scholarly journals Effects of single bolus dose of intravenous Dexmedetomidine on intrathecal hyperbaric Bupivacaine: a randomized double blind placebo controlled trial

2016 ◽  
Vol 3 (1) ◽  
pp. 8-12
Author(s):  
Manjunath Reddy ◽  
Archana Byadarahalli Narayanappa ◽  
Sreenivasa Babu
Keyword(s):  
Side Effects ◽  
Spinal Anaesthesia ◽  
Bolus Dose ◽  
Controlled Trial ◽  
Sensory Block ◽  
Control Group ◽  
Double Blind ◽  
Single Bolus ◽  
Single Bolus Dose ◽  
Group D

Background: To prolong the effect of spinal anaesthesia into the postoperative period many pharmacological agents are being used intrathecally and intravenously. The present study was designed to assess the effects of single bolus dose of intravenous Dexmedetomidine on spinal anaesthesia and analgesia in patients undergoing lower abdominal surgeries under spinal anaesthesia with 0.5% Hyperbaric Bupivacaine.Methods: One hundred patients posted for lower abdominal surgeries under spinal anaesthesia were randomly allocated to two groups. Group D (study group) patients received single bolus dose of 0.5mcg/kg of intravenous Dexmedetomidine and Group C (control group) received 10ml of normal saline. Variation in the onset, duration of sensory and motor level, duration of analgesia, effect on sedation and side effects were recorded.Results: The duration of sensory block and two segment regression was significantly prolonged in Group D (189.90±7.66 minutes, 104±20.6 minutes) as compared to Group C (145.60±11.98 minutes, 75±22.5 minutes). The onset of sensory block was earlier in Group D then compared to Group C which was statistically significant. The duration of analgesia in Group D (218.8 ± 11.36 minutes) was prolonged when compared to Group C (178.6±17.96 minutes). Sedation score and incidence of bradycardia was high in Group D when compared to Group C.Conclusion: Single bolus dose of IV Dexmedetomidine prior to spinal anaesthesia prolongs the duration of sensory block and duration of analgesia with satisfactory arousable sedation and acceptable side effects.

scholarly journals Evaluation of the Effect of Single Bolus Dose of Intravenous Dexmedetomidine in Spinal Anaesthesia for Lower Limb Surgeries

2020 ◽  
Vol 5 (1) ◽  
pp. 970-975
Author(s):  
Bandana Paudel ◽  
Pramod Rai ◽  
Robins Tiwari ◽  
Sanjay Gautam ◽  
Sumitra Paudel ◽  
...  
Keyword(s):  
Spinal Anaesthesia ◽  
Lower Limb ◽  
Receptor Agonist ◽  
Motor Block ◽  
Bolus Dose ◽  
Hyperbaric Bupivacaine ◽  
Single Bolus ◽  
Lower Limb Surgery ◽  
Single Bolus Dose ◽  
Group D

Introduction: The use of intrathecal adjuvants in spinal anaesthesia in enhancing and prolonging it’s action has been well established and is widely used for surgery below the umbilicus. Dexmedetomidine, a selective α2A receptor agonist is a suitable adjuvant due to its selective activity. Objectives: To evaluate the effect of a single bolus dose of intravenous dexmedetomidine as an adjuvant in cases undergoing lower limb surgeries under spinal anaesthesia. Methodology: One hundred patients posted for lower limb surgery under spinal anaesthesia with hyperbaric bupivacaine, were equally divided into two groups. In group D, in addition to spinal, intravenous dexmedetomidine 0.5mcg/kg over 10 min was given whereas group C patients received spinal and intravenous normal saline . Results: The onset of sensory and motor block was faster in group D (2.09 ± 0.71 min, 3.18 ± 1min)compared to group C (3.5 ± 0.82 min, 6.19 ± 1.87 min) which was statistically significant . The duration of sensory and motor block was also significantly prolonged in Group D (174.5 ± 14.04 min, 133.4 ± 10.42 min) as compared to Group C(138.2 ± 11.51 min, 120.4 ± 8.8 min).The duration of analgesia in Group D (225.3 ±20.11 min)was prolonged when compared to Group C (168.3 ± 15.11). Conclusion: Intravenous dexmedetomidine as a single bolus dose before spinal anaesthesia can fasten the onset of sensory and motor block, prolongs the duration of sensory and motor block and also increased the duration of analgesia.

scholarly journals Comparison of Intrathecal Fentanyl and Butorphanol as an Adjuvant to Intrathecal Bupivacaine 0.5% in Infraumbilical Surgeries- A Randomised Double Blind Study

2020 ◽  
Author(s):  
Sandip Roy Basunia ◽  
Prosenjit Mukherjee ◽  
Md Bakir Hossain Munshi
Keyword(s):  
Spinal Anaesthesia ◽  
Motor Block ◽  
Controlled Trial ◽  
Sensory Block ◽  
P Value ◽  
Double Blind Study ◽  
Hyperbaric Bupivacaine ◽  
Double Blind ◽  
Group A ◽  
Group B

Introduction: Neuraxial opioids are widely used as adjuvants to local anaesthetic as they improve quality and duration of block. Neuraxial opioids like Butorphanol and Fentanyl allow prolonged analgesia in the postoperative period and faster recovery from spinal anaesthesia. Aim: To compare the safety and efficacy of Butorphanol and Fentanyl combined with bupivacaine for spinal anaesthesia in infraumbilical surgeries. Materials and Methods: The present study was a randomised controlled trial in which 110, ASA I and II patients of either sex who underwent elective infraumbilical surgeries under spinal anaesthesia were selected. Patients were allocated randomly into two groups A (n=55) and B (n=55). Group A (F) received intrathecal 0.5% hyperbaric bupivacaine 12.5 mg (3 mL) with fentanyl 25 microgram (0.5 mL) to make it total 3.5 mL. Group B (B) received intrathecal 0.5% hyperbaric bupivacaine 12.5 mg (3 mL) with butorphanol 250 microgram (0.25 mL) and Normal Saline (NS) 0.25 mL to make it total 3.5 mL. Heart Rate (HR), Systolic and Diastolic Blood Pressure (SBP, DBP), two segment regression time of sensory block, motor block were assessed at preset intervals. Chi-square test or Fischer’s-exact test were used and a p-value ≤0.05 was considered as statistically significant. Results: Mean of two segment sensory regression time of Group A was 41.94±1.73 minutes and Group B was 50.56±4.43 minutes (p<0.0001). Time to onset of motor block in Group A was 5.28±.32 minutes and Group B was 5.27±.32 minutes (p=0.96). Mean duration of motor block in Group A was 81.23±4.87 minutes and Group B was 109.83±2.61 minutes (p<0.0001). Time to rescue analgesic was 289.27±7.37 minutes in Group A and 378.41±10.25 minutes in Group B (p<0.0001). HR, SBP and DBP were comparable among the groups. Conclusion: Intrathecal bupivacaine-butorphanol mixture was clinically better as it provided longer duration of analgesia with lesser incidences of pruritus and nausea/vomiting compared to intrathecal fentanyl-bupivacaine mixture.

scholarly journals Comparison of the efficacy of oral oxycodone and oral codeine in the treatment of post-craniotomy pain – a randomized, double-blind trial

2019 ◽  
Author(s):  
Rui Min Lee ◽  
Beatrice Chin Ling Lim ◽  
Chin Ted Chong ◽  
Mandy Pei-Pei Lim
Keyword(s):  
Side Effects ◽  
Analogue Scale ◽  
Controlled Trial ◽  
Similar Efficacy ◽  
Control Group ◽  
Double Blind Trial ◽  
Double Blind ◽  
Scale Scores ◽  
Double Blinded ◽  
Experimental Group

Abstract Background Post-craniotomy pain has been reported to be moderate to severe. Management of post-craniotomy pain is often inadequate, yet limited by the side effects of opioids. We aim to find out the efficacy of oral oxycodone as compared to oral codeine for the treatment of post-craniotomy pain in our institution.Methods A randomized, double blinded controlled trial was used to evaluate the efficacy of oral oxycodone versus oral codeine. 40 patients were randomized to the control group of codeine (n = 20) or the experimental group receiving oxycodone (n = 20) in addition to regular oral paracetamol for both groups of patients.Results There was no difference in the visual analogue scale scores at 24 hours (2.78 versus 1.85, p = 0.11) or side effects in the oxycodone group compared with the codeine group.Conclusions Oral oxycodone had similar efficacy as oral codeine in the management of post-craniotomy pain.

scholarly journals Comparison of combination of probiotic and standard therapy compared to standard therapy on eradication of Helicobacter pylori infection in children

2016 ◽  
Vol 50 (1) ◽  
pp. 38
Author(s):  
Fransisca Theresia Aryani ◽  
Agus Firmansyah ◽  
Abdul Latief
Keyword(s):  
Helicobacter Pylori ◽  
Treatment Group ◽  
Side Effects ◽  
Standard Therapy ◽  
Eradication Rate ◽  
Controlled Trial ◽  
Control Group ◽  
Double Blind ◽  
Cancer Management ◽  
H Pylori

Background Helicobacter pylori (H. pylori) infection is thought to be the etiology of chronic gastritis, peptic ulcer, and risk factor for gastric cancer. Management of H. pylori infection in children is associated with several problems such as compliance to therapy, untolerated side effects, and antibiotic resistance. Probiotic is reported to give beneficial effect in the management of H. pylori infection and there is no study yet on the effect of probiotic in eradication of H. pylori infection in Indonesian children.Objectives To study the effect of additional probiotic in the standard therapy on the rate of H. pylori infection eradication in children and its side effect.Methods This was a double blind randomized controlled trial performed in 23 children with H. pylori infection at Kampung Melayu and Rawa Bunga District. The diagnosis was determined based on Helicobacter pylori stool antigen test (HpSA). Subjects were randomly assigned to either receive receive amoxiycilin, clarithromycin, omeprazole, and probiotic (2 x 109 cfu of Lactobacillus acidophilus La5 and Bifidobacterium lactis Bb12) or amoxicillin, clarithromycin, omeprazole dan placebo (maltodextrin). HpSA examination was evaluated again after 2 weeks of therapy.Results Two of 13 subjects in the treatment group and 6 of 10 subjects in the control group experienced side effects. Eradication rate in the treatment group is higher than the control group (13/13 vs 7/10) but the correlation between additional probiotic with the eradication rate of H. pylori is not statistically significant.Conclusions Probiotic can reduce the incidence of side effects due to antibiotic used in H. pylori eradication (2/13 vs 6/10, p < 0.012). [Paediatr Indones. 2010;50:38-41].

scholarly journals Comparison of bolus administration effects of lidocaine on preventing tourniquet-induced hypertension in patients undergoing general anesthesia: a randomized controlled trial

2021 ◽  
Author(s):  
Ji WooK Kim ◽  
A Ran Lee ◽  
Eun Sun Park ◽  
Min Su Yun ◽  
Sung Won Ryu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Controlled Trial ◽  
Control Group ◽  
Double Blind Study ◽  
Bolus Administration ◽  
Double Blind ◽  
Single Bolus ◽  
Randomized Controlled ◽  
Induced Hypertension ◽  
Tourniquet Inflation

Background: This study assessed the effect of a single bolus administration of lidocaine on the prevention of tourniquet-induced hypertension (TIH) and compared the effect of lidocaine to that of ketamine in patients undergoing general anesthesia.Methods: This randomized, controlled, double-blind study included 75 patients who underwent lower limb surgery using a tourniquet. The patients were administered lidocaine (1.5 mg/kg, n = 25), ketamine (0.2 mg/kg, n = 25) or placebo (n = 25). The study drugs were administered intravenously 10 min before tourniquet inflation. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were measured before tourniquet inflation, after tourniquet inflation for 60 min at 10 min intervals, and immediately after tourniquet deflation. The incidence of TIH, defined as an increase of 30% or more in SBP or DBP during tourniquet inflation, was also recorded.Results: SBP, DBP, and HR increased significantly over time in the control group compared to those in the lidocaine and ketamine groups for 60 min after tourniquet inflation (P < 0.001, P < 0.001, and P = 0.007, respectively). The incidence of TIH was significantly lower in the lidocaine (n = 4, 16%) and ketamine (n = 3, 12%) group than in the control group (n = 14, 56%) (P = 0.001). Conclusion: Single-bolus lidocaine effectively attenuated blood pressure increase due to tourniquet inflation, with an effect comparable to that of bolus ketamine.

scholarly journals Is Infusion of Subhypnotic Propofol as Effective as Dexamethasone in Prevention of Postoperative Nausea and Vomiting Related to Laparoscopic Cholecystectomy? A Randomized Controlled Trial

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Mine Celik ◽  
Aysenur Dostbil ◽  
Mehmet Aksoy ◽  
Ilker Ince ◽  
Ali Ahiskalioglu ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Nausea ◽  
Controlled Trial ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Controlled Study ◽  
Control Group ◽  
Double Blind ◽  
Significant Difference ◽  
Group D

Background. Postoperative nausea and vomiting (PONV) is one of common complications in patients undergoing laparoscopic cholecystectomy (LC). Aim of this study was to compare the efficacy of subhypnotic (1 mg/kg/h) infusion of propofol with dexamethasone on PONV in patients undergoing LC.Methods. A total of 120 patients were included in this randomized, double-blind, placebo-controlled study. Patients were randomly assigned to 3 groups; patients of group dexamethasone (group D) were administrated 8 mg dexamethasone before induction of anesthesia, patients of group propofol (group P) were infused to subhypnotic (1 mg/kg/h) propofol during operation and patients of group control (group C) were applied infusion of 10% intralipid. The incidence of PONV and needs for rescue analgesic and antiemetic were recorded in the first 24 h postoperatively.Results. In the 0–24 h, the incidence of PONV was significantly lower in the group D and group P compared with the group C (37.5%, 40%, and 72.5%, resp.). There was no significant difference in the incidence of PONV and use of antiemetics and analgesic between group D and group P.Conclusion. We concluded that infusion of propofol 1 mg/kg/h is as effective as dexamethasone for the prevention of PONV during the first 24 hours after anesthesia in patients undergoing LC.

A controlled trial of the effect of 4-hydroxypyrazolopyrimidine (allopurinol) on the toxicity of a single bolus dose of 5-fluorouracil.

1985 ◽  
Vol 3 (1) ◽  
pp. 103-109 ◽  
Author(s):  
P V Woolley ◽  
M J Ayoob ◽  
F P Smith ◽  
J L Lokey ◽  
P DeGreen ◽  
...  
Keyword(s):  
Platelet Count ◽  
Bolus Dose ◽  
Controlled Trial ◽  
Maximum Tolerated Dose ◽  
The Other ◽  
Controlled Study ◽  
Single Bolus ◽  
Single Bolus Dose ◽  
Wbc Count ◽  
Higher Doses

We have evaluated, in a controlled study, the modification of the toxicity of a single bolus dose of 5-fluorouracil (5-FU) by allopurinol. Patients first received a single dose of 5-FU and were monitored for toxicity. If a measurable nadir in WBC or platelet count occurred, then the same dose of 5-FU was repeated with concurrent allopurinol, given for four consecutive days at an initial dose of 300 mg twice daily, starting the day before the administration of 5-FU. With this schedule, each evaluable patient received courses of 5-FU with and without allopurinol that could be compared for toxicity. Twenty patients received initial 5-FU doses of either 1,200 mg/m2 or 1,500 mg/m2 and later had the same dose repeated with allopurinol. Nineteen of these patients had a higher WBC count with allopurinol than without it. In several patients who received a further course of 5-FU with 900-mg/d allopurinol, the WBC count was yet higher than with 600-mg/d allopurinol. The myelosuppression produced by 5-FU was characterized by a decrease in granulocyte levels that was much greater than the decrease in lymphocyte levels, and the result of allopurinol treatment was to attenuate this effort on granulocytes. In a second part of the trial, the goal was to establish the maximum tolerated dose of 5-FU given with concurrent allopurinol. In this part of the study, all patients entered were given 5-FU, usually 1,200 mg/m2, with allopurinol, usually 600 mg/d for four days. Escalations of one or the other drugs were made on subsequent treatments. The data for 22 patients showed that 1,800 mg/m2 of 5-FU was well tolerated if given with 600 to 1,200 mg of allopurinol per day, and that the WBC count nadirs were no more severe than those of 1,200-mg/m2 5-FU without allopurinol. Neurotoxicity became limiting in some patients treated at these higher doses. We conclude that allopurinol given in the proper dose and schedule can diminish the granulocytopenia produced by bolus doses of 5-FU, thereby allowing a 50% increase in the maximal tolerated dose of 5-FU.

Sign in / Sign up

Export Citation Format

Share Document