scholarly journals Comparative Study of Single Dose Epidural Morphine and Intermittent Dose Morphine with Bupivacaine in Post Cesarean Analgesia

2013 ◽  
Vol 7 (1) ◽  
pp. 41-44
Author(s):  
K Agarwal ◽  
M Sharma ◽  
N Agarwal ◽  
VK Agrawal ◽  
A Agarwal
Keyword(s):  
Single Dose ◽  
Caesarean Section ◽  
Epidural Morphine ◽  
Analgesic Efficacy ◽  
Well Being ◽  
Obstetric Anesthesia ◽  
Controlled Study ◽  
Morphine Group ◽  
Lower Segment Caesarean Section ◽  
Significant Difference

Aims: Obstetric anesthesia presents a challenge to the anesthesiologist. The effective pain management allows the parturient adequate degree of comfort and promotes physical recovery and a sense of well being. Methods: This randomized controlled study was designed to assess the analgesic efficacy and side effects of single dose direct epidural morphine (Group 1) versus intermittent 12 hourly epidural morphine with bupivacaine (Group2) for postoperative analgesia in lower segment caesarean section cases. Results: Each group consisted of 36 patients. Demographic characteristics of two groups were comparable and differences among them were not statistically significant. Mean duration of analgesia was significantly longer in group one patients (16.5 ± 2.5) in comparison to group two patients (11.5 ± 1.5). Mean highest visual analogue scales (VAS scale) was significantly lower (3.2± 0.9) in group one patients in comparison of group two (6.7±0.8) patients. Only 43% patient in group one required supplementary analgesic (Inj Paracetamole/ Diclofenac) and 71% required Inj epidural Morphine / Inj bupivacaine in group two. Mean number of supplementary analgesic required in group one was 0.7 and it was 1.8 in group two. There was no significant difference in nausea, vomiting, itching and pruritis in two groups of patients. Conclusions: our study showed that the use of single dose epidural morphine was associated with lower pain scores at rest and movement when compared to intermittent epidural morphine with bupivacaine in post-caesarean section analgesia. Single dose epidural morphine was found more convenient, less cumbersome and less costly as compared to intermittent epidural morphine for post-caesarean section analgesia. Nepal Journal of Obstetrics and Gynaecology / Vol 7 / No. 1 / Issue 13 / Jan- June, 2012 / 41-44 DOI: http://dx.doi.org/10.3126/njog.v7i1.8835

scholarly journals Epidural Morphine by the Thoracic or Lumbar Routes in Cholecystectomy. Effect on Postoperative Pain and Respiratory Variables

1989 ◽  
Vol 17 (2) ◽  
pp. 166-169 ◽  
Author(s):  
E. Hakanson ◽  
M. Bengtsson ◽  
H. Rutberg ◽  
A. M. Ulrick
Keyword(s):  
Postoperative Pain ◽  
Pain Relief ◽  
Analogue Scale ◽  
Epidural Morphine ◽  
Morphine Group ◽  
Thoracic Epidural ◽  
Respiratory Parameters ◽  
Significant Difference ◽  
Elective Cholecystectomy ◽  
Respiratory Variables

Thirty-seven women undergoing elective cholecystectomy were randomised into two groups, receiving either lumbar epidural morphine (group L) or epidural morphine via the thoracic route (group T). The effect on pain relief was assessed by a visual analogue scale and included both resting pain and ‘provoked’ pain. Respiratory parameters (PEF, FEVI and FVC) were also studied. The patients were investigated preoperatively, and 4, 6, 12 and 24 hours after the start of surgery. No significant difference was observed between the groups concerning pain relief or respiratory performance. We conclude that after cholecystectomy lumbar epidural morphine is as effective as thoracic epidural morphine in relieving postoperative pain.

scholarly journals Comparison of analgesic efficacy between TAP block and local site infiltration post operatively in caesarean section

2018 ◽  
Vol 6 (4) ◽  
pp. 1407 ◽  
Author(s):  
Nabanita Das ◽  
Usha Shukla ◽  
Dheer Singh ◽  
Urvashi Yadav
Keyword(s):  
Caesarean Section ◽  
Postoperative Analgesia ◽  
Analgesic Efficacy ◽  
Tap Block ◽  
Local Site ◽  
Pain Scores ◽  
Group I ◽  
Significant Difference ◽  
Patient Pain ◽  
Study Population

Background: Patients undergoing caesarean section need to be alert, comfortable and mobile in order to take care of their babies, for which they must be pain free in post operative period. The aim of present study is to compare the analgesic efficacy of TAP block with local anaesthetic infiltration specifically in LSCS patients in reducing patient pain postoperatively, as well as to decrease the analgesic requirements.Methods: The study population consisted of 60 patients posted for elective and emergency caesarean section. They were blindly divided into two groups of 30 patients each. Group T received 40ml 0.25% Ropivacaine in Transverses abdominis plane (TAP) block for postoperative analgesia and group I received 40ml 0.25% ropivacaine as infiltration at incision site for postoperative analgesia. Patients were observed for numeric pain score NPS, analgesic requirements, total analgesic consumption and adverse effects if any.Results: There was highly significant difference in numeric pain scores at 2nd, 6th, 12th and 24th hours (p<0.0001). Both the time for first rescue analgesic and total amount of analgesic consumed are statistically significant (p<0.0001).Conclusions: TAP block is an effective postoperative analgesic procedure for post caesarean section patients.

scholarly journals Incidence of post-operative (caesarean section) infectious morbidities in cleansing and non-cleansing group after povidone iodine vaginal cleaning

2021 ◽  
Vol 10 (9) ◽  
pp. 3393
Author(s):  
Pragya Verma ◽  
Dolly Chawla ◽  
Rashmi Khatri ◽  
Preeti Verma
Keyword(s):  
Caesarean Section ◽  
Povidone Iodine ◽  
Medical College ◽  
Lower Segment Caesarean Section ◽  
Significant Difference ◽  
Maternal Morbidity And Mortality ◽  
Group A ◽  
Randomized Control ◽  
Group B ◽  
Control Study

Background: Despite of wide spread use of prophylactic antibiotics and various antiseptic measures, post-operative infection remains one of the significant and serious complication of caesarean delivery contributing to high maternal morbidity and mortality. Objective was to study the incidence of post-operative infectious morbidities in patients with/without povidone iodine vaginal cleansing done prior to caesarean section.Methods: A prospective randomized control study was done in the department of obstetrics and gynecology of Dr. Baba Saheb Ambedkar Medical College and Hospital, New Delhi.Results: Mean age of participants in group A is 26.22±2.47 years and in group B is 26.48±2.3 years. Majority women (84.0%) underwent emergency lower segment caesarean section (LSCS). (6.4%) women developed post-operative endometritis, out of which maximum (4.6%) belong to no vaginal cleansing group (B) compared to 1.8% in povidone iodine vaginal cleansing group(A), which is statistically significant (p=0.01). Over all (13%) women had post-operative fever, with significant difference among the two groups i.e. (8.6%) were in group B versus (4.4%) in group A (p=0.005).Conclusions: Povidone iodine vaginal cleansing prior to caesarean section is significantly effective in reducing post-operative infectious morbidities.

scholarly journals Egg white hydrolyzate reduces mental fatigue: randomized, double-blind, controlled study

2020 ◽  
Vol 13 (1) ◽  
Author(s):  
Mariko Oe ◽  
Hisae Sakamoto ◽  
Hiroshi Nishiyama ◽  
Ryou Sasahara ◽  
Yasunobu Masuda ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Single Dose ◽  
Antioxidant Capacity ◽  
Stress Test ◽  
Egg White ◽  
Mental Fatigue ◽  
Controlled Study ◽  
Test Results ◽  
Double Blind ◽  
Significant Difference

Abstract Objectives This study aimed to show that ingesting egg white hydrolyzate (EWH) could improve antioxidant capacity and reduce mental fatigue. Two clinical trials were conducted to examine the antioxidant capacity and the fatigue reduction function of EWH. In Study 1, 19 athlete students were received a single dose of EWH (5 g/day) or placebo. In Study 2, 74 athlete students ingested EWH (5 g/day) or placebo before training for 2 weeks. Results Single dose of EWH significantly increased the antioxidant ability compared with the placebo group (p < 0.05), and there was no significant difference between the groups in the oxidative stress test results on Study 1. Two-week intake of EWH significantly decreased mental fatigue compared with the placebo (p < 0.05). This study showed that ingesting EWH improved antioxidant capacity with a single dose and reduced mental fatigue after 2 weeks of ingestion. Trial Registration Japan Medical Association Center for Clinical Trials identifier; JMA-IIA00395 (Study1) and JMA-IIA00396 (Study2), both trials were retrospectively registered on 26 October, 2018.

A Comparative Study of Single Dose and Multiple Dose Antibiotic Prophylaxis In Caesarean Section

2021 ◽  
Vol 8 (3) ◽  
pp. 89-93
Author(s):  
Dr. Poorvi Agarwal ◽  
Dr. Harshal Nimbannavar ◽  
Dr. Prajakta Khose ◽  
Dr. Supraja Subramanian ◽  
Dr. Himadri Bal
Keyword(s):  
Single Dose ◽  
Caesarean Section ◽  
Antibiotic Prophylaxis ◽  
Multiple Dose ◽  
Prophylactic Antibiotic ◽  
Dose Schedule ◽  
Antibiotic Use ◽  
Skin Incision ◽  
Significant Difference ◽  
Group B

Background: Rampant antibiotic use brought about its own set of problems like the rise in incidence of antibiotic resistant strains, allergies and other complications of antibiotic use. Unfortunately in many of our set ups we are still stuck in prolonged post-operative antibiotic regimes. This study aims to fill that lacunae and thereby aid our gradual shift away from over reliance on prolonged antibiotic usage in prevention of SSI. Hence we decided to investigate the efficacy of the use of a single prophylactic intravenous dose of antibiotic vis a vis multiple doses in reducing post-operative infective morbidity in caesarean sections. Methods: The study included 200 patients at term, satisfying the inclusion and exclusion criteria, reporting to the labour room and undergoing caesarean section. The patients were then divided into two groups of 100 each by simple randomization. Patients in Group A were given a single dose of Inj. Cefotaxime 1gm IV + Inj. Metronidazole 500 mg IV infusion 30 minutes before the skin incision. Group B cases were given the first dose of Inj. cefotaxime 1g IV + Inj. metronidazole 500 mg IV 30 minutes before the skin incision followed by injectables for 2 days: Inj. cefotaxime 1g IV BD and Inj. metronidazole 500mg IV TDS. Subsequently for the next 3 days Tablet Cefixime 200mg BD and Tablet Metronidazole 400mg TDS were administered orally. Results:  The present study did not show any significant difference in the post operative infection incidence between the single dose and multiple dose schedule. Conclusion: our study makes an important observation regarding use of antibiotic prophylaxis and its duration for prevention of post operative infections in mothers without compromising any safety aspects of either the mother or the child.  As noted in our study, there was no difference in the outcome as regards post operative infectious morbidity in patients of both the groups. Hence, based on the findings of our study we conclude that single dose prophylactic antibiotic should be the norm for caesarean sections.

scholarly journals The Effect ofChanna striatus(Haruan) Extract on Pain and Wound Healing of Post-Lower Segment Caesarean Section Women

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Siti Zubaidah Ab Wahab ◽  
Azidah Abdul Kadir ◽  
Nik Hazlina Nik Hussain ◽  
Julia Omar ◽  
Rohaizan Yunus ◽  
...  
Keyword(s):  
Wound Healing ◽  
Placebo Group ◽  
Postoperative Pain ◽  
Caesarean Section ◽  
Controlled Study ◽  
Human Consumption ◽  
Lower Segment ◽  
Patient Satisfaction Score ◽  
Lower Segment Caesarean Section ◽  
Cosmetic Appearance

Channa striatushas been consumed for decades as a remedy to promote wound healing by women during postpartum period. The objectives of this study were to compare postoperative pain, wound healing based on wound evaluation scale (WES), wound cosmetic appearance based on visual analogue scale (VAS) scores and patient satisfaction score (PSS), and safety profiles betweenC. striatusgroup and placebo group after six weeks of lower segment caesarean section (LSCS) delivery. A randomised, double-blind, placebo-controlled study was conducted. Subjects were randomised in a ratio of 1 : 1 into either theC. striatusgroup (500 mg daily) or placebo group (500 mg of maltodextrin daily). 76 subjects were successfully randomised, with 38 in theC. striatusgroup and 35 in the placebo group. There were no significant differences in postoperative painp=0.814and WESp=0.160between theC. striatusand placebo groups. However, VAS and PSS in theC. striatusgroup were significantly better compared with the placebo group (p=0.014andp<0.001, resp.). The safety profiles showed no significant differences between the groups. In conclusion, six-week supplementation of 500 mg ofC. striatusextract showed marked differences in wound cosmetic appearance and patient’s satisfaction and is safe for human consumption.

Evaluation of the analgesic efficacy of AZD1940, a novel cannabinoid agonist, on post-operative pain after lower third molar surgical removal

2013 ◽  
Vol 4 (1) ◽  
pp. 17-22 ◽  
Author(s):  
Jarkko Kalliomäki ◽  
Märta Segerdahl ◽  
Lynn Webster ◽  
Annika Reimfelt ◽  
Karin Huizar ◽  
...  
Keyword(s):  
Receptor Agonist ◽  
Rescue Medication ◽  
Third Molar ◽  
Analgesic Efficacy ◽  
Controlled Study ◽  
Surgical Removal ◽  
Single Dose Study ◽  
Jaw Movement ◽  
Post Operative Pain ◽  
Significant Difference

AbstractAimTo evaluate the analgesic efficacy of AZD1940, a novel peripherally acting cannabinoid CB1/CB2 receptor agonist, in patients undergoing third molar surgical removal.MethodsThis was a randomized, double-blind, placebo-controlled study in patients scheduled for surgical removal of an impacted lower third molar. Patients received a single oral dose of 800 μg AZD1940, 500 mg naproxen or placebo 1.5 h before surgery. The dose of 800 μg AZD1940 was selected based on earlier data from a single dose study in man, in which it was identified as the highest well tolerated dose. Ongoing post-operative pain (primary variable) and pain on jaw movement were assessed on a visual analog scale (VAS, 0-100 mm) from 0 to 8h postoperatively, deriving the area under the curve of ongoing pain (VAS AUC0–8h), and of pain on jaw movement (VASJM AUC0–8h). The time to requesting rescue medication (acetaminophen) was recorded. Subjective cannabinoid effects were assessed by the visual analog mood scale (VAMS).ResultsIn total, 151 patients were randomized to AZD1940 (n = 61), placebo (n = 59) or naproxen (n = 31). There was no statistically significant difference in pain VAS AUC0–8h or in VASJM AUC0–8h between AZD1940 and placebo. Naproxen significantly reduced both pain VAS AUC0–8h and VASJM AUC0–8h as compared with placebo (p < 0.0001 for both). Significantly fewer patients on naproxen requested rescue medication and the duration of time to rescue was greater, as compared with placebo, whereas there were no significant differences between AZD1940 and placebo in these outcome variables. Statistically significant increases in VAMS items “sedated” and “high” were observed after AZD1940 compared with placebo. The increases in VAMS were numerically small compared with previous findings with a centrally acting cannabinoid. The most commonly observed adverse events (AE) on treatment with AZD1940 were postural dizziness (80% of subjects), nausea (26%), hypotension (21%) and headache (13%), most AE being mild to moderate.ConclusionThe CB1/CB2 receptor agonist AZD1940 did not reduce post-operative pain after lower third molar surgical removal at doses exerting subjective cannabinoid effects.ImplicationsActivation of peripheral CB1/CB2 receptors per se is probably of less clinical relevance for the treatment of acute nociceptive pain in man.

scholarly journals Analgesic Efficacy of Pfannenstiel Incision Infiltration with Ropivacaine 7.5 mg/mL for Caesarean Section

2010 ◽  
Vol 2010 ◽  
pp. 1-7 ◽  
Author(s):  
N. K. Nguyen ◽  
A. Landais ◽  
A. Barbaryan ◽  
M. A. M'Barek ◽  
Y. Benbaghdad ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Caesarean Delivery ◽  
Analgesic Efficacy ◽  
Control Group ◽  
Time Interval ◽  
Double Blind ◽  
Pfannenstiel Incision ◽  
Significant Difference ◽  
H 26 ◽  
Labour Suite

Background. Pain after Caesarean delivery is partly related to Pfannenstiel incision, which can be infiltrated with local anaesthetic solutions.Methods. A double- blind randomized control trial was designed to assess the analgesic efficacy of 7.5 mg/mL ropivacaine solution compared to control group, in two groups of one hundred and forty four parturients for each group, who underwent Caesarean section under spinal anaesthesia: group R (ropivacaine group) and group C (control group). All parturients also received spinal sufentanil (2.5 g).Results. Ropivacaine infiltration in the Pfannenstiel incision for Caesarean delivery before wound closure leads to a reduction of 30% in the overall consumption of analgesics (348 550 mg for group R versus 504 426 mg for group C with ), especially opioids in the first 24 hours, but also significantly increases the time interval until the first request for an analgesic (4 h 20 min 2 h 26 for group R versus 2 h 42 1 h 30 for group C). ThePvalues for the two groups were: for paracetamol, for ketoprofen andPfor nalbuphine which was the most significant. There is no significant difference in the threshold of VAS in the two series.Conclusion. This technique can contribute towards a programme of early rehabilitation in sectioned mothers, with earlier discharge from the post-labour suite.

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