scholarly journals Oral midazolam versus oral triclofos for sedation of children for computed tomography scan - a randomized clinical trial

2015 ◽  
Vol 2 (2) ◽  
pp. 41-45
Author(s):  
Anushu Gupta ◽  
Maitree Pandey ◽  
Lalita Choudhry ◽  
Aruna Jain ◽  
Harish Pemde

Background: Effective and safe pediatric procedural sedation is still a concern especially in areas outside operation theatres. The aim of the study was to compare the efficacy and safety of oral triclofos and oral midazolam in children undergoing computed tomography.Methods: A prospective randomized double blind study was conducted in 100 children aged one to five years. Group-I (n=50) received oral triclofos 100 mg/kg and Group-II (n=50) oral midazolam 0.75 mg/kg. Both groups were given oral atropine 0.03 mg/kg and supplemented with intravenous midazolam upto 0.1 mg/kg in case of inadequate effect. Onset and duration of sedation, success for completion of procedure and time to recovery were noted. Student’s t test and Z test of proportions were used for statistical analysis.Results Majority of children 36(72%) in Group-I achieved Ramsay Sedation Score >4 as compared to 25(50%) in Group-II. Computed tomography scan could be successfully completed at comparable rate (52% vs 56%). Success rate improved to 96% vs 80% after supplementing intravenous midazolam in Group I & II respectively (p< 0.05). Onset (37.91minutes ± 7.96 vs 26 ± 10), duration of sedation ( 117.91minutes ± 72.41 vs 66.2minutes ± 33) were significantly shorter and recovery (98.19minutes ± 72.58 vs 47.4minutes ± 31.42) in Group I & II respectively was faster in children who received oral midazolam (p< 0.05).Conclusion We conclude that both drugs were equally effective and safe for computed tomography scan in children. However better recovery profile of midazolam makes it more suitable for day care procedures.Journal of Society of Anesthesiologists of Nepal 2015; 2(2): 41-45

Author(s):  
Mukesh Choudhary ◽  
Neeti Mahla

Background:  Midazolam is a water-soluble, short acting benzodiazepine. The objective of our study was to study the effect of two different doses of oral midazolam premedication on propofol induction dose and characteristics. Methods: Randomized, prospective, double blind study conducted on 100 ASA I and II patients, falling between the age group of 18-60 yrs were randomly divided in to two groups, group I and group II, who received 7.5mg and 15mg midazolam orally 45 mins before the surgery respectively. Results: Mean time taken for induction in group-A was significantly higher in group-I as compare to group-II. No significant difference was noted with respect to degree of sedation, changes in the heart rate and means arterial pressure, oxygen saturation between the two groups. Conclusion: Our study concluded that 15mg midazolam premedication offers more benefits than 7.5mg midazolam by reducing induction dose of propofol without any undesirable effects like excess sedation, bradycardia and hypotension. Keywords: Midazolam, Induction, Premedication


2013 ◽  
Vol 20 (03) ◽  
pp. 409-415
Author(s):  
ASHFAQ AHMED ◽  
MOHAMMAD ASLAM

Objectives: To compare the efficacy of low-dose prophylactic use of ketamine with ketamine plus midazolam for theprevention of shivering caused by spinal anesthesia, during lower segment cesarean section. Main Outcome Measures: Heamodynamicmonitoring, avoidance of lactic acidosis/ increased carbon dioxide production and patient satisfaction. Design: Prospective RandomizedControlled trial. Place: Department of Anesthesia and ICU PNS Shifa Karachi. Duration of study: March 2010 to June 2010. Patients andMethods: 100 ASA-I & II consecutive patients who reported for LSCS in PNS Shifa Hospital were studied. In this double-blind study,patients were randomly allocated to receive ketamine alone (Group I, n= 50), and ketamine plus midazolam (Group II, n = 50). Afterstandardized Spinal anesthesia, a shivering was recorded at 5 min intervals for 15 minutes. Results: Shivering was observed in 9/50(18%) patients of group I (Ketamine only) as compared to only 2/50 (4%) patients in Group II (ketamine + midazolam) (p=0.025) whichis statically significant. The two groups were comparable regarding distribution of age (p=0.37), BMI (p=0.27) and duration of surgery.Results were analyzed by using chi square test. Conclusions: The efficacy of i.v. ketamine plus midazolam is better as compared to lowdosei.v. ketamine alone in preventing shivering in lower segment Cesarean Section patients, during spinal anesthesia.


Author(s):  
Tripat Kaur Bindra ◽  
Davinder Chawla ◽  
Parmod Kumar ◽  
. Parul

Background: Local anesthetics are now widely used, as they have a good safety profile and are available in long acting preparation. They provide the benefit of analgesia without systemic side effects that may result from use of enterally and parenterally administered drugs.Methods: This prospective randomized double-blind study was conducted on 100 patients with symptomatic gall stones disease undergoing laparoscopic cholecystectomy. Patients were randomized to receive either 0.5% of 3mg/kg of Ropivacaine diluted in 100 ml NS, instillation at intraperitoneal space before creation of pneumoperitoneum (group I) or 100 ml NS instillation at intra peritoneal space before creation of pneumoperitoneum (group II). VAS score for pain abdomen as well as shoulder were recorded postoperatively at various time intervals and compared in both the groups. Total analgesic consumption in 24hrs was also noted and compared.Results: The mean postoperative VAS score for abdomen and shoulder pain was significantly (p values<0.05) lower in group I than in group II till 24 hrs postoperatively. The latency time from end of operation to first analgesic requirement was significantly longer in group I than in group II.Conclusions: Intraperitoneal instillation of Ropivacaine before the creation of pneumoperitoneum significantly decreased the total abdominal pain, shoulder tip pain with lower analgesic consumption. As it is safe and without apparent side effects, we believe that intraperitoneal instillation of local anaesthetic in patients undergoing elective laparoscopic cholecystectomy is an effective modality for postoperative pain management.


2020 ◽  
pp. 70-72
Author(s):  
Prabhat Kumar Choudhary ◽  
Sadab Faisal Ansari ◽  
Namita Saraswat ◽  
Debarshi Jana

Aim: To compare the efficacy of Tramadol with that of Butorphanol for the control of shivering in patients undergoing neuraxial blockade. Materials And Methods: A randomized, double blind study of 60 patients undergoing lower abdominal and lower limb surgery under spinal anesthesia who got shivering during intra operative period up to 60minutes. Out of which 60 patients, who will develop shivering after neuraxial blockade will be randomly allocated to one of the following groups. Each group contains 30 patients. Group I: (Tramadol Group) Patients received tramadol intravenously (50mg) Group II: (Butorphanol Group) Patients received butorphanol intravenously (1mg) Inclusion criteria: ASA Grade I Or II, age 18 to 60 years, weight 30 to 70 kg, lower abdominal and lower limb surgery under spinal anesthesia. Exclusion Criteria: Patients not willing to take part in study, ASA grade >2, significant systemic illness, patients with fever, pregnancy, patients with history of seizure, patient on oral anticoagulant therapy, emergency surgeries, conditions where neuraxial blockade will be contraindicated. Result: Time taken to control Shivering was significantly lower in Group I (Tramadol) as compared to group II (Butorphanol), more patients with higher sedation score with Butorphanol group compared to Tramadol Group, Nausea and vomiting higher in Tramadol Group compared to Butorphanol Group. Conclusion: Tramadol is most rapid acting & effective in control of shivering with neauraxial block without any significant side effects and least reappearance of shivering as compared to Butorphanol.


Author(s):  
Shailendra Kumar Sharma ◽  
Shalendra Singh ◽  
Debashish Paul ◽  
Nihar Ameta ◽  
Priya Taank ◽  
...  

Background: Post-operative nausea and vomiting (PONV) is generally self-limiting, associated with high level of patient dissatisfaction and may delay hospital discharge. The anaesthetist is usually blamed, despite evidence that PONV results from a variety of factors and variety of antiemetic drug available in market. With this issue we aim to compare the effectiveness of dexamethasone with granisetron or ondansetron in patients undergoing laparoscopic gynaecological surgery.Methods: 120 patients were registered in this prospective, randomized double blind study. Group I (n=60) received ondansetron 4 mg intravenously (IV)+dexamethasone 8mg I/V or II (n=60) received granisetron 1 mg IV+dexamethasone 8 mg I/V prior to anaesthesia. Post-operative data of PONV was recorded at pre-defined intervals.Results: The majority of the patients were of the age group 20-25 years (55.83%). The mean score of Group I subjects was 0.30±0.72 and that of Group II was 0.20±0.57 (p=0.43).  There are 3.33% of patients in group-I having vomiting episodes, and 1.67% of patients in group-II having vomiting episodes, none of the patients developed 2nd episodes of vomiting in either group. Thus it appears that dexamethasone in combination with ondansetron and granisetron is effective in decreasing the number of episodes of PONV. The occurrence of sickness episodes within 24 hours of surgery revealed no significant different in both groups. Haemodynamic variables showed no significant difference recorded in postoperative care unit between the study groups. The most common complaint was headache 16.67% in both groups.  Conclusions: Dexamethasone 8 mg with either granisetron 1 mg or ondansetron 4 mg showed no significant difference in antiemetic efficacy with minimal side effects and excellent patient satisfaction.


Mediscope ◽  
2019 ◽  
Vol 6 (2) ◽  
pp. 73-77
Author(s):  
Muhammad Sazzad Hossain ◽  
Md Mamunur Rashid ◽  
Mohammad Mamunur Rashid ◽  
Md Anisur Rahman Babu ◽  
Afsana Sultana ◽  
...  

Background and aim of study: Propofol is one of the most frequently used medications for inducing and maintaining anesthesia. However, propofol injection causes pain and discomfort in more than 70% of patients. This study was performed to determine the effect of magnesium sulfate on reducing pain at the onset of anesthesia induced by propofol injection. Materials and methods: A total of 80 healthy adult patients were selected in this study with either sex, scheduled for routine elective surgical procedure under general anesthesia. The patients enrolled were divided randomly into two groups of 40 patients each. Group I received 30 mg/kg of intravenous magnesium sulfate in 5 ml. Group II (placebo group) received 5ml of 0.9% intravenous normal saline 1 minute before propofol injection. The patients were asked to report their pain during injection of propofol. For all statistical tests, p<0.05 was taken to indicate a significant difference. Results: The incidence of pain experienced in magnesium sulfate group was 30% patients and in saline group was 60% patients, which is statistically significant p<0.05. The severity of POPI was also lower in magnesium sulfate group than the saline group (p<0.05). The incidence of mild and moderate pain in groups I versus group II was 22.5% versus 37.5% and 7.5% versus 22.5% respectively p<0.05. There was no severe pain recorded in any groups. Conclusion: Magnesium sulfate can be used before induction of anesthesia to reduce pain on propofol injection. Mediscope Vol. 6, No. 2: Jul 2019, Page 73-77


2021 ◽  
pp. 014556132110346
Author(s):  
Konstantinos Garefis ◽  
Konstantinos Tarazis ◽  
Konstantinos Gkiouzelis ◽  
Anastasia Kipriotou ◽  
Iordanis Konstantinidis ◽  
...  

A tracheal diverticulum is a type of paratracheal air cyst and is usually an incidental finding after a computed tomography scan of the neck and thorax. With an incidence between 1% and 4% in adults, tracheal diverticula are rare entities that can be symptomatic in certain cases. We present a case of a COVID-19 positive patient who presented to our hospital and was diagnosed with multiple tracheal diverticula during his hospitalization.


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