scholarly journals Does Gabapentin Relieve Acute Preoperative Anxiety?

2014 ◽  
Vol 2 (3) ◽  
pp. 9-14
Author(s):  
L Pathak
Keyword(s):  
Side Effects ◽  
Open Cholecystectomy ◽  
Preoperative Anxiety ◽  
Controlled Study ◽  
Anesthetic Technique ◽  
Medical Sciences ◽  
Double Blind ◽  
Group 2 ◽  
American Society ◽  
Chronic Anxiety

INTRODUCTION: The role of Gabapentin in relieving chronic pain, chronic anxiety disorders and acute postoperative pain is well known by now. Trials done with the administration of Gabapentin to treat preoperative anxiety showed mixed results. So, this study was conducted to test the hypothesis that premedication with Gabapentin 1200 mg versus placebo would reduce preoperative anxiety in patients undergoing open cholecystectomy under general anesthesia. MATERIAL AND METHODS: A prospective, randomized, double blind and placebo controlled study was carried out at Universal College of Medical Sciences & Teaching Hospital (UCMSTH) from August 2012 to Januray 2014. Total 160 adult patients of American Society of Anaesthesiologist (ASA) I and II were divided into 2 groups of 80 each. Patients in group 1 and group 2 received capsules Gabapentin (1200mg) or identical placebo capsules 2 hours prior to surgery respectively. Preoperative anxiety was assessed for three times using Anxiety Visual Analogue Scale (VAS) score. A uniform anesthetic technique was used in both groups. Parameters including preoperative and postoperative sedation scores and various side effects were also observed.RESULTS: VAS anxiety scores after one hour of drug intake (47.19±17.37 versus 63.13±17.77) and just before induction of anaesthesia (43.81±17.72 versus 81.81±21.57) were significantly lower in Gabapentin group as compared to placebo group. No patient experienced any significant side effects or sedation in either group throughout the study period.CONCLUSIONS: Premedication with 1200 mg Gabapentin in open cholecystectomy patients significantly reduced preoperative anxiety as evident by decrease in anxiety VAS scores without any significant side effects.  DOI: http://dx.doi.org/10.3126/jucms.v2i3.11821 Journal of Universal College of Medical Sciences Vol.2(3) 2014: 9-14

scholarly journals Effect of gabapentin premedication on preoperative anxiety and postoperative pain

2014 ◽  
Vol 11 (3) ◽  
pp. 254-259 ◽  
Author(s):  
L Pathak ◽  
A Chaturvedi
Keyword(s):  
Side Effects ◽  
Postoperative Pain ◽  
Open Cholecystectomy ◽  
Preoperative Anxiety ◽  
Controlled Study ◽  
Double Blind ◽  
Vas Scores ◽  
Group 2 ◽  
Induction Of Anaesthesia

Background: In addition to chronic pain and anxiety disorders, few studies have found promising role of gabapentin in relieving acute postoperative pain as well as acute anxiety too. Objectives: To evaluate the effect of gabapentin premedication on preoperative anxiety and postoperative pain in patients undergoing elective open cholecystectomy. Methods: A prospective, randomized, double blind and placebo controlled study. Eighty adult patients of ASA I and II were divided into 2 groups of 40 each. Patients in group 1 and group 2 received capsules Gabapentin (1200mg) or identical placebo capsules 2 hours prior to surgery respectively. Preoperative anxiety and 12 hours postoperative pain was assessed using Anxiety and Pain VAS score respectively along with the observation of side effects. Postoperatively, intravenous pethidine 0.5 mg/kg was given when pain VAS > 40mm and time to first pethidine injection and total pethidine consumption in 12 hours was recorded. Results: Anxiety VAS scores after one hour of drug intake (35.75±20.11 versus 46.63±12.73) and just before induction of anaesthesia (45.75±30.27versus 68.13±29.84) along with postoperative Pain VAS scores were significantly lower in gabapentin group. Time to the first pethidine demand was significantly longer (145.34±194.54 min versus 26.30±51.02min) and cumulative pethidine consumption throughout study period was also significantly lower (35.91 ± 16.61 versus 57.84 ± 20.72mg) in gabapentin group. Conclusions: 1200 mg gabapentin premedication in open cholecystectomy patients significantly reduced preoperative anxiety, postoperative pain and total pethidine consumption with negligible side effects. DOI: http://dx.doi.org/10.3126/hren.v11i3.9642 Health Renaissance 2013;11(3):254-259

scholarly journals Randomized, double-blind, placebo-controlled study of the analgesic effect of intraoperative esmolol for laparoscopic gastroplasty

2019 ◽  
Author(s):  
Vinicius Barros Duarte de Morais ◽  
Rioko Kimiko Sakata ◽  
Ana Paula Santana Huang ◽  
Leonardo Henrique da Cunha Ferraro
Keyword(s):  
Side Effects ◽  
Pain Intensity ◽  
Analgesic Effect ◽  
Multimodal Analgesia ◽  
Controlled Study ◽  
Physical Status ◽  
Double Blind ◽  
Group 2 ◽  
Postoperative Morphine ◽  
Group 1

Abstract Background Patients undergoing bariatric surgery can have respiratory complications in addition to vomiting and ileus. Esmolol can decrease the consumption of opioids, reducing their side effects. The purpose of this study was to evaluate the analgesic effect of esmolol in patients allocated to laparoscopic gastroplasty. Methods Forty patients between 18 and 50 years old, of both genders, physical status ASA I-II, who underwent bypass gastroplasty were divided into two groups. Participants in group 1 received a 0.5 mg/kg bolus of esmolol in 30 mL of saline before induction of anesthesia, followed by infusion of 15µg/kg/min until the end of surgery; those in group 2 received 30 mL of saline bolus and infusion of solution in the same volume as group 1. The anesthesia included fentanyl (5ug/kg), propofol (2-4 mg/kg), rocuronium (0.6 mg/kg), 50% oxygen without nitrous oxide and 2% sevoflurane, with remifentanil if necessary. There were evaluated: remifentanil consumption, time to analgesic supplementation, pain intensity for 24 h and morphine dose over 24 h. Side effects were noted. Results Intraoperative remifentanil supplementation, time to recovery, and postoperative morphine supplementation were lower in the esmolol group; there was no difference in time for the first supplementation. Pain intensity was lower, except at T0 and after 12 h. There were no differences in side effects. Conclusions Intraoperative esmolol promotes an analgesic effect without causing adverse effects, making it an effective drug for multimodal analgesia for gastroplasty.

scholarly journals Transcutaneous Electrical Acupoint Stimulation Reduces Postoperative Analgesic Requirement in Patients Undergoing Inguinal Hernia Repair: A Randomized, Placebo-Controlled Study

2021 ◽  
Vol 10 (1) ◽  
pp. 146
Author(s):  
Mateusz Szmit ◽  
Siddarth Agrawal ◽  
Waldemar Goździk ◽  
Andrzej Kübler ◽  
Anil Agrawal ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Inguinal Hernia ◽  
Side Effects ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Adverse Drug Events ◽  
Controlled Trial ◽  
Controlled Study ◽  
Anesthetic Technique ◽  
Analgesic Requirement

Given the rising rate of opioid-related adverse drug events during postsurgical pain management, a nonpharmacologic therapy that could decrease analgesic medication requirements would be of immense value. We designed a prospective, placebo-and-randomized controlled trial to assess the clinical effect of transcutaneous acupoint electrical stimulation (TEAS) on the postoperative patient-controlled analgesia (PCA) requirement for morphine, as well as side effects and recovery profile after inguinal hernia repair. Seventy-one subjects undergoing inguinal hernia repair with a standardized anesthetic technique were randomly assigned to one of three analgesic treatment regimens: PCA + TEAS (n = 24); PCA + sham-TEAS (no electrical stimulation) (n = 24), and PCA only (n = 23). The postoperative PCA requirement, pain scores, opioid-related side effects, and blood cortisol levels were recorded. TEAS treatment resulted in a twofold decrease in the analgesic requirement and decreased pain level reported by the patients. In addition, a significant reduction of cortisol level was reported in the TEAS group at 24 h postoperatively compared to the sham and control groups. We conclude that TEAS is a safe and effective option for reducing analgesic consumption and postoperative pain following inguinal hernia repair.

Parental Presence during Induction of Anesthesia Improves Compliance of the Child and Reduces Emergence Delirium

2021 ◽  
Author(s):  
Diego Gil Mayo ◽  
Pascual Sanabria Carretero ◽  
Luis Gajate Martin ◽  
Jose Alonso Calderón ◽  
Francisco Hernández Oliveros ◽  
...  
Keyword(s):  
Pediatric Surgery ◽  
Pediatric Anesthesia ◽  
Preoperative Anxiety ◽  
Preoperative Preparation ◽  
Parental Presence ◽  
Emergence Delirium ◽  
Group 2 ◽  
American Society ◽  
American Society Of Anesthesiologists ◽  
Preparation Strategy

Abstract Introduction Preoperative stress and anxiety in pediatric patients are associated with poor compliance during induction of anesthesia and a higher incidence of postoperative maladaptive behaviors. The aim of our study was to determine which preoperative preparation strategy improves compliance of the child during induction and decreases the incidence and intensity of emergence delirium (ED) in children undergoing ambulatory pediatric surgery. Materials and Methods This prospective observational study included 638 pediatric American Society of Anesthesiologists I–II patients who underwent ambulatory pediatric surgery, grouped into four preoperative preparation groups: NADA (not premedicated), MDZ (premedicated with midazolam), PPIA (parental presence during induction of anesthesia), and PPIA + MDZ. The results were subsequently analyzed in four age subgroups: Group 1 (0–12 months), Group 2 (13–60 months), Group 3 (61–96 months), and Group 4 (> 96 months). Preoperative anxiety (modified Yale Preoperative Anxiety Scale [m-YPAS]), compliance of the child during induction (Induction Compliance Checklist [ICC]), and ED (Pediatric Anesthesia Emergence Delirium scale) were analyzed in each group. Results Eighty-one percent of patients in the PPIA + MDZ preparation group presented a perfect compliance during the induction of anesthesia (ICC = 0), less preoperative anxiety (mean score m-YPAS = 26), less probability of ED (odds ratio: 10, 5 [3–37.5]; p < 0.05), and less ED intensity compared with the NADA group (1.2 vs. 5.8; p = 0.001). Conclusion PPIA associated with midazolam premedication improves compliance during induction and decreases the incidence and intensity of ED.

scholarly journals Perioperative pregabalin for reducing pain, analgesic consumption, and anxiety and enhancing sleep quality in elective neurosurgical patients: a prospective, randomized, double-blind, and controlled clinical study

2016 ◽  
Vol 125 (6) ◽  
pp. 1513-1522 ◽  
Author(s):  
Nir Shimony ◽  
Uri Amit ◽  
Bella Minz ◽  
Rachel Grossman ◽  
Marc A. Dany ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Sleep Quality ◽  
Rating Scale ◽  
Preoperative Anxiety ◽  
Controlled Study ◽  
Double Blind ◽  
Analgesic Consumption ◽  
Pain Scores ◽  
Neurosurgical Patients ◽  
Duration Of Surgery

OBJECTIVE The aim of this study was to assess in-hospital (immediate) postoperative pain scores and analgesic consumption (primary goals) and preoperative anxiety and sleep quality (secondary goals) in patients who underwent craniotomy and were treated with pregabalin (PGL). Whenever possible, out-of-hospital pain scores and analgesics usage data were obtained as well. METHODS This prospective, randomized, double-blind and controlled study was conducted in consenting patients who underwent elective craniotomy for brain tumor resection at Tel Aviv Medical Center between 2012 and 2014. Patients received either 150 mg PGL (n = 50) or 500 mg starch (placebo; n = 50) on the evening before surgery, 1.5 hours before surgery, and twice daily for 72 hours following surgery. All patients spent the night before surgery in the hospital, and no other premedication was administered. Opioids and nonsteroidal antiinflammatory drugs were used for pain, which was self-rated by means of a numerical rating scale (score range 0–10). RESULTS Eighty-eight patients completed the study. Data on the American Society of Anesthesiologists class, age, body weight, duration of surgery, and intraoperative drugs were similar for both groups. The pain scores during postoperative Days 0 to 2 were significantly lower in the PGL group than in the placebo group (p < 0.01). Analgesic consumption was also lower in the PGL group, both immediately and 1 month after surgery. There were fewer requests for antiemetics in the PGL group, and the rate of postoperative nausea and vomiting was lower. The preoperative anxiety level and the quality of sleep were significantly better in the PGL group (p < 0.01). There were no PGL-associated major adverse events. CONCLUSIONS Perioperative use of twice-daily 150 mg pregabalin attenuates preoperative anxiety, improves sleep quality, and reduces postoperative pain scores and analgesic usage without increasing the rate of adverse effects. Clinical trial registration no.: NCT01612832 (clinicaltrials.gov)

scholarly journals Reliable and rapid smooth extubation after Ketofol for induction of general anesthesia in Laparoscopic Drilling of polycystic ovary: A randomized controlled trial

2020 ◽  
Author(s):  
Atef Mohamed Sayed Mahmoud ◽  
Joseph Makram Botros ◽  
Safaa Gaber Ragab
Keyword(s):  
General Anesthesia ◽  
Polycystic Ovary ◽  
Controlled Trial ◽  
Controlled Study ◽  
Double Blind ◽  
Randomized Controlled ◽  
Airway Response ◽  
American Society ◽  
American Society Of Anesthesiologists ◽  
Better Than

Abstract Background the outcome of ketofol on the hemodynamics and the airway response during induction of general anesthesia has been studied before. Its effect on smoothness of extubation has not been studied before. So, we aimed to assess the effect of ketofol on the smoothness of extubation and compare it with propofol only for induction of general anesthesia. Methods This double-blind, randomized, and controlled study was conducted on one hundred and six American Society of Anesthesiologists Physical status ''ASA PS'' class I and II female patients aged 18–40 years old and scheduled for laparoscopic drilling for polycystic ovary disease under general anesthesia. The patients were assigned into one of two groups (53) patients each; group KP = ketofol and group P = propofol. Results There was good sedation score during suction and extubation in the ketofol group. Airway response and smoothness of extubation were better in the ketofol group better than the propofol group. Conclusion Ketofol as an induction anesthetic agent was effective in attenuating the airway response during extubation more than profofol only. Trial registration: This trial was retrospectively registered at the Clinical Trial.gov with the Identification Number: NCT04365686.

scholarly journals Evaluation of the effectiveness of transcranial electrostimulation in treatment of neuropsychiatric disorders

2021 ◽  
Vol 5 (2) ◽  
pp. 019-026
Author(s):  
Hakobyan Gagik ◽  
Sekoyan Eduard ◽  
Shoman Karyna ◽  
Ekaterina Krasnopeeva
Keyword(s):  
Side Effects ◽  
Vascular Dementia ◽  
Flexible Substrate ◽  
Age Groups ◽  
Adhesive Layer ◽  
Neuropsychiatric Disorders ◽  
Controlled Study ◽  
Double Blind ◽  
Transcranial Electrostimulation ◽  
Clinical Diagnoses

Objectives: Evaluation of the effectiveness the method of transcranial electrostimulation in treatment of neuropsychiatric disorders with the use of a patches by the company “Aganyan”. Materials and methods: The study was a double-blind, randomized, placebo-controlled study, participated 106 patients with neuropsychiatric disorders. All participants in were divided into tables according to gender, age and diagnosis. Each subject was given the “Aganyan” patches and a special brochure, in which the method of application was indicated in detail. The wearable patch includes a flexible substrate, a binder an adhesive layer, with an electrode foil attached to it. Patients applied one patch behind each ear. The patches were applied for eight hours every third day for three months. To assess the effectiveness of therapy in patients the following tests were used: The Montreal Cognitive Assessment Scale; MMSE Scale: Concise Mental Status Scale; diaries of observation of the patient’s condition to identify side effects; special brochures in which the subjects independently indicated the effects of the “Aganyan” patches. Tests were performed before and after the use of the “Aganyan” patches. Results: When using the patches of the “Aganyan” company, none of the participants in the study had any side effects; According to the results of the Montreal test according to the criterion of memory and the MMSE test, the effectiveness of the patch was noted in patients with all clinical diagnoses. The greatest positive dynamics was revealed according to the results of the Montreal test according to the criterion of memory in patients with migraine (30%), insomnia (31%), vascular dementia (32%), and according to the results of the MMSE test in patients with diagnoses: cerebrovascular disease: consequences of a cerebral infarction brain (31%), vascular dementia (56%). Conclusion: The patches of “Aganyan” company have proven its effectiveness through electrical stimulation with low-intensity current in patients in different age groups with different clinical diagnoses.

scholarly journals Comparison between use of combination of mifepristone and misoprostol versus misoprostol alone in the management of intrauterine fetal death

2018 ◽  
Vol 7 (7) ◽  
pp. 2778
Author(s):  
Sreeveena Talasani ◽  
Pran Hitha Venkamolla ◽  
Kalpana Betha
Keyword(s):  
Side Effects ◽  
Fetal Death ◽  
Intrauterine Fetal Death ◽  
P Value ◽  
Ultrasound Scan ◽  
Efficacy And Safety ◽  
Medical Sciences ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Background: Intrauterine fetal death (IUFD) is estimated to occur in 1% of all pregnancies. The advent of prostaglandins has revolutionized the management of IUFD. There are limited studies using a combined regimen of mifepristone and misoprost for induction of labor in IUFD. Hence this study was undertaken to assess the efficacy and safety of combined regimen with misoprostol alone, in the management of IUFD.Methods: This hospital based prospective study included 60 pregnant women with IUFD admitted at Mediciti Institute of Medical Sciences, during the period January 2015 to July 2016. An ultrasound scan was performed to confirm IUFD and localize the placenta. Women were divided alternatively into 2 groups with 30 in each group (group 1- women received 200 mg mifepristone orally followed by misoprostol after 24 hours & in group 2, 100 µg misoprostol  every 6 hourly for a maximum of 4 doses between gestational age  24-26 weeks, 25-50 µg 4 hourly for a maximum of 6 doses beyond 26 weeks).Results: The mean induction to delivery interval was 10 hours in group 1 and 16.3 hours in group 2 (p value 0.007). Mean dose of misoprostol required in group 1 was 1.87 and 2.67 in group 2 (p value 0.008). With respect to side effects, the two groups did not differ significantly.Conclusions: The combined regimen was more effective than misoprostol for the induction of labour in IUFD, in terms of higher rate of successful delivery and shorter induction to delivery interval. 

Ondansetron Is Effective to Treat Spinal or Epidural Morphine-induced Pruritus 

1999 ◽  
Vol 90 (2) ◽  
pp. 432-436 ◽  
Author(s):  
Alain Borgeat ◽  
Hans-Ruedi Stirnemann
Keyword(s):  
Placebo Group ◽  
Side Effects ◽  
Visual Analog Scale ◽  
Case Reports ◽  
Controlled Study ◽  
Epidural Administration ◽  
Analog Scale ◽  
Double Blind ◽  
Hemoglobin Oxygen Saturation ◽  
Group A

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 (&gt; 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 &gt; 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 &lt; 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.

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