual Analog Scale (VAS). Result: The VAS value from patients who were given local infiltration of ketamine in peritonsillar pillar were lower (5.83 ± 0.72 at 2 hours and 2.83 ± 0.58 at 24 hours post extubation) compared to patients without ketamine infiltration (7.83 ± 0.58 at 2 hours and 3.58 ± 0.51 at 24 hours post extubation). The result showed statistically significant difference (p <0.05) at 2 hours and 24 hours post extubation. Conclusion: The VAS score of the ketamine infiltration group is lower at 2 hours and 24 hours post extubation than the group without ketamine infiltration, showing there was a noticeable effect of local ketamine infiltration on the post tonsillectomy pain scale.Keywords : post tonsillectomy pain, ketamine, local infiltration, visual analog scale ABSTRAKLatar belakang: Nyeri pascatonsilektomi adalah salah satu efek samping operasi yang sangat mengganggu kenyamanan pasien, dan dapat menyebabkan gangguan menelan, kurangnya asupan nutrisi, dehidrasi, infeksi sekunder dan perdarahan. Ketamin merupakan obat anestesi yang memiliki efek analgetik yang kuat dan mudah didapatkan di semua tipe rumah sakit dengan harga yang relatif murah. Tujuan: Mengetahui efek pemberian infiltrasi lokal ketamin terhadap skala nyeri pascatonsilektomi. Metode: Penelitian eksperimental dengan desain Post Test Control Group pada 12 sampel tanpa pemberian infiltrasi lokal ketamin dan 12 sampel dengan pemberian infiltrasi lokal ketamin di pilar peritonsil saat tonsilektomi. Dilakukan penilaian nyeri 2 jam dan 24 jam pascaekstubasi menggunakan skala nyeri Visual Analog Scale (VAS). Hasil: Nilai VAS pasien yang diberi infiltrasi lokal ketamin di pilar peritonsil lebih rendah (5,83±0,72 pada 2 jam dan 2,83 ± 0,58 pada 24 jam pascaekstubasi) dibanding tanpa diberi infiltrasi lokal ketamine (7,83 ± 0,58 pada 2 jam dan 3,58± 0,51 pada 24 jam pascaekstubasi), dan bermakna secara statistik (p<0,05) pada kedua penilaian. Kesimpulan: Terdapat efek nyata infiltrasi lokal ketamin terhadap skala nyeri pascatonsilektomi, dimana nilai VAS kelompok yang diberi infiltrasi ketamin lebih rendah, baik pada 2 jam ataupun 24 jam pascaekstubasi dibanding kelompok yang tidak diberi infiltrasi ketamin.

scholarly journals The Effect of 1,8-Cineole Inhalation on Preoperative Anxiety: A Randomized Clinical Trial

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Ka Young Kim ◽  
Hyo Jin Seo ◽  
Sun Seek Min ◽  
Mira Park ◽  
Geun Hee Seol
Keyword(s):  
Visual Analog Scale ◽  
Controlled Trial ◽  
Major Constituent ◽  
Control Group ◽  
Analog Scale ◽  
Almond Oil ◽  
Eucalyptus Oil ◽  
Significant Difference ◽  
Before And After ◽  
Selective Nerve Root Block

The aim of this study was to investigate the effect of inhalation of eucalyptus oil and its constituents on anxiety in patients before selective nerve root block (SNRB). This study was a randomized controlled trial carried out in 62 patients before SNRB. The patients were randomized to inhale limonene, 1,8-cineole, or eucalyptus oil, each at concentrations of 1% vol/vol in almond oil or almond oil (control). Anxiety-visual analog scale (A-VAS), state-trait anxiety inventory (STAI), profile of mood states (POMS), pain-visual analog scale (P-VAS), blood pressure, and pulse rate were measured before and after inhalation prior to SNRB. Measures of anxiety, including A-VAS (P<0.001), STAI (P=0.005), and POMS (P<0.001), were significantly lower in 1,8-cineole than in the control group and significantly greater in 1,8-cineole than in the eucalyptus group in A-VAS. P-VAS was significantly lower after than before inhalation of limonene, 1,8-cineole, and eucalyptus, despite having no significant difference in the four groups compared with control group. 1,8-Cineole, a major constituent of eucalyptus, was effective in decreasing anxiety before SNRB. The present findings suggest that inhalation of 1,8-cineole may be used to relieve anxiety before, during, and after various operations, in addition to SNRB.

scholarly journals Phenylephrine Effectiveness in Handling Hypotensive Issues During Spinal Anesthesia Conductance for Cesarean Section Deliveries

2019 ◽  
Vol 4 (3) ◽  
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Research Group ◽  
Elective Cesarean Section ◽  
Control Group ◽  
P Values ◽  
Management Protocol ◽  
Significant Difference ◽  
Elective Cesarean ◽  
The Impact

Background: Hypotension is frequent clinical challenge during spinal mode of anesthetic induction for cesarean delivery. Requiring an effective and prompt management mode since it has unfavorable clinical outcomes such as hemodynamic cardiovascular instability issues besides reduced uteroplacental perfusion. Aim: Investigating the impact and effectiveness of different prophylacticdosages of Phenylephrine on hypotensive issues during spinal anesthesia for cesarean section deliveries. Methodology:A prospective, randomized, clinical research study involved 184 cases That are classified as American Society of Anesthesiologists physical status I and II with term singleton pregnancies scheduled for elective cesarean section under spinal anesthesia randomized to receive 0.9% saline 2 mL (Control Group) or phenylephrine1.0 ug/kg (PHE1 research Group), 1.5 ug/kg (PHE1.5 research Group), or 2.0 ug/kg (PHE2 research Group) immediately after induction of spinal anesthesia. Results: The adverse effects of prophylactic bolus ofPhenylephrine among the research groups control, Phenylephrine 1, 1.5,2 in which there was statistically significant difference as regards hypotension, rescue Phenylephrine,lowest SBP,highest SBP,early highest SBP,mean SBP, occurrence of hypertension (p values= <0.001, <0.001, 0.002, <0.001, <0.001, <0.001, <0.001consecutively) there was no statistical significant difference as regards nausea and bradycardia (p values=0.929, 0.823consecutively). Conclusions: The research findings obtained denote and imply that a prophylactic Phenylephrine 1.5 ug/kg bolus followed by additional boluses when necessary could be an alternative management protocol to decrease the frequency of hypotensive issues occurrence during spinal anesthetic mode for cesarean deliveries.

Comparison of Two Concentrations of Triamcinolone Injection in the Prevention of Supratip Edema after External Rhinoplasty: A Randomized Trial

2017 ◽  
Vol 31 (6) ◽  
pp. 412-415 ◽  
Author(s):  
Babak Saedi ◽  
Amin Amali ◽  
Mina Arabpor
Keyword(s):  
Visual Analog Scale ◽  
Study Groups ◽  
Control Group ◽  
Analog Scale ◽  
Significant Difference ◽  
Triamcinolone Injection ◽  
Scale Scores ◽  
Photo Editing ◽  
Group B ◽  
External Rhinoplasty

Background A comparison of the two methods of corticosteroid (triamcinolone) use in reducing supratip edema (pollybeak deformity) after rhinoplasty. Methods Ninety patients who were candidates for rhinoplasty were randomly divided into three groups. Group A received no treatment, group B received 8 mg/mL of triamcinolone, and group C received 16 mg/mL of triamcinolone. Their effects on dorsal edema were evaluated by using the patients' and surgeons' visual analog scale scores. Also, dorsal edema was measured by using photo editing software. Results There was no significant difference in the patients' characteristics in the study groups. The surgeons' visual analog scale scores were significantly better in those patients who received triamcinolone injection than in the control group (p = 0.02). However, none of the other assessment methods showed significant differences among the study groups. There was no significant difference between the two evaluated concentrations. Conclusion Triamcinolone injection had positive temporary effects on reducing supratip edema without any important complications.

scholarly journals Prevalence of dental hypersensitivity after applying immediate dentinary sealing in the fixed partial prosthesis

2020 ◽  
Vol 3 (1) ◽  
pp. 16-20
Author(s):  
Jonathan Salguero Cárdenas ◽  
Norka Altamirano Vergara
Keyword(s):  
Visual Analog Scale ◽  
Pain Scale ◽  
Control Group ◽  
Dental Clinic ◽  
Analog Scale ◽  
Chi Square ◽  
Catholic University ◽  
Significant Difference ◽  
Chi Square Test

Objective: Evaluate the effect of inmediate dentinary sealing, as treatment of hypersensitivity in patients attending the fixed prosthetic clinic at the Catholic University of Santiago de Guayaquil dental clinic. Materials and methods: This study was designed as clinic, prospective and correlational. 25 patients were selected, they were divided into 2 groups, one group included 14 patients in which teeth were prepared with SDI (29 teeth) and a second control group of 11 patients in which teeth were not prepared with SDI (19 teeth), giving a total of 48 teeth. Surveys were made 1, 2 and 3 weeks after preparations and the presence of hipersensitivity was registered with the visual analog scale. Results: A chi-square test was made and in the analysis of the pain scale (EVA), the study sample exhibited a significant difference in a range above 3 for the group in which SDI was not applied. Conclusion: This study demostrates that the application of SDI helps diminish significantly dental hipersensitivity.

scholarly journals A Clinical Trial on the Effects of Different Regimens of Phenylephrine on Maternal Hemodynamic After Spinal Anesthesia for Cesarean Section

2020 ◽  
Vol 10 (4) ◽  
Author(s):  
Mahshid Nikooseresht ◽  
Mohammad Ali Seifrabiei ◽  
Pouran Hajian ◽  
Shadab Khamooshi
Keyword(s):  
Blood Pressure ◽  
Clinical Trial ◽  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Cesarean Delivery ◽  
Saline Control ◽  
Control Group ◽  
Significant Difference ◽  
The Mean ◽  
Phenylephrine Infusion

Background: Phenylephrine is used to prevent and treat hypotension during spinal anesthesia for cesarean delivery. Objectives: The present study aims to investigate the effects of different regimens of phenylephrine on blood pressure of candidates for the cesarean section. Methods: In this double-blind, randomized clinical trial, a total of 120 candidates of elective cesarean delivery under spinal anesthesia was randomly categorized into three groups. Groups 1, 2, and 3 received bolus and prophylactic saline (control group), prophylactic bolus phenylephrine (100 µg), and prophylactic phenylephrine infusion (50 µg/min), respectively. The incidence of hypotension, maternal hemodynamics, hypertension, rescue phenylephrine dose, nausea, and vomit were compared between the groups. Results: In all the three groups, the incidence of nausea and vomit, bradycardia, hypertension, and neonatal Apgar score were not statistically different (P > 0.05). However, the adjuvant phenylephrine dose requirement was remarkably different. Moreover, the mean systolic blood pressure differed significantly in the second and 7th minutes after the spinal block (P < 0.05). 35% in the first group, 15% in the second group, and 2.5% in the third group had hypotension (P = 0.001). Apart from the first measurement after spinal anesthesia, the mean heart rate showed no significant difference between the groups. Conclusions: The use of prophylactic phenylephrine infusion is recommended to control the optimal blood pressure in parturients undergoing cesarean section after spinal anesthesia.

scholarly journals PENGARUH TERAPI MUROTAL TERHADAP SKALA NYERI KEPALA PADA KLIEN CEDERA KEPALA DI RSU PROF. DR. MARGONO SOEKARJO DAN RSUD BANYUMAS

2019 ◽  
Vol 1 (2) ◽  
pp. 119
Author(s):  
Arif Hendra Kusuma ◽  
Agus Setiawan ◽  
Rohman Azzam
Keyword(s):  
Head Injury ◽  
Visual Analog Scale ◽  
Head Injuries ◽  
Nursing Intervention ◽  
Pain Scale ◽  
T Test ◽  
Control Group ◽  
Analog Scale ◽  
Head Pain ◽  
Significant Difference

AbstrakCedera kepala merupakan suatu trauma yang menimpa struktur kepala sehingga dapat menimbulkan kelainan struktural dan atau gangguan fungsional jaringan otak. Cedera kepala dapat menyisakan tanda ataupun gejala somatik yang nyeri kepala. Penatalaksanaan terhadap nyeri dapat berupa tindakan non farmakologis salah satunya dengan terapi murotal. Penelitian ini bertujuan untuk menganalisis pengaruh terapi murotal terhadap skala nyeri kepala pada klien dengan cedera kepala Di RSU Prof. Dr. Margono Soekarjo dan RSUD Banyumas. Desain penelitian menggunakan metode Quasi-eksperimental melalui pendekatan pretest-posttest control grup design. Jumlah sampel sebanyak 22 responden (11 responden kelompok kontrol dan 11 responden kelompok intervensi). Skala nyeri diukur menggunakan Visual Analog Scale (VAS). Uji statistik menggunakan uji independent t-test. Hasil penelitian ada pengaruh yang signifikan terapi murotal terhadap penurunan skala nyeri kepala pasien cedera kepala ringan (P value = <0,001; α<0,05). Saran: penelitian ini merekomendasikan terapi murotal dijadikan sebagai intervensi mandiri keperawatan untuk mengurangi skala nyeri pasien cedera kepala dan menjadi salah satu SOP dalam perawatan pasien cedera kepala khususnya yang beragama Islam.Kata kunci      : Terapi murotal, nyeri kepala, cedera kepala  AbstractHead injury is a trauma that befell the structure so that the head can cause abnormalities of the structural and functional disorders or brain tissue. Head injuries can leave scars or somatic symptoms such as headaches. This research aimed to analyze the effect of murotal therapy on head pain scale among the client with head injuries In Prof. Dr. Margono Soekarjo Hospital and District Banyumas Hospital. The design of the research was quasi-experimental through a pretest-posttest approach with control group. The number of samples was 22 respondents (11 respondents in control group and 11 respondents in intervention group). The pain scale was measured using the Visual Analog Scale (VAS). Statistical tests using independent t-test show a significant difference of head pain scale before and after murotal therapy among head injury patients (p= 0.001 ; α < 0.05). This research recommends murotal therapy as an independent nursing intervention to reduce head injury patients pain scale and become one of the SOP in the treatment of head injury among Muslim patients. Keywords: murotal therapy, head pain, head injury 

scholarly journals Effect of vitamin C on the incidence and severity of postdural puncture headache in patients undergoing cesarean section with spinal anesthesia

2021 ◽  
Vol 43 (1) ◽  
pp. 55-60
Author(s):  
Sepehr Eslami ◽  
Mina Shakeri
Keyword(s):  
Vitamin C ◽  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Normal Saline ◽  
Intervention Group ◽  
Control Group ◽  
Significant Difference ◽  
Group 2 ◽  
Positive Effect ◽  
Group 1

Background: Some studies have shown that vitamin C has a positive effect on reducing headaches after spinal anesthesia, but studies in this field are inadequate. The aim of this study was to determine the effect of vitamin C infusion on the decrease of headache after spinal anesthesia in cesarean section. Methods: This clinical trial study was performed on 160 patients undergoing cesarean section referred to Kowsar Hospital of Yazd in 2017. The patients were randomly divided into two groups including group 1, 2 gr of vitamin C in 500 cc normal saline, and group 2, 500 cc of normal saline was injected preoperatively. The two groups were compared for headache incidence. Results: At the time of recovery, 2 hours later, the frequency of headache in the intervention group was significantly lower than the control group (P <0.05). But there was no significant difference between the two groups regarding headache at 4, 6, 12, 24, and 48 hours postoperatively (P>0.05). Conclusion: Considering the patient's condition, and according to the anesthesiologist and surgeon, vitamin C can be used to reduce pain in patients undergoing cesarean section with spinal anesthesia.

scholarly journals Preoperative lidocaine infusion for the pain management in laparotomy procedures: a randomized control trial

2019 ◽  
Vol 26 (06) ◽  
Author(s):  
Hamid Raza ◽  
Ahmed Uddin Soomro ◽  
Maqsood Ahmed Siddiqui ◽  
Kamlaish ◽  
Muhammad Sheraz Raza Naqvi
Keyword(s):  
Pain Management ◽  
Visual Analog Scale ◽  
Randomized Control Trial ◽  
Control Group ◽  
P Value ◽  
Study Group ◽  
Care Hospital ◽  
Analog Scale ◽  
Significant Difference ◽  
Randomized Control

Objectives: To evaluate the role of pre-operative lidocaine infusion for pain management in laparotomy procedures. Study Design: Prospective double blind randomized control trial. Period: 8 months duration from April 2017 to November 2017. Setting: Tertiary care hospital in Karachi, Pakistan. Method: N= 50 patients belonging to ASA Classification types I and II were selected to be part of this study. All the patients underwent major abdominal surgeries (laparotomy). The study group received lidocaine 2%, 1.5mg/kg IV bolus half an hour before induction, followed by an infusion of 1.5mg/kg/hour. The anesthesia was induced with fentanyl 3ug/kg, propofol 2mg/kg, followed by rocuronium 1mg/kg to intubate the patient. Maintenance was done with using 33% nitrous oxide in oxygen along with 0.8% of isoflurane. Fentanyl was administered as an infusion initiating prior to the procedure with a maximum dose of 1ug/kg/hour and ceasing the infusion half an hour prior to end of procedure. Visual analog scale was used to measure the pain intensity at an interval of twenty minutes during the first hour of the procedure, and at 2,4,8,12,24 and 48 hours after the end of the procedure. If the visual analog scale score was found to be more than 3, 1 to 3mg of Morphine was administered every ten minutes up to a dose of 0.1mg/kg intravenously. A proforma was used to collect data, data was analyzed using IBM SPSS version 21.0. Results: The study was conducted on n=50 patients, with a mean age of 38.35 years in the study group and 36.48 years in the control group. The intensity of pain was found to be significantly less in the case group as compared to the control group having a p value of <0.001 during the first 48 hours of the procedure. Decreased consumption of morphine was observed in patients in the study group, as compared to the control group with a statistically significant difference, having a p value of less than <0.05. In our study we did not observe any side effects related to toxicity levels of lidocaine or morphine. Conclusion: Our study confirms the results of previously done studies, and we found that in our patient population Perioperative lidocaine infusion decreased the post-operative pain experienced by the patient and decreased the need for consumption of analgesics. Thus we conclude that lidocaine infusion perioperatively is an effective pain management modality.

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